Traumatic Brain Injury Rehabilitation: Gina Part Three
Despite the dangerous transfer of her to Green Bay, Gina does make good progress while she is in traumatic brain injury rehabilitation there. But for her and the family, it was still rough going. It takes her a day or two after her transfer for her to grasp where she is, what has happened to her.
Gina Dislikes Her Traumatic Brain Injury Rehabilitation
Her husband explains:
She did not like being at the hospital where she was. It was – she didn’t like the schedule they had her on. She didn’t like the monitoring that they were doing. She wasn’t happy there at all.
She spent a lot of time in a state of denial. She didn’t think anything was wrong with her. She felt that she was competent to, to take care of herself, that everything was going to be okay. And to this day, she still hides a lot of the injuries and pain that she’s going through.
This was awful very difficult on there son, who had been with her when she got hurt. Gina’s husband explains:
I think for the longest time he went through a stage of guilt, because he knew that his mother had taken him and his friends tubing, and if it wasn’t for him they would have never gone on this trip and nothing would have happened. And so, I think he felt really guilty about the whole situation.
Did that have a negative impact on him?
In some ways, yes, but in other ways it was a positive thing for him and I. Him and I became really close through this. As a young kid, he’s kind of always went to his mother for things, and to this day now him and I can console on each other.
In continuing with Gina’s whirlwind tour through coma recovery, she is soon sent home from Green Bay after her traumatic brain injury rehabilitation.
I think it was only about another week she was at St. Vincent in the rehab center. They wanted her to stay, but she just did not want to be in the hospital at all.
They discharged her from the hospital to come home for recovery. But she needed somebody with her at all times. They were afraid she would do things like start the stove and walk away or – so there was probably three or four weeks we had to have somebody in the house at all times and she did not like that at all neither.
An important issue in predicting recovery from a coma, from any brain injury, is the length of amnesia, both before and after the injury. Loss of memory for events before an accident is called retrograde amnesia. Loss of memory for events after an accident is called anterograde amnesia, or more commonly, post traumatic amnesia. Gina has surprisingly short periods of both.
Asked about her most recent to the accident memories before the accident, Gina said:
That was the night before, the Friday night before. I do remember seeing the ad for that again, but that was earlier in the evening. I do remember signing on the computer at 10:30 at night to get directions to this place, what the prices were going to be; just hours, the particulars about it. And for some reason my 12-year-old son was still up and told him, yes, we can go, but I had errands to run in the morning. I don’t remember any of this unless it’s the computer.
That would be roughly 12, 14 hours before?
Yes. I remember the whole week before and it was pretty much an unremarkable week. It was going to work, coming home, doing supper, just errands; nothing, nothing that sticks out that was unusual.
Gina was in Theda Clark for approximately 9 days. She actually has a memory while still there.
I remember the – my first memory actually is the last day I was there and I was being, what do you call it, told I had to go to Green Bay. I remember actually sitting in the bathroom on the toilet and they were removing stitches from my head, which was very painful, and they forced me to look in a mirror at myself; because apparently I had been feeling around where the stitches were. I was aware that they had shaved half of my head.
I was not happy about it and I mean I didn’t want to look. I just didn’t want to look, and I do remember them forcing me to do that. And I don’t remember much beyond that except being in my dad’s van driving to Green Bay and just begging and begging my husband to just bring me home.
It is not unusual to have an island of memory during a period of amnesia when a particular memory is emotionally charged. This occurs because of the role of the amygdala’s (one of the brain’s most primitive emotional centers) role in memory creation. Both the amygdala and the hippocampus are located deep inside the brain, in the limbic system. If a memory is particularly emotionally charged, the amygdala will help the adjacent hippocampus to imprint this memory. This is likely the explanation as to why she would remember just this one thing from her time at Theda Clark. Says Gina:
Well, I knew – the biggest thing was having to look at myself. I knew half of my head was shaved. I had long hair and just being a woman you don’t want to be bald. I was just horrified to see the bruises, to see the big indentation in my head, to have to feel it, to face it, to look at it.
I do remember fighting or arguing with the nurse that I’m perfectly fine, that they ruined, why they had to cut away my hair. What, what is this dent? I was more concerned about, because it was pretty ugly I guess to look at and to feel it, and it was like is my skull going to – is this going to fill in? I don’t know, I remember like I said, it looked like the side of my head was caved in. And actually, I still have it. I call it a ditch.
The other explanation as to why she might remember this is the emotional turmoil around her being transferred so early after her injury. She also has difficult memories from being in Green Bay during her traumatic brain injury rehabilitation:
I remember the first night because they put me in this bed and they zipped, I was zipped into something that I supposedly couldn’t have gotten out of, because they didn’t want me walking around or getting out of bed by myself. I was – I panicked getting in there, because I just felt like I was in a cave. I felt like I was trapped like a caged animal. I do – one of the things with my husband’s training was always wherever you are you need to look for fire exits and you need to know where there’s two different ways to exit.
And I do remember arguing with them that if that hospital started on fire I wasn’t going to get out and I don’t know why. I do remember in the middle of the night it kept bugging me. I broke the zipper and went to the bathroom by myself and they came in, because when I went into the bathroom after I broke the zipper these alarms went off. I didn’t realize it was my room. I went to the bathroom and came out and they were yelling at me and I remember being just pissed and told them I told you I didn’t want to be in there. I – so then I had to promise that I would call a nurse if I had to go to the bathroom.
I do remember them, the nurse, the next day it was, I had got up to go to the bathroom and she wouldn’t close the door and I was upset with that. And I fought with them about that and said, “I’m not going to the bathroom in front of somebody.” So my vanity was kind of sticking out a little bit there, but I just remember them, I don’t know they kept pushing and pushing I was just incredibly tired all the time.
Her husband adds further corroboration to an early return of memory. He was asked if she remembers being in Green Bay for her traumatic brain injury rehabilitation :
She does, but it was a terrible experience. She was – again the security systems that they had, they had a tent put up over the bed that they pretty much locked her in the first night. She did not want to be in that and I, I went home and cried. I mean, it was a terrible thing to see her put in this device.
There were some positive developments that came out of her time in Green Bay and her traumatic brain injury rehabilitation, as well as the beginning of recognition that she had a lot of recovery ahead.
I do remember I kept insisting that I was fine and at the time I was the Treasurer at the PTO at my son’s school and I kept insisting I was fine and they gave me a blank check and said, you need to write this out in the amount of $50.00 and it needs to be made out to your school and I couldn’t do it. I looked at the check like what is this and I have no idea. That was my first realization that there’s something wrong here and it was like I said kind of tough love more or less. Like okay, just prove it.
I do remember, I said I knew how to cook. Actually that one I passed. They had me make a grilled cheese sandwich and I did okay with that. I was able to do it correctly. I didn’t burn the place down. I didn’t start a fire. I didn’t burn the sandwich. It was edible. I do remember eating it.
I know I was insisting that I was perfectly fine and they almost had to, they had to prove to me that I couldn’t do this, that there was a problem, there were issues that I had to work on, that you know, it’s just you’re injured and this is what you’ve got to do.
She got speech, physical and occupational therapy for her traumatic brain injury rehabilitation while she was there. She explains:
Mainly I know addition, subtraction, just a lot of flash cards, a lot of reading and comprehending and going back, a lot of writing. They wanted me to write with, I’m right-handed and they wanted me to right with both hands. I didn’t understand why they were forcing me to write a lot of stuff with my left hand because I, I guess I was coming in and out of it. I, I was fighting a lot of it, just making them, why do you have to do this? They did some physical therapy.
I do remember being able to do the balance, being able to do everything that they were concerned about apparently because they backed off on that real quick.
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