Traumatic Brain Injury A to Z - Bladder/Bowel Changes

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Dizziness

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It’s not unusual for patients to feel dizzy during TBI recovery. Watch as Tracy and the group explore strategies for managing dizziness.
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Dizziness

Julie
You know Michelle, now that Tom’s awake he’ll probably be moving around more. You may find that he complains about dizziness.

Tracy
That’s right, Julie. Dizziness is a very common effect of TBI. Tom may complain that the room is spinning, moving, you know causing that sense of vertigo. So if that happens, he could lose his balance, he could fall. You just want to “fall-proof” the house.

Carl
Julie had me get rid of all her area rugs and electrical cords, things that Sam could slip or trip on. We also put on non-slip mats on the shower and bath floors.

Tracy
Good idea, Carl. Good idea. Also, you want to make sure that the room is well lit. That Tom is encouraged to use any of the assistive devices that his team might’ve provided for him.

Travis
What’s an assistive device?

Tracy
Oh things like canes, walkers…equipment that may help your Dad get around when he comes home.

Okay, just a few more things… You’ll want to remind your Dad to avoid sudden movements. It can also help to sit for a few minutes before walking. You know it just gives the brain time to adjust. So encourage him to sit or to lie down as soon as he feels dizzy.

Julie
Sam didn’t seem to get dizzy very often at first, but once he started walking again, he couldn’t seem to keep his balance. They had this kind of belt like contraption that Carl would hold onto while Sam walked up and down the halls in the hospital. It was a good part of Sam’s therapy.

Carl
Heck, it was good therapy for me, too. At least I felt like I was doing something.

Tracy
Something very helpful, Carl. Sam’s lack of balance is pretty common. Our brains control our physical movement, our balance, so obviously a TBI can cause problems with that. Now fortunately, those problems usually go away over time and with physical therapy.

In fact, many of the effects that you see may improve over time. Some of the others might be sensory changes, spasticity, vision problems, seizures, a variety of cognitive effects are some of the possibilities. So you’ll find a description of what to expect, along with those tips on how to manage those conditions, in the Managing Less Common Effects of TBI in your Guide for Caregivers.

Okay, I think this is a good point to take a break.

This week please take some time to write in your journal. It’s important. If you haven’t started one yet, you’ll find a template in your Guide for Caregivers. Keep track of the progress that your family member is making - - even those… those small steps. And write down your experiences, your feelings. But do take time for yourself.

Julie
Along that line, Tracy, we use a website called caringbridge.org. When Sam first got hurt, everyone in our family was calling every day, trying to get information. And it was just too much; it was overwhelming. Carl and I couldn’t keep up, and stay with Sam at the same time. Then the people at the Fisher House in Landstuhl, told us about caringbridge. It’s great. You can download pictures, and create a website for your injured soldier, and keep everyone posted. Every day I go on there and write in my journal. It’s good therapy for me, and our entire family can check up on Sam’s progress.

Tracy
That’s terrific, Julie. Yeah, I’ve met many people who’ve used both caringbridge and another website, called caringpages.com. It’s really helped in a couple of ways - - keeping family and friends updated, serves as a journal for the caregiver. You know if you have a chance, check the sites out. I think they’ll help.

So next week lets talk about taking care of yourself, which is key to being an effective caregiver. Okay. Thanks everybody for coming. And remember, I’m here for you if you need anything, you know where to find me. Okay.
 

Bladder/Bowel Changes

Even bowel and bladder functions are controlled by the brain. For many people with TBI, bowel and bladder functions are impaired in the early days to weeks following injury. Health care providers expect this and are prepared to help. Urinary catheters and use of diapers or pads may be needed. Bowel and bladder retraining are part of the rehabilitation process. Fortunately, with time and practice, most people with TBI regain control of these body functions.

What you might see:

  • Loss of bladder or bowel control 
  • Increased urgency to urinate 
  • Incomplete bladder or bowel emptying 
  • Increased bladder infections 
  • Constipation
  • Memory and cognitive problems such that the person does not recognize the need to urinate/defecate or recall when he or she last did so
  • Skin problems due to incontinence

How you can help:

  • Indwelling urinary catheters followed by the use of pads or diapers are common early on. Reassure your service member/veteran that these are nearly always temporary.
  • The rehabilitation nurse will teach bladder “training” which often includes a specific fluid schedule, limiting fluids in the evening, and timed attempts to empty the bladder. Help your service member/veteran adhere to the recommended schedule and interventions.
  • Bowel “training” often includes scheduled attempts, a high fiber diet, adequate fluids, physical activity, eating meals at regular times, and possible use of medications, including suppositories. Help your service member/veteran to adhere to the recommended schedule and interventions.
  • Monitor for skin breakdown and report it to health care providers.
Related Information:
Dizziness
Other Physical Effects
Glossary
Frequently Asked Questions
"It had been 15 months and he had slowly improved. But he couldn’t talk. He’d kind of start trying to mouth words, but he just couldn’t talk. And so, on October 21st, 2005, I’ll never forget that morning. I came in to the bedroom and I said, Fred, how are you doing?’ And he said, ‘Fine.’ Okay. I think he just talked to me. So I just turned around and went back into the kitchen, got his breakfast, came back in and thought, okay, let me try this again. I said, ‘Fred, how are you doing?’ And he said, ‘Fine.’ It wasn’t a lot at first, but he could talk." -  Denise G.

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