Had the Head injury in 2007, came to us in 2013!
She is a brilliant child of successful Doctor Parents, aspiring to become a doctor herself. A child highly interested & excelling in both studies and extracurricular activities.
The YEAR was 2007. She was in 12th standard & coming to Bengaluru from her home town (60 kms away) to join a reputed CET coaching centre here. Her father was driving the car without overnight sleep (due to an emergency in the hospital) led to the accident. She was deeply unconscious and on ventilator with Tracheostomy – diagnosed as severe Diffuse Axonal Injury. Unconscious for over 3 months. She was treated in the best hospitals – but even after over 4 years of treatment & rehabilitation elsewhere, she had severe disabilities/ deficits and the family had given up hope of any further improvements and were resigned to the fact that she may remain like this for the rest of her life. This made the parents distraught and they were blaming themselves for this mess.
Eventually, their doctor friend referred them to newro. Our initial CAREPa-Re evaluation revealed significant functional disabilities relating to movements (gait, balance), endurance, ADL (Activities of Daily Living), cognitive-perceptual issues, speech & language issues, neuropsychological issues (with child-like, immature behavior, inappropriateness), very poor memory and other mental processing skills and poor executive functions. She had lot of visual and auditory hallucinations. She needed an intensive and long-term multi-disciplinary rehabilitation – Physiotherapy, Occupational therapy, Speech therapy, language therapy, cognitive behavioral therapy therapy, counselling and cognitive therapy.
The parents were counselled regarding the same and rehab was started. From 2013-2019, she underwent a goal oriented, customised and intensive neuro rehabilitation program as an out patient. Inspite of it being more than 6 years after the initial head injury, she showed good initial improvements and then encouraged the parents to be engaged long-term. The parents being doctors and owners of a flourishing hospital in their hometown actually reorganised their lives to ensure that they left no stone unturned in their quest to build on the initial encouraging results and even moved to Bengaluru to be able to focus on her rehabilitation.
After the physical disabilities and ADL issues were rehabilitated successfully, the focus shifted towards the severe and ‘functionally’ disabling behavioral and cognitive deficits (neuropsychological & behavioral rehab – Cognitive Behavioral Therapy [CBT] & Cognitive Therapy [CT]). A detailed neuropsychological assessment revealed significant deficits in all areas and a comprehensive cognitive and behavioral rehabilitation plan was put in place. Here general ‘social’ awareness & appropriateness was poor and she lacked confidence. This plan also involved psychological counselling sessions – both for the patients and her parents and this was done daily and for many months and then with lesser frequency for many years. Also she was given therapy with yoga and deep relaxation techniques to bring down her anxiety and calm her down.
It was however the well-structured and customised cognitive rehabilitation that was done by our neuropsychologist Dr. Prathiba Sharan was the ‘game changer’! Not only did the patient show a dramatic improvement in all the faculties (across all 3 modules), but she and her parents got the confidence and belief and hope that she can become normal. Even as she continued full-time daily rehabilitation, she also enrolled to an online MBA course which she completed with distinction and she is now happily married to a surgeon!
#caregiverburden #caregivermotivation #cognitiverehab #cognitivetherapy #longtermrehab #behavioraltherapy #avocationalrehab #ADL #NPBA #CAREPa-Re #CAREPa-Reevaluation #counselling #psychologicalcounselling #journeyofhope #gaitrehab #balancetherapy #CBT #cognitivebehavioraltherapy #yogatherapy #DRT #deeprelaxationtechniques
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