To answer the question, we must first examine what is meant by recovery. Brain Injury is not an illness that one "recovers" from. Through appropriate medical care and rehabilitation, improvement is possible. Because of the complexity of the brain and the unique effect each brain injury has on the survivor, it is impossible to say exactly how long it will be; especially in the first hours, days, and weeks, before you know the outcome. A so-called "mild" brain injury may result in substantial deficits which may affect a person's life permanently, while a person who has suffered a "severe" brain injury may be able to return to a life that is, while not identical to, close to the one they had before the accident.
Depending on the nature of the injury, this prognosis will differ from patient to patient and the true extent of their injury may not be known for months or years, especially when the injured person is a child. Sometimes the damage is to one specific area of the brain and doctors can give some opinion as to how damage in that area will affect the patient and perhaps offer a prognosis on the course of recovery. Sometimes the damage is diffuse (in many areas) making it very difficult to determine the outcome. "Wait and see" is sometimes the most accurate answer.
"Rate of recovery? It varies, obviously. But the important yardstick is the patient's ability to communicate on a consistent basis. Everyone is warned that their loved one could stay at any level of recovery after the first year and a half, then make small gains for an undetermined amount of time -- even years later."
While being told "to wait and see" may be very frustrating to the family members of the survivor, it can also be frustrating to the survivor to try to live up to the hopes his/her family has of a speedy and full recovery. The truth is the process of recovery takes longer than you think.
The most important role you play in the outcome is to become an advocate for the patient and make sure that he/she receives the best medical care and has access to the rehabilitation programs he/she needs to maximize his/her potential. (Including current advances in treatment and rehabilitation).
One of the best ways you can do this is by learning everything you can about brain injury. This means asking lots of questions of medical and health personnel. It also means keeping track of what you've learned. The Brain Injury Association recommends that you keep a looseleaf binder and organize the information you receive in sections (for example; a section on rehabilitation). This will aid you in making informed decisions regarding treatment options for your loved one.
When I was nursing we learned of a study, done by a surgeon, that found that people under anesthesia healed more quickly and had fewer complications when told that the surgery was going well, that it looked like healing would be complete and rapid, and the outcome of surgery was positive. Perhaps it was the power of suggestion to an unconscious person's mind, but to many peoples' surprise it worked.
In ICU we began speaking to a person who was in a coma as though the person would have a positive outcome, and refrained from saying things in earshot that were negative, even though we could not be sure that we were heard, or that it would bring about a positive change for every person. Realistic but optimistic talk did not bring every person out of a coma, or completely heal every injured brain, but good natured, optimistic banter was remembered by some who surprisingly told us that it helped them by giving them something hopeful and encouraging to hold on to.
Upon awakening, those who could recall conversations remembered people and words that no one knew was being heard by the person in a coma. One young woman, who wasn't spoken positively about, told me that she had heard the prognosis that it would be better if she didn't make it. She said she had wanted to scream and in her aware coma moments afterward she was overcome by despair. In the time after she did regain consciousness and became stable enough to transfer out of ICU she was despondent. Though it has been many years since I have seen her I still remember her because her despair was so palpable. She left ICU with a psychological burden in addition to her physical hurdles. I wondered what would become of her. Words had such a powerful impact, and no one knew they were heard.
Attorney Gordon S. Johnson, Jr.
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