it’s complicated

On the 21st of this month, Michael will have been working toward recovery for 21 months. Twenty two months since the accident, one month spent in a coma.  I don’t know where I thought we would be. How do you plan for the unknown? There’s no “based on historical data” with a brain injury because not one of them is the same.  The medical world can tell you what was injured and what those areas control or contribute to when they analyze an MRI or CT Scan but they will also be the first to admit that they cannot predict the outcome after an injury to the brain.  The medical professionals are an essential part of recovery and I am so thankful that Michael has had some of the field’s “best” on his team. Without their guidance, this brain injury thing would be more than a long road; it would be an insurmountable journey. Although Northern Virginia has it’s downfalls, we were and are very blessed to be where resources for brain injury survivors are within an hour’s drive.  Blessings…we have many.

I was looking for a notebook this morning and stumbled upon “For One More Day”. Beneath it was the book that replaced the large blue posters that hung in Michael’s room in Fairfax Hospital.  Jordan brought in the first of three posters and within days they were full of pictures and well wishes, pleas for recovery, tic marks for how many days Shannon had been able to get away with illegal parking, notes about the good looking nurses and a few “so and so was here” but every one a message of hope that Michael would open his eyes to realize just how much he was loved and needed. (Fast forward – the posters remain in Mike’s room today).  My brother Ron and his wife Kirsten replaced the posters with a small notebook when Micahel was moved to Mt. Vernon Rehab and although not quite as noticable as something hanging on the wall, the sentiments were the same.  Danny wrote “Mike, I stopped by today with Catherine and Liz. We went to Five Guys and brought you back a burger…”  Karl wrote “…I stopped by before going to church and we talked about the Tech game…” In the book Michael reads the log of reminders that he was not alone on this journey;  he was loved and needed.

Twenty one months…how’s Mike doing?  It’s complicated. 

I’ll begin with his schedule. Monday is two hours of Cognitive Rehab through Brain Injury Services in Springfield. I went the first couple of sessions and one day I needed logistical assistance and asked Nate if he could take Mike.  Since then, Monday is group for both Mike and Nate. The group not only offers Michael an opportunity to improve cognition but offers a safe environment to share his ideas and circumstances with others who’s lives are so different from their independent lives before brain injury.  From my perspective, the window into the world of other TBI survivors has granted Nathan insight to the significance and value of his contribution.  Interacting with intention is what we do as parents but it also happens to be what we can and should do to assist after TBI.  HERO alert – Nate volunteered to assist with the rehab group program at BIS on his day off.  Pay it forward. Brain Injury Services INC Springfield VA – I can’t say enough about them or their services – DONATE please.  http://www.braininjurysvcs.org It is such a worthy cause.

Monday – Cognitive Rehab Group session at BIS in Springfield 10:30 -12:30 / Bowling with friends 9pm – midnight

Tuesday – swim with Nate

Wednesday – Cognitive Rehab – Individual 2 hour session

Thursday – work with Jim at DITO

Friday – 10 -11:30 Yoga in Manassas 1pm  Neuropsychologist in Springfield

Mike is working on an outline for his future speaking ventures and in those notes is the word “average”.  Average = normal. Michael says he is working his way to average.  Who would have ever thought Mike Rosner would ever strive to be “average”? Who would have ever thought that night that getting behind the wheel after drinking would eradicate the normalization of independent living, social re-adaptation, family life, and education or vocational endeavors? Mike obviously didn’t think about that did he? Now cognitivly impaired, including frontal executive functions (problem solving, impulse control, self-monitoring) attention, short-term memory and learning, speed of information processing and speech and language functions. One decision changed everything forever. Oh, but that’s just me talking. 

The changes in personality and behavior are complicated by the lack of awareness of the changes. I don’t like to post things that might have an adverse effect so I post with hopes that my words have a positive effect. A TBI survivor may be unable to appreciate that his behavior is different, which is in stark contrast to the fact that family and friends are painfully aware that the person has changed in fundamental ways. The TBI survivor might have a vague sense that he is different or “not who I used to be” and yet struggle to define the ways in which his behavior or personality is different. After TBI, they’re not aware of changes in their behavior and especially not executive functions. But, they may be able to see changes in more concrete things like physical changes or motor function.  It’s not purposeful, it’s just a symptom of the cognitive deficits and the dreaded frontal lobe executive dysfunction .  Even in the moment and able to admit to some difficulties, he won’t be able to remember, or connect the implications of these deficits for future situations. Like I said, it’s complicated.

So, how is Mike doing? 

He is amazing and still pushes himself beyond what most with his injuries would or could. Is he like before? No.  Is he healed? No. But he is still improving.  He mentioned to his doctor the other day that he thought maybe he had plateaued. she basically said “no way”.  Nate told me the other day that he was so happy that each week he saw something new and improved.  Yesterday morning for the VERY FIRST time, Mike refilled his meds on his own with no prompting, no hints, no ques….there is an alarm set to take meds on his watch at 9AM. The alarm went off, the case for the week was empty and so the “normal” thing to do would be to get the arsenal of medications from the cabinet and refrigerator and refill the meds and vitamins for a seven day period dividing to the appropriate AM or PM per the prescription.  He “normally” did what needed to be done.  I came in to the room to see Michael making another “first” in initiation and 21 months in to this recovery, it was just like the day I watched him walk up the stairs to get his socks because his feet were cold.  I wanted to cry out,  to jump up and down with joy because he continues to defy the odds. As much as he fights me, as much as the deficits in motivated behavior from the hippocampus circuitry of reward (oh, yeah I’ve had to learn a lot – it’s the apathy thing) as much as I feel like some days he pushes away every thing I try to accomplish with him… it (the brain injury) is not winning! 

We are STILL winning…Michael is STILL improving.  It is worth it all. 

Keep Hope Alive.  Just Do It.

LIVESTRONG Michael.

xxoo

Learn to become still … take your attention away from what you don’t want, and place your attention on what you wish to experience.