Talking to a friend yesterday about going through the day with intention.  I was talking about using every day events as opportunities for Michael to re-train his brain.  Mundane things to most of us because we’ve been doing them mindlessly for years and for the person who isn’t raising a young child or working as a caregiver for a TBI survivor, (or even me sometimes) it might appear that we’re not getting a lot accomplished in a day. 

The first thing I’d like to say is that rehab is a long process and we’re just a year out of coma. The clock starts ticking after coma, not the day of the accident…BUT based on what Mike’s neuro surgeon told us despite the severity of his injuries, he has a better chance to recover than other victims. Age - he is young. If Mike had been older, chances are we would not be where we are today. The brain stops growing at age 24 and Mike had turned 25 in June when he suffered the injury to his brain in October 07. Youth has many advantages. Prior intelligence- the reserve of neurons and connections he had built thanks to an intellectually stimulating and diverse life, and his overall curiosity and desire to learn. It seems that more research shows how people who are mentally active throughout their lives are better prepared to deal with problems like TBI, Alzheimer’s and even Dementia.

Still, recovery is a long process. Michael had about six weeks of structured physical and cognitive in-patient therapy focused on speech and language areas while at Mt. Vernon Hospital. Therapy continued at home 2 to 3 times a week until he was accepted into the Bridge Program at Mt. Vernon for out-patient rehab. From March until May, 2 to 3 days a week he was fortunate to make great strides toward recovery and I was fortunate to have the opportunity to observe their techniques. The therapists identified the main tasks for him to work on in a challenging, yet familiar way. Since then Mike has had to rely on us to find effective ways to keep improving.

I learned alot during those days at Mt. Vernon. I try to do research about brain injury every day and I’m forever looking for TBI rehabilitation training tools on-line. But going back to the conversation with my friend, when you’re raising an intelligent child, or rehabbing one to recover intelligent, independent life, every thing we do is with intention, with purpose. We use daily tasks as an opportunity to teach - to create a learning environment. The brain learns with repetition and new experiences. A trip to the grocery store uses the executive level thinking that processes through the frontal lobes. Using a list, navigating the isles, locating the items and the decision making that causes the right and left hemispheres to work together.

All the processes required for self care didn’t come easy at first - remember how excited we were about Mike getting socks because his feet were cold…now without prompting, he is making decisions on whether he needs a jacket when going outside. Deciding on his own to pick up a brain game or use a hand strengthener while browsing the Internet. No longer needing a reminder to wash his face and brush his teeth before bed.  It may not seem like a big deal but going out without a family member to challenge social skills and decision making without the comfort of support is a huge opportunity for growth.  Don’t under estimate your role in his recovery - it will take a village.

Not all days but there is improvement -Michael can remember what he had for dinner last night, what movie he watched or what he did at Jimmy’s yesterday.  Nate said when Bobby and I were in SC, he said to Mike that he was hungry - Mike said he was too and proceeded to go to the kitchen to make himself something for lunch.  Remember from whence we came - progress continues in all areas.

We work on training the brain to remember. We read and take notes with the Intellectual Devotional in the morning - several times a week I query his memory of past readings which is always better than mine. We train visual memory by placing items on the table and tasking the brain to remember the items and their order. He has a new brain game for Wii so not only is he working on strength and balance with Wii, he is using it to train his brain. He is working on puzzles and can recite the alphabet backwards (try it, it’s not easy). Being so close to the situation it’s a little harder for me to measure sometimes, but I hear from others that they are amazed to see how Michael is getting better. He is not at the same level he was before the injury, but I can see progress every month and I have hope that he will continue improving.  We are currently searching clinical trials for TBI related research and both Michael and I have sent emails to potential opportunities we’ve found on line.  No luck yet - the search continues.  We’ve found that the majority of research happens at the acute stages or in China or India.  Mike would agree to go just about anywhere - especially UCLA but something closer would be nice - come on VCU!  How about you Johns Hopkins?

We’re still trying to walk two miles a day but if it’s not possible we work out downstaris on the elyptical or stationary bike.  We try to do two sets of 20 push-ups, resistance training with weights, regular and side planks and always some sort of stretching, and when we can we head to the courts - either tennis or basketball.  Being in a coma for a month can drastically affect your muscles and although most of his strength has returned, his ankles are still very weak. (but not the dreaded flop foot we feared) The weak ankles can’t support his weight which puts additional strain on the arches of his feet.  We went to The Running Store in Gainesville (highly recommend them) and Mike was fitted with shoes to help support his ankles and arches - everytime he puts on his shoes he comments on how much he loves them!  Thank you Liz!!

I think I mentioned in an earlier posting about Mike telling me it was ok that he was not the same person he was before the accident. I guess I’m not either - I’m finding gray hair and I’m much more wrinkled but I think I’m also a little wiser. Especially in the beginning, it wasn’t always easy to fully accept what had happened to Michael, or to realize the larger impact that it didn’t just happen to him. It happened to Nathan in more ways than you can imagine. It happened to Emily. It happened to Bobby, to David, to Mary, to our parents. It happened to Karl, to Matt, to Danny, to Jimmy - it happened to Mike’s friends. It happened to me.

We lost many parts of the Michael we knew but like he said, it’s ok. What we got was a miracle. We prayed for it. We were all a part of it. We felt it. Most of us praised God as it was happening. Our God is an awesome God - we thank him for our many blessings.

Michael has been a very fortunate survivor of traumatic brain injury. There are over a million cases every year of TBI. Many of them are military-related (over 300,000 estimated US service members have sustained TBI during assignments in Iraq or Afghanistan), and here mainly due to traffic accidents or sports related concussions.

The Iraq War is helping the way researchers and doctors see and tackle traumatic brain injury so I hope that transfers to benefits for civilians, too. From the recovery point of view, there is not alot offered to survivors of TBI after one year. I think there’s more understanding and hope today than a few years ago partly because of the media attention from the Iraq War but ALL TBI survivors need attention. They need the continued opportunity to recover through supportive rehabilitation environments and physical and cognitive therapy.

Another friend called on Veteran’s Day to tell me to watch a segment about TBI on a daytime TV show. Mike and I watched it together and as they talked about the wonderful opportunitues made available for this soldier’s recovery, Mike said with all humility “yeah but he got his brain injury from being a soldier, I got mine from being stupid”. It was hard to watch as this survivor struggled to find the right words - I deeply related to his wife when she began to talk over him to help him find those words. I don’t know how other viewers felt but it brought me to tears. I answered Michael with tear filled eyes and a shaky voice “Michael, he is just like you. He is someone’s friend, he is someone’s child and he survived a brain injury. You are no different than him - he has a purpose in this life and so do you.”

LIVESTRONG Michael.
xxoo