Posted on September 8, 2011 · Posted in TBI Voices
This entry is part 8 of 24 in the series Nancy

Hospital For Severe Brain Injury: Nancy Part 8

While not all prayers are ever answered after any brain injury, Nancy while still in the hospital for severe brain injury wasn’t given more than she or her family could handle.  But the challenges got greater as her awareness returned.

She is in third or fourth grade at the time of the brain injury?

Fourth grade.

Her birthday’s later in the year then?

Two weeks after the accident.

So she has her 10th birthday in the hospital for severe brain injury?

Yes.

So they’re worried about her eye, the optic nerve getting severed.  What else are they worried about as she starts to wake up in the hospital for severe brain injury?

Swallowing was the issue.  She could talk one word answers and, the swallowing was what we were worried about.  So we actually had to have her do a swallow study before they’d let her eat anything.  We couldn’t let her eat for another couple of days so they had the feeding tube actually in her for like, I want to say a week and a half just because there was no desire to eat.  She had no desire to eat.  That brain function wasn’t there – that hunger was knocking on the door and she couldn’t prioritize it.

She lost a lot of weight in the hospital for severe brain injury?

Yes. She had like a little layer of baby fat to her but she was a healthy kid, not overweight by any means, but when she got done in the hospital she was quite thin.  Everything was thin.

Is she starting to show any dysfunction at this point in the hospital for severe brain injury?

Not much to do when you’re laying in a hospital bed, you know, just answering questions.  She never really started the processing of different situations and how to get from Point A to Point B and things like that.  The neurologist had come in and checked her sitting up, her reflexes and physical therapist came in just to try to see if we could get her in a wheelchair in a sitting position and if she could tolerate that and she did.

Is she moving her extremities fine?

Yes, as far as I knew they were fine.  She was all crunched over and kind of on one side and I just figured it was probably from the whiplash sensation, she was probably really sore.  She was hooked up to, I don’t know what I said, 8 or 12 IVs and she had machines everywhere and they started unhooking one by one by one and took the femoral line out.  That was a good sign when I started seeing all those unhooked.

Femoral line meaning in the leg? 

Right.

Did she have a feeding tube in the stomach while in the hospital for severe brain injury?

It was nasal.  Nasal tube.

Was she getting any nutrition to speak of?

Well, what they were afraid of was that if they would have left her on for two weeks –  I guess there’s a measurement of time that the feeding tube is insignificant, that they would have to do something different, probably a direct stomach line then.  But we just started introducing her to things a little bit by little bit, you know different foods and they decided to pull the line and, uh, they tried simple things like applesauce.

When did the swelling in the eyes go down enough so that you can begin, she can begin to see?

Whew, that was about three weeks and they actually sewed the eye shut.  Just the left.

At what point did they do that?

It was the first weekend that, my son had come down.  He hadn’t seen her.  And unfortunately it’s just like this red piece of rubber with, to pad the eyelid where the suture came through and of course it looked very scary to him and he hadn’t seen her and he knew what was going on but obviously you can never prepare yourself so it was quite frightening for him.

She looking relatively good at this point as far as what she looked like right after the accident in the hospital for severe brain injury?

Oh yes.  You know, the swelling was going down, the neck was coming back into shape, the ears were fine, you know, they weren’t puffy.  Her balance was a little questionable yet but she got up and went to the door to answer the door when they came to wish her a happy birthday in hospital.

So how long after her accident?

Two weeks.

 

And so she answers the door even though she can’t see?

Out of that eye, yeah, the other right eye’s open.

When did the right eye open?

Oh, it was about seven days after the accident.

So when she first wakes up she’s essentially blind. Could she see light from the beginning when she woke up?

Right.  Right.  I don’t think that there was any issue with that.  Something that was quite interesting though is being a reader, she was a reader, really good vocabulary, high vocabulary for a fourth grader, and, because she couldn’t see, she could hear everything. I always told everybody, this is a happy room, there’s no, nothing sad here, there’s no, information given that is negative. We have to go out in the hall and talk about it if there is because she could almost repeat verbatim sometimes the conversations we had.

So she started learning auditorially as her major (source of information)

Her memory seems to be excellent during this period?

Yes.  Like if, if we were talking in the room, she could repeat back chunks of the conversation almost verbatim – I would say at least, you know, full sentences or a full sentence.

Did she have problems taking that immediate memory and moving it into long-term memory?  Would she remember having been there the day before? Did she have continuity in her memory?

No.

Explain.

I would ask her, do you remember having the applesauce yesterday, and she’d say no.  Or do you remember doing this yesterday; we were in the shower yesterday, do you remember that?  No. She had no interest to do anything so she would just sit there until you told her to move or asked her to something and then she would do it, she would engage.  But it would be arduous because I didn’t realize that she didn’t understand the processes, you know, that if I wanted her to put on her shoes, she didn’t know how.

She fools you with that really precise short-term immediate memory?

Right.

How long a period of time is it before the memory starts to slip away?  Is it five minutes?  An hour?  Three hours? 

That’s a good question because we would hear that sour cream commercial, a dollop of Daisy and we would sing that. I would sing that to her and then later on I’d start singing it and then she’d sing it with me and she would sing it with me but never on her own but she would remember the words.  And I mean it could be weeks.  That was our commercial, every time, if it came on we’d stop and sing the song all the time together.  But I don’t know if she had the ability to do it on her own without initiation, that was the hardest part.

Next in Part Nine – Assessing the Extent of Nancy’s Retrograde Amnesia and Post Traumatic Amnesia

By Attorney Gordon Johnson

800-992-9447

 

About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447