Thursday, November 8, 2007

Mild Traumatic Brain Injury


My friend, Zipperhead, suggested I post a link or two here concerning MTBI and I think it's an excellent idea, but I also thought I'd like to discuss some of what I've learned about this topic.

When the first neurosurgeon to take charge of my care after I flew forward off my horse and landed on top of my head hard enough to break a bone in four places first saw me in the emergency room, he did not address brain injury. Months later, another neurologist told me (and reported) that this was most likely because of the severe and life-threatening nature of the Jefferson Fracture. I guess it's called Triage and my doctors had to deal first with what they felt was the most severe issue.

Noone brought up brain injury to me, and therefore, since I was in fact brain-injured, I didn't think about it at all. All I thought about was getting better in a month (I thought) and getting back to my job of training horses.

Yet, I knew that something wasn't right inside of my brain. But I wasn't thinking clearly enough to really "get" that it had been injured in the fall. In another post someday, I will write of how skewered my thinking was in those first months post injury.

A couple of months later, while at a follow-up appointment with my neurosurgeon, he said off-handedly, "I think you probably suffered a concussion." I said, "What IS a concussion exactly?" (I used to be a freelance reporter so I don't mind asking what might sound like elementary questions!)

He replied, "It's brain damage."
I was alarmed and cried, "Do you think I have brain damage?"
He reassured me. "No, no, the CT scan doesn't indicate that at all."

(Later on, I looked back at those CTs and found that they did not include the brain at all, only the Cspine, but that's another story)

I came home and ended up talking to my mother on the phone and told her what the neurosurgeon had said. She turned around in her office chair and pulled a volume down from a shelf holding an archaic set of encyclopedias and looked up "concussion." As she read the descriptions to me, for the first time, I knew that was what had happened to me. Those definitions and symptoms fit me to the proverbial "T!" I finally had a name for it.

You see, I had been alone when I was launched from the back of that big, Paint eventing horse. Noone was present to witness whether I'd been knocked out or not. After I'd come to and struggled to the house and called the EMTs, the paramedics asked me if I'd suffered "Loss of consciousness" (LOC). I told them I had not and they wrote in bold letters on their report, "NO LOC."

Again, later on, while researching MTBI, I learned that the victim is not the best witness of what occurred. If you are all alone, how do you know if you were knocked out? One of the signs of MTBI is loss of memory either before or after the injury!

So, in this round-about way, I came to realise that I had suffered an MTBI. Again, figuring things out for myself and assisted by a tattered page of a dusty volume from a set of out-dated Encyclopedia Brittanicas 3000 miles away.

Five months after my injury, I had an appointment with my first neurologist. He stated, after interviewing me, "I think you had a more severe brain injury than anyone has previously recognized." I felt vindicated, indeed. It's funny. You'd think a patient would never want to hear such words, but after fighting an inner battle for months, knowing something was askew inside my skull, but not having anything official stating such, well, those words gave me validation. "Yes," I thought. "I did hurt my brain and now someone is acknowledging that!"

A friend sent me via email an incredible link to something called, "A Letter From Your Brain." I have the link posted in the right-hand column under "Favorite Links." If you know of anyone who has suffered a brain injury, I encourage you to read this piece and to share it with your loved one.

And I want to explain that even though the word "Mild" is in the diagnosis "Mild Traumatic Brain Injury," no one is saying that there is anything "mild" about it. This word simply helps to distinguish this injury from one more severe that results in coma and much worse debilitation. MTBI is simply "mild" compared to "TBI" or traumatic brain injury.

I have read a couple of books about this condition and would like to recommend them here, as well.

Coping With Mild Traumatic Brain Injury: A Guide to Living with the Challenges Associated with Concussion/Brain Injury, by Diane Roberts Stler, Ed.D. and Barbara Albers Hill.

And the one I found the most helpful:
Head Injury: the facts, by D. Growall, P. Wrightson and P. Waddell.

I get a good deal on books like this at, buying used books. I've never had a bad experience doing this.

And finally, some links:

and a really good one here, in "tiny url" form, found at the Mayo Clinic site:

Thanks, Zippy, for a great idea. I will post these links under my favorites as well. It's important for us to understand that those with brain injuries will have changes in their behavioral patterns, in their sleep patterns, emotionally and cognitively and these changes may last a lifetime. I was told that maximum improvement is found about one year post injury. You are as good as you are going to get one year after you suffered your MTBI. After that, we must learn to deal with our new brains and rely upon the support of loving family and friends.


Anonymous said...

thanks, v.
i couldnt have said it better myself! hope all is well and happy packing!

Cleo said...

Thank you. I am going to pass this along to my brother and sister-in-law.

By His Grace said...

Glad it can be of some use. It's so common! And Cleo, especially amongst us cow-folks. And Krista, esp. amongst cheerleaders!

hugs to you both

Anonymous said...

Is it acceptable for patients to be moved to several different doctors before a diagnosis is made? especially with something as potentially dangerous as a brain injury. Should the first doctor know he may not be fully qualified and so find a colleague who knows more. could this possibly rasie a question of medical negligence?

clarksburg said...

An injury to the head is always a serious matter as it could lead to all sorts of complications, what feels like a normal headache could be something else. If you or someone you know suffers a head injury they should be checked by a professional as soon as possible. If it a industrial accident then inform your boss of the incident and ask if you can leave for treatment.

Anonymous said...

Head injuries are unbelievably weird. I had two w/in five days. My doctors all said I should be six feet under. Coming up on the seven year anniversaries of those injuries(both horse related!), I still experience a few lasting effects...severe headaches, intense pressure in one eye (which was torn during one of the accidents), and daily nausea! Being that the nausea is daily, it is the worst residual effect. After the accidents, I spent three months flat on my back. As a primary school teacher, my Kindergartners got use to me throwing up into the waste basket for the first year after the accidents. Things are definitely better now, but some things I am left with. It is tiresome, but I am so lucky to have survived my injuries, and treasure each and every day. I wish all w/head injuries complete and speedy recoveries, or at least the ability to deal with them in the best ways you are able. Best wishes.