"But 'waking up' is a slow process of what we call 'emerging.' The first part of the waking up process is when the eyes open and they have wake/sleep cycles, the sleep cycles being the longest. As the wake cycles get longer and longer, movement begins to occur; then speech; then purposeful movement; reaching for things, making things work -- purposeful speech -- asking questions.

Arms and legs are the first things to move; then the head, from side to side. Speech begins with moaning, then moves on to mumbling, and happens more often when lying in bed." ~ Martha

It should be remembered that sometimes, while a patient is in a coma, they may exhibit behaviors which mimic conscious behaviors. For instance, they may turn their head toward a sound. This may or may not be a purposeful movement.

I can not stress enough that coma is often not what we imagine. No two patients are the same. Some will display movement and sounds throughout the comatose period, some may need to be restrained to prevent injury to themselves or others. It is best to view these behaviors realistically. This is the hard truth about coma; we do not know if or how well any particular patient will recover. But coma is rarely like it is portrayed in movies and on television, where one day the patient opens their eyes, smiles, and is discharged the next day. Recovery from brain injury takes time.

The brain is very complex. Even in the event of a "mild" brain injury, when there is no loss of consciousness, people often experience long term problems with memory, fatigue, concentration, anger, dizziness, etc. These problems may never be resolved and may require lifetime coping strategies.

Even in the event that the patient recovers quickly, it may take years to fully understand the extent of the injuries. If they are able to return to work, they may do an adequate job until faced with a new task or placed in a stressful situation.. The extent of memory impairment may not be evident until they are required to learn a new job. They may have deficits that will not be obvious until faced with a new or different situation or environment. These "subtle" deficits may be harder to find help for than more obvious deficits.

That is why you must be informed about brain injury. And why it is important to develop support systems now. You must be prepared for an injury which is permanent, as hard as that sounds. Information is your best option for dealing with brain injury.