Brain injury ‘gives family a new mother’

I met Susan* pacing up and down in distress outside the operating theatres of a major private hospital. In the wee hours of the morning, she had received a phone call from her father that turned her world upside down.

Susan’s parents are retired and in their sunset years, they regularly spent time in the village home taking it easy.

On this particular day, the two were headed back to the city from the farm after the maize planting season. They intended to have lunch with Susan and her family at noon and had opted to start their drive back at 4am to avoid the weekend traffic.

Barely an hour into the journey, an oncoming truck headed straight at their car with headlights in full glare, momentarily blinding the driver, reducing his capacity to react appropriately to avoid the certain head-on collision. The loud hooting from the truck driver caused even more confusion and the driver took a life-saving decision to swerve off the road into the darkness.

The driver survived the accident with a broken leg and multiple bruises, Susan’s father escaped with multiple soft tissue injuries, but no broken bones. Her mother, on the other hand, suffered severe head injury. They were all taken to Eldoret town for treatment. Later, they were airlifted to Nairobi.

REGAIN CONSCIOUSNESS

When I met Susan, her mother was in surgery with the best neurosurgical team fighting to save her life. She had suffered brain injury with bleeding into the brain and contusions of the brain tissue itself. It was six hours before the lead surgeon came out to update Susan and the rest of the family about the progress. The surgery had been successful, but it was going to be a long walk back to health for the mother.

It was a long 30 hours before Susan’s brothers arrived from Boston to help with making the tough decisions that she had been dealing with single-handedly. She was the last of three children and the only one in Kenya with her parents.

It was a long and difficult four months for Susan’s mom in the hospital. She fought for her life in the intensive care unit for five days before transitioning to the high dependency unit for the next two weeks. Having her in a regular ward was encouraging, but she was not out of the woods yet. Despite regaining consciousness, a new chapter opened of trying to ascertain what disabilities the injuries had left her with.

She needed intensive physiotherapy to regain mobility and capacity to use her hands. The fine motor functions were lost and the occupational therapist would spend endless days with her so she could learn to feed herself again, write basic letters and wipe her nose.

But what was most devastating was the disruption of speech. She could not say out whole words. Her brain could only voice the last half of the words, making communication excruciatingly difficult. Speech therapy was added to the daily treatment too.

NEGLECT HERSELF

Susan’s mother painstakingly made her recovery. The journey lasted many months, but there was finally light at the end of the tunnel. She was able to recover a fair portion of her speech and could walk with the help of a cane. Her family was there cheering her on every step of the way.

However, over time, the family noted that their mom had completely changed. She appeared unconcerned about anyone, but herself yet she had always been the loving, doting mom and grandma.

She suddenly developed new habits of telling little white lies. She would explain something and along the way, the explanation would seem to make sense but was generally untrue (confabulation).

She appeared capable of taking care of herself, but would do a shoddy job of it, a new habit that was completely unlike the mom who was extremely neat and kempt. Over time, it was noted that she tended to neglect half her body.

She would sometimes literally comb the left half of her hair and moisturise the left side of her face and ignore the rest.

Even more discomfiting was her tone and language. Susan’s mom had always been the proper lady. Suddenly, she lost all inhibition. She would not hesitate to bluntly disapprove of other people’s dressing, lifestyle choices, parenting style or eating habits. Her grandchildren became less comfortable around her as she would bluntly make negative remarks about them.

PERSONALITY CHANGE

The family was aghast. They sought help from doctors and after several reviews, the neurosurgeon finally put a name to it.

Susan’s mom was suffering from Frontal Lobe Syndrome. This was a complication arising out of injury sustained to the frontal lobe of the brain during the accident. This had resulted in the personality change, the loss of inhibition, the hemi-neglect of one half of her body and the speech problems she had struggled with.

The family was not prepared to hear the prognosis. Their mom would never fully recover from her condition. She will require lifelong support through assisted living, speech therapy, physical and occupational therapy. They sought second and third opinions in the US for their mom to no avail. All doctors had the same thing to say.

Susan’s family has had to make a lot of adjustments to accommodate their mom. As a family, they have had to undergo psychotherapy to be able to cope with these changes. They live for the good days when they catch a glimpse of the mom they grew up knowing but most days, they work with the cards the accident dealt them with grace.