Physical Injury in Addition to Severe Brain Injury

Physical Injury in Addition to Severe Brain Injury: Zach Part Eight

In addition to the brain injury, you had some physical injury?  A broken jaw?

I had like I shattered my foot.   So when I was learning how to walk again, they didn’t want me to have to stay off my foot, so they waited to do surgery on it.  So I had to learn how to walk on a broken foot.  That was, that was fun, (sarcastically) I’ll say that, it was fun.  But, then I collapsed my lung and I think I might have punctured it too, but I’m not sure.  I broke my jaw and then obviously the head.  But, yeah I did like a whole bunch a stuff.

So you got, not only have this laceration which is above your left ear as a physical injury, you broke your jaw on the same side?

Yes.

So that was probably from the same blow?

Yeah, yeah, I assume.

Do you have any other scars on your face from your physical injury?

Scars on my face?  I just have my trach.

Your trach?  Okay.  Do you have a feeding tube scar?

I do have a feeding tube scar, yeah.

The broken foot, the jaw.  Knees, legs, back? Were they also part of your physical injury?

Well, now my body’s like just like – I feel like I’ve aged like 30 years. It just hurts to do anything.  That’s why I’m trying to move to Florida because cold weather, I really just can’t do it anymore.

So in physical therapy the first goals are to get you to walk and to retune your muscles?

Yeah.

And some of that stuff is without even standing?

Yeah, yeah.

You were talking about the hand bike?

Yeah, I would do that.

People think of physical therapy as this active stretching, rehabilitation process, akin to a personal trainer.  And while it is that, after a severe brain injury and extended coma, all of the muscles have to be retrained, as atrophy will be significant as a result of the length of time doing nothing but lying in a bed.  Often times, the PT will be working with even comatose patients, moving the limbs and muscles through range of motion, to prevent the worst of atrophy and stiffness.

One of the risk factors that comes from the attention that the most serious of physical injury gets in a case like Zach’s, is that the soft tissue injury, which would be expected to be quite significant in any serious motor vehicle wreck, may get little attention.  While the precise cause of Zach’s chronic pain issues have not been identified, it is likely he had significant soft tissue and joint injuries that got overlooked and little rehabilitation attention.  If you have just awoken from a life threatening coma and brain injury, a stiff neck, lower back injury may not seem significant.  But as anyone with a chronic pain injury can attest, such injuries can be significantly limiting.  Pain itself can be a disability.

Next in Part Nine

Focus on Left Hand In OT After Right Sided Brain Injury