Lawyer Monthly - April 2022

Fatigue can be an enormously complicating issue when attempting to navigate through the fog. Many people are fatigued despite having what they believe to have been a good night’s rest. They report always being tired despite sleeping more than they are accustomed to. Tiredness can escalate in frequency and severity and is accompanied by some degree of insomnia. Many people suffering from post-concussion syndrome (the lingering effects of this horrible injury) experience some degree of this condition too. They either cannot get to sleep easily or, once asleep, cannot stay asleep. The failure to get sufficient restorative sleep simply exacerbates all the symptoms they were suffering from the days and weeks before. In extreme cases, the force of a collision can even damage or “flatten” a person’s pituitary gland. This tiny gland, when damaged, cannot produce hormones like it once did. A lifetime of growth hormone supplements can be insufficient to help. Without effective treatment, a person can easily sleep at least 18 hours just to get through the remaining six hours in a day. Photo- or phonophobias also often accompany mild traumatic brain injuries. Light – especially ubiquitous fluorescent lights – routinely produce migraine headaches that can last for days. Loud noise can also produce headaches which leave these brain-injured people heading straight for quiet and dark rooms, which sadly seem representative of what their lives have become. Mood issues are also commonly experienced as people navigate through the haze. Their loved ones often comment that the injured person is simply not the same person as they were before the collision and resultant brain injury. They are more irritable, moody and angry. An individual who was once a calm, patient person can suddenly have their fuses shortened to mere millimetres. These short descriptions of many, but not all of the constellation of symptoms, hopefully illustrate how life-altering the fog of concussion really is. When a thick fog really sets in, it should be easy to see how it can impact every aspect of a person’s life. From a student’s inability WWW.LAWYER-MONTHLY.COM | APR 2022 MY LEGAL LIFE - STEVEN FLORENDINE to complete their educational goals to impairment so significant that it affects whether they can manage or keep their jobs and sadly, but all too frequently, keep any of the relationships they once had. Many failed romantic relationships are scattered through the post-concussion landscape once the fog (that does not lift) lumbers on. How should clients be aided while recovering from these? Education, patience, time and certain specific treatments seem to be the best guide those with concussions navigate back to “normalcy”. Once properly diagnosed, a patient with a concussion at least knows why they are struggling. They can then, hopefully, be given sound recommendations for specialists and coping skills to help with their specific symptom-set. But more is required. Much more. Their loved ones should be educated on what to expect from this “new” person in their lives. This step is crucial and almost always overlooked. One of the main problems with those who have sustained a mild traumatic brain injury is that they “look completely normal”. They are not in a cast; they are not utilizing crutches; they do not have any of the blood and gore easily associated with injuries. Yet as we have seen, they clearly are injured – but their injury only manifests itself through the symptoms. 18 How can a personable conversation with the client and their family help in this process? This is an exceptionally important step in recovery, not only for the injured person, but for their loved ones: they are all walking around in the fog. Sadly, only the one with the concussion initially experiences it. Shining the light on what to expect can allow loved ones to also become beacons of light for someone with a concussion. Simply Illuminating what to expect and stressing the need for patience is sometimes sufficient. Letting loved ones know there are reasons why their partner, parent, child, or friend is still laying on the sofa hours later without having “accomplished” anything is helpful. It can defuse the situation from one of accusations and blame to one of understanding. In what ways do these issues become more pronounced when the brain injury is severe? All the symptoms we have discussed so far are ones commonly experienced by people who have sustained a “mild traumatic brain injury” or “concussion”. As serious as many of these symptoms are, most symptoms in a “mild” concussion resolve fairly quickly, with 2 years seemingly the typical end point for recovery. However, some people with a mild concussion will suffer from a lifetime of walking through and with the fog. These are still considered “mild” concussions. Their standard diagnostic tests, including regular MRI and CT scans, will be interpreted as “normal”. Obviously, that does not mean they have not sustained a concussion. The fogs effects will continue to waft through many aspects of these people’s lives as they barely lumber on. When a brain injury is deemed severe, the effects and symptoms are much more pronounced and often are obvious and include death or coma. Shining the light on what to expect can allow loved ones to also become beacons of light for someone with a concussion.

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