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Navigating Recovery After a Brain Injury: A Guide for Patients

Whether you have a mild concussion from a sports collision or a traumatic brain injury (TBI) from a car accident, a brain injury will make an impact on your life. Here’s what can happen if you get a brain injury and what happens during your recovery.

To start, you need to understand what a brain injury is. It’s when your brain tissues get damaged from a blow, jolt or wound to your head or body. Brain injuries can affect your thinking, your emotions and the way your body functions. 

Types of brain injuries

The main types of brain injuries are:

Concussions 

A concussion is a mild TBI that can happen if you hit your head. They are common, but you need to take them seriously. 

With a concussion, you may have headaches, confusion, nausea, dizziness and temporary memory loss. You may have seizures right after a concussion, but it’s rare to have them again.

You need medical care right away so you can recover as quickly and as well as possible. “Sometimes concussions seem mild but can then worsen over the next 72 hours. If symptoms get worse after more than 72 hours that could be a sign of a more serious injury,” said Ian Crain, MD, a neurologist with Banner Brain & Spine.

Most people heal in four to six weeks, but for some people it can take up to three months. If you have a history of mood disorders like anxiety, depression or migraine headaches, it can take longer to recover.

Contusions 

These are bruises you can get on your brain tissue if you get hit on the head. You might have bleeding or swelling with a contusion. You may have trouble speaking, lose coordination or have mood changes. You need medical treatment right away.

Moderate and severe traumatic brain injuries 

These injuries are more serious, and you are expected to have long-lasting issues with your thinking, mood or the way your body functions. They happen when your head is hit or penetrated, and the injury disrupts your normal brain function. 

With a moderate to severe TBI, you may become unconscious, lose your memory and have trouble using your body properly. Losing consciousness and having amnesia can occur with mild (concussion), moderate and severe TBIs.

“The difference between them is based on how long you lose consciousness or memories for,” Dr. Crain said. It’s critical to get medical care right away for moderate and severe TBIs, and you may need long-term rehab.

Anoxic brain injuries 

These injuries happen when your brain doesn’t get enough oxygen, so cells get damaged or die. They can happen during drowning, suffocation or cardiac arrest. With these types of injuries, you can lose a lot of function in your brain and body. You need medical intervention right away to help you regain functioning. 

What to do right after a brain injury

You need medical care right away after a brain injury, even if you think it’s minor. Go to the emergency room or urgent care. It’s especially important to get care if you see danger signs such as:

  • One pupil that’s larger than the other.
  • Drowsiness or an inability to wake up.
  • A headache that gets worse and does not go away.
  • Slurred speech, weakness, numbness or reduced coordination.
  • Repeated vomiting or nausea, convulsions or seizures.
  • Unusual behavior, increased confusion, restlessness or agitation.
  • Loss of consciousness.

Health care providers will run tests to see what type of brain injury you have and how severe it is. You may need a physical exam, neurological tests and imaging studies such as CT or MRI scans.

If possible, you may want to get care at a center that specializes in treating concussions and TBIs. “That can be important for a quick and successful recovery,” Dr. Crain said.

Your provider will use your test results to plan your treatment and rehabilitation. They will want to manage your symptoms and prevent more damage. You might need medication for pain and inflammation. In more serious brain injuries, you could need surgery to stop bleeding or relieve pressure in the skull. 

Early recovery from a brain injury

In the first days after a concussion and weeks after a more severe brain injury, you need to get a lot of rest. Along with sleeping, that means resting the brain during the day. Your provider may outline what you should do. At first, you may need to avoid physical activity, take breaks and keep your surroundings calm and quiet.

You need to let your brain rest as well. That means steering clear of bright lights, loud noises, screen time, high demands on your vision or thinking and other stimulating activities. You might feel mentally tired and have trouble concentrating. Keeping your mental activity to short times and taking breaks can help.

You may need pain medicine to treat headaches, medication to help with nausea and vomiting and melatonin so you can sleep. For more severe injuries, you may need medication to prevent seizures or to help with sleep, fatigue and thinking. Your provider can recommend the best options. 

“Medications can help you function better, but they don’t heal your brain any faster,” Dr. Crain said. 

During this time, if you or a loved one see any changes in your thinking, behavior, physical abilities or emotions, let your provider know right away. 

“At this time, don’t take part in any activities that could cause another brain injury, such as driving, sports or working at heights,” Dr. Crain said. “Preventing another brain injury is the most important aspect of recovery.”

Rehab and therapy

When you start feeling better and your provider thinks you’re ready, you may work with therapists to help your healing. Depending on your brain injury, you may need physical, occupational and/or speech therapy.

Physical therapy may:

  • Help you improve mobility, walking, balance and coordination.
  • Build your strength and reduce spasticity or rigidity.
  • Improve your coordination and fine motor skills.
  • Teach you techniques to reduce pain and discomfort.

Occupational therapy may:

  • Help you relearn daily living skills like dressing, cooking and bathing.
  • Improve your memory, attention and problem-solving skills.
  • Teach you to use tools or techniques to manage daily tasks, if you have limits on your physical abilities or thinking skills.
  • Work with you and your employer for support and accommodations if you are returning to work. “If you are having difficulty returning to work, an intensive and comprehensive neurological vocational rehabilitation program through the Department of Economic Security can help,” Dr. Crain said.

Speech therapy (speech-language pathology) may:

  • Work on the way you talk, the words you choose and what you understand so you can communicate.
  • Improve communication-related memory, problem-solving and organizational skills.
  • Provide exercises if you have trouble swallowing.
  • Teach you other ways to communicate if needed.

Rehab takes time, and you’ll need to be patient. Your therapists may help you set milestones so you can see the signs of your progress.

Overcoming challenges

After a brain injury, you might have to deal with some common challenges. Here are some techniques for overcoming them:

  • Invisible symptoms: “One of the most common challenges you may face is having symptoms others cannot see. Brain injury can sometimes be called the ‘invisible injury’ because you can look completely normal on the outside,” Dr. Crain said. It can help to educate people about what you’re experiencing. A health care provider or mental health professional can help you frame these conversations.
  • Adjustment disorder: You may have trouble adjusting to life when you can’t do things that require a lot of thought or effort anymore. Cognitive behavioral therapy (CBT) with a mental health provider can help.
  • Mood symptoms: Anxiety and depression are common with all types of brain injuries. “They can get worse over time if you don’t address them,” Dr. Crain said. Counseling and medication can help. 
  • Memory: Use calendars, planners, apps and routines to help you stay organized and reinforce your memory. Break information into smaller, manageable chunks. Keep your space neat and clutter-free.
  • Concentration: Make your environment quiet and free of distractions. Tackle your high-priority tasks first and take breaks. Talk to your health care providers about exercises to improve your attention and thinking.
  • Mobility: Work with your physical therapist to improve mobility. You can learn how to modify how you walk, climb stairs or get in and out of chairs. Consider using assistive devices like canes, walkers or wheelchairs. Make sure your living space is designed to reduce the risk of falling.
  • Fatigue: Prioritize rest and sleep, tackle your hardest tasks when you have the most energy and take plenty of breaks. Eat a balanced diet and stay hydrated. Tell your family, friends and colleagues what you can do and what challenges you’re facing.

Emotional issues after a brain injury

Dealing with the emotions that come up after a brain injury can be tough. You may feel frustrated, angry or sad. These strategies can help:

  • Talk to your provider about the medical and emotional aspects of your recovery, since understanding what to expect can help you feel more confident.
  • Accept that you’ll face changes and may need to adapt to them.
  • Recognize that your recovery timeline won’t be the same as anyone else’s and might not move at the pace you want.
  • Set realistic expectations, track and recognize your progress, practice gratitude and try to have a positive mindset.
  • Celebrate small victories like completing a therapy session or a daily task. Reward yourself with a favorite activity or meal.
  • Share your successes with loved ones and health care providers.
  • Be patient, since healing takes time. Show yourself compassion. Accept that you may face setbacks that you need to overcome.
  • Learn coping mechanisms like deep breathing, mindfulness or taking part in activities that help you relax and feel content, like spending time in nature, with loved ones or doing hobbies.
  • Communicate with family and friends and share your feelings, concerns and goals. Teach them about your brain injury so they can understand your limitations, expectations and challenges. They can encourage you, help you with daily activities and give you emotional support.
  • Consider joining a support group so you can connect with others who are facing challenges like yours. 
  • Work with a mental health provider to understand your emotions better and learn how to cope. 

Long-term living after a brain injury

You may fully recover from a brain injury, or you may have some lasting effects. You’ll want to keep your scheduled checkups with your provider to monitor your progress and address any concerns.

Your provider may:

  • Conduct cognitive, physical and diagnostic tests to check your brain’s health and watch for any signs of problems. 
  • Check and possibly adjust any medications you are taking.

Healthy habits may help keep your brain and body working as well as they can:

  • Get regular physical activity, as recommended by your provider.
  • Choose a healthy, balanced diet.
  • Get plenty of restorative sleep.
  • Manage stress with techniques like mindfulness, deep breathing exercises or hobbies that help you relax.
  • Minimize or avoid alcohol and recreational drugs. 
  • Stay connected with your family, friends and community.

Depending on how serious your brain injury was and how your recovery and rehab have gone, you may need to make plans for your future. You might set long-term goals so you continue to improve, and you may need to work on career and educational plans. You may want to update legal and financial documents.

The bottom line

If you have a brain injury, even if it’s mild, you need medical care right away. A health care provider can evaluate your symptoms, run tests and create a plan for treatment, rehab and recovery. The right recovery plan will help you get back as much of your brain function as possible, depending on your injury.

If you would like to connect with an expert to learn more about treatment and recovery for brain injuries, reach out to Banner Health.

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