Sunday, March 18, 2007

List of potential problems

I was very moved yesterday when you filled a self-assessment of a list of possible problems after a traumatic brain injury, such as your aneurysm. I have attached below a copy of the list. It may help friends and family to provide a context when they see some of the problems with which you are struggling. Recovery from a brain injury is a long process that can be made longer without useful information.

A few weeks ago you told me that we both had an aneurysm. I agree!, and I would extend this statement to all the family and close friends. Although you are the only one that landed in the hospital, the impact of the aneurysm reaches all those who love you, all of us feel the loss, the pain, the desire for you to get well; all of us feel at a loss of words when we see you trying to find a word unsuccessfully; we feel powerless when you get tired and there is nothing we can do about it; so it helps to know what we may be dealing with, not so much to put a label on you, but to reframe our reactions and have more productive conversation and interactions with you. All of us have to learn to deal with the aneurysm.

I was moved by your reactions, because you cried when you marked most of the items in the list as problems you face right now. I realized that even though you were aware of them, you had not seen them together in a list. On the positive side, this list gives us a measure to gage your recovery.


Possible problems after a traumatic brain injury

* Balance and co-ordination
* Difficulties or inability to walk
* Weakness or difficulty moving arms and legs
* Abnormal muscle tone
* Changes in sensation (ie. areas of numbness and tingling or areas that are overly sensitive)
* Decreased energy and endurance
* Problems with fatigue
* Difficulties sleeping
* Changes in hearing, seeing, smelling and tasting
* Light and sound sensitivity, ringing in ears, dizziness, light-headed feeling
* Changes in appetite, either not hungry or very hungry
* Swallowing problems
* Chronic pain, including headaches
* Increased sensitivity to caffeine, alcohol and other drugs
* Possible seizure activity

* Difficulties speaking (forming words)
* Difficulties understanding words/conversation
Inability to write
* Problems reading and understanding what was read
* Unable to stay on topic
* Problems thinking of the right words
* Difficulties expressing ideas in a concise way

Cognitive (thinking)
* Disorientation to time, place or person
* Poor concentration, easily distracted, unable to stay on topic
* Memory problems
* Slowed thinking and slower to respond
* Difficulty with reasoning, reaching logical conclusions and judgment Mind gets stuck on one issue
* Difficulties keeping track of two or more things and following a sequence
* Problems planning, organizing, problem solving, making decisions and initiating tasks
* Needs direction and structure to accomplish tasks

Problems with pacing activities
* Acts on impulse
* Difficulty dealing with change
* Lack of awareness, insight into problems and/or lack of acceptance
* Lack of flexibility in thinking
* Concrete in thinking

* Irritable and easily frustrated
* More sensitive to stress
* Depression
* Lack of facial expression
* Emotional outbursts
* Emotional (crying for no apparent reason)
* Withdrawn from family and friends
* Poor coping skills
* Feeling of grief and loss
* Behaviour and social skills
* Hard to keep up in social situations
* May be inappropriate - emotionally, behaviourally and sexually
* Self-centred; childish behaviour
* Personality changes (i.e. no longer outgoing)
* Changes in difficulties with relationships, especially with family
* May be impulsive
* Compulsive talking

* Decrease or inability to do the following: self care tasks; household management tasks; drive a car; work or return to work; be involved in previous social activities or hobbies.

Source: The Ontario Brain Injury Association

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