First Hand: Richard Halliday

This is the first entry in an ongoing series of posts we are going to be doing called “First Hand.”  This series will be “first hand” accounts of head injuries as told by the patient and/or a family member.   A huge thank you to Richard Halliday for putting the time and effort into this wonderful post.

As written by Richard Halliday

DON’T FORGET TO SMELL THE ROSES!

You never know when a accident will happen and completely change you and your life. I changed and my life completely changed August 19th 2009

It was warm summer day and I was back to work coming off a relaxing family vacation in Jackson Hole Wyoming, I was ready to get back to work with a business that sells restaurant and grocery store equipment. Full of energy I started off my day by going to one of the companies warehouses to pick up a piece of equipment for a customer; simple job, get a fork lift, lift the equipment onto a truck and bring back to the customer. I arrived and walked to the back of the warehouse and found the forklift (wear a helmet and make sure your equipment is up to OSHA standards) as I was driving from bay to bay about 15 miles per hour my forklift forks caught something in the concrete floor, the forklift stopped with such force that it ejected me into a stationary metal bar splitting my forehead open and knocking me temporally unconscious. I came to, daze and confused blood running down my face, all I was thinking was the forklift had blown up because all I remember was hearing a loud sound and a terrible shocking feeling through out my body and after that everything went dim. I walk to a area where a employee was and I told him to call a ambulance. I was fading in and out of consciousness, the employee looked at my forehead and said that I had a deep cut from my eye lid to the top of my forehead he tried to stop the bleeding. I pulled my cell phone from my bloody pocket and called my wife, I told her I had been injured and that if I went into a coma, please don’t pull the plug! The paramedics arrived and tried to strap me to a board but laying down made me feel as if I was going to pass out, I agreed to several straps and they game me smelling salts to stay conscious. After a bumpy ride to the hospital emergency room I was given a CT scan and they stitched me up with 20 plus stitches. The emergency room doctor said that the CT scan did not show a fracture in the skull or any bleeding on the brain, he stated that I most likely had a concussion and whiplash and should be able to return to work after 3 to 5 days. I was relieved that I was ok and that I would not be down for very long. The doctor gave me a hand out that described my condition and things to look out for in the days following the accident.

The instructions read as follows: Call you doctor if:

• Your head ache gets worse or is not relieved by acetaminophen.
• You have problems talking.
• You have difficulty hearing.
• You have a change in you vision.
• You loose you balance or have trouble walking.
• You have trouble thinking clearly.
• You have forceful vomiting.

I had all the symptoms but the forceful vomiting, so I contacted my family doctor. My doctor looked me over did the usual tests, blood pressure, heart rate, looked into my ears, nose, throat and eyes and said well you have all the signs of a concussion. I told him that I got the spins/vertigo real bad while driving or turning to my left and lying down, he suggested physical therapy and the obvious don’t drive and prop yourself up to sleep. One week had passed and it was time for me to get my stitches out, so pushing myself, dazed and confused I decided to drive the hour drive to the hospital that stitched me and have them removed. About 10 minutes into the drive the road keep looking as if it was going away from me and I started getting nauseas and very dizzy and completely confused, I put the sun visor down so that I could not look to far out in to the distance as to be able to continue driving, after 30 minutes I was getting very paranoid because I could not tell if I was dreaming or driving, I slowed down like a grandpa and made my way to the hospital. At the hospital the nurse that was taking out the stitches stated that I did not appear to look right and decided to admit me to the hospital for additional tests. Another CT scan a few more questions and they once again released me with nothing more to go on besides “you have a concussion and possible whiplash, here is a hand out that described your condition and things to look out for in the days following this appointment”. I called and friend and he drove me home.

I had a hard time realizing what time of year it was and what century it was. For many weeks I thought I was living in the 70’s I could recognize my family my home but only in the dimmest sense, my want and need were for this familiar, I could clearly remember clothing that I wore in High School, my car and my music, these were the things I needed and wanted to make me feel aware and part of life. I knew that something way really odd so I did not give in to my temptation to find the old things. I spent time on the internet researching for answers to my injury, this caused me great fatigue because what I was looking for I could not find. Yes, I did find terms like TBI traumatic brain injury, closed head injury and other terms like dim sense of reality, dream like state to help me put into words of how I was feeling. Still I was unaware of the fact that my pushing myself to try and do what was normal was actually making things worse for me.

The symptoms were not getting better, I still had the spins/vertigo, my eye site was distorted like looking into a carnival mirror, I could not lay down without being propped up or I would go into the full spins. I had a very difficult time understanding what people would say when they spoke to me, I just could not process what they were saying, there lips moved, they made sound but I still could not understand them unless they slowed down. Noise and bright light were very distracting, It was impossible to go to a Starbucks and sit down for coffee the noise was overwhelming, my balance was off, I had a gimpy left leg that appeared to drag as I walked, I noticed that my ability to walk was like trying to walk on a tight rope with out a net, I had no energy, could not relax and was constantly living in a dream like state. Most of all I could not get any real answers so I spent a lot of time talking to family who for the most part did not fully understand my condition and simplified the symptoms as anxiety or depression. Important to note that anxiety and depression are some of the related symptoms of a traumatic brain injury.

As the weeks went by I still was unable to do simple things like I use to be able to do. No longer could I just go to sleep and wake up the next day feeling alive and refreshed, just leaving the house to go for a walk became a difficult task, I could not stop the head spins because the landscape appeared to be moving around. Watching TV was not a good thing either the movement made me sea sick. As the weeks went on I had several more Dr appointments with my family doctor, my wife was very upset that I was not getting better and she started doubting my condition. The doctor tried to be helpful and stated that he studied to be a neurologist thought out medical school and decided on family practice because as he said, the brain is a organ that still is not completely understood and people that suffer from a concussion can recover is weeks, months or sometimes years or not at all, “we just don’t know” This was not the answer we were looking for so the doctor suggested we see a neurologist and gave us a referral. Once we found a neurologist in our area the doctor office told us that he would not see us without a MRI, he would not accept the CT scans from the hospital. After fighting with Worker Compensation fund of Utah for a approval for that MRI and getting a timely response from them I decided I had to look else were for answers. One night in October at my sons school concert my wife and I were sitting by one of my sons friends mother, we were talking when my wife remembered that this parents daughter had hit a tree skiing the year before at Deer Valley. We asked about her daughter and told her of my experience and asked for suggestions. She was incredibly helpful sharing what she had learned in her year long battle to help in her daughter recovery. One of the suggestions was to call Melinda Roalstad MS,PAC at the Kamas Health center and meet with her and get the imPACT test She said that Melinda had experience with head injuries both preventive and recovery and worked in the past with the US ski team athletes. I decided to give Melinda a call.

I made an appointment and could not get a ride to her office so I decided to drive because I need some answers and wanted them now. It was a miserable drive I was physically sick when I arrived, please note that this drive under normal health is quite relaxing and scenic but not driving with a head injury. I was completely impressed when I sat down and started speaking with Melinda, she was speaking my language as if I must have been speaking a foreign language to all the health care professionals before her. She asked detailed questions, like what part of you head was hit, what were you symptoms, have you been sleeping? Are you taking breaks during the day? Have you limited your work load? Do you recognize your daily stressors and try to minimize them? The questions continued, questions that the hospital, my doctors had not asked. I was surprised I thought that I was just supposed to “Man Up” and work through the symptoms. She explained the importance of planning your day with work, rest, exercise and stressed the importance of learning to recognize the importance of taking frequent breaks to rest your brain. I took the imPACT test that Melinda described to me as an objective way to look at the “function” of the brain rather than the traditional CT or MRI scans that look at structural aspects. Seeing the unseen, in my words. With this test Melinda was able to compare me to healthy people that previously took the imPACT test of my same age and showed me where my cogntive deficiencies were.

I thought of this the other night as a way of describing the ImPACT test that Melinda gave me. The best way to describe the test is like a meter measuring humidity. Imagine looking through a glass window protected from the outside elements , a person has no idea if there is water in the air unless they see it raining or snowing, humidity may be present but not visual to the eye and only present and noticeable if you are standing outside the window in the elements. Naturally doctors will look at you through that window and only see what is visible on a CT scan, MRI or x-ray, this form of testing although important, can not see what is not visible and can not feel what is not present. “the ImPACT test helps you look at the “function” of the brain rather than structure and has been correlated with functional MRI scans in research. This is much different than a regular MRI which tells you about “structural” problems. Mild traumatic brain injuries generally show no structural abnormalities on CT or MRI scans but rather affect the functioning of your brain and why it is so hard to “see” the injury.” The best results would be derived if the individual had taken the test prior to the injury to compare a before and after scenario, but in my case we had to start from where I was after the injury and then compare going forward to see progress.

After meeting with Melinda several times now I have finally accepted the fact that the lack of sleep and not managing your stressors can really effect your day, Melinda told me that with a brain injury your energy levels are all ready very low and what was once a simple task can now becomes a major one. In the past I did not believe this and I would continue to try to push myself through the day by willing my mind or with power of positives thinking, all I can tell you is, it does not work. I am not saying don’t try and just give up, but what I am saying is you have to know your limits. This is especially difficult for your friends family and employer to deal with, if you look fine on the outside they once again assume you are fine. Prepare yourself for the possibility of your friends and family that they will not fully understanding what you are going through. With a head injury once the doctor takes out the stitches or the cut and bruise heals no one can see what going on in your head. It makes you want to carry pictures or ware a neck brace so that you can explain what is happening to those who doubt you.

As I mentioned before Melinda suggested that I keep track of my daily activity by planning my day and recording my rest brakes and energy levels, this is a very helpful way of forcing yourself to learn what you can and can’t do as well as paying attention to stressors that set you back. Its your life and your health, you are in charge, give yourself permission to take a break, remember simply tasks can be many times more taxing on you now that you are injured, don’t over do it. This might be the most important recovery tool for you.

I am not out of the woods yet and I am still dealing with my head injury, slowly but surly I am getting better and having more days that I feel present and alive. As you can tell I am not a professional writer so take it easy on me if you are a grammar teacher or english major, I just wanted to find a way to express myself you those who need someone who can speak the same language and is most of all interested in finding a way back to who they use to be .

One last thing on that journey back to yourself, for me I have decided to make sure I remove some of the ugly parts of my pre-head injury life by remembering to be more thankful for my health, my family and my friends, and to lend a friendly helping hand and to make sure not to forget, to slow down and smell the roses!