Stories about Vocational Rehab and Returning to Work after Brain Injury
The following are stories of real life survivors of brain injury. Clicking on the titles will take you to their actual story.
It was through speech pathology that Betty learned the skills to reintegrate herself into the outside world. “I would probably right now be at my mom and dad’s house collecting disability, probably doing nothing”
Once Betty had finished her voc rehab, she was able to find work as a dental hygienist, but surprisingly, her first job was her easiest and it got progressively harder to stay employed after that. She made what was likely a brain injured mistake in quitting her first job. Jobs got harder to keep and when she did find one with some longevity, she quit that again.
Quite remarkably, Chris went back to a part time job she had at the time of the accident, even before she finished high school. She did work there for four years after her accident, but aspects of her disability cost her that job and she has not been able to find other work since. She explains that she worked for a major shoe company: She worked four hours a day. Even though her left hand is severely disabled, she was able to do the computer input job with one hand. She ultimately got fired because of attendance issues.
Further vocational assistance makes economic sense. Chris proved that she could work. She did it for four years after her injury. What a miracle her return to work must have seemed at the time, considering the year of inpatient care. To allow that miracle to evaporate, because she needed more help being on time and with transportation, is unconscionable.
Chris worked for a shoe company before her accident. After her accident, she returned and worked there part-time for 4 years typing in ordering information, Chris was eventually fired due to problems with attendance. As is typical with many who sustain a brain injury, Chris had difficulty with time management and distractibility. She was not able to realistically plan how much time was required for various tasks and had difficulty keeping her attention focused on the task at hand (i.e., getting ready to go to work).
Did you ever attempt to go back to work?: “Yeah I was actually working by the time I went into get my psychological evaluation.” So you get hurt August 15, when is it you first try to go back to work?: “Oh, geez, the end of October. I believe after that I was working at the camp. I was working.” So by the November 1. Six weeks out you’re back to work. How does that work out? : ‘Well it felt good, because I felt like that’s where I belonged. I mean I was very passionate about, what I did with people and so it felt, that felt good. I could relate more to the clients at that point than I could anyone else.”
So, you went back to work, six weeks, two months after your accident. Tell me about that.: “My boss, she was a pretty great lady. She had her own, unfortunately, she had issues happen in her life that happened with mine and, and she’s still a nice lady. But I no longer believed in my job and I no longer believed that taking people out of the institution and pretty much putting in a community institution is what we’ve done.”
There appears to be no doubt that her capacity to function was materially changed by the second TBI. She successfully returned to work, within months of the coma. Her return to work after the concussion, ended badly. Elizabeth states; “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.”
As often happens, the employer sent Elizabeth back to work on a different job, even though she wasn’t ready to return to her previous job. Sometimes the return to work, even if premature, can be a good step in recovery, because it continues the cognitive challenge, at a time when therapy is being limited. But it does come with risks of another injury, another head injury. Elizabeth explains how some things were more difficult for her after her first TBI; “Certain places, certain lines you were on to measure the cheese, pack it in the boxes, certain skids, how you had to put the boxes, and for me with my brain injury it comes down so fast on certain machines the cheese just kind of flies right by you, and you have to be able to pick it up and weigh it up and do things like that. And so it was, it was frustrating. I mean, I used to be able to handle stuff like that without a problem, and coming back for the first time everything was kind of hard. I felt like I couldn’t keep up or I wasn’t fast enough.It went by fast, but actually it was okay. It was like starting all over again, and it was kind of fun trying to, it was fun trying to learn things again and trying, trying to understand, and it’s okay to laugh. It’s okay not to give up, and that’s what I was doing.
Gina is such a person. Despite a severe injury; the drive, ambition and personality traits that allowed her to excel as an insurance agent before the accident, made an early return to work possible for her. She went back to work only six weeks after her skull fracture. With accommodations, she has returned to a job that involves enormous memory and multi-tasking challenges.
The synergistic relationship that Gina and her boss had in a small office, made work the best therapy for her. Gina explains: “I was extremely tired. When I started back at work, my boss had said just come back for an hour and just see how you do and the first month I worked two hours a day, three days a week. That’s all I could handle.He was perfectly fine with that and just said, you know, he retrained me, said you’re doing better every time. I basically, he’s, he listened in on every conversation I had, had me do absolutely no changes, no quoting. Before I did anything with anybody’s file, it’s sit down and tell me what they want, what you’re doing, how you’re going to do it and I did okay. Like I said, I think he probably had to correct me a couple of times but he kept me going and kept saying, you know you’re improving, you’re not going to give up because you’re going to lay on the couch and die. Obviously he knows me better than I thought.I’d go in for those two hours. He had me come in between the hours of 1:00 and 3:00 because those are the slowest times of the day and if I wasn’t working, he was going through and re-teaching me everything. I did not get back to my hours that I’ve got now for a full two years. He just, we just kept working into it.
Gina has had a good result, a remarkable success in returning to a job that would derail most comparably injured people. But despite mistakes that were made in her early care, she got to where she is today because of commitment, her commitment to adapting, her husbands commitment to being patient. But key was the extraordinary commitment of her boss in believing that the Gina he knew, relied on, trusted, would return.
She became keenly aware of how overwhelming the pace of information could be when she attempted to learn a new profession, a particularly challenging one. She explains: “One of the other parts of my recovery was, I wanted to see; I needed to earn some more income. So I got a chance to be a very part-time person, as a neuropsychomotrist, working with another neuropsychologist.” I thought, oh this is cool. I worked at it for a year. It’s very complicated, it uses a lot of math, there might be 70 different tests, and they all operate differently. They hired me knowing that I was brain injured. I made wonderful contact with all the patients. It took me six months to seven months to, to start trying to score them, which is a lot of math and algebra, and I couldn’t remember T scores fromâ€¦ I mean, I couldn’t remember any of it. People said well just give it some more time, all you need to do is practice this, and I began to realize my brain wouldn’t do that. My brain would not if it ever was able to, because it also had to go at a really fast clip, and I couldn’t keep up, and this is what I think brain-injured people have to live with all the time, what can I do and what can’t I do.
It is clear that unlike her time as a neuropsychomotrist, through music she achieves vocational achievement, that gives self actualization. With that return of confidence, many of the mood issues that can snow ball after TBI, are controlled.
His Mom states about his retention after the accident; “I don’t know if anybody said that he was a mechanic and he still does things he’s retained.”
Ian’s Dad was asked about whether Ian could do real world job. He offered this: “We know that when he was talked to by the doctors, one of the things they did say was if he did have a job he’d have to be monitored at his job and he could only work maybe four hours if he was lucky; four hours then he had enough.”
We asked him whether he was able to go back to being a mechanic? Ian states; “I wanted to. In the worst way I would love to, but physically-wise and strength-wise and everything, I just couldn’t do it. I’m right-handed. I find myself doing more things with my left hand than with my right. Like say, if I play a dice game, especially with my kid, I used to shake dice with the right hand all the time. Now, I do it more with my left hand.”
“In October, no in September 2006 I started trying to work part time (almost three years after his injury). Well I, I was afraid to go back to work, because I knew it was going to be another difficulty, but once again, it was one that I wanted to prove that I could do, and I, I knew I could only, because I couldn’t stay because of fatigue, I had to rest and such. Jeremiah describes the struggle to prepare himself to return to work as like hunting and pecking on a moving keyboard.
He explains: “Well I was approached by a, a good friend of mine who was an engineering manager at GE Healthcare. I think I approached him first, because I knew he was. I’d asked him do you have anything that you think that I might be able to do, because we went to the same church and still do. I said is there something that you might have available? He eventually came over to my house one day and he said: I have something that I think you might be able to do here. It was a regular engineering position that he had open, and, as a contractor. The only problem at that point was it was a full-time position, and so I said I don’t believe I can work full time, because I knew I couldn’t because of my rest necessity. And then he came back another time, a couple months later, and he had another position that was part time, but it had, it required the use of a program that I hadn’t used, a CAD program.So then he came back again, maybe a few weeks later, and he said he had another position. It was actually in the same, all three were in the same program underneath him. I could work whatever hours I would like to work and no necessity to work so many a week, no necessity not to. So the only thing is I had to go through a contract agency because it was a contract, so I wouldn’t get paid by GE, and so that is what I ended up doing.
What were your biggest obstacles to success in your return to work?: “Memory and pain. Memory and pain and fatigue, and I’m sure there were other ones too.”
She continues on telling about the role this Tennessee Rehabilitation Center played for her: “They were supposed to help me find employment too, but they didn’t. And then they says, well if you, if you find your own employment we will consider graduating you as you completed the program. So one day my trustee little car, in my mom’s car I was driving around and I applied for a job at Walâ€‘Mart. I worked at Shoney’s first. So I went to get the job first at Shoney’s. Worked there as a door greeter. And then the manager promised me a promotion or a raise for doing such good work but then he, he failed to follow through. So then I went to work for, I went and got a job at Wal-Mart.”
Do you make a living?: “No. Well, I work with a lot of geriatrics. It got so bad one of my clients says Kelly, you know, if you were, I wish you were my physical therapist because if you were a physical therapist I could just come to you and get my, get my physical therapy and my massage all at once.”
Lori talks about how she returned to work: “That’s probably, well, I have to kind of go off path. My parents worked with my former place of employment as soon as I was in the hospital. And as soon as I started getting better, my supervisor worked directly with my parents to try to get me back in. So I know that once I was able to walk – maybe not even walk real well – someone, and it wasn’t my parents, someone drove me to my prior place of employment. And I went for like ten minutes, an hour, you know, just built up until I could put in a full day, and then they hired me back and had me work for a full day.”
I returned to work and realized I was unable or uninterested in what previously interested me. I attempted many different avenues, then went back to college. I was blessed with the opportunity to develop again.
One of the things that we didn’t get a chance to talk about when the last time I interviewed you was, you went back to work at some point, did you not? : “I’ve tried a few times.” And you got a college degree from Oshkosh. When did you get your degree? : “I got it for the 1998 year; graduated in December and got my certificate in January.”
When you graduated in 1998, did you have any success in getting a job?: “I worked. I was working at United Cerebral Palsy in Oshkosh, and then I got a full-time job with a group home, but I had problems.” You said you were working for United Cerebral Palsy, and that was while you were still a student?: “That was a great place to work.” What did you do for them?: “Well I was a weekend leader. A weekend leader is the person who hands out meds, does all the big paperwork, plans ideas for the weekend. And then I was a grunt worker. I would just show up and work a weekend, have fun with the kids, and then one summer I was camp director.” Then after you graduated you worked for?: “I donâ€™t know the name of the company. It was a group home up in Oshkosh, but like I said, I had problems.”
What problems did you have in that job?: “Well in that job, let’s see, you have to go back to that time. I was taking 19 meds a day, and those were all psychotropic meds. They were all inflicting my judgment and understanding, to where working at that group home I ended up getting a misdemeanor against me because I got in a fight with one of the clients.”
Talk to me about the next job you had.:”The next job is actually I went back to an old place I used to work for. After I got in trouble up here I moved back down to Louisville, Kentucky with my first wife for a while. I used to work for Sears when I was in high school and I went back to Sears and I was selling vacuum cleaners and stuff.” So that was a lot of human contact issues.: “Lot of human contact issues.” Were you fine until somebody got angry at you?: “Actually I sold shoes the first time I worked at Sears. And people were getting more, people got more angry at me at that job then when I was selling shoes than”
It has been nine years since the wreck and Otto appears completely normal in my interview. He is sharp, reasoned, personable with a nice laugh and sense of humor. He has returned to work and to coaching. Like 85-90% of those with a concussion, he has had a good recovery. Yet, a significant MTBI for someone over 40, especially with a prior history of concussion, can leave disability. I asked him about these concerns.
So as far as working, I tried to work for a few days, when the doctor said go ahead and try, back in November, and, you know, after three days of work, four or five hour a day only, I was a wreck for another week, so it’s been, it’s been tough.” When you talk about being a wreck, is it that pressure, that wave thing that gets to be more and more of a problem the more you tax your capacities?: “Yeah, it’s, it’s like, it’s like multitasking gets added on, and issues get added on and it just. I get headaches and pressure and build; it’s weird, the waves, yeah. So then I become stuck in the house for a few days and can barely do anything around the house, let alone get out of the house.”
You say you do a little bit of work and is that something to do with Avon?: “I do Avon and then I also help out with the people that need yard work done.” What kind of yard work?: “I help like raking leaves, planting, taking plants, taking them out. Mulch.” Do you get tired quickly doing that or can you do that all day?: “I get tired but I deal with it. I don’t let it bother me.”