Coming out of the Induced Coma, Post-traumatic Amnesia and the immediate aftermath of an ABI…

My Name is Tom and I am the survivor of an ABI. I have covered all the basic medical, science type stuff that will hopefully provide you some with knowledge as to why I suffered from the after effects that I did. You will hopefully notice a change in the tone of my writing as I am no longer repeating facts I have found out from a book, my medical notes or the www, I am speaking from the heart. What I aim to do now is get on with telling you my story and about my experiences, in other words the more useful stuff.

Anyway, where were we? Right, I had come out of surgery; I was hanging on to life by my fingernails and had been placed in an induced coma to allow my brain time to rest following the injury. A section of my skull had been removed to reduce my high level of ICP and was being carefully stored beneath the skin of my stomach to ensure it had the blood supply it required to stay alive. My family was in bits (just as much as my skull was) and nobody knew what was going to happen next.

I had been in the coma for only a few days with my ICP dropping steadily over that period until it stabilized. Doctor’s were astounded at how quickly this was happening. A patient coming in to the hospital with the injuries I had suffered, with a Glasgow Coma Scale score of 3 and recovering at this speed was unprecedented. Such was the rapidity of my recovery that they attempted to bring me out of the coma on the fifth day. However, a severe case of projectile vomiting during this attempt discouraged them. The risk of me choking on the vomit was too great, apparently (not because they were afraid of getting covered in sick). So I was sedated and sent back to my local hospital in Dorset within a few days.

Here, the attempts to bring me round would continue. My mother says how much of a struggle the whole thing was. I did not know what was happening or where I was. I was confused and distressed at the situation. I would thrash around as they tried to wake me up, I was pulling out tubes and pipes, and lashing out (I even pulled out my catheter the second time they tried to bring me round. For anyone that doesn’t know, a catheter is the pipe that goes up your urethra so you can pee!). It was about ten days after I had been put in the coma that I finally was brought out of it. I was awake! I was Awake but I was certainly not myself. I’ve been told I could recognize people and occasionally acknowledge their presence, but I was aware of little to nothing that was going on around me.

The truth was that I was suffering from Post-traumatic Amnesia. PTA is a state of disorientation and confusion that occurs after a massive head trauma that causes a patient to forget events that have happened after the injury. If I were to say anything to the families of people with PTA, it is that it will pass. From our experience as a family, we found that the presence of people that the patient knows and recognised was helpful, as was the presence of memory cues posted on the walls of my room (telling me basic information such as where I was, time of day, days of the week etc.). Honestly, from our experience, the sound of a parent’s voice and their presence was invaluable. It may not be medical fact that we are working from, but it can only do a patient good to hear a voice of comfort when they are in such a distressing situation, surely? It’s difficult to put into words,I think this part is somewhere between human instinct, in the way the patient recognises the voice of a parent, a partner, or sibling, and empathising  with the patient. Wouldn’t you want people there for you, in that situation, talking to you and telling you it would be ok?

The reality is, with PTA, that after a head injury, the short-term memory in the brain is not being processed into long-term memory. Think of it this way, if I may give a simple example. You have your lunch, say a cheese sandwich, normally this will go into the short term memory before being processed and placed in the appropriate drawer of the filing cabinet to be retrieved and looked at a few hours later. In the case of PTA, the piece of information is not being transferred from the short -term memory to the long-term memory; hence it cannot be retrieved and looked at later on. To help with this process my parents had pictures, written memory cues and so on, posted all over my room.

During this stage, the only advice I can really give anyone is to be there as much as possible, to talk to the patient and give gentle reminders while being patient. It’s perhaps better also if the carer or family can perform the memory tests on the patient (which is essentially the patient being presented with sheets of pictures or to countdown from twenty backwards). The reason I say this, is that a carer or family member who is around the patient for long periods of time is more likely to spot periods of time where doing the test is best for the patient (when they aren’t tired, when they haven’t just woken up etc.) as opposed to when it is better for the doctors/nurses. What we found, essentially, is that the presence of family or carers is so important!

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