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Sound of Silence

Much like the Simon and Garfunkel song…well, back to that in a minute.

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So I have always been proud of my muti-tasking abilities throughout my life.  Being able to focus in many directions at once and deal with any level of noise without issues.  In fact, when I was much younger I used to go dancing and I loved bopping away and really enjoyed the techno beat of the music.  I used to be in marching band years ago, Jazz Band, Choir, Show Choir (kinda like Glee for those who have never heard of it) and let me tell you….you just get used to moving, spinning, dancing, and lots of noise.  I have always been a lover of music in almost all forms and preferred to listen to music almost all the time.

I loved going to football games, Image result for marching band competitionsporting events, and Pep Rally’s are an amazing memory.  As I grew into an older adult some of my music interests changed, yet I still held on to that love of music (which my parents would have probably argued on some days was noise to them).  When I worked in Emergency Medicine, I love the sound of the sirens, the pager going off, the squelch on the CB or radios, the multiple directions and decisions that had to be made to save a life.  I knew by their sounds whether it was “go time” or not.

When I met my husband I loved that he played the guitar.  My dad used to play all the time and we were a musical family growing up and I was quite ecstatic that I didn’t lose that with marriage.  When I became a mother I loved the sounds of my children.  All their sounds. From that first cry, to their first words, to their first debate/argument (yes – abhorred and loved at the same time too).  I was pretty good about being able to sort and filter out what I wanted to hear and didn’t want to hear merely by choosing…then remembering to finish what it was I was working on (which seemed to be everything all at once).  I could talk to more than one kid at a time, answer the phone, stir the dinner I was cooking, with music playing in the background….though admittedly it was often more than one type of music from more than one kid at a time as they listened to their “stuff”.  I loved my jobs.  I loved working and the business of it all and the multiple directions needed.  I was always felt I flourished in tight deadline and crisis situations in the workplace.  A lot of times, admittedly – in my younger years, my colleagues found me to be a little “too happy and cheerful”.  I heard that a lot.  What can I say……I really loved doing whatever it was I was doing at that time.

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There was also nothing more spectacular than going to a movie theater with the whole family and listening to the loud blaring beginning of that giant picture on the screen with each thunderous sound from one scene to another.  Now that is relaxing!

That is…..until the wreck.

I came out of that wreck different in a lot of ways I still continue to discover.   Some things about my personality became enhanced, some disappeared altogether, some new things cropped up that I have been unable to explain.  Some things about my tolerance, patience, general mood, ability to withstand hearing things in the same way and do things in the same way changed dramatically.  The way I thought about things, processed things, felt things, literally EVERYTHING became like I was experiencing them for the first time……or even worse, not at all. I do not dance anymore.  I do not multi-task like I used to, and I do not hear like I used to.Image result for noise

I honestly could not stand noise in any form for a while.  Literally, nothing.  Just the sound of the nurse’s feet walking in the room and the scuffing of their shoes was overwhelming.  The door opening and closing, the beeping and whirring sound of the blood pressure cuff, the constant talking in the hallway, the toilet flushing, people always asking me questions I couldn’t understand or I would answer quickly in the hopes they would soon just be quiet.  My memories of the hospital are in and out.  I remember voices and feelings more than I remember faces, names, or the day to day stuff that went on.  I remember pain.  Lots of pain.  I was dizzy, head a constant headache, and nope….no music thank you.  I also noticed I had a problem with how horribly bright it was everywhere.  When they would turn down the lights it was delicious and relieving.  Even the red lights from the monitor would hurt my eyes.  Those little night lights built into the wall at hospitals….nope, not my friend.

Then I went home.  Things were so different.  The house looked different as we pulled in the driveway.  The sound of the van door shutting, the leaves blowing, the clunk of the wheelchair, the shushing of the adults to the kids as I made my way inside.  The days that followed brought lots of appointments and a constant assault on my head, my eyes,  and my ears.  On top of it all I could “hear” the crunching of my shattered scapula moving with each therapeutic effort.  I could hear a high pitch tone that never seemed to go away for the longest time.  It almost sounded like a dog whistle or a fine squealing.  It was awful.  I noticed that while I had this going on, it sounded kind of muffled at the same time and it became difficult for me to focus on words, sounds, and more than one noise, or more than one person talking at a time was enough to send me into tears.

As time passed I noticed it helped if I read Image result for reading lipspeople’s lips to understand what they were saying.  Sometimes still I will see lips moving, know they are talking, yet understand NOTHING. I have learned to ask for repetition a lot.  Sometimes I just act like I know what they said….nod….and smile.  I learned little tricks, like wearing earplugs, sunglasses, carrying a blanket to cover my head with, lots of those types of things to cocoon myself from the auditory assaults of whatever environment I was in.

Eventually it just became easier to be at home where it was supposed to be peaceful.  However, we are a big noisy family. So that was not to be for me.  My family tried….hard in fact, to keep things quiet.  It seemed unfair to them.  However I was grateful for their attempts to cater to my newfound love of absolute quiet.  My bedroom became my safe zone.

Time has passed. Things keep changing.  Some though remain the same. Things are a bit better now.  I can stand being in outside more often than not. I can handle the lights in the grocery store on most days.   I do notice that my intolerance for noise seems to increase along with my intolerance for light. I startle quite easily some days, not so much on others….which causes ridiculous amounts of anxiety which can trigger some really unique reactions.

Nowadays, I am listening to music more often.  I still am not able to listen to it every day and some days not at all as it is too much to process if I am doing something else….like ohhhh sayyyyy….driving!  Just this week I was travelling down the highway and it was nice out so I thought I would roll down my window.  Just the sound of that gush of wind was too much for my brain to handle. I couldn’t roll up the window fast enough.  Other days I can have it down without incident.

I notice that when I am feeling flooded or overwhelmedImage result for fatigue or in the throws of a very neuro fatiguing day or situation (driving can be very neuro fatiguing by the way) – just having the window down and the wind in my ear seems like it is TOO MUCH.  Those are the days I just cannot seem to wait to get home.

Now 3.5 years later here I am.  Hearing loss in my left ear due to the damage from the traumatic brain injury.  Progressing with my vision therapy which has helped in more ways than I can begin to mention here.  Still reading lips, and an overcast day is a breath of fresh air for my eyes as it is not so bright.  Though I try to avoid driving too much at night as there are more lights than I remember being aware of before….there are a few things that everyone who knows me well….knows for sure – talk to me one person at a time; one task at a time; if I didn’t answer you chances are I didn’t hear you; if I tell you I need quiet and I cannot take any more I really mean that; and if I am having a rough brain day and need that beautiful bit of immediate solitude….

Ah yes, where I started this post from; like the lines from that Simon and Garfunkel song …..”No one dare disturb the Sound of Silence”

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Polytrauma – The Ripple Effect

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There is a chain of events that happens with an auto accident that involves serious injuries, polytrauma, or death.  rippleA ripple effect that swirls and snatches and seeks to destroy not just the patient, but the family, the spouse, and friendships of that patient as well.

First, there is the initial accident.  This not only causes the injuries, but causes a multitude of mental stressors as well.  Fear, anger, shock, disbelief, numbness, sadness, enormous helplessness and grief.  If the person survives there are things that help relieve those stressors – such as gratefulness, happiness, apprehension, confusion, hope, and for some, a distinct solidification of their spiritual base.

The stressor for the patient is that the accident itself has happened to begin with; thus causing a multitude of injuries that may affect more than one aspect of their life. They may have memory and cognitive issues in addition to orthopedic injuries.  They may have behavior changes and appear to be a different person than they were before the auto accident.

The person may or may not have support and help from a trusted circle of family or friends as they fight to survive, exist, and recuperate. After a while though, often times, friends disappear.  Sometimes, the burden is too big to understand or absorb for family as well. A catastrophic injury absolutely shows you the genuineness of the people around you. Life continues to move on without you and you become acutely aware of this.  The relatives, coworkers, friends who were supportive at first…eventually go about their lives and forget that you are there….still struggling.  The patient is left circling in the same spot, sometimes for months at a time.

Every stressful event that happens AFTER the accident compounds and slows the recovery process and adds to the mental and emotional stressors in the patient and their relationships with others.  PTSDAny delayed treatments, or misdiagnoses, or haggling over care of the patient (whether by the family or the patient themselves) causes additional added stressors, which impacts the ability to heal in a timely fashion.

Something not often talked about or studied is the real impact that Polytrauma and Traumatic Brain Injury has on the spouse or children of the patient.  There are changes that happen in those relationships.  The household dynamics may change significantly leaving the family feeling disorganized and broken.

Children may feel insecure, may blame themselves, feel helpless and hopeless about their parent’s recovery or their parent’s relationship.  They may act out in ways they did not used to.  They may regress in their development, they may become isolated or clingy. They may try to act in a parental role with siblings themselves.

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They may find ways to cope that are not healthy.  Some kids are able to adjust to the changes going on with their parents with lots of support, education, explanation, and patience. Some are not able to adjust.  Sometimes the injured parent is too different for them to understand. Sometimes witnessing the changes in their parent is too painful.  Sometimes a spouse or child can incur secondary trauma/PTSD as their loved one recovers.

The dynamics in a marriage are also hit with one wave after another depending on the level of injuries a patient has and how severe they are.  In a polytrauma or with a traumatic brain injury, often times spouses are forced to take on the previous responsibilities of the patient (household duties, scheduling, transportation, budgeting, cooking, cleaning).  This may overwhelm the spouse if they previously depended on their now injured spouse to handle those responsibilities.  Compassionn FatigueThe financial stress will compound quickly.  The person injured, if a working parent, may be unable to return to work for a period of time…if ever.  This creates a massive financial dynamic shift for the whole family.   If insurance is not available, or does not cover all of the medical bill this can spell financial ruin for a family.  Not many individuals or families are in a financial position to endure a catastrophic injury/event.  This is only compounded when the parent that is left working loses their employment because they are taking too much time off work to care for their spouse/family member.  This can exponentially compound the stressors in the household.

Even the kids can be affected by the financial changes both directly and indirectly.  A family may have to go to food banks, acquire assistance from agencies for bills, food, utilities, transportation, etc.  Some may end up losing their homes and become homeless.  This is a dynamic ripple affect that goes beyond the initial injury at the time of the accident.  This ripple affect can continue for weeks, months, or years.

Brain injury often brings on drastic personality changes, which may include irritability, depression, limited awareness of injury-related changes, and argumentativeness.

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Some spouses may feel like they are married to a stranger.

They become concerned about whether their spouse will ever be the same again.  The reality is, they will not.

 

The working spouse may feel alone in the marriage or like a single parent (if they have kids) due to the inability of the patient to take on the same responsibilities and roles as before.  The non-injured spouse may also lose their marital benefits for an undetermined amount of time.  The loss of a partner that they previously shared comfort, affection, mental support, and did activities with. This can put another layer of strain on the marriage, which is now no longer, a normal marriage.brokenheart

While most people, in an ideal environment without financial devastation and strong support systems in place, progress in their healing over time in a seemingly more timely fashion;  a patient with all these added stressors can actually see a delay or lengthening of their recovery period, an exacerbation of some of their symptoms and the real potential for more permanent disabilities.  Some patients may even develop mental health challenges in relationship to adjusting to their life of “new normals”. Coming to grips (acceptance) of their injuries, limitations, and the domino affect of seeming losses from their injuries, can be crippling and make the patient and their caregiver feel isolated and in a constant “survival mode” state.

The team in place to help the person recover should absolutely include their providers, and include the insurance company handling their claims as well.  Any delays or standoffs regarding reasonable and necessary patient care only seeks to elongate and sabotage the patient’s recovery and future progress.

The ripple affect continues.  The waves of pain also continue, yet the tsunami of numerous medical appointments lessen as time goes on.  The relationships the patient is left with will continue to shape the shores of their life as they now know it.   Some relationships will erode over time, some will get swept away by the current of recurrent trauma’s, some will stand the test of time and hold strong and true.

These moments.  The moments that are not measured by the number of breaths we take, but rather the moments that take our breath away are the ones that leave us grateful for being able to wake up to the ripple of a brand new day.

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WebSite Page Update – Scapula Nonunion

Check out our newly updated webpage about scapula fractures and shoulder injuries from trauma.

SHOULDER INJURIES FROM TRAUMA –  SCAPULA NONUNION

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Quote of The Week

“You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome.”

~ Hunter Patch Adams

Flail Chest and Rib Plating

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