Navigating Life After Traumatic Brain Injury: From Hospital to Home

0:00:09 - Kiley Como
Hey everybody, welcome back to another episode of Mind Matters: Navigating Head Injuries and Concussions. Today we're going to be talking with John Mobley. He's one of our senior attorneys with our concussion and brain injury group. My name is Kiley. I'm sitting in for Shane today. I'm the firm's treatment coordinator and a registered nurse. So, John, let's kind of pick up and talk about traumatic brain injury from the family's perspective.

0:00:32 - John Mobley
Absolutely, Kiley. Thank you for that introduction. In kind of preparing for this podcast, we wanted to take a little bit of a different approach. One of the things we wanted to do is that basically just identify the fact that when a brain injury occurs to one of our clients, they're not the only person impacted, because immediately their family, friends, spouses, they get pulled into this injury as well, almost as if the injury can occur to them. And so what we want to do by virtue of this, this podcast is go over some of the things that could potentially educate the family member or the spouse of one of our brain injured clients so that they can just be better equipped and better prepared to know what to expect.

Because it is a very, very overwhelming process. From the moment the impact, the fall or the motor vehicle crash occurs, it is just a domino effect of all sorts of things that no one is ever going to be prepared for. You're in the middle of the process of shock, then grieving, then trying to get ducks in a row while being in shock and grieving, and it's just an immensely difficult, difficult situation for any person to be put in. So that was the main thing we wanted to do here is just kind of go over some of the things of what to expect so that people can be more adequately prepared. And just to kind of circle back for those people tuning in for the first time is that you know brain injuries, just a little background on them. You know they are highly, highly prevalent and common. About 1.4 million Americans per year are diagnosed or experience it, with a nice asterisk by that number because most are underreported or never reported. So we think the number is much greater.

The most common causes are, you know, falls, motor vehicle accidents, assaults, things like that. A lot of clients come to us for all those reasons. If the fall occurred because someone else wasn't doing what they're supposed to do, a lot of times those clients come to our firm for help. The impacts range from mild to severe. This whole story kind of starts in the, typically the emergency room when it's a bad accident, and that's kind of where we pick up here.

So the first category and segment we kind of wanted to jump into is the immediate aftermath and, you know, what to expect at what we've labeled the hospital phase. That's where maybe you get a call driving to work one day that your spouse or family member has been in a motor vehicle accident and you know they found in their wallet or purse contact information and this might be the first call you got. So you rush to the hospital. A million things are racing through your mind. You don't know what's going on. You have more questions than answers. It's a really jarring, shocking experience and traumatic experience for you know people to get that news. So once you get to the hospital, you know the first thing we want to point out is: who are the people you might meet?

You know, who are you gonna run into? Who is gonna be a part of your life for the next day to weeks, depending on how long your loved one is there. We call these people the recovery team. Typically it's gonna be, you know, one of the specialists you may see, depending on if it's a very severe accident, maybe the neurosurgeon, brain doctors, brain surgeons, very smart people. And you know, they may be the first person to have a conversation with you because they sit at the top of the totem pole for injuries like this. They're going to be the, the, the field general for the treatment for your loved one, making the biggest decisions really, surgical decisions. They will best be able to advise you on immediate outlooks. If your loved one is suffering some severe brain injury or potentially a life-threatening one, they're probably gonna be the one that breaks the hardest news to you as well. And those are difficult conversations.

We also will see a lot of times neurologists pulled in as well, brain doctors, they may not do surgery but they specialize in the nervous system, its disorders. We see them come in a lot once the immediate threat to life has settled down a little bit, that would be the neurosurgeon. And you'll have a lot of hard and difficult conversations but be able to get a lot of your questions answered with the neurologist as well when you say, well, are they going to be back to normal?

You know, it's too early to tell at that point. And any good neurologist will educate you on this and answer the family's questions, so that you can focus that time instead on grieving and being there for your loved one and working with them.

We also see a lot of these injuries will also have orthopedic aspects to them, so you may also interface with an orthopedic surgeon. There's any sort of, a lot of times when someone hits their head so bad on a steering wheel or a windshield, they have herniations in their neck, bulging disc, or they may you know experience fractures to the face, neck, anything like that. At that point you'd probably be talking and getting advised, especially if your loved one is not completely coherent or is still out of it. You may, depending on you know your ability or your, what sort of documents you have in place, you may be able to, you may be the one making decisions for your loved one. And then, beyond that, there's also the neuropsychologist. Neuropsychologists they basically specialize in, you know, people with brain injury and their behavior and the relationship between those things. And they typically come in a little bit later. They may be consulted in that initial phase, but they will come in later as well as
part of the assessing just how serious this brain injury is, and neuropsychologists have a large amount of tests and abilities to gauge just how bad the brain injury is. That might come later on, though.

Of course then you have nurses. That's probably going to be the people that you talk to the most. They'll be on the front line dealing with the patient and their injuries and dealing with pretty much every aspect of the care and answering questions. They'll probably be the person you get to know the most. Absolutely.

And then beyond that, we have physical therapists and occupational therapists. Once we've reached that point of, is the patient in a coma or threats to life, and once stuff starts to stabilize a little bit, then we kind of shift towards that therapy and what do we have to do to get them back on their feet? What do we have to do to get them back on their feet? What do we have to do? Do they remember how to walk? Was the brain injury so bad that they've lost motor function? And that's going to be a long process with the therapist to get some of that pre-accident ability back or even just for you know, baseline functionality so that you know they can actually walk out of that hospital, or do things or be able to know what's going on. Some of the other doctors that, or specialists that we may see on rare cases is like respiratory therapists.

Yes, believe it or not, the brain controls breathing. So when you hurt your, usually if respiratory therapists is involved, it means that the brain injury was quite severe and there's just no ifs, ands or buts about it. So it's one of those things where you just need to be prepared as the family members or the spouse, that, if you have, some of these doctors showing up, it means that you're in a very, that your loved one's in a dire situation.

And beyond that, we also see involvement with, you know, case managers and social workers. If the person, if they're deemed to not be able to take care of themselves or maybe they don't have that support structure and they need really like a government entity to step in and a medical person to step in, we see assignment of some of these social workers and case workers to help them navigate what's going to be a very difficult process moving forward.

And one of the final specialists that we see, Kiley, a lot, is the neuro-ophthalmologist. That's if the client or the patient is having vision problems, they will actually get sent to a special eye doctor that, you know, focuses on the interaction between the vision and the brain so that your loved one can get their vision back.

We constantly see clients with moderate to severe brain injuries tell us all the time that their prescription, their glasses, changed since the accident, or they now need to have some sort of corrective lens. And it just, while people, you know, unless you do this for a living or you see people impacted with brain injuries, you wouldn't think that that's something that occurs. But you can actually hit your brain so hard that your vision changes. So that's why these specialists get called in.

0:09:14 - Kiley Como
And I can say with an absolute certainty, as a bedside, I was a neuro ICU nurse for many years, everything John just said was 100% accurate. All those docs, everything, 100% how it works out. So, John, amazing, amazing stuff. That's so true. It's an army of people in there taking care of that patient and it very much is in that kind of stages, as you said. It's very touch and go for a while but, uh, you just, just starting right. I mean, you're in it for months, years potentially. So thank you for that. It's a serious injury, this traumatic brain injury. Um, the family's got a lot on their minds right up front, but you know there's a lot to be done correct? So kind of help us walk through what a family member of somebody who suffered a traumatic brain injury might be faced with, like what kind of things might they be ready for?

0:10:01 - John Mobley
Absolutely. And you know, in preparing this portion we wanted to give you know, really actual checklists so that they can work to not only be there for the loved one, but you know, a lot of, there's a lot of downtime with some of this stuff. Especially if your loved one is unresponsive or, you know, in a coma, or is incoherent, then you know there's going to be a lot of time. There's a lot of sitting around at the hospital. They don't, they don't tell you about this, but you're in there, you're in the room, you're feeling helpless, you're sad, you're mad, potentially at the person that hit them in the vehicle. You just have this full range of emotions and a lot of people, they just they want to do something. They want to be able to do something actionable. You know what's the first thing we ask as humans? We say, well, what can we do to help?

You know, can we bring the casserole when you're, when you're feeling sick? You know, what can we do to actually be of help instead of just sitting there, because otherwise you're just left in that hotel room with your thoughts, and a lot of times they're not good. So you know one of the things you can do after you know, obviously we want any client to, and a family member to be able to, grieve and give support, but you can also do some very good things to help immediately assist that loved one. just basic things. One is you know, go ahead and get that social security card or begin looking at benefits that may now, all of a sudden, depending on the severity of your brain injury, might be things that you're gonna need help with. We're talking about entities that may be able to help foot the bill on some of this therapy. If they're going to be for sure deemed disabled, you may want to start collecting information and beginning the processes to be able to have access to some of those benefits.

Just basically-- just for basic things to get, we of course want them to locate insurance cards. Those are certainly things you can do. That can be everything from health insurance to car insurance, any sort of disability cards or benefits that they may have. Because a lot of these companies have, you know, reporting requirements where we just wanna know who to call, who to contact, to be you know if there's money out there. A lot of people have something called MedPay on their car insurance. That gets activated and we can go after it. It's called MedPay, the long name is medical benefits coverage. Okay. Depending, some people have $100,000.

And all that you have to do is, once the accident happens and this would be on your car insurance, any car insurance that you paid for, it becomes, you know, immediately accessible. And you can use that money to help pay for immediate bills, keep stuff out of collections. So these are important things that the sooner you can get them, obviously we'd rather have money sooner rather than later, because in a serious brain injury accident, you know you're not only facing medical difficulties but it might be the most financially stressful moment of any person's life. So, you know, having quick access to money, government benefits and any sort of existing insurances you may have is absolutely crucial.

Some other things that we like to do is, you know, any birth certificate, school records, these are all important things in preparation for what may turn out to be a potential case, just in terms of getting the basic evidence that we would need as the attorney to show who they were before and who they were after. If the client or if the person who sustained the injury was on the job working at the time, they may potentially have a workers' comp claim right? So what that means is you know they'll need things like work records and things of that nature that could potentially be asked for or collected so that you know they can begin the process of that workers' comp claim.

Also, tax returns are a big thing. We as attorneys, when we're going after lost wages, we need tax returns to show not only what you have lost by virtue of being in that hospital for your long, you know, multi-day or two week or longer stint. If you're going through therapy and trying to get a full rehabilitation, you may be out of work this whole time, you know, and if you're not making money, you're not able to pay rent, your mortgage, all the bills that everyone is, acutely aware of that have to be paid in life. You know, none of that's able to happen when you are, when you've sustained a terrible brain injury.

So that's why we really have to have go into rapid response mode to get any and all documentation that's going to do whatever we can to find any and all monies to make your life easier. Because, unless-- not many Americans have some huge nest egg of savings laying around. Studies are out there, I can't quote them here, but the studies are out there that a lot of people don't have a huge amount of savings. Only a lucky few really have rainy day funds. So when you are out of work, not working and incurring huge medical bills, it's absolutely imperative, on something as serious as a brain injury, that we find all these monies for you. That's why we would always recommend, if it's a bad brain injury, reaching out to an attorney immediately, because we can help.

We've been through this process so many times and we can help speed things up. Sometimes speed is the name of the game.

When you've got bills coming in and your loved one is essentially not able to do anything, meet their requirements, and that becomes your problem as well as the spouse or the loved one. It can be very, very, very difficult. Some other things that we kind of want to know is any assets owned by the-- or the family members can look for, is any assets that the person with a brain injury has so you know what bills need to be paid.

You know what things need to be taken care of if it's not on auto pay, so that we know, you know, is the mortgage being paid? You know, because a brain injury can be a very long, long-term battle and who knows who the person that emerges hopefully survives, uh, emerges out on the other side. Are they capable of handling all their business affairs?

If they own a business, are they capable of paying payroll? Do you need to make arrangements to get that you know done to keep the business afloat? There's just all these things that we don't think about, that only become very, very apparent once the injury occurs and it's, it's overwhelming. So we try and just break stuff down so that we can get the right foot forward for family members so they can kind of know, you know, with all those thoughts racing through their head, what, exactly, what are the highest priority things?

So another thing that may come up for family members while in that hospital room is, you know, getting a copy of the accident report. But something that we see is that a lot of times, especially if the injured family member or spouse or whomever taken by EMS directly to the hospital, the officer who showed up on the scene may not have gotten their statement about what happened. So they may come to the hospital room and actually find your loved one and try and do an interview, who they may or may not be able to give any sort of statement or be in the condition if they can. And it really helps to kind of help guide your loved one through that process. We always recommend trying to get the, you know, card and contact information of the officer. So if they later need a statement to formulate that accident report, you can give them a statement so that your point of view, especially if it's like a he said, she said situation, makes it

into the accident report. So it's not being formulated just based off of one person's opinion or one person's interview, maybe the other vehicle. Something else to point out is, you know, is it's really important for these family members to also focus on their own self-care and their own nutrition and things while they're going through this process, because you're only gonna be so helpful to your loved one if your body is also standing up to the task at hand. So you wanna make sure you're eating and doing things like that to stay healthy and keep your sanity while you're going through this process. That's a big part of it. And then you know typically what happens is you know there's a transition process that occurs when the person is eventually moved from the ICU and into what's called like the more you know, regular patient room or rehabilitated portion of their care.

0:18:20 - Kiley Como
Well, that's going to do it for the end of this episode. We've got a lot more we want to talk about, so make sure you come back to join us on our next episode with John Mobley. That's going to do it. Please hit, like and subscribe to our channel and remember if you're in pain, call Shane. 980-999-9999.