Tuesday, 21 July 2015

If you brain isn't broken READ THIS!

           I often tried to give a Day In The Life of living with a mild or moderate brain injury to no avail.
It is not that I think its important enough or wouldn't be a good read but it really does not place enough emphasis on the true nature of the beast.
What does it really mean to be brain injured?

          As a Medic, I am surrounded by incidents as they are referred to by industry.  Sounds innocuous enough?  You know, the things I refer to, that for one reason or another means, someone took a left instead of a right and got hurt.   My job as a medic is to administer first aid to said worker, make out a report, which includes what the injuries were, whether or not the individual was wearing their Personal  Protective Equipment at the time I came upon him or her. Finally, I state the disposition of the case which usually means I hand the individual off to other medical practitioners such as Paramedics or doctors. Case Closed.

Its a sterilized view of something that went totally wrong in a split second that not only affects the individual himself but countless others including, coworkers, family members, rescuers, and a long list of employers, investigators and a list that would dwarf most well written novels.

You see, an accident or incident is in fact the cause of many things coming together at once that individually might not cause the injury but combined it becomes the perfect storm.
A recent situation in an oil rig site shows how the perfect storm occurs.
There is a person trained to monitor air quality at the rig site.   He has air monitors situated at various locations to detect the presence of oxygen levels, H2S (Hydrogen Sulfide) levels, CO levels and finally LELs (Lowest Explosive Levels).
The monitor on the day in question saw the LELs monitor sounding off every couple of seconds.  This was frustrating for all involved because they all knew there was high levels of explosive gases at the tank farm.  This was due to a broken lid atop of one of the tanks they were using to store a highly flammable substance known as Condensate.
The air quality person, turned off the monitor at the tanks because all knew about the situation and knew to take precautions and not smoke or weld in that area of concern.
The owners also knew about the culprit of the excess fumes coming from the broken hatch but continued to use the one of 26 tanks to store the Condensate.
Later that day they decided to remove the faulty tank and sent in 2 guys to open the bottom hatch and then clean out the tank.
The Air quality person was supposed to monitor the situation but felt that these guys were familiar with the situation and were experienced in what their job required, so he did not stay on site.
The two men grabbed their tools to open up the tank which requires using a hand held drill to unbolt the trap door.
They were not wearing their personal air monitors and had been supplied with an electric drill instead of an air driven gun.
The perfect storm.

The men opened the hood to their truck to attach the connections of the electric drill to the battery posts.  They kept the truck running while they went to the trap door and began unbolting the nuts.
Since the trap door was off above the minute the bolts were removed the gases inside flooded out the bolt holes and into the surrounding atmosphere.  With no monitors to warn about this explosive mix all it required was a source of ignition.  There were three in close proximity.  The running truck, the wires attached to the battery posts and the electric gun itself.
The spark from the gun caused a flash-over explosion that engulfed both the workers.

In a split second their world reached 1200 degrees causing burns to their unprotected skin which in this case was their entire face and neck.

In the eyes of industry, this was an incident.  In my world as a medic this was an incident.
In the world of the injured, this was a painful injury that took many months of healing to overcome.

The reason I bring this up is, the choice of bypassing one step in the process may not be significant but combine it and all hell breaks loose.  If the monitor was turned off but the two guys had used personal monitors they would have been warned and avoided the accident.  If the tank in question had been removed and not used to store Condensate on the same day it was being removed then the explosive levels might have not been so high.
Had they used an air driven drill instead of electric then this incident may not have occurred.

So today you have a choice. Your are late for work, so you hop on your bike and realize you forgot your bike helmet, or worse you don't think it will happen to you or its just not cool  and off you go.  You ride your bike everyday and are aware and never had an issue.  A person hops into his car and his cell phone rings just as he's pulling out of the driveway and bolts backing out from between two cars and collides with you.
Like you, this person is a great driver, no tickets, just slept in, and you were in his blind spot and so was he until that fateful moment where your worlds collided and you awake with a brain injury.

Had you been wearing your helmet, the brain injury would have been a concussion but now its a brain bleed and they needed to perform a craniotomy where they remove your scull to relieve the pressure on your brain.

The prognosis is guarded but you are lucky and after a few weeks in hospital you are sent home to begin picking up the pieces of your life.

Welcome to the first day of mild to moderate brain injury for the rest of your life!

What does that mean?
Short Term Memory, 40 percent of what it used to be.
Considering that 99 percent of us mild to moderate survivors have this dilemma, chances are that, so will you. Small price to pay considering all you went through?  Think about that?  It could have been avoided by following one small step, wearing a helmet. I bet you won't leave home without it now?
Like any new rule it takes a few months of consciously thinking about doing it. It is like the new rule of wearing a seat belt.  At first it was a pain in the ass.  Now, when you hop in the car, you almost feel naked without one on.

Now I have never, I mean NEVER, met a person with just one issue missing when it comes to brain injury.  That is why I call this My Broken Brain.  It is a metaphor because it is not like a broken bone at all because it never ever heals.  So, tongue in cheek, I chose the title, My Broken Brain because that is how the uninjured envision a brain injury as, a broken bone heals in 6 weeks so must your brain.

So lets pretend that all you suffer from is memory loss.

Day 1
So you get up today with your new memory loss and you have a shower and you think to yourself as toweling yourself dry, I have to brush my teeth.  As you grab you underwear you place them in the hamper and grab a clean pair.  You get dressed and grab a coffee.  You grab that brand new helmet you should have been wearing prior to the incident and head to work.  You get part way down the road and realize you forgot your pack-sack with your brief case, so you turn around and go back for it.  Partway down the road again,  you think, oh I forgot to brush my teeth, so you think you will stop at the store for gum to freshen your breath.
You get to the store and see the pop and think that would go good with lunch and forgetting why you even stopped, you head off to work.
At work you remember you forgot the gum! DAMMIT!
After work you grab your pack-sack and think I will stop at the drugstore and pick up a second toothbrush and take it to the office ruling out the need to remember.
At the drugstore you see an awesome deal on Easter candy and thinking of your kids, you grab one for each kid and you also see shampoo of which you are running low on, so you grab it and leave.
Part way home the thought of the toothbrush hits you like a ton of bricks and you give yourself hell for being such an idiot for again forgetting it!

Day 2
You have your bath and muse that at least you wont run out of shampoo.  You dry off and think, before I get my underwear I will nip it in the bud and brush my teeth.  You look in the mirror and think, boy do I need a shave, and grab the shaving cream and you are off to the races.  Shaved and now dressed you grab your pack and place it by your helmet because you ain't forgetting that again.  You pour a coffee and suddenly the tooth brushing thought crosses your single injured mind.  You go down the hall back to the bathroom and success!  You brush your teeth.  Now you are running behind schedule.  You grab your trusty helmet and off you go.
Feeling light, the thought of what did I forget, hits you as hard as the car that knocked you into this world of having one short circuit and you turn around to retrieve your pack sack.

Day 3
You get up, do your regular routine and you luck out and remember to brush your teeth.  You go to the kitchen and yesterday's coffee is still sitting there reminding you how inept you really are.  Grabbing your helmet you hop on your bike and stop and think, what am I forgetting?  Ah, the pack sack!  You are having a great day.

Now think about this.  You are on day 3 of the rest of your life!  No big deal?  Have you ever been stressed out about leaving an element on the stove?  Have you ever studied for an exam and get caught on a question that you know the answer of but just cant conjure it up until right after you leave the classroom?

Those 3 days are exactly what we the brain injured face day in and day out in every aspect of our lives.  We are in a state of stress equal to that, of did I leave the element on or not, forever!

This brings about a change in confidence.

This brings about a change of behavior that usually is not the bubbly kind but the short fused pissed off at the world, that will be noticed by everyone.

Can we spell, you're fired?  Can we spell, I'm divorcing you? Can we spell, you're under arrest for assault?
Can we spell, AA?  Can we spell NA?

Now, in brain injuries, you rarely get away with just one bum hitch.

I have Anomic Aphasia, meaning I have a crappy time remembering names.

Yeah, so what?

If you are a sales person, a realtor then its a big thing.  You generate more sales by recalling their name and the names of their family and making them feel important.  You sell them a house and that could mean 2 or 3 more from them garnering hundreds of thousands of dollars in commissions.  Think of the referrals they may generate because you treated them like they were family.

Embarrassing when you can't recall the name immediately after its spoken.

Add to that concentration being non-existent and see how that bodes for higher education when taking notes means you forget what he is saying because you are trying to recall what he just said.

Then we add to the mix,sleep disorders, noise and light sensitivity along with losing half of your vocabulary or the ability to spell simple words like winter or tomato.


The price for brain injury is truly out of reach to forget one step in any process.  Whether its wearing a hard hat, a bike helmet, avoiding contact sports like boxing,or driving without a seat belt.

It is a simple split second to choose to do or not to do.  It is a split second to be involved in a life altering, life long struggle recovering from brain injury.

It's ultimately your choice.  Will it be selfless or selfish?

If you choose not to, selfishly, you often force your loved ones to have to spend their life looking after you and deny your parents a retirement, a wife of security, your children of hope and opportunity.

Small price to pay to say yes to being a responsible person.