Second Brain Injury in Contrast to the First TBI

Second Brain Injury: Elizabeth Part Two

In contrast to the severity of her first injury, her second brain injury was seemingly mild. The second brain injury occurs just a week past the third anniversary date of her severe TBI, on March 10, 2005. Elizabeth explains:

I went to work, I was doing fine. I was walking to my truck after I punched out and it was very slippery and I was walking very slow and very careful, but when things are slippery you can’t stop it all the time, and I slipped and I fell and I hit my head again.

Did you get knocked out with your second brain injury?

No, plus people saw it and they came, two people came running to me right away and helped me up. And it hurt, I was crying, and I said to let me go, I wanted to go home, and they said no, you’re going in and you’re reporting it and we saw it happen. And so I had to go in and sign all the papers and write everything down, and then I saw my neurologist the very next day.

Did you go to the hospital that day to see if you may have had a second brain injury?

No.

Did you see a doctor?

No. I called my neurologist first thing the next morning and told him what happened, and they said come on in, did a CT scan, were checking everything out. He knew from the previous injury and from the surgery that was done what had happened the first time, and so they kept their eye on me, how much pain, was my head hurting a lot more. The dizziness that I had under control at one time, the dizziness got worse. I had to see another therapist again to help me to be able to sit up straight and not get dizzy and take my time standing up, and I know I can’t twist too fast. Things that I was able to handle I had to pretty much try to learn all over again.

With respect to amnesia: She remembers walking to her car. She remembers the people running towards her after she fell. She remembers filling out the paperwork. She remembers calling her neurologist and remembers seeing him. While it is possible that her brain has manufactured these memories, there is no way to establish any period of amnesia from what she relates now. The only way to reliably determine amnesia is through asking questions about events after the immediate time period around the second brain injury, in the hours and days after the injury. See http://www.subtlebraininjury.com/blog/2010/01/evolution-in-the-understanding-of-concussion-distinguish-between-confusion-and-amnesia-in-diagnosing-concussion.html

There appears to be no doubt that her capacity to function was materially changed by the second brain injury. She successfully returned to work, within months of the coma. Her return to work after the concussion (the second brain injury), ended badly.

I went back to work. I was doing the best that I could do but I would call in, I would leave early, and I had to do that a lot, a lot of the plate hurt so bad that I couldn’t take having to work as fast as they work, and I had to slow things down. I had to slow everything way down from what I was able to do since the first one.

Her husband of 14 years further corroborates how much the second injury changed her. He said:

The second one probably enhanced what she couldn’t really grasp, made it really hard for her now. It just kind of like multiplied it. Let’s say it was a times 2, now it’s a times 3 or 4, you know, that way.

What is perplexing about the total picture of her disability is that most of her deficits are the type of deficits associated with severe brain injury, as we will detail in later Parts of the Elizabeth story. And most of these deficits were clearly there before her second injury. What seemed to have changed because of the concussion was her ability to accommodate the deficits. At the conclusion of the Elizabeth story, I will postulate an explanation for this quandary.

Next in Part Three – Treatment and Rehab for Elizabeth’s Severe TBI.