Rebounding After Brain Injury

Genesis rehab programs help put the pieces back together

Jerry Ward completes a puzzle during a session with speech pathologist Lori Dryg.

Jerry Ward completes a puzzle during
a session with speech pathologist Lori
Dryg. He suffered a brain injury last
summer, and after eight months, is
now transitioning back to work.

Jerry Ward's visible injuries have healed since his motorcycle accident last summer.

The bruised legs and hip, the cracked ribs, broken clavicle and subdural hematoma have mended. He can walk again. In fact, he walks more than 3 miles a day now and has lost 92 pounds -- down from 320 pounds before his injury.

Eight months after the accident, some would say he looks healthier than he did before.

Not as easily apparent, however, is the "hidden" injury to his brain. Brain injury has affected how he thinks, acts and feels. It has lingered after the physical pain has healed.

In reality, he lost the weight because he no longer has a sense of taste. It's difficult for him to sit through an entire movie or TV sitcom without losing focus. It's easier for him to comprehend a face-to-face conversation than talk on the telephone.

He remembers people he knew in school yet can easily forget the name of someone he just met. Large crowds and noisy gatherings make him anxious; the multitude of voices becomes too distracting.

The brain is selective, and what he remembers doesn't always make sense to him.

"The biggest challenge is memory," says Ward, who worked as the postmaster in Cordova, Ill., before the accident and has traveled the world as a youth missionary. "You can give me a person's name, and I can tell you what post office box number they have. But I can look at that person and may not remember their name."

Giving patients a ‘lift'

Ward credits the Learning Independence For Tomorrow (LIFT) program at Genesis with helping him return to an active, productive life. Last week, he began transitioning back to work a couple of hours a day -- the first time since the June 14, 2009, the day he swerved his motorcycle to avoid a car making an unexpected U-turn.

He didn't hit the car, but his head hit the concrete hard.

The closed head injury resulted in a craniotomy to treat a subdural hematoma and a two-month stay on the Genesis Physical Medicine and Rehabilitation Unit in Davenport, the largest inpatient rehabilitation unit in Iowa. It's the only Quad Cities hospital with CARF-accredited brain injury programs.

"For the first two weeks in the hospital, I didn't even turn away from the bed," he recalls. "The therapists would try to get me to sit up, and I would just lay down.

After about a month, I was still using a wheelchair. I didn't want to walk. I would maybe walk 20 feet and be so tired by the time I finished I would walk into the wrong room. I was very confused. I had no endurance."

Ward also had aphasia, or damage to the language areas of the brain.

"I might want to say ‘I'm going to the kitchen' but instead say ‘I'm going to the garage.' The therapist would ask, ‘Jerry, if you're sitting in the chair, say ‘yes' or ‘no.' I was so confused," he says. "I knew I should know the right answer, but I couldn't say it. I felt like I was flunking out of first grade.

"When I progressed a bit, the therapists would say, ‘If you're sitting in the chair now, raise your right hand?' Now, I felt a little like I had advanced to third grade. It was very, very frustrating."

After his long inpatient stay, Jerry Ward began the intensive, outpatient LIFT program, the only one of its kind in the Quad Cities area. The program is at Genesis Medical Park, Maplecrest in Bettendorf.

There, he learned strategies to deal with losses in his concentration, attention span and short-term memory. His treatment plan included the help of experts in occupational, speech, physical and recreation therapies and social work.

"At first, I was very insecure about coming to the LIFT program," he says. "I would be introduced to people and think ‘I don't understand why I need to know this.' But the more I worked, the more I understood."

Like many brain injury patients, Jerry Ward wasn't fully aware of his limitations caused by the injuries to three of his five brain lobes. Not only does the LIFT program work on improving reasoning, problem-solving, attention and concentration skills, but it also makes patients more aware of their deficits.

"He had a lot of trouble understanding what was said to him. He couldn't understand and interpret what the words meant," says Lori Dryg, a speech pathologist who coordinates the LIFT program. "He also was often distracted. A noisy room really, really bothered him. Thanksgiving Day was difficult for him with all the family being there and so many conversations going on. He had trouble with short-term memory and endurance, with simple math computations and focusing enough to read and comprehend."

She adds, "Jerry had the best combination to get better: He had a really strong family support system; he became aware of his limitations; and he's a very hard worker. All that put together pushed him to improve."

Road to recovery

Depending on what area of the brain is damaged, people with brain injury can have a variety of physical, cognitive, behavioral and emotional impairments. Challenges can range from weakness and trouble with coordination to problems with memory, organization, speaking or swallowing.

No brain injury is the same, and the effects are complex and vary greatly from person to person.

"You know the saying ‘All the king's horses, and all the king's men couldn't put Humpty Dumpty together again?' After brain injury, you're never exactly the person you were before," Dryg says. "We hope you can get to a point where, with compensation strategies, you can function independently and maybe no one but you recognizes you're having some problems."

Trips out into the community, such as to the shopping mall or a restaurant, help patients in the LIFT program build independence and confidence and work on functional skills. The program also acts as a liaison to patients as they return to work.

Last December, Dryg visited Jerry Ward's workplace to better understand the skills his job entails -- from multi-tasking and helping customers to filling out financial reports and meeting time-sensitive deadlines for mail delivery. For the next three months, she and others helped him hone those skills.

Because he has difficulties with auditory comprehension, Ward has learned to double-check and clarify any information he is given over the phone.

Co-workers are encouraged to e-mail him questions instead.

With time and hard work, he improves. He tolerated the noise at a recent Super Bowl party, and he recently went to the movie "Avatar" and it made sense to him. Eventually, he hopes to drive a car again.

"A lot of people will say to me, ‘You're doing so much better' or ‘You look so good!' " Ward says.

"But still I feel like I'm struggling -- like maybe I've advanced to the fifth grade at this point."

His brain injury has made him stronger and given him renewed appreciation for his family, his Genesis therapists and the members of his church who have supported him during the ordeal.

"The chance to live again...I just appreciate this second chance so much," he says. "I'm very glad to be alive."

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