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February 29, 2012

A Poignant Moment in Neuro Rehab

Sometimes brain injuries are difficult to understand. A patient can be up and walking aand talking and laughing with family, and the next minute they can be throwing furniture. I've had such a patient recently. He experienced a stroke, and thankfully, is a survivor.

He seems fine. He can carry on a conversation. He can walk, and walk quickly, with only slight imbalance. He's plenty strong and he is impulsive. When the sun goes down, he undergoes a personality change. He becomes hostile. He is clearly confused. Even during the day, he cannot tell you what the date is. And he wants to go home really badly. When asked how he feels, he say "I'm fine, fine. When can I go home."

His family is afraid of him. They don't think they can handle him at home. They want to get him into rehab. Walking with him one day, we were talking, and he became frustrated because he was having word-finding troubles. When we turned a corner, he lost his balance. I pointed out these things to him, and he admits, these things didn't happen to him before he came to the hospital. He became teary. It was the first time he expressed an understanding of his deficits since his stroke.

I reassured him that his noticing these things meant that he was getting better. And while his walking was improving, the reason he had not been released to go home is because we were looking for consistency in his steadiness. I told him that we had people at the hospital who could help him with his speech and memory problems. In a nutshell, he is in an environment that is safe, with a staff of people here to help him until these rough patches in his abilities are polished smooth again.

Returning to his room, his nurse asked him, "what is today, sir?" His reply, "I can't answer that right now." He lay face down in his bed and cried.



Posted by linda at February 29, 2012 6:11 AM

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