Brain Injury Insights: Long-Term Hurdles and Cognitive Impairments

0:00:10 - Shane Smith
Hey, I'm Shane from Shane Smith Law. This is an episode of Mind Matters: Navigating Head Injuries and Concussions. I'm here with John, one of the brain injury and concussion attorneys here at Shane Smith Law. For all of our listeners and if you can like and subscribe to see future episodes of Mind Matters, we'd appreciate it. John, what are we talking about today here?

0:00:29 - John Mobley
Hello, Shane, thank you for the introduction. We're going to be talking about some of the long-term effects that we see our clients diagnosed with brain injuries experience and suffer, and you know it's really a focus on how TBIs can lead to long-term hurdles and cognitive impairments.

0:00:49 - Shane Smith
So what's the timeline we're looking at here? When does sort of long-term begin and when is short-term?

0:00:55 - John Mobley
So the latest and greatest studies from some of the specialists that we see present that you know are kind of the nation's leaders in brain injuries say that you know after about six months if those brain injury symptoms have not gone away, unfortunately they are probably permanent.

0:01:12 - Shane Smith
So you're stuck with it. So six months is a pretty clear marker. If you're not better by six months, you got problems.

0:01:18 - John Mobley
You have problems and they are, to be clear, not curable. Brain injuries and brain injury symptoms that pass that marker are not curable. They are treatable. They can go up and down in terms of improvement or getting worse, but they will typically be there.

0:01:36 - Shane Smith
So I was going to say what's treatable mean versus curable. I mean curable makes me think it goes away totally. What's treatable mean? What's that going to do for me?

0:01:45 - John Mobley
Treatable means that you engage in cognitive therapy. Sometimes it can be vestibular therapy. You may see a specialist or a neuropsych that specializes in this area of the body and they may give you some memory exercises. It really depends on which part of the brain you injure and what executive function they call it the brain is responsible for. So if you injure the part of your brain that is associated with memory, the therapist or neurologist may give you honestly we see, honestly see where our clients are given puzzles to do.

Sometimes, if it's also your memory we see our clients will place post-it notes all over their house to be, like you know, turn off the burner. Remember your sister's phone number is this phone number and it's almost like occupational therapy where it helps you, give you the tools you need to succeed in an already hard world that just got harder for the person with a brain injury.

0:02:49 - Shane Smith
So treatable means they're going to give me stuff to help help deal with it, and sometimes it may be worse, sometimes it may be better. I mean, is that medicine? Does that come into play too? Can they give you some medicine? Or is it all just these tips and techniques, or maybe some physical therapy?

0:03:03 - John Mobley
It can absolutely be medicine too, and that ranges the entire spectrum. That way, see some things that help. Sometimes we see anti-seizure medication. In addition to that, there's hyperbaric oxygen chamber treatment, even seeing magnets being used now, which we don't see a lot, but there is definitely a lot of additional treatment that you can seek in the form of therapy to treat the disease.

0:03:31 - Shane Smith
So the short, short, I guess, to the point answer is if I'm outside of six months and I've got stuff still going on, I don't need to just accept that. I can get some kind of treatment to help me deal with it better.

0:03:42 - John Mobley
Absolutely, and that's really what's encouraged by all the specialists, because you really can improve your symptoms with active, good follow-up care. There's therapy for everything. Some of our brain injury clients have injuries to their inner ear or suffering from ringing in the ear, tinnitus, and there's therapy for that as well. Sound therapy, using noise canceling or white noise machines to help them sleep, because some of our brain injury clients say it's a deafening cicada or cricket sound in their ear that impacts their ability to sleep, so their doctors will prescribe them white noise machines. Simple solutions.

0:04:23 - Shane Smith
I was going to say, it makes me laugh, just because my wife and kid like white noise and have for years, but to think that I can get a prescription for one. But if you don't know, though, and nobody tells you, hey, do this coping mechanism, you don't know, unless you're just trying to figure it out yourself.

0:04:40 - John Mobley
Absolutely, and figuring stuff out on your own with a brain injury is very difficult because your organizational skills are sometimes reduced, your memory is reduced, you miss appointments. A lot of people, and this is the saddest part Shane honestly about brain injuries, is that they don't always make the best patients or therapy candidates because they either forget about appointments or don't want to do the appointments, or they're suffering from depression, from the brain injury, so it's hard to get out of bed to go do the appointments. So compliance is a real issue and unfortunately, all that does is make their life even harder because they're not doing the therapy.

So this is where we beg family and friends and spouses to really step up to the plate and help them if they are lucky enough to have that sort of safety net.

0:05:27 - Shane Smith
I was going to say, I personally have known clients with a brain injury and it affected their emotional aspect. And I talked to a doctor who's not a brain injury doctor, he was a regular doctor trying to help this person. He said I don't want to see him anymore, he's a psycho. He yells and screams at my staff. He does all this kind of stuff. Because he didn't used to be this way. But, like you say, one of the issues of dealing with brain injury people right, they're very emotional sometimes.

0:05:51 - John Mobley
Absolutely. If you want to work and thrive in this space and help people, patience has got to be your best friend, because for that exact story that you just shared.

Anyone that works in this space has just as many stories to share about how difficult it can be sometimes. Because from the perspective of a brain injured client, they don't understand why stuff is not the same. And that's so often why we have to reach out to family and friends and really get to know our clients so that we can kind of see how they were before the accident and how they were after the accident. And sometimes the client who has the brain injury cannot tell us that directly, or is not what we call a reliable narrator of their own condition or stories. So we have to reach out to the spouse to understand just how different they are.

0:06:41 - Shane Smith
And I know that's one of the things we've done for a long time and when we suspected brain injury is send one of our forms to the client, but then we try to send another one to a family member or friend to see what they say, because, like you say, sometimes they don't know or they get mad and just throw it, You know, wad it up and throw it away, they don't want to cooperate or it makes them sad to think about how things are different I guess.

0:07:01 - John Mobley
Absolutely yeah, because you, sending the forms to multiple people. It's really the only way sometimes we can get the full picture.

0:07:10 - Shane Smith
And I can't tell you the number of times where we're talking to somebody and I say, well, my spouse wants to talk to you, and the spouse can tell a totally different story of what's going on with the person.

0:07:22 - John Mobley
Right, absolutely. I've seen that so many times throughout my career dealing with these types of cases. It's like a night and day situation when you talk to someone close to them versus their account of what's happening.

0:07:34 - Shane Smith
So what are some of the other long term symptoms we should be looking for?

0:07:37 - John Mobley
Absolutely. So we see, besides the memory issues, we're also now seeing issues with attention deficits, general cognitive impairment. Also, there's quite a few, and this is kind of the scary one, quite a few studies out there now showing and pretty reliable too on a sample size showing that if you have sustained a concussion or a brain injury, you are two to four times more likely to develop early onset Alzheimer's and dementia. So you know, when we ask for very large amounts of money to compensate our clients, it's because we have to keep all these things in mind. It's not just their medical bills, it's what they're gonna face in the future. I mean, can you put a price on losing your consciousness and your memories and everything, all the terrible things that come with dementia and Alzheimer's, which is a lot of people's worst fear, can you put a price tag on that? Or what would it be like to lose six years because you have early onset Alzheimer's? I mean, it's hard to put a price on those things and that's kind of what our responsibility as attorneys is to do.

0:08:46 - Shane Smith
And I mean yeah, I mean because and you asked a spouse, right?

What's it gonna be like? I mean everything I know about it, when somebody has Alzheimer's, it gets, one if you just take out the emotional aspect of it, right, that the spouse just lost a person who can't even remember them anymore. What about the care and feed- you know, medical care and feeding and handling and helping of that person gets exorbitantly expensive, right, I mean, it's-

0:09:22 - John Mobley
Absolutely, that's why we really enlist really good what's called life care planners, because all those intangible and tangible things need to be itemized. Because you know, sometimes these people that sustain brain injuries, you know their impairments are so severe that they need an assistant, a medical assistant. They need someone to help them just organize their lives and say we really have to do due diligence to kind of know how their future earning potentials are gonna be impacted. Maybe they were a high-performing CEO who can only work half the hours a week, you know. So we have to be able to itemize all these things so we truly can get full justice for our clients.

0:09:55 - Shane Smith
What about when family you know when we're talking to our clients about that and you talk about the medical assistant or the nurse or somebody to help take care of this. What about the family member who says, well, I'm just gonna take care of my spouse, that's what I'm supposed to do, and how does that impact a settlement? Or what you do with the insurance company?

0:10:10 - John Mobley
Right, absolutely. So you know there's types of claims called loss of consortium claims, and we see them a lot with TBI clients because, you know, essentially the only victims are not just the people that sustained a brain injury. All of a sudden, unfortunately, they become somewhat of, in some instances, a burden to a spouse. Now the spouse is not only juggling four kids and trying to work a job or a part-time job, but they now have an additional role to fulfill in the house because they're making up for their spouse's loss of contribution to the household, loss of maintaining the house.

They've become a medical assistant, they've become a secretary, because they're keeping up with the person's you know appointments and treatments and therapy and everything else. So it's a tremendous loss for the entire family unit and that's certainly something that we as attorneys take very seriously when we're trying to itemize and figure out how to make someone whole again is, you gotta look at the whole picture.

0:11:10 - Shane Smith
So what would you tell our listeners that they should be looking out for after that six month mark? What are the key things they'll be looking out for?

0:11:17 - John Mobley
Absolutely, so I mentioned kind of attention deficit disorders. You know there's now studies where they looked at about 12,000 plus minor children who had sustained brain injuries and saw a huge uptick in the development of ADHD from a brain injury. So that's one thing. Minor TBIs are harder sometimes to document and know the extent of, but at least in minors you can look for things like inattentiveness and ADHD. And then, of course, dealing with that from a medical standpoint is going to be the appropriate path there. Also, another big thing is the emotional changes that we see, we've had, we've seen where spouses of brain injured clients say that it's like they're now married to a stranger. Wow, and you just think about that and it kind of gives you chills. It's devastating to think that the person you married is not the same person.

0:12:18 - Shane Smith
Yeah, I think that's my wife's nightmare, right? Something happens, and for her it's memory that I would just forget everything. But also your personality changes. You're a different person, right? I mean you go from a smart, caring, loving husband to an angry person or a depressed person, or now you're not a self-starter anymore. I mean, all these things can happen, right.

0:12:39 - John Mobley
Absolutely, and we've seen you mention angry, we've literally, and these were some hard conversations with our clients, where you know the person who sustained the brain injury before the accident was kind of mild mannered, soft-spoken, very kind and patient and then post brain injury would snap at the smallest thing would yell at the children, would yell at the spouse.

It has a transformative effect, and sometimes not in a good way. No, and you think, how does this impact the spouse, the family, the person? The sad truth is that it affects a lot of relationships and probably increases the likelihood that that relationship fails eventually.

0:13:23 - Shane Smith
Well, anything else in the long-term effects should we tell our listeners to be looking out for or be ready for.

0:13:29 - John Mobley
You know those are the big ones, honestly, that we see a lot of besides, just the typical ones like continued headaches and sensitivity to light, but those are pretty straightforward that the neurologist can identify long-term. But the ones we discussed here today are the main ones that you know, it really helps for family and friends to keep an eye on past that six months mark.

0:13:56 - Shane Smith
So if I'm still sensitive to light at six months, definitely should be, I mean, you would have told me to be seeing a neurologist already, but I should certainly, somebody needs to take me to the doctor, without question. Okay, John, thanks for being on the show today. I think it's important to talk to our listeners about the long-term effects, right, and some of those triggers that say you got a serious problem, and the fact that once you cross the six-month mark, I mean that you're stuck with it. You know it's, we can manage it, but it's probably not going to go away. It's awful to hear, but also important information, I would say, for our listeners. For our listeners out there. If you like navigating head injuries and concussions, hit like and subscribe down below, hit the bell for notifications for our next podcast update and remember, if you're in pain, call Shane 980-999-9999. And if you've got a head injury question or you've been in car accident, you suffered a head injury, John would love to talk to you and see if he can help.