Nature of Brain Injury: TJ Part Eight
In the majority of our cases, we don’t get to see the medical records. When we began this project in 2010, I had hoped to get to see a small snippet of records, such as the discharge summary with each participant. I wanted this so that I could put the interviews in the context of the specific nature of brain injury suffered. That hasn’t been practical, but most participants have had a good idea of the nature of brain injury.
I believe that the nature and extent of amnesia is a better predictor of severity and outcome than the specific pathology in the acute phase. So I have asked each of our survivors, as I asked TJ, about the nature of brain injury and about the extent of his amnesia:
Do you remember being at Spalding?
A little bit.
What do you remember about being there?
Not really anything. It’s really a little bit.
You have your step-mom in the background, giving you a, a little bit of prompting.
I just need her for the dates. The dates and times and so.
Do you know what the nature of brain injury you incurred?
Brain injury with diffuse axonal injury.
Do you know what that means?
The accident take away your brain, mangled. They are mangled or severed.
While there are multiple pathologies that can occur in a severe brain injury, generally those types are divided into categories that involve injuries or bleeds in specific parts of the brain, increases in intracranial pressure (ICP) and diffuse injuries to the axons, the long communication fibers which connect neurons to each other. In any given brain injury, the nature of brain injury may involve all three. But in most cases, the diagnosis will focus on the most severe (or perhaps obvious) pathology. Those involving bleeds and increases in ICP will often involve brain surgery. In cases where the nature of brain injury involves diffuse axonal injury, brain surgey will typically not be involved.
For more on these classifications, go to http://subtlebraininjury.com/focal.php For more specific information on diffuse axonal injury, go to http://subtlebraininjury.com/diffuse.php For an outline of what is covered at those pages, go here: http://subtlebraininjury.com/sitemap.php
In TJ’s case, the length of coma, 7 plus weeks, clearly points to a very serious nature of brain injury. But Michelle was able to fill in more information, as well.
Was he at Spaulding before he began to realize who you were?
Ah, no; when he, actually he did not have, he knew who his family was right away. It wasn’t like he didn’t know who they were. People that he had met prior to the accident, like the girl he was in the accident with, he had no idea who she was. Her mother, they came to visit once. He had no idea, but if my husband’s family, my family, his mother’s family, he knew who everybody was.
Did he remember his daughter?
His daughter never came and we didn’t want her to. That would have been too traumatic to see him and TJ went through a lot and he was in a net bed and he was doing tumble slots, I mean, he would stand up.
Tell me what those things are. What is a net bed?
A net bed is like if you had taken a big playpen and attached it over the top of a bed so that he cannot get out of the bed. He was zippered in and when he says he feels like he was in jail, well he was strapped down and he had an ankle monitor on because he tried to get out and twice he did. Twice he was through the doors, down the elevator and into the cafeteria.
This is at Spalding?
Spalding. So they had to put a big alarm bracelet on him.
They call that elopement. Did they talk about elopement, use that term with you?