Rehabbing post TBI

Introduction:

As a 19-year survivor of severe Traumatic Brain Injury, it is easy to think back and be thankful for where I am today.  I am very aware of the victims of this injury, and the many who are navigating with life changing disabilities.  I know that I am fortunate to have been able to return to life again post TBI.  You may be wondering what my secret was, or what I did that differentiated my recovery from others.  First, I can say that I had faith in a higher power that my survival/existence was purposeful and I had faith that I was going to get better!  Unfortunately, I did not know what that meant initially, but my recovery became a never-ending game of trial and error.

After being in a coma for 4 weeks, and transferring to the rehab hospital, I began saving memories again.  I remember waking up in a new, unfamiliar hospital room, but I felt like I was someplace where I would begin to get better.  I was new to my surroundings, but I was unfamiliar with my body.  I was lying in a hospital bed, but I did not feel like I could get up or move the way I wanted.  As I scanned the room, I saw a yellow posterboard with familiar pictures on it.  Next, I noticed a whiteboard in my room with a schedule on it:

9-10AM OT

10-11AM Speech Group

11-12PM Rest

2:30-3:30PM OT

I did not know or understand what I read nor did I know what was included in the tasks listed on my schedule.  It looked like I was now in a rehab hospital and I would be getting to work.  It felt like I had been in the bed for a long time.  I did not have any bed sores, but you know how it is when you wake up from a full night of rest and you’re looking around and thinking ‘where am I’?  I knew I was not in my own bed, but how did I get here, and what’s next?

These are my initial thoughts from the rehab hospital.  Prior to arriving there, I learned that I had been to two different ICU departments.  After learning and practicing my activities for daily living (ADL’s) for a couple of months and receiving recreational therapy, I was admitted to a Day Rehab program.  At Day Rehab I was able to go home at night, but each morning I was picked up and taken to rehab for 6 hours of OT, PT, speech, and vocational therapy.  It was here where I regained the most confidence!   I used to say going to Day Rehab was like going to work, but it was here I relearned to walk on a Stairmaster, practice typing on a laptop, practice cooking, share my thoughts with a psychologist, go shopping, and even practice doing the electric slide among other things!   After completing Day Rehab, I was referred to Driver’s Rehab which became the jump start to independence!  Once I was able to make it back to work independently, I scheduled myself for some outpatient therapy sessions.  During this time, I researched and tested different assistive devices that made moving forward in life with limited functionality of my entire body.  All of this rehab was draining and very frustrating at times, but it was all apart of the things faced to get to where I am now… 

For me, rehab was very important to where I am today!  It was also important to do things on my own outside of the rehab center to get better!  The overall goal of rehab after TBI is to improve the patient to function at home and in society.  It is important that the survivor has the opportunity to work with therapists who help the patient adapt to their disabilities or change their living space (environmental modification) to make everyday activities easier to accomplish.  Here are available rehab settings available per The Brain Injury Association of America:

Acute Rehabilitation

As early as possible in the recovery process, individuals who sustain brain injuries will begin acute rehabilitation. The treatment is provided in a special unit of a trauma hospital, a rehabilitation hospital, or another inpatient setting. During acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. Activities of daily living include dressing, eating, using the bathroom, walking, and speaking.

Post-Acute Rehabilitation

When patients are well enough to participate in more intensive therapy, they may be transferred to a post-acute rehabilitation setting, such as a transitional rehabilitation facility. Transitional rehabilitation facilities are sometimes called residential rehabilitation or transitional living facilities. The goal of post-acute rehabilitation is to help the person become as independent as possible. Patients undergo at least six hours of therapy per day. This type of comprehensive rehabilitation in a post-acute facility is considered the gold standard for care and treatment following brain injury.

Sub-Acute Rehabilitation

Patients who cannot tolerate intensive therapies may be transferred to a sub-acute rehabilitation facility. Sub-acute rehabilitation programs are designed for persons with brain injury who need less-intensive rehabilitation services over a longer period of time. Sub-acute programs may also be designed for those who have made progress in an acute rehabilitation setting (and are still progressing) but are not making rapid functional gains. Sub-acute rehabilitation may be provided in a variety of settings, such as a skilled nursing facility or nursing home.

Day Treatment (Day Rehab or Day Hospital)

Day treatment provides rehabilitation in a structured group setting during the day and allows the person with a brain injury to return home at night. Some people may transition to a day program following their discharge from an inpatient post-acute rehabilitation facility, while others may proceed directly to sub-acute rehabilitation after discharge from the hospital.

Outpatient Therapy

Following acute, post-acute, and/or sub-acute rehabilitation, a person with a brain injury may continue to receive outpatient therapies to maintain and enhance his or her recovery. Individuals whose injuries were not severe enough to require hospitalization or who were not initially diagnosed with a brain injury when the incident occurred may attend outpatient therapies to address problem areas as a result of their brain injury.

Conclusion:

I am very fortunate to have had the healthcare plan I had at the time, as it allowed me to participate in so much rehab.  I know it is not like that for all patients, I saw a number of them leave rehab when they had so much more to do.  This is why I believe rehab should not be limited to your current status, but where you are trying to go.  For this reason, I believe rehab should be made available to anyone that wants to finance it.  I also believe that there should be a process to receive government funding for rehabilitation just like there is when going for higher education.  It will lead to better recoveries and happier survivors.    We as survivors also need to advocate for ourselves more.  If you’re not satisfied with your rehabilitation plan, speak up!  They say a closed mouth doesn’t get fed, and I can also say a closed mouth doesn’t get you rehabbed to the highest…

Stay strong survivors!!

“Rehabilitation – Brain Injury Association of America.” Brain Injury Association of America, https://www.facebook.com/BrainInjuryAssociationofAmerica, https://www.biausa.org/brain-injury/about-brain-injury/treatment/brain-injury-rehabilitation. Accessed 17 June 2022.

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