Lisa has 27 years of experience treating speech, language, memory and swallowing disorders. She has a master's degree in speech pathology from Vanderbilt University.
It was a wonderful night for Dana and Melvin. Mel had just received a promotion at work and decided to take his wife out to celebrate at their favorite steak house. During dinner, Mel laughed at something Dana said, just as he put a big bite of steak in his mouth. Suddenly, his eyes bulged and he grabbed his throat. Dana asked what was wrong, but Mel couldn't speak.
Dana panicked, yelling for help. The waiter rushed over and began giving Mel the Heimlich maneuver. At the next table, Dana heard a woman calling 911, stating the address of the restaurant and telling them a man was choking. Mel's face turned blue and he passed out during the ordeal; it felt like an eternity took place before the chunk of steak flew out of his throat. Mel was still unconscious when the waiter began CPR. At this point, paramedics arrived to take over, started working on him and rushed to the hospital.
At the hospital, Dana waited on word concerning Mel. She was finally allowed into the intensive care unit, where she found him lying very still. He didn't respond to her entering the room or even when she tried speaking to him. Vickie, the charge nurse, revealed that Mel had suffered an anoxic brain injury. Anoxia is the term for ''lack of oxygen to the brain''. Vickie further explained that after four or five minutes without enough oxygen, brain cells begin to die; that is why Mel wore an oxygen mask and was being given a medication to help his brain absorb extra oxygen - to compensate for the period of time it had lost. She said the sooner Mel woke from his coma (or unresponsive state), the better his prognosis would be (his potential to recover).
While she waited through the night, Dana talked with the hospital staff and family members of other patients. Another ICU nurse mentioned that this type of injury could be caused for many reasons: heart attack, drowning, stroke, high-altitude mountain climbing, or any other condition that would prevent the brain from getting enough oxygen. She gave Dana an information sheet to read, and told her that recovery is often a slow and lengthy process. The nurse encouraged her as well, pointing out that Mel had a number of factors on his side; he was very healthy, relatively young, and his pupils responded to light when they checked his eyes.
Early the next morning, Mel began to wake up. Dana got excited, but then worried when Mel didn't know who she was right away. He acted like he couldn't remember anything that happened and was very confused and agitated. The nurses gave him some medication to calm him down and help him rest. Over the next few days, his awareness improved, but impairment was obvious. He had difficulty paying attention or following a simple conversation. Occasionally, he had seizures, and although his speech was clear, his words made no sense. He could not name his children, much less common objects.
Dana was so disheartened. The therapy staff continued to be reassuring, reminding her that the scans of Mel's brain showed minimal damage. The restaurant waiter's quick action of administering CPR had kept some blood going to Mel's brain and probably saved his life. Mel began many forms of therapy while in the hospital: physical, to help him stand and walk; occupational, to help him relearn daily living activities, such as eating and bathing; and speech, to improve his lack of words and concentration. Once he was medically stable, he moved to a rehabilitation facility to start an overall intense therapy program.
As Mel recovered and became aware of the whole situation, he also became much more irritated. He had just been promoted to a high-level position at his job, and now he could barely write his name! Dana understood his frustrations, but was still hurt when he lashed out at her. The rehab psychologist, Dr. Taylor, explained that part of the reason Mel was having a hard time controlling his feelings was due to the brain injury; an effect called emotional lability. The doctor began teaching Mel coping strategies to help navigate through his feelings, and also taught Dana and their family how to support him and not be afraid.
Progress was slow, but steady. Within a few months, Mel had dramatically improved. He was able to walk independently and his speech was better. Sometimes he still had difficulty remembering the names of things, but had learned tricks to work around it. He and Dana began to move forward, and as Mel expressed desire to return to work, Dana became concerned. They met with Mel's bosses, who wanted to be as supportive as possible. Mel was an awesome employee and they wanted to retain him, even if it meant he would need to be in a part-time or less demanding position. Mel had a hard time dealing with the loss, but with the love and support of his wife and family, he wanted to be able to put together a new life.
Anoxic brain injury is caused by partial or complete interruption of oxygen to the brain. People who suffer such an injury often spend some amount of time in a coma (or unresponsive state). The duration of the coma often indicates their potential for recovery. Effects of anoxia can include seizures, headaches, confusion, poor memory and coordination, and emotional lability, or difficulty in controlling one's emotions. Improvement can be slow, but the best progress is usually made within the first year following the incident.
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Nervous System Study Guide5 chapters | 58 lessons
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