The brain is a mysterious creature.
It directs us to get up every morning, get dressed and get on with our day.
It daydreams, deciphers and deliberates.
But when the brain is subjected to trauma, it sometimes turns on us like a jilted lover. Our close and trustworthy companion could morph into a wildly erratic and unpredictable stranger.
Michael Lawrence, PhD, ABPP-CN, a Spectrum Health neuropsychologist, has seen it play out. With many patients. Many times.
He’d like everyone to know some key facts about traumatic brain injuries.
7 things you need to know:
1. The person may look healthy
About 10-15 percent of all head injuries are moderate to severe, leaving cognitive, emotional or behavioral/physical issues, according to Dr. Lawrence. While mild brain injury patients can recover in several months, many moderate to severe brain injuries traumatize the frontal lobe, which controls emotions, insight, judgment and problem solving.
“It’s almost like they are walking around like they are intoxicated,” Dr. Lawrence said. “When you think of someone who is severely inebriated, they can be impulsive, unpredictable and they may engage in risk-taking behavior.
They may look healthy, but when you sit down with them you realize they have severe difficulties.”
2. Changing environments may be an issue
Many brain injury patients can no longer drive safely, Dr. Lawrence said, because they cannot adapt to changing environments.
They drive the same way in a blinding blizzard as they would when cruising down the highway under convertible-top-down skies, he noted.
3. Symptoms linger and the person is changed
After a traumatic accident, patients’ physical needs are swiftly tended to by medical professionals. Perhaps there’s surgery, therapy of all sorts and other attentive care.
But when a patient suffering from a traumatic brain injury goes home, that’s when the real work starts for the patient and caregivers. Most of the emotional and financial burden ultimately falls on loved ones.
This is not a quick-fix condition. Symptoms and complications can linger for months, years and even decades. The person is changed, perhaps forever. This leads to difficulty when the patient attempts to resume his or her life after going home from the hospital.
4. Making rational decisions may be difficult
Patients suffering from traumatic brain injury may have outbursts of unpredictability.
They may develop seizure disorders and the inability to control their anger, including temper tantrums typical of a toddler. They may act impulsively, with little concern for consequences.
“He can’t remember things, he can’t focus and he can’t think clearly,” Dr. Lawrence said of a typical traumatic brain injury patient.
5. Brain cells don’t come back
You need all of your brain cells intact to function normally.
“Once you have bleeding in the brain and damage to the brain cells, those brain cells don’t come back,” Dr. Lawrence said. “The idea that you only need 10 percent of your brain is completely false. You need all of your brain.”
6. Therapy and social activity help
Through therapy and other means, patients learn ways to control anger, strategies to cope with memory problems and the importance of being socially active.
“What ends up happening is patients are essentially in a cocoon,” he said. “In the hospital they’re receiving great care. Technically, a patient that would have died 20 or 30 years ago is surviving. In the hospital and rehab there are multiple people helping 24/7—bathing, dressing…”
But when brain injury patients return home, they don’t fit into their old lives and often feel isolated. It’s important for them to develop new social circles, where they fit in.
“Rehab does a great job getting people physically well,” Dr. Lawrence said. “Oftentimes, their physical body heals but the brain doesn’t. Sometimes meds will help with behavior and emotion and sometimes therapy will help. Oftentimes, both are essential.”
7. Compassion is critical
Dr. Lawrence said support from family and the community is essential.
“We always encourage and empower patients to seek help, join support groups and learn as much as they can about their injury,” Dr. Lawrence said. “But we also need to help patients and family know sometimes this is out of their control. They do not mean to get angry or say something mean. They simply can’t help it. Sometimes they just can’t do better and they need to be treated with grace.”
For information on Spectrum Health’s Neuro Rehabilitation Outpatient Services, call 616.267.8330.