Last night I fell asleep doing some homework. (Tip: clinical case studies can substitute for sleep aides) I’m not quite sure what to think of Corey’s recent behavioral and cognitive changes. The only way I know how to cope is research!
We believe Corey’s behavioral responses are linked to the memory loss she sustained from the accident. As Corey regains her memory, her current environment doesn’t reinforce her recurring memories, therefore the disconnect causes disorientation and anxiety.
Memory loss falls into 3 categories. Immediate; lasts only a few minutes; we use it to recall a phone number dictated to us. Short term; the ability to remember something 30 minutes after hearing/reading it and Long term; the information we recall day after day, in a week or ten years from now.
With an acquired brain injury there are also sub-categories. Retrograde and Anterior grade amnesia. Amnesia means you lost a memory that you once had. It’s as if someone has erased part of your past. Retrograde amnesia means you’ve lost memories for events prior to the specific accident. For some, retrograde amnesia can cover a minute or even a few seconds up to a few hours or day before the accident.
Anterior grade amnesia is the events following the accident that have been erased. This is due to the brain injury itself. The chemical balance in the brain is upset. As the brain chemistry normalizes and brain systems begin working, memory also starts to work. Memories tend to return like puzzle pieces of a jigsaw puzzle; returning in random order.
~ TBI guide
The daily cognitive challenges we work with are best described in the analogy of a Library. I will choose a history book from a shelf and relocate it somewhere in the public library. I tell you what it is and it’s up to you to find it. You will have to search the entire library in order to find that one specific book. Now imagine the search. Continue to picture each section out of order. Your new task; having to re-catalog the entire library and you don’t know how to read?
A personal example of this memory/amnesia issue would be the following. We returned home last night after our day at Bryn Mawr. Corey needed to use the bathroom. Pointing to the renovated bath/laundry room I asked her, “Do you want to walk into your bathroom or walk to the powder room”? She was very upset as she yelled and pointed towards the ceiling, “My bathroom is upstairs and that’s the laundry room”. I reassured her she was correct and replayed the patented explanation, “You’re right! You do have a bathroom upstairs but after the accident we renovated the laundry room so this is your bathroom, too”. She looked at me with a blank stare and asked, “What accident”?
Corey is recalling more details from her long term memory. The timeline fluctuates but has revealed partial memories from the summer prior to the accident. At times she is responding more accurately and rapidly with some short term memory details. However, we are observing her immediate/short term memory getting worse which is raising her anxiety level. Unfortunately, the result is her lashing out more frequently with me and even with the kids when they are home; this is why it’s been more difficult recently.
The most important words typed today are “As Corey regains her memory”! We focus on the moments of clarity and physical strides but the daily challenges are what pushes us to redirect and help her forge the path to her recovery, which is exhausting for all of us especially on a “bad” day. That’s when we have to stop, take a breath and remind ourselves ~ this isn’t Corey, it’s the brain injury. It’s critical we replay the positives; she’s regaining her memory, she’s moving her arms and hands, she’s moving her legs and feet, she’s eating, she’s cooking, she’s laughing, she’s smiling…she’s coming back to us!
The “NEW” photograph of Corey unveiled in this puzzle will be exquisite…once the pieces are found and put into place, xoxo