Attention to brain injury one focus of May as ‘Better Hearing and Speech Month’
See also: Traumatic Brain Injury, More Information
The last thing Stephanie Baxter remembers is seeing a dirt truck in her lane, and then hearing the voice of an On-Star operator.
Her Suburban had rolled off a 25-mph Cheboygan County road, and she was found unconscious by two passersby. She can remember thinking after she awoke how she wanted her husband, Ken, there, “but I remember thinking that he’d think I’d be dead. I was confused, and I really wanted my husband to take me to the hospital.”
In the ambulance and the emergency room, Baxter, of Petoskey, was evaluated for broken bones and other injuries. She was given painkillers at the hospital for her soreness and sent home.
Over the next couple of weeks, her family had started noticing changes in her behavior and personality, and she had a hard time remembering her four children’s names.
“I homeschooled my kids for a long time,” Baxter said, “and I couldn’t even do my daughter’s math. I forgot appointments. My daughter had to start helping me dry my hair.”
When she got sick in church, she was worried enough to consult a doctor that something was wrong. She was referred to Dr. William Nicholson of Petoskey, a behavioral health psychologist with special training in neuropsychology.
Something was, in fact, wrong.
While the impact of the traffic accident was low — just around 25 mph — it was enough to cause mild traumatic brain injury. For those who suffer from MTBI, however, using the term “mild” does an injustice. It has turned Baxter’s world upside down, as she struggles to find the right words, becomes easily agitated with bright lights and background noises — crinkling papers, the click of a pen — and is overwhelmed with the multiple tasks involved with simply taking a shower.
“Sometimes I wish I had a huge scar here,” Baxter says, pulling her blonde bangs back from her forehead, “so I could say, ‘See this? I have a brain injury.’”
Understanding TBI
Traumatic brain injury and its variable incarnations in its sufferers is one of the brain’s mysteries. The same force of injury in one person can cause irreparable bleeding and even death, and in another, impair just one function of language, like word selection.
And TBI is deceptive. A perfectly healthy, normal looking person — like Baxter — can have suffered a trauma within the skull from any number of outward sources: car accident, work injury, fall down the stairs, blunt force, even skiing.
Earlier this year, it was traumatic brain injury that claimed the life of actress Natasha Richardson, who fell while skiing on a beginner slope, hit her head, was lucid and then died several hours later as her brain began to bleed.
Baxter’s injuries aren’t as severe as those suffered by Richardson. Hers did not bleed, there was no visible swelling; there were only the after-effects, which have led to endless frustrations for the 41-year-old mom and wife.
To help her compensate for her new limitations and regain communication abilities, she’s been working with Beth La Framboise, a speech-language pathologist at the Abby D. Rehab Center in Petoskey, formerly known as the Speech and Swallow Center.
“We work with patients on any deficit that would impair communication; that could be language, speech, understanding, reading and writing, and swallowing,” said La Framboise.
Most of the patients who are in need of speech services have either suffered a stroke or a head injury, she added, like Baxter. At the time of her accident, a brain scan was completed, but no signs of injury were evident. This is common, La Framboise said, especially in cases where there’s no bleeding.
“Mild TBI is hidden, it’s buried, it’s easily missed,” La Framboise said. “The damage can be minor, in just a few places, almost like little bruises. It can be diffuse.”
A big part of life’s daily challenges for Baxter is in time management and multi-tasking, things the mom of four kids ages 13-5 used to be able to master like any mother. She is able to drive, but relies heavily on the GPS system to help her find her way, even around Petoskey’s small perimeter.
La Framboise said Baxter’s treatment is focusing on helping her to regain her ability to multi-task, organize thoughts and spur her initiation to start tasks. “(With TBI), your life is altered, changed, but that doesn’t mean it can’t be managed or fulfilling,” she said.
Baxter says the twice-weekly therapy sessions and prescription Aricept, used to treat Alzheimer’s patients, are helping her toward at least learning how to compensate for her limitations.
A day planner is her key to staying on track and not becoming overwhelmed with the daily tasks of living many people without TBI take for granted.
“(Therapy) is a place where you can learn you’re not alone,” Baxter said. “It’s very important when you have a TBI and you’re trying to get your life back that you learn to compensate. And also that the person who does your therapy is kind, understanding, loving and pushes you to do things in a kind and creative way.”
La Framboise said she hopes physicians put renewed emphasis on checking for mild TBIs after even low-impact crashes like Baxter’s, and she also stressed the importance of regular follow-ups with a physician in the days and weeks following an accident or head injury.
“Any time anybody comes into the ER and they’ve hit their head, it needs to be addressed with more urgency, with more seriousness,” she said. “The sooner you can begin treatment, the better the outcome. The brain can always burn new pathways.”