Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 04-11-2012, 07:03 PM #1
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Default Occupational Therapy appointments

I just woke from a 4 hour nap following my OT appointment today. I was exhausted within 10 minutes of being there.

First, we live in a very rural area. The local towns have populations of 700. The local "big town" is 4000. I rarely see other people and have been staying at home mostly for the past 2 months. It doesn't take much to overwhelm me right now.

I have my pill box and am to keep a pain journal. This will help me become independent. I also have a daily planner, which she showed me how to use. I will start using and then post a picture somewhere so that you can see how it is is to be used.

I don't remember everything that was said/talked about, but my wife took notes and I can remember the generals.

It was decided today that I was too tired to try the light board. I will do that next week.

Today she tested my eyes and determined that I have some sight damage -- either muscular or brain connections with my left eye or something.... I don't remember (again only the generals). The periphery sight is fine, but in some spaces it becomes fuzzier. Now I am to wear an eye patch and we will take glasses and cover part of the left eye frame. We hope that may help with some dizziness. She is also recommending PT -- to see if the ear crystals are out of place.

I had to copy 2 pictures, which was not a problem (expect that as a former artist, I was greatly frustrated with my ability. She thought it was fine). I also had a circle in front of me and had to draw a clock face. This was difficult. I started with the 1 at the top and knew that the 3 was on the right and 6 on the bottom. I needed help to figure out that the 12 was on the top. And then I could draw the line to a 3, but couldn't figure out where a 40 was. I also struggled with understanding how it could also be --- to 4. I was in tears. I knew that I knew this stuff -- it felt wrong, but I couldn't figure out how to make it right. My head is ringing just thinking about it.

The other thing I had to do was sort a deck of cards. (this is also homework). She had me split into suits. This was also hard for me. I would have a 5 of hearts in my hand and not know if I put it with a number 5 or with a heart or with another red (that had a 5 on it). It was confusing and frustrating. When she had me split into colors of red and black, it was easy.

That was all that we had time for. I was entirely exhausted and slept for 4 hours when we returned home.

On Monday I start with speech therapy for an hour, have a break and then do OT.
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wife and mother of 5 (18, 13, 11, 7, 5)
was: design professor, farmer, and had been studying masters in herbalism and doctorate of naturopathy before accident. now: practicing patience.

What happened: Feb 5 2012 passenger in a single MVA which flipped over end and then rolled 3-4 times. Dx with moderate concussion and released. Dx with PCS a few weeks later

Dealing with: temple to temple headaches, nausea, tinnitus, extreme noise sensitivity, light sensitivity, vertigo, short term memory issues, concentration, become overwhelmed easily, word-finding, stuttering, confusion, sleep issues (falling/staying asleep), fatigue +++

Prescribed: Occupational Therapy, Speech Therapy, Physical Therapy, and rest!!!

Last edited by emme727; 04-11-2012 at 08:33 PM.
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Old 04-12-2012, 12:27 PM #2
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I'm so glad you have so much therapy to help you recover. Sounds like you have a really knowledgeable therapist too.

Thanks for keeping us updated.
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Old 04-12-2012, 12:35 PM #3
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Your OT experience sounds familiar with mine. I also experienced some of your same frustrations and thinking similar to your comments: "I knew that I knew this stuff -- it felt wrong, but I couldn't figure out how to make it right." Been there, believe me.

All these activities are designed to reestablish those neuro pathways. My experience was that the simple stuff gets easier; they make it harder, then that gets easier too. I had some very serious deficits in spatial, executive and short term memory functioning. After time and doing what was prescribed in OT and speech therapy I finally tested “normal” (whatever that means) in my neuropsych evaluation.

Hang in there!
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What Happened: On November 29, 2010, I was walking across the street and was hit by a light rail commuter train. Result was a severe traumatic brain injury and multiple fractures (skull, pelvis, ribs). Total hospital stay was two months, one in ICU followed by an additional month in neuro-rehab. Upon hospital discharge, neurological testing revealed deficits in short term memory, executive functioning, and spatial recognition.

Today: Neuropsychological examination five months post-accident indicated a return to normal cognitive functioning, and I returned to work approximately 6 months after the accident. I am grateful to be alive and am looking forward to enjoying the rest of my life.

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Old 04-15-2012, 04:17 AM #4
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Thanks for the detailed description. It sounds like some of those tests shed light on some of the functional problems you are having, which is good - it will give her targets which can help you in a practical way.

Make sure she is fully aware of how tired you were after the session, and how you had to go straight home and sleep for 4 hours. This, obviously, is not a normal reaction to the tasks she had you do. It is therefore a significant result of her assessments, but one which she won't know about unless you tell her.

I don't yet know very much about the specifics of what OTs do for 'mild' head injury, but for other conditions which induce fatigue (eg cardiac or respiratory problems) it is common for one of the main OT interventions to be measures to help manage this fatigue eg through planning, prioritising and spacing tasks through the day.

If anything this could in some ways be even more helpful for us as we sometimes lack insight into what will cause our fatigue, and when to stop. I know I would have found professional guidance on this incredibly helpful early on.

This may well be what the planner is for. If not then you may want to ask her if she could give you some help in this area.

Hope it all goes well!
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mTBI March 2011, spent around a year recovering.

Since recovery I have achieved a Master's degree with distinction in Neurological Occupational Therapy
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Old 04-16-2012, 01:06 PM #5
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Today I had a speech assessment and will be starting officially with speech this week. I had a short break and then OT therapy.

Speech consisted of times tests, storytelling, reading, etc. I was in tears during parts of it. I have definite issues with word-finding and stuttering. I will find out more on Wednesday.

OT: we talked about the week, she glanced at my pain journal, which she hopes to use as an indicator of what causes more severe headache pain. By the way, I am allergic to most pain meds, so I have to just deal with this.

I had to go through a list and check off things that I did or did not do. I was also required to write down what I needed to do or bring for next time. My wife had been writing things down for me. But the goal is independence.

I used to write. She would like me to keep a daily journal of everything -- the good, the bad, the ugly. And my OCD perfectionism isn't allowed to interfere.

Then we played the card game again. First, sorted into colors, then tried again, sorting into suits. Once again, the sorting was confusing. I was thinking 3 goes with 3, not heart with heart. Then I had to lay them in order Aces through Kings and sort by number. My OCD became apparent after that -- careful placement and organization. Then she had me go back to suits and I was baffled. I struggled to move from numbers to suits (couldn't get numbers out of my head), so I was very confused and finally shut down. I know that she was testing certain things -- what would confuse, how OCD (she intentionally moved my cards to see my reaction -- I stopped and couldn't focus on anything but moving the cards back into place).

I returned home nauseous and with a splitting headache. I wrote both in my journal of pain.

Wednesday I bring my cookbook (as a baker I wrote my own recipes). I will be using their kitchen and learn how to organize to bake.
__________________

wife and mother of 5 (18, 13, 11, 7, 5)
was: design professor, farmer, and had been studying masters in herbalism and doctorate of naturopathy before accident. now: practicing patience.

What happened: Feb 5 2012 passenger in a single MVA which flipped over end and then rolled 3-4 times. Dx with moderate concussion and released. Dx with PCS a few weeks later

Dealing with: temple to temple headaches, nausea, tinnitus, extreme noise sensitivity, light sensitivity, vertigo, short term memory issues, concentration, become overwhelmed easily, word-finding, stuttering, confusion, sleep issues (falling/staying asleep), fatigue +++

Prescribed: Occupational Therapy, Speech Therapy, Physical Therapy, and rest!!!

Last edited by emme727; 04-16-2012 at 01:31 PM.
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