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  1. #1
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    Default Brain injury

    Hey just wondering if anyone could help me out with some hints and ideas of how to deal with this.
    On the 27/6/16 I fell off a motorbike in a paddock with no helmet on. I was flown to a major hospital where I spent 16 days in an induced coma with a blood clot and a fractured skull and a lot of brain swelling. I am yet to get a doctor explain to me what happened even though I am in rehab.
    Just wondering if anyone could give me any ideas of what happened and how I can overcome it and get home to my children. My husband has talked to doctors but can't seem to explain it to me so i can understand it.
    Thanks

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  2. #2
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    Sorry I can't really help. Do you have any follow up appointments with the doctors to talk to them?

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    I'm still in rehab and we have been promised a doctor will discuss it with us but was just hoping someone else may be able to prepare me to see them.

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    Default Brain injury

    @J37

    Might be able to help?

  5. #5
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    I've no experience with brain injury but have with spinal injury - it seems strange that you've been moved to rehab without a doctor discussing your prognosis with you, I would be demanding a meeting with the doctor, your physio and your OT. I don't know the extent of your injury but if your husband needs to make adjustments at home for your return you'll need all these people onboard and to assist you with funding if any is available to you. Good luck.

  6. #6
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    Thanks for all your answers.
    I managed to see a doctor and my ct scans today and even though I asked heaps of questions he really struggled to answer much. I was hoping to be a bit more capable of what questions to ask but feel it wouldn't have helped me anyway.
    My physio is really happy with my recovery and after a funeral last week and support from so many people i have emotionally/mentally managed to get in a far superior place.
    Being at rehab I can see how badly I could have ended up but am still struggling to get my head around what happened and how it will affect my life!

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  7. #7
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    Quote Originally Posted by Wise Enough View Post
    @J37

    Might be able to help?
    I'd need a lot more information, but I am happy to help.
    If you want to send me your CT brain report, and any other imaging and reports, I am happy to interpret and explain them for you.
    It would be helpful to know what treatment you had; whether you needed a burr-hole, drain, had raised ICP (intra-cranial pressure) and subsequent ICP-monitoring, etc. You said you were in an "induced coma", but that can actually mean different things in different situations. It usually means the patient is intubated and ventilated, whilst heavily sedated with propofol or morphine/midazolam.
    If you have had subsequent CT scans that would also be helpful.

    The hospital should have an OT and Physio, and they should be able to help you transition back to normal life; that's their job.

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  9. #8
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    Unfortunately I can't get hold of the ct scans yet.
    I had a drain as I had excessive swelling and bleeding in the front of my brain as well as staples in my scalp after surgery. I was flown into the capital city from the country and they did surgery on me the same night I arrived. I was placed into an induced coma under sedation by the neurosurgeon and they took four days to find my skull fracture.
    Unfortunately I was on a ventilator and managed to get pneumonia after a week which kept me under sedation. They also gave me a tracheotomy which I am struggling to understand and deal with.
    I am finding it really hard to completely understand how and why it happened and how I can prevent it from happening again. I have two kids 5 & 3 who are struggling to deal with it as well and feel I could get much better if I could understand it myself.
    I was also very aggressive to the ambos which is common with this injury but it has put me in a bad place with my needle and hospital phobia.
    I guess what I need is the questions I can ask the doctor to be able to get my head around it and prevent it from happening again as they just keep using a chicken/egg excuse as to why it happened.
    If you need any other information just let me know.

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  10. #9
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    I'm a bit confused about why you are asking "Why did this happen and how can I prevent it from happening again"? You said that you "fell off the back of a motorbike in a paddock without a helmet on".

    It's very hard to answer any of this without seeing your CT scans. But the short answer is that you clearly hit your head with enough force to fracture your skull, and cause an associated bleed in the brain. This occurs as the force of the blow to the head tears/ruptures the blood vessels.

    The management is slightly different depending on the location and type of bleed; sub-dural (just underneath the "lining" of the brain), extra-dural (between the skull and the dural lining of the brain), intra-cranial (within the substance of the brain), etc.

    The skull is a fixed, enclosed space. So anything which causes an increase in the volume of the skull's contents, such as a bleed, therefore increases the pressure within the skull (the intra-cranial pressure, ICP). The important thing is to reduce this pressure back to normal ASAP. Otherwise the increased ICP in turn puts pressure on the surrounding brain matter and can cause direct damage to the brain, AND the increased ICP can put downward pressure on the hole at the bottom of the skull (where your spinal cord exits your skull), and squashes it, causing cardio-respiratory arrest and death, or "brain-death".

    So, relieving that increased pressure is critical. Putting in a burr-hole, temporarily removing a section of the skull, putting in a drain, etc...whatever it takes.

    You said the doctors didn't find your skull fracture for 4 days; this isn't really a big deal, as you can't "fix" a skull fracture anyway. The critical thing is to fix the associated injury.

    Obviously you can't be awake during any of this, so patients are essentially given a "prolonged general anaesthetic" with deep intravenous (IV) sedation. So, you need to be intubated and ventilated. It's standard to be given high doses of IV antibiotics in this situation, but despite this, MANY patients develop pneumonia while ventilated unfortunately. This is due to many factors; infection which is "resistant" to antibiotics, lung damage due to being ventilated, a suppressed immune system due to being on steroids as part of the management of the brain injury, etc.

    Patients who are ventilated for more than a few days become increasingly difficult to "extubate" (take their breathing tube out) when it is time to lighten their sedation and get them to start breathing on their own. There has been/is a lot of time and money spent on newer and better ventilation methods in ICU-patients, but the evidence to date shows that an early tracheotomy (putting the breathing tube from the trachea/windpipe directly out through the neck) means the patient can start to breathe by themselves, and avoid considerable complications of longer-term ventilation. The tracheotomy is generally not permanent in this situation. So if the patient can start breathing spontaneously (by themselves) through the tracheotomy as their sedation is lightened, this will result in a much better outcome for them...a faster and better recovery. Leaving a patient intubated and ventilated for too long can result in being essentially "ventilator-dependent", as I said, and a tracheotomy is a big part of avoiding that situation.

    So, not knowing much about your case, this is the best I can do for the moment. It's a truly sh!t situation, as many accidents are unfortunately. Don't worry about being rude to the ambos...they have seen it many times before, and are pretty resilient people!! But it's definitely important to talk all this stuff through with a Psychologist and/or OT. This should be able to be arranged through your hospital's rehabilitation clinic, and is an important part of your recovery.

    You seem fairly "cognitively-intact" given what you've been through!, but you may notice changes or problems with your behaviour, memory, mood etc. So, find a Psychologist and an OT you feel comfortable with. An Occupational Therapist will help you with practical strategies for dealing with the kids, and generally getting back to normal family life.

    But stay off the motorbike!! My husband has one, and I hate them with a passion. (A product of having worked in a major trauma hospital and ICU!).

    Hope this helps

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    Last edited by J37; 16-08-2016 at 03:50.

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  12. #10
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    Hey j37 thanks for your reply.. I guess what I'm asking is why I fell off?? I don't remember it happening and apparently I lost consciousness but at this stage the doctor is saying they can't tell me what caused it as they don't know what came first a chicken or an egg.
    I heard him talking to other doctors today and he was using much more medical language then what I got out of him when he showed me the ct scans. Apparently I had an inter cranial bleed that they had to stabilize but I am one of those people who like to be able to understand things as it helps me get on with my life a lot better off. My neurophyscologist has told me to write questions down and the therapists will help me get my answers when we have our meeting on Thursday.
    The main thing I can't get around is why it happened. I have been fairly healthy my whole life whereas the last 8 weeks have really hit me quite hard.
    So what question should get me the answer I feel that I need?


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