Bobby Porter – Caregiver

HUSBAND OF SURVIVOR

My name is Bobby Porter; I am the husband and caregiver of Tammy Porter;

YoungCouple

Tammy is my wife for over 24 years, we got together just after high school. We lived in Atlanta GA at the time of her Injury that ultimately resulted in a TBI-Traumatic Brain Injury that changed of all our lives over the past six years.  This was all due to the carelessness of an employer.
Before the Injury, Tammy was normal like any other young wife, mother and soon to be a grandmother at the time. She did not have constant headaches, nor did she have any problems with her memory, verbal responses or severe PTSD with depression. Six years after the TBI she has difficulty saying words correctly, with her short-term and long-term memory loss, and impaired judgment she will forget what she was saying in the first place.

I never knew, at 42 years old, how the soon to receive phone call would put my marriage vows to the test and I would become the permanent caregiver to my wife. By that time, I had been the caregiver to my 16-year-old son that is disabled with autism, bipolar, schizophrenia and much more. Being in the medical field for the past 22 years and thanks to my master’s of psychology, I was ready and willing to help my wife get better no matter what it would take.

The phone call that no husband wants to receive

On Wednesday, March 6th, 2013 Tammy Porter was at work at McDonalds Restaurant MCDwhen I got the phone call that no husband wants to receive.

It was around 12:06 am. I answered the phone, and my wife Tammy was on the other end, she was not as coherent as normal in her voice I could tell something wasn’t right. It was finally clear to me that she had been injured by something heavy and it had hit her in the head. I asked her if she was okay, she stated that she was bleeding and started crying; a few seconds later she gave the phone to one of the other employees who advised me that they had called an ambulance and it was on its way; the employees also advised me that Tammy got hit in the head by a large metal casing that was on the wall; the casing had fallen off and cut a large gash on the top of Tammy’s head.

How the TBI happened in the first place

Tammy Porter (my wife) was struck in the head

WayportBox

by a large metal Box called a Way Port Box that was on the wall and weighed about 150 lbs. The Way Port Box set about 4.5 feet above the place she was standing.

[The force of the box hitting her head and left shoulder was Mass= 150lb (m), Acceleration= 4.5-foot drop (a) Total impact of force is= The result is 4.85639846430738 ton-force (TNF) per foot of drop. 4.5×4.856= 21.8537930894 lb. Per Square inch. Overall speed (s) increase total = 5.78232287 x〖10〗^(2) M^(-1) per foot of drop].

The Injury to her head affected the left hemisphere and Frontal lobes (proximity to the sphenoid wing) about 9.75 centimeters in length, 0.95 centimeters in width and the laceration was 0.12054 centimeters deep. The impact also affected the brain vessels and tissue around the injury throughout the upper hemisphere and frontal lobes; the injury also impacted the mandible and left and right orbital eye sockets. The laceration took 12 medical staples to repair the site of impact, and stop the profuse bleeding from the impact.

After I arrived at the hospital to be with my wife

My daughter, granddaughter, and I arrived in the emergency room around 1:15 AM to find out that my wife was sitting in the waiting room after being transported by ambulance with this severe head injury.  I was kind of puzzled why they had not started working on her right away, or why they waited to find out if she was okay. I went to the desk where two nurses were sitting and advised them she was in a lot of pain, the bleeding was not stopping, and she was getting very sick. They told me we would have to wait our turn and it should not take much longer.  This would end up not being the case.

At 2:05 am they sent her to triage, Tammy’s Blood pressure was elevated to 178/120  and her pulse was 119 bpm.

Around 4:40 am they finally called her back to the emergency room to be examined.  Keep in mind this was after sitting outside in the waiting room for many hours with a head injury, constantly bleeding, and not knowing whether she had any internal problems.

Around 5:20 am, the physician’s assistant decided to do a CT scan on Tammy’s head and ordered her something for pain after she came back. She finally receives something for pain around 5:35 am.

 

Around 5:55am, the physician’s assistant came in and put staples in Tammy’s
head; she advised my wife and I that my wife had a closed head injury and if anything were to change regarding her symptoms, that were should come back to the hospital or see her doctor the next day.

The medication that was given to my wife at the hospital for pain had started wearing off, and she was getting very nauseous and started vomiting profusely. I took the prescription that was given to her by the ER doctor to Wal-Mart in hopes that this would help her get better. After I dropped it off, I was advised that out of the two prescriptions that she had,  the main prescription she needed for nausea and vomiting could not be filled without prior authorization and that they would have a caseworker contact us when the prescription was filled. The pharmacy advised Tammy that it would take a couple of days to get things straightened out and that they would contact her when the prescription was filled.

Back to the hospital, my wife is getting worse

On Thursday, March 07th, 2013 I had to take Tammy back to the same hospital because she was getting worse.  She was having difficulty with her vision and headaches. She was having difficulty thinking and talking. Tammy was also having visual problems that were impacting her ability to read, and she had become light sensitive.

As we arrived at the emergency room, I advised them that Tammy was there before and that we were told if anything got any worse, to bring her back. A short time later they took Tammy back to the trauma room and did their initial workup; they advised her that the doctor would be in shortly. Sometime later the doctor arrived and examined Tammy; they advised her she would need to have a repeat CT scan to make sure nothing had changed. After the doctor had gotten Tammy’s results from the CT scan, he advised her that she had post-concussion syndrome or a possible TBI and that it could last a few weeks, months. or even up to a year. The doctor also advised her that she would need to  go to a neurologist as soon as possible to find out if something was underlying from the accident.

As they were sending her home, no better than she was when I took her back to the hospital, I told my wife, “are they not going to do an MRI? Are they not going to look for any type of intracranial bleed on the brain? or at least look to see if the size of the brain was in normal element or made the Injury impact more then we know at this point.?” She was exhausted and just wanted to go home. According to the American Society of Neuroradiology “Magnetic resonance imaging (MRI) is a powerful diagnostic tool that can detect signs of injury such as minute bleeding (microhemorrhage), small areas of bruising (contusion) or scarring (gliosis), which are invisible to the CT scan. Newer, specialized types of MRI can assess brain structure at an even finer level or measure brain function to detect alterations in brain structure and function due to TBI”.
(American Society of Neuroradiology, 2017).

Workers Compensation finely approved the first MRI scan; it was ordered by Doctor Sandy S. McGaffigan. Nine months later the first MRI scan was finally underway on December 29th, 2014, post Impact of Brain Injury that was on Wednesday, March 6th, 2013. By that time there was no way to find any conclusive evidence if she had received any intracranial bleed on the brain previously.

How she is doing after her last hospital visit

It then became the weekend of March 09th and 10th of, 2013. During this weekend of Saturday through Sunday, Tammy had a very hard time.  She stayed dizzy, light-headed with the blurred vision the entire weekend. Knowing that the Workers Compensation Insurance Company is closed on the weekend, I had no idea by that point who to contact so we could get her to a doctor. On top of the blurred vision Tammy could not complete sentences very well, and now she was losing her balance. She is very sensitive to light and sound cannot focus in on small print, as it was making her sick to her stomach.

On Monday, March 11th, 2013 I called Workers Compensation to talk to the adjuster and was told by a representative that she would have to transfer me to the new adjusters, and we would need to leave a message for them to call me back. I left a detailed message with the claim number, time, date, my phone number, and Tammy’s information so that the adjuster could contact me as soon as possible. I never did get a call back nor did I receive any emails on this matter.

Emotional complication post Impact of Brain Injury

The injury to the Frontal lobe gave Tammy (my wife) lasting effects not limited to: (aphasia) of her Speech and language, (apraxia) Problems with daily activities and  routines that used to go well; reduced memory for verbal (spoken) matters, decrease in analytical skills,  insecure anxious and withdrawn behavior, and extreme highs and lows of depression. The injury to the left hemisphere has impacted her memory both (short-term) and (long-term), problem-solving, decision making, control of behavior, and emotions.  She exhibited problems with (Sequencing) and displayed an inability to plan a sequence of complex movements needed to complete multi-stepped tasks, (attending) with an inability to focus on task, mood changes (easily overwhelmed by emotions), and difficulty with problem solving.

How cold weather affects her Physiological changes

Through observation of my wife Tammy and verbal conversations with her, I have determined she is suffering from repetition associated with her concussion and TBI. She will still have dizziness, light sensitivity, smell sensitivity,  nausea, the pressure in her head, and pressure in the eye. She is also suffering from twitching when sleeping, severe headaches, increased hypertension, impaired judgment, and anxiety with panic attacks. During the cold weather, the pain in her head is more severe on the left side of her frontal lobe, the part of the brain that controls important cognitive skills, also the exact side of the head injuries.

Disabilities and Medical Conditions from TBI

Tammy is spending most of her time having difficulties in the area of visual sensory processing, severe depression, ranging from the pole of extreme highs and lows throughout the day that will linger for several hours. She has difficulties in communicating how she is feeling, at the same time juggling her responses. She seems to understand a conversation that is going on at the time, but if you have her try to repeat it back to you, she is unable to remember all of the conversation, if any. Tammy is experiencing some severe mood swings, giving answers to questions not related
to the original questions.

  1. Disabilities and Medical Conditions: She had a TBI-Traumatic Brain Injury, active
    Language and Speech impairments, experiences difficulty saying words correctly in a consistent way, short-term and long-term memory loss, problems and impaired judgment, and anxiety with panic attacks. She is very sensitive to fluorescent lighting. Post-concussion syndrome, severe headaches, increased sensitivity to sounds, and hypertension (high blood pressure). All of this has changed Tammy’s life – from the headaches, memory loss, difficulty multi-tasking, anxiety, irritability, difficulty overcoming changes in weather conditions and fatigue, that according to the medical professionals, should have been resolved within 6-11 months after the injury happened.
  2. Cognitive and Communication Problems: She has Difficulty keeping up with a conversation, poor organizational problems, and impaired judgment. Unable to do more than one thing at a time, she has speech impairment when articulating her words. Tammy cannot follow written instructions without getting nervous and have some kind of an anxiety attack. The symptoms of her chronic depression have affected her performance from the bedroom to everyday life in our marriage.  She has problems concentrating for periods of time, having trouble organizing thoughts, and becoming easily confused or forgetful. Almost every day Tammy will experience difficulty learning new information; unable to interpret the actions of others. Therefore, she has greater problems in any social situation.
  3. Visual sensory processing: Tammy frequently seems bothered by light, especially bright lighting, becomes distressed in unusual visual environments. Difficulties in the area of body awareness and difficulties in the area of balance and motion are seen through observation. She seems to have fewer difficulties with incandescent lighting but increased difficulties with fluorescent lighting, therefore experiencing some severe mood swings and severe headaches until she leaves the room.
  4. Difficulties in the area of planning: Tammy is showing, evidenced by observation only, that she frequently performs inconsistently in daily tasks, has trouble figuring out how to do multiple things at the same time, seems confused about how to perform tasks in proper sequence, and fails to complete tasks with multiple steps.
  5. Post-traumatic responses: She has experienced physical and emotional trauma which is associated with very high rates of posttraumatic responses. Tammy has flashbacks and dissociation that are often triggered more than once but not less than 5 or 6 times a week. She has severe signs of PTSD with emotional distress or physical reactions to what has happened to her after the accident from work. As the PTSD is triggered, Tammy gets mad about what has happened to her at work. She also can’t understand why it happened to her. The flashbacks and dissociation are triggering panic attacks daily. She is experiencing fatigue, but decrees in need of
    sleep. Through the day she is having speech impairments such as slow or slurred speech.
  6. Panic attacks: She is showing, evidenced by observation, trouble getting words out quickly before or during a panic attack. Tammy’s panic attacks have gotten worse and harder to overcome just about every day. She will struggle to pull herself out of the anxiety disorder after it starts, and will get little to no relief from the panic attacks, even with medication.
  7. Hallucinations: Tammy has a strong tendency to see things that are not there, for example, people, cars, flashes of light that do not exist to anyone but her. This makes her feel like she is going crazy and then it will throw her into a severe panic attack. She has the hallucinations most of the time with different types of paranoia; Tammy has Delusions even when I am driving, example cars or people on the side of the road that are not there. A different example would be when she had a hallucination of a nude Chinese man sitting in a trashcan, yet in reality, was not true.

Biggest struggles a caregiver to my wife

The biggest struggle with caring for my wife of 24 years with a TBI-Traumatic Brain Injury would be the short-term and long-term memory loss. Knowing that different parts of the brain control different functions and with her TBI not all the right functions are working as it did years ago. Cognitive Communication Problems has put a large strain on our marriage. An example would be if I ask her a question, her response may be absent altogether or nothing about the original question.

Another example would pertain to her short-term and long-term memory loss. Like any other husband and wife on a day to day basis, we would go through the things that happen during the day. Her ability to recall what went on has been decreasing over the years post onset of the original head injury and the finding of the TBI-Traumatic Brain Injury. I may recall something my kids may have done, something that happens on TV and she will not even recall that the event even happened or the specifics that pertain to each event.

Tammy is always feeling sad all the time, anxious, or lifeless, she becomes easily irritated or angry for little or no reason. She has a lack of motivation; her panic attacks have gotten severe, and she will start crying unexpectedly with no apparent reason. She never feels good about herself anymore; she will put her self down. As her husband, this kills me. I love my wife and don’t like to see her like this.

Intimate relationship after her TBI-Traumatic Brain Injury

Is it the decreased desire for an intimate relationship with me after her TBI-Traumatic Brain Injury or is it the emotional changes she is going through that we are not getting the upper hand on? I believe some of it would be that she feels less confident after her TBI.

Perhaps it could be a change in thinking capabilities that are posing deep difficulties with attention, recall, communication, scheduling ahead, and intellectual reasoning, that could be upsetting sexual functioning for her.

The production of hormones like estrogen are often affected with brain injuries and even more grossly increased with a TBI-Traumatic Brain Injury. The lack or decrease of hormones will affect her sex drive, putting a large strain on the intimate relationship after her TBI-Traumatic Brain Injury.

The hardship after TBI and becoming homeless

It was like any other day for my family, we just got up, my wife was getting ready for work and I was cooking something before she had to leave, not knowing that day would change our life forever. My wife has gone through so much over the years with the loss of our son to heart disease, finding out our other son was now disabled, and with me having three heart attacks and the brain injury she sustained at work in March of 2013, that fully disabled her.

As of today, my wife will never be able to hold down a job, she spent over 14 years in the same field. She is not getting any better. She has lost her short-term memory, and most of her long term memory with the Traumatic brain injury and post-concussion syndrome. She is going to a neurologist, psychologist, and speech pathologist, which will continue for many years to come.

According to Fox news, patients that have been suffering from a concussion or severe headaches after a head injury are more than likely going to have a harder time going back to work, and some patients never returned to work. (Monier, 2015)

Closing this chapter of our life

2013 was the worst year for my family ever, we lost our main source of income, after my wife was severely injured at work. We were unable to pay for our home so we were evicted. We had to move into a motel for over 10 months. Uprooting my kids from the place they were happy and secure took the biggest toll on my family. We got help from a friend and moved into an apartment in Decatur, Ga, giving my family a safe place to call home and a place to complete my classes at South University of Georgia. All I knew was I needed to keep going forward in all my psychology classes and keep myself working towards my future, so I would be able to help my family never end up in this type of predicament ever again.

Mr. Bobby Porter, MA, Psychology
South University of Georgia
College of Arts & Sciences
Behavioral Health & Clinical Psychology

 

Ref:
Traumatic Brain Injury (TBI) and Concussion. (2017, August 03). Retrieved May 27, 2018, from
https://www.asnr.org/patientinfo/conditions/tbi.shtml
Monier. J. (2015) 9-week-old suffers brain injury; father faces child abuse charge. Retrieved
Tuesday, March 17, 2015, from http://www.fox10phoenix.com/story/28182356/2015/02/23/9-
week-old-suffers-brain-injury-father-faces-child-abuse-charge

More about me:

https://bobbyporter.wordpress.com/

I also have a book released about my story as well:

BobbyPorterBook

 

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