QUESTION I had a brain bleed in 2005 that has left some scar tissue on the injured area. I have had two grand mal seizures since then – the first was when I skipped my medication and the second was when I drank too much alcohol one night and didn’t sleep.
Two years after my first grand mal seizure, I successfully went off my medication for six years and had no seizures. Then I started drinking alcohol again, not eating well, was dehydrated, had emotional distress and was not sleeping, and had another grand mal.
I’ve tried four different medications, but all had difficult side effects. I am currently on Tegretol 200mg twice daily, but my memory is horrible and I’m exhausted most of the time. I used to be an athlete, and now I fight depression because I miss running and riding my bike.
I know this is not who I am. The neurologists I have consulted seem to have the same non-compassionate approach: “Try another med and send her on her way. See you in six months.” Really?
These eight years have been confusing and sad because I know this isn’t where I should be. Any feedback would be greatly appreciated.
ANSWER: The impact a brain injury has on the life of a patient and family can be truly disturbing. Most of the frustration arises when the fear of the unknown grips us.
From the patient’s perspective, whether having suffered a stroke or tumour or even trauma from a car accident, the road to recovery is often tough and lonely.
The rate of improvement varies for individuals and there are so many variables at play when trying to predict an outcome.
Most people have a family member or know someone who has suffered some form of brain attack. This includes strokes, tumours, aneurisms or trauma, in most cases.
Brain injury is a topic that is often rushed, forgotten or deliberately ignored by many practitioners, partially due to the lack of insight and poor follow-up by patient and doctor.
Discussions around the topic are often tough and morbid, because of the sad clinical course in some instances. The unknown factor of prognosis also seems to play an important role.
There is just so much to consider, both as a patient and as a family member. Harsh realities such as personality changes, occupational challenges and cognitive abilities are just a few crucial adaptations.
We are fascinated by the brain’s ability, not only in its role in human intelligence but also how it functions. How do we start to explain this intricate hub of electrical activity in a network of highly sophisticated infrastructure and specialised brain cells called neurons.
These cells need oxygen and food to perform basic functions – this means blood supply is crucial for optimising brain performance. Along with some other essential factors such as stimulation and sleep, our brain loves routine and is ingeniously designed to do many tasks in cycles – the sleep/wake cycle is a prime example.
How do I enhance blood supply to my brain ?
* It’s simple – have a healthy blood pump (heart). Strengthen that muscle as much as you can through rigorous and disciplined exercise.
* Keep the pipes clean and unblocked – be cautious of trauma to blood vessels, as well as lifestyle diseases such as diabetes, hypertension and dyslipidaemia (cholesterol issues).
* Be mindful of familial and genetic susceptibility to heart attacks and stroke.
What about diet?
* There are dietary factors that contribute to better brain function, such as fresh fruit and vegetables, which contain vitamins, minerals and essential elements.
* Enough water and electrolytes facilitate good communication between cells.
* Antioxidants and phytonutrients are also proving to be helpful.
* Removal of free radicals and the by-products of metabolic processes in the brain assists in healing processes.
Hope that inspires
I am constantly humbled by the tenacity of the human spirit to endure and overcome adversity. I am deeply touched by the mature approach and attitude of some people who rise above their illness – despite it being an incurable one in many instances.
Thank you for sharing your story in such an honest fashion.
Recovery, rewiring and rehab
* A damaged brain needs to be rewired and often, if the damage is too severe, neuroplasticity kicks in. This refers to the incredible ability of the surrounding areas of the sick brain to “take over” the lost function. Neuroplasticity means there is hope for lost brain function to return in many cases.
* So much of why certain people recover and others don’t still needs to be clarified. Factors such as age, size and mechanism of injury, as well as localisation in the brain, all play a role.
* Obviously, the loss of certain abilities is more debilitating than others. Would you rather have a paralysed arm and leg or a loss of memory? Is a lack of emotion easier to live with than the loss of speech fluency? This is impossible to rank. What we do know is the pronounced effects of decrease in cognition or physical ability can lead to depression.
* The challenge for all affected by the event lies in understanding the injury and the impact on the victim’s life. Set up resources and infrastructure as soon as possible. Quantify the loss of function at regular intervals to note slight changes.
* Perserverence pays off, and when many people have thought rehabilitation has ground to a halt, function continues to improve some years down the line. The understanding for many is that the level of functioning up to one year post head injury is the predicted outcome of long-term function. Usually the first 12 months of rehabilitation show the fastest improvement. - Cape Argus
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.
The advice in this column does not replace a consultation and clinical evaluation with a doctor.