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Fatigue

Fatigue

Julie
At first, when Sam wasn’t sleeping much, we were just all so exhausted. I worried about how the fatigue would affect Sam’s healing. He was just so agitated, and he… he didn’t understand what was happening to him. The fatigue was literally etched onto his face.

Tracy
That’s a good point. Yeah fatigue is a common complaint among people with TBI. Just like the body, the brain needs a huge amount of energy for healing after a traumatic injury. And, as we’ve just learned, sleep patterns can be totally disrupted, especially in the first weeks and months after the injury.

For most people, fatigue gradually lessens over time while stamina and endurance improve. And for others, their endurance is just not what it used to be so… so they have to pace themselves more than they did before the injury.

Megan
So when the time comes, will there be anything I can do to help Clay with that?

Tracy
Oh well, sure. You can help him pace himself. You can encourage him to conserve energy for those important tasks of the day, like physical therapy. Setting up a daily schedule can be a huge help. 

Now since regular exercise will increase stamina, his physical therapist will work with you to develop a safe exercise program, based on his abilities of course.

Megan
Yeah it’s just hard to imagine him exercising right now. I just want him to wake up.

Tracy
I know... it just takes time.
 
Julie
Well, Sam had a lot of problems with fatigue. Even before he would say anything, we could tell that he was tired.

Carl
Yeah, he would be so irritable and angry. He’d start to yell, and sometimes his face would even start to droop. His confusion would be so much worse when he was fatigued.

Tracy
How did you handle that?

Carl
Well it helped to make a list of Sam’s signs of fatigue, and when they happened. That way, we could work his schedule around it, like setting important appointments for times when he was the most awake.

Julie
And based on that list, we noticed there were particular times of day when he was most fatigued, so we blocked those times out for rest.

Michelle
That’s a great idea. Now that Tom’s awake more, and he showing more signs of fatigue, I’m gonna start keeping a list.

Sensory Changes

The brain is the center for all five of our senses: sight, hearing, taste, smell, and touch.

When the brain is injured, each of the senses is at risk for change. There is often not much to be done about these changes in the first year after injury.

Doctors often use a “wait and see” approach with the hope that sensory changes will go away on their own.

For some sensory changes that don’t go away over time, surgery may help. For others, therapy and learning to live with the effect will be in order.

What you might see:

  • Vision changes, such as blurry vision, double vision, or sensitivity to light 
  • Hearing changes, including muffled hearing or ringing in the ears (tinnitus) in one or both ears
  • Changes in taste and smell. This could be a complete lack of taste and smell or an altered taste, such as a metallic flavor in the mouth

How you can help:

  • A neuro-ophthalmologist can evaluate visual changes. A neurologist can evaluate other sensory changes.
  • Reinforce wearing of an eye patch or special glasses if ordered for double vision.
  • Ask your service member/veteran to avoid alcohol. It may increase sensitivity to light and noise.
  • Seek professional advice about whether or not it is safe for your family member to drive if he or she is having a change in vision.
  • Have his or her hearing checked. Use hearing aids, if needed. 
  • Ask a dietitian about tips for eating if taste and smell are lost or altered.
  • Make sure you have a working smoke alarm in the house if his or her sense of smell has been lost.
  • Try to be patient. Sensory changes can improve over the first several months or years after TBI. Work with the health care team to track how the senses are working. Seek further evaluation and treatment options as needed.
Related Information:
Fatigue/Loss of Stamina
Other Physical Effects
Glossary
Frequently Asked Questions
"A really super thing for us in terms of communicating with the hospital staff—and the hospital already had this installed in the room—is a big dry erase board. Some people use it and some people don’t. We use it to make a list of all the things we want to talk about with the doctors. That way, if I’m not in the room when the doctors come by on their rotation, they’ve got the big list right there and they can see it clearly. That helps keep the communication going." -  Anna E.

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