WOMEN AGES 50+ FOR AUGUST 2023

Regarding Post Traumatic Amnesia ...

"People who experience PTA for more than 24 hours are likely to have sustained a severe brain injury and to experience long-term complications, whereas PTA of less than 1 hour is likely to indicate a minor brain injury."
https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/post-traumatic-amnesia/




Regarding Diffuse Axonal Injury ...

"DAI describes the shearing, or tearing, of nerve fibers known as axons. This trauma usually results from the brain quickly shifting within the skull. Following a sudden impact, mechanical forces cause nerve fibers to stretch and tear.

Axons are the long, thread-like portion of neurons that conduct electrical impulses. They are responsible for communication between nerve cells. As such, damage to axons may impair their ability to communicate and help coordinate bodily functions, which can lead to severe disabilities.

DAI is the most common cause of coma, disability, and persistent vegetative state in people with TBI. Clinically, health experts define DAI as a loss of consciousness that lasts for 6 hours or more after the injury. It may also cause behavioral, social, physical, and cognitive changes in a person that may be temporary or permanent."
https://www.medicalnewstoday.com/articles/diffuse-axonal-injury#definition


They say that when you meet one person with a severe brain injury ... you've met one person with severe brain injury. They're all unique and different.

One of the reasons for the uniqueness of brain injuries is that neuroscientists still don't know what each portion of the brain does. They've got a vague idea, but even the images posted by different places vary a bit.





Another reason is that sometimes things aren't stored or processed in the "usual" locations. For one reason or another, my brain might choose a different place to process something from your brain. And that is very hard for a neuroscientist to tell without doing extensive studies on us as individuals.

Other reasons that brain injuries are unique include things like genetics, intelligence level to begin with, amount of education and learning, life experiences, socio-economic status, previous brain injuries, alcohol and drug consumption, diet, exercise, etc.

Those things also factor into recovery.


Fortunately my husband had/has good genetics, has experienced a good socio-economic status, had a very good pre-accident intelligence level combined with education, learning and life experiences.

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In my husband's case, according to several specialists the percentage of injury he sustained was about 35% - 38%. If you think about that ... you take your whole body, and permanently injury 35% - 38% of it. Pretty significant.

The largest part of the injury is, of course, the brain. But as we know from strokes etc., if you damage the brain, you'll often damage other parts of the body, and that is what has happened.

My husband's left leg is weak and doesn't have the same level of feeling as the other leg. He also kind of loses track of it, so he has to be very careful walking on uneven surfaces.

His right arm is the same way. In a person with a stroke, they'll often have one side affected, but in my husband's case, it is cross-body: left leg, right arm.

He has no sense of taste or smell.
He has double vision when he looks to the side.
He has vestibular issues, which he has treated from time to time.
He developed seizures a year after the injury and has to be on medication for life for those.
He seems to feel pain more than he used to.
He gets extremely fatigued very quickly.
He is much more emotional than he used to be.
He is easily overwhelmed by noise, crowds, new things, changes to routines, etc.
He loves routine.

So he can walk around (slowly) and he can ride a bicycle because the left leg sort of comes along for the ride. He can do the basic things occupational therapy they always test for like showering and personal care, preparing food, and doing basic household tasks. He can ride a bus and do a bit of shopping.


More specifically within the brain, however, there are further issues.

He has aphasia so he has trouble finding words and talking coherently, especially when he is tired. He reads (especially the news), but sometimes has trouble comprehending what he is reading (he misunderstands) and he forgets what he has read.

He also frequently perseverates (to repeat something insistently or redundantly) and in combination with his tendencies to be tangential and verbose, this means that he reads something in the news and then repeats it frequently and works it into conversations and waxes eloquent about it over and over and over for months. Then one day, he'll change the topic a bit and will dwell on that topic for the next several months.

If he gets stressed, he'll do this even more frequently and will work in some of his past topics.

Currently, his topic is the recession.

He is also very literal so won't get puns and jokes.


Outside of language difficulties, he struggles with short term memory and laying down new memories.


He also has executive difficulties. This part is hard to explain because it will vary with individuals, and we all experience some of these things occasionally. In my husband's case, he will show evidence of elements of what I've defined below every single day to the point where accomplishing things is difficult for him.

I think you would have had to know him before and after the injury to pick up on some differences. Other things you might notice only if you spent some time with him. And others are more readily obvious.

And it changes based on how fatigued or overwhelmed he is.



"To better understand what executive dysfunction is, it helps to know more about executive functions. The main executive functions are:

Working memory.
Cognitive flexibility.
Inhibition control."


https://my.clevelandclinic.org/health/symptoms/23224-executive-dysfunction

"What are some examples of executive dysfunction?
Because executive functions involve so many processes inside of your brain, executive dysfunction can take many forms. Some examples of executive dysfunction include:

• Being very distractible or having trouble focusing on just one thing.
• Focusing too much on just one thing.
• Daydreaming or “spacing out” when you should be paying attention (such as during a conversation, meeting, class, etc.).
• Trouble planning or carrying out a task because you can’t visualize the finished product or goal.
• Difficulty motivating yourself to start a task that seems difficult or uninteresting.
• Struggling to move from one task to another.
• Getting distracted or interrupted partway through a task, causing you to misplace items or lose your train of thought (like leaving your keys in the refrigerator because you wanted a snack, but your hands were full, so you put your keys down inside the refrigerator and forgot about them).
• Problems with impulse control, like snacking when you’re trying to manage your diet.
• Struggling with thinking before you talk, causing you to blurt out the first thing that pops in your head without considering that it might hurt someone’s feelings.
• Having trouble explaining your thought process clearly because you understand it in your head, but putting it into words for others feels overwhelming."

https://my.clevelandclinic.org/health/symptoms/23224-executive-dysfunction


"What is executive dysfunction?
People with injury to their prefrontal cortex can have difficulties with their executive function skills - when this happens, they are said to have executive dysfunction.

Executive dysfunction is also sometimes referred to as 'frontal lobe problems' or 'dysexecutive syndrome'.

The most common effects of executive dysfunction are summarised below:

Difficulties with motivation and initiation
A survivor may lose their sense of 'get up and go', making it difficult for them to start or complete tasks. This may be mistaken by others for laziness or disinterest. For example, a survivor may frequently be reminded about needing to book an appointment, but even though they intend to do it, they don't get started on it so it doesn't get done.

Difficulties with organisation
A survivor may struggle with making and sticking to plans. Thinking through the steps to get things done may be difficult for them. For example, a survivor may be unable to keep track of appointments and frequently get these muddled up.

Difficulties with flexible thinking
Adapting or changing behaviour, or switching between tasks may be difficult, as the survivor may become stuck or fixed on certain information or behaviours - this is called 'rigid thinking'. For example, thinking to lower the heat if food is unexpectedly cooking too quickly.

Difficulties with problem-solving
Thinking through problems and forming solutions may be difficult for the survivor. It may also be difficult for them to anticipate the consequences of their decisions. For example, a survivor may be unsure of what steps to take if they have lost their bank card.

Impulsivity
A survivor may act too quickly and impulsively without fully thinking through the possible consequences, for example spending most of their pay-cheque on something without considering the bills that need to be paid later.

Difficulties with planning
Thinking ahead and going through the various steps to complete an activity may be more difficult for the survivor. For example, it may be confusing for a survivor to follow the various steps needed to arrange and book a holiday."
https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/executive-dysfunction/