We were in a massive car accident 20 months ago, and my husband suffered a concussion. He blacked out a few minutes after the accident happened, for several minutes, then talked repeating cycles nonstop for about an hour until they got him out and into the ambulance (what happened? I don't remember (we got hit) Are you okay (yes) is Daughter okay (yes) what happened, I don't remember (we got hit) are you okay (yes) is daughter okay (yes) what happened, I don't remember.....) He has no memory of accident or that hour afterwards, still. Stupid ER sent him home that night, tho he was barely functioning, next day he was going in and out of coherency and throwing up, so back to ER for six hours then sent home again.

PCS has been holding on since then. Doctor still has him leaving work an hour early each day (wanted 2hrs, but hubby refused). Sleep study showed no apnea, but diagnosed post-traumatic hypersomnia, basically excessive need for sleep from the injury.

Last few weeks, he has been getting worse and worse in terms of the post-concussion type symptoms. There is no active intelligent processing of anything said to him.
We are leaving house. Dog in crate is starting to flip out (fairly new dog), I say, do we ignore and just leave, or do we have to intervene? he says Maybe. Well, we are crossing the threshhold and closing the door, we either Do or Don't.
He is holding a dishpan with birdcage water troughs in it. We hear the power company trucks we have been waiting for coming up the road. He starts to run through the living room, around the furniture, still carrying the dishpan. He is struggling with getting the front doors open and through them, still carrying the dish pan. I have to yell at him, Put down the pan, before he looks at it in his hand and starts to put it down three different ways before letting go and continuing to run to the road to flag down the trucks.
We are cleaning things, and have two vacuums out and in use. He pulls down the airconditioner filter to vacuum it. It is cardboard and paper-type filter, and even has two small holes in it, it is an odd size, hard to find, and the only one we have right now. He takes it outside and starts BANGING it against the driveway. I yell at him to stop! what the frig are you doing? He says he wanted to knock the dust off it first. He stepped over TWO vacuums to go outside and start destroying the thing. Stuff like this goes on all the time.
He starts doing something, then stops halfway through to do something else, then stops halfway through to do something else, then stops....then complains that he has so much to do and still has to get back and finish the first thing he quit halfway through on. Nobody makes him stop, he does. And these are things like dumping water in the toilet tank to flush it (we were out of power from the hurricane) and putting away two small bags of groceries and getting a snack and taking the dog for a walk.....nothing long or major or earthshattering, just a few minutes of sticking to it.
He reasons things out and chooses the worst and most irrelevant things as first priority--the dog is crosslegged at the door begging to please get me outside and he'll say I'll take doggy out then I'll clean the kitchen then I'll put up a new roll of toilet paper then I'll get a drink then I'll watch that youtube video with son, no, I'll change my clothes first, no, I'll do the toilet paper first then I'll drink, then I'll take doggy out, no, I'll watch that video with son, then I'll clean the kitchen, then I'll do the toilet paper, then I'll take the dog out (who at this point is turning blue with need)....and I have to say TAKE THE DOG OUT ALREADY!!!!! And he gets mad at me for telling him what to do.

I have to watch him every single minute because you never know what he will be doing or where he will be putting things (we cannot find anything anymore) or when he will take off to the store because he thinks of one thing we need (and buy only the one thing, not any of the others we have been needing, or any of the other errands needing to be done in town) or when we will have a conversation and come to an agreement on the best plans for all involved, and then he just goes and does the first thought he'd had because he cannot unstick his head no matter how much he thinks or talks about something. I have multiple physical limitations from the accident, and cannot be up and doing and handling everything.

He is getting much worse these last few weeks. I have tried to tell him, but nothing goes in, nothing comes out, and he now won't do anything he's told because he's tired of being told, but he's really not functioning right at all. Our 13 year old son has started going along with him when he goes out to keep an eye on him; and "joining" in on projects out in the yard to keep him from doing something stupid. After 20 months post-concussion, I know that things may still not have gotten better, but I didn't think at this point they should be getting so obviously worse. He has a neurologist appointment in a week or two, I'm planning on going along as usual, but he's going to think I'm ambushing him when I tell the doc what I'm seeing, because he's just not getting it what I've been trying to tell him lately.

At this long after the initial injury, is this kind of regression okay? Or is there likely something else going wrong? I have so many medical issues and limits and problems of my own to deal with, and the kids, and the house, and the bills and our totally blown budget, and him, and now he's getting worse, and I just cannot fathom having to deal with this, like this, for the rest of my life.

very sorry your having to go through this

it can be very frustrating and overwhelming at times

it should get better with time. maybe see a neurologist if you havent already and maybe he could go to some therapy classes to help things

praying for healing for your husband

My heart hurts for you. I completely understand your frustration, fear and concerns. I don't have an answer as to whether this is normal progression, but have a suggestion for you... Find a brain injury support group in your area. They will be people that can support you, laugh with you, cry with you and HELP you become aware of great doctors in your area, as well as NOT great doctors.

It sounds to me like you're describing a lot of cognitive issues. Has he had cognitive testing (done by a speech therapist)? If not, I would highly recommend it. My husband has NOT had testing yet - we're working on dealing with some of the other overwhelming problems that cause him to feel so terrible he doesn't function for days on end. We both realize there has been cognitive damage (not as severe as you're describing) and he has begun using Lumosity website as well as other game sites. Check out Lumosity or one of the other brain training websites - I think it'll prove to be beneficial.

I believe a brain injury causes hairline fractures (even though not necessarily visible on MRI or CT scan). Our physical therapist said essentially he needs to "re-wire or re-train" his brain to help compensate for the cognitive issues, just as he has to practice to re-learn the balance and coordination issues.

Always remember - take care of YOU too.

Peace and grace to you...
Amy

He had the neuropsych testing about a year ago. First thing in the morning, fresh from bed and a cup of coffee, not later in the day when he was tired and so obviously goes downhill. He says they said there was not much wrong, just some short term memory stuff, and he didn't need treatment. At a later visit with neurologist, he mentioned something about "the techniques they taught him", well, if it was more than make a list, he either forgot or decided not to do it.

So now I have a giant toddler running loose at times. I could not cope with a real toddler at this point, let alone a giant adult one, that we all have to depend on.

But why he's gotten worse lately, I dunno. It's approaching two years since the accident. Worse should not be in the picture at this point. It's like he's forgotten how to think for himself, and just expects me to do it all for him, but then resents being told what to do, and so won't. So what do you do with a guy who will neither think nor listen?

winic1,

Welcome to NeuroTalk. Sorry to hear of you struggles. I can't imagine what you are going through.

My first recommendation is for you to download the TBI Survival Guide and print it out. It is at www.tbiguide.com

Second, I have serious doubts about the validity of the neuro-psych assessment. If it was done in just the morning, it was a seriously abbreviated assessment. Many neuro-psychs have a bias against mTBI causing long term problems. They also tend to use the wrong battery of tests and even misinterpret the results. A proper mTBI neuro-psych assessment is the Halstead Reitan battery. It can take all day.

Is a car insurance company paying the medical and testing bills? This can be a source of the bad information. Many health insurance companies also are ignorant with the idea that if he is walking and talking, he must be OK.

What kind of work does your hubby do that he can do with these severe symptoms?

His work may be wearing his brain out. It is called sundowning. His brain fatigues and starts failing at sundown.

When he is getting his wires crossed, it is usually a problem with executive functioning. Fatigue makes this symptom worse. Any kind of stress makes it worse.

A baby step for you to start is getting his nutrition upgraded. He needs to help his brain detoxify. No more coffee or caffeine. No MSG or processed soy products. They cause a glutamate toxicity in the brain. No alcohol beyond a single serving per day.

Get him started on a serious B vitamin regimen. Check the other thread for some vitamin recommendations. B's at up to ten times the RDA, D3, folate, all of the anti-oxidants, and others you will find in the other posts.

Get his folate, B-12, hormones including all thyroid, tested by blood test. This will help get his B-12 and folate up to normal. He should be at the top of the normal range for these. An injured brain is very hungry for good nutrition.

His neurologist can order the tests but most neuros are not very good with concussion. A Physical Medicine and Rehabilitation doctor may be a better choice.

Also, get an application for Social Security Disability Income started. It can take a while to get approved and his work performance is likely lacking so he could qualify.

And, when he is confused and screwing up his thoughts, please do not yell or sound harsh. It will only make his brain dysfunction worse for the moment. His tasks should be one at a time. If he tries to take on multiple tasks, try to redirect him to just one task.

I am very high functioning but still have to only take on ONLY one task at a time.

If there is anything you can do to simplify your household, it will be a big help. The new dog can be a challenge unless he can take it on as his only household duty. Trying to follow a disciplined dog training regimen can be just the task for him to focus on. Plus, the dog's companionship can be very supportive to his condition. Their demands are much less.

Try to keep the noise and visual stimulation at a minimum. His brain easily overloads. It tries to process everything at the same time. This is a gating and filtering dysfunction. The brain does not gate (or direct) the information to the proper area. It also fails to filter out distractions (the power company trucks) that cause his mind to flit from one idea/task to another. I have the same problems.

He is going to need the whole family's help to simplify his tasks and thoughts.

And, when he has unexplained outbursts, try to redirect him to something else. His brain can get locked on an idea (the power company MUST stop at our house) to such an intensity that he explodes. The problem may be real (yes, you need the power company to stop) but the outburst is way beyond any acceptable response.

I put my family through these same problems since a concussion in 1996. Three subsequent head traumas since then took me on a steep downhill path. So, YES, BEEN THERE, DONE THAT.

Your are a saint for hanging in there, especially with your own injuries to deal with. BLESS YOU.


Let us know any specifics we can help you with.

My best to you.

btw, It will help many of us if you could format your posts into paragraphs of 5 or 6 lines at most. Those of us with vision difficulties struggle to follow from the end of one line to the start of the next. I cut and pasted your post into WordPad and added a bunch of paragraph spaces so I could read it.