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Headache

Headache

Tracy
Okay, now that we have all introduced ourselves let’s begin by talking about how to manage some of the effects of TBI. Michelle tell us a little bit more about how Tom is doing.

Michelle
Well, he is talking more, and beginning to recognize people. He waved at his doctor, and he seemed to remember his physical therapist that he had seen just only a few times before. Some people may think these are just little things, but after what we’ve been through, it’s definitely progress.

Julie
That’s great! And all of those small steps will add up. With Sam, we just didn’t know what to expect. We weren’t given a very positive prognosis, so when he said his first word, we were amazed. We know how significant those first steps are. That is great Michelle.

Tracy
Travis, how do you feel about the progress your dad is making?

Travis
I don’t know…It…it scares me. I mean sure he’s making this progress, he’s talking more and he recognizing a few more people…but to me he's still confused a lot. And he’s still in pain a lot of the time…I know that his head hurts and I just want the pain to stop…

Carl
Yeah. It’s tough to see someone you love in pain. When Sam was first waking up, his head hurt all the time. We just felt so helpless because we didn’t know what to do…

Tracy
Sure. Well as you all have experienced, a TBI can affect so many aspects of a person’s life. What we’re going to cover next are some of the things that you, as a caregiver, can do to help that loved one when it comes to specific symptoms. Now this information will be particularly helpful when your family member comes home from the hospital. Since Sam has recently come home, Carl and Julie, we’d appreciate your input on this, if you wouldn’t mind sharing some of the things that you’ve learned.

Julie
Sure.

Tracy
Now keep in mind that your family member is likely to experience some, but not all, of these effects. I mean many effects are common right after the injury; you may have already noticed them. And many are likely to improve over time. But though we know more now about TBI than ever before, no one can say with certainty just what effects each injured person will have.

So we do know that most people with TBI can and will make improvements. I mean of course, with the proper diagnosis, the treatment, the follow-up care... they’re so important, but so are the supportive family and the community.

Michelle
You said many effects are common. What kind of effects are you talking about, Tracy?

Tracy
Well, since we’ve been talking about headaches, let’s start there. Some people have headaches most of the time, others headaches just come and go. There’s fatigue, there’s stress... a history of migraines make those headaches worse. But now the doctor will of course will prescribe medications for your loved one and possibly some other options for later in the recovery.

Michelle
What other options are there?

Julie
Since Sam had so many severe headaches early on we tried several things. What worked for him were acupuncture and exercise.

Carl
Yeah, but we didn’t start out with those treatments. First, we tried medication. That didn’t completely get rid of them, so we talked to Sam’s doctor. He suggested stress management, like deep breathing and lying down in a dark and quiet place during a headache. So Sam tried that, along with the acupuncture and exercise.

Tracy
Well Carl and Julie just mentioned several strategies for headaches.  Depending on where your loved one is in the recovery process, those strategies can change. Another thing to consider is to give your family member some guidance in terms of behavior. For example, encourage him to avoid bright sunlight, wear dark sunglasses. Also, obviously avoiding alcohol, foods that trigger headaches like cold foods, some cheeses, chocolate... things like that.

When a headache does occur, keep track of it in your journal. Note the time of the day, the activity that he was doing, also the intensity of the pain. And if the headaches don’t improve or if they get worse, let a member of the health care team know right away.

Seizures

Seizures happen when the electrical system in the brain misfires.

Seizures can be frightening to watch.

Two kinds of seizures may occur following a severe TBI:

  • Early seizures—also called “generalized seizures” or “Grand Mal seizures”—typically happen during the first week after an injury.
  • Later seizures usually occur after the first week of injury in individuals who have never had a seizure before. People who have late-onset seizures are more likely to have a penetrating injury or one that causes a large amount of bleeding in the brain.

Seizures can be temporary or chronic. Late-onset seizures carry a greater risk of future seizures than do early seizures.

A neurologist is the member of the health care team who usually diagnoses seizures. He or she will treat seizures with medications.

What you may see:

  • Generalized shaking or jerking of the arms and legs 
  • Loss of consciousness 
  • Altered attention, emotion, sensation, or movement 
  • Complaints of strange odors or sensations

Late-onset seizures can also cause changes in smell, behavior, or personality. Sometimes, people mistake a seizure as a psychiatric disorder.

Ask your doctor early on about how to recognize a seizure and what to do if one occurs.

How you can help:

  • For a first seizure, call your doctor as soon as possible.
  • If not a first seizure, alert the doctor. Make an appointment to have anti-seizure medication and blood levels checked.
  • Talk to the doctor before adding or stopping medications or herbal treatments. These can change the blood level of the anti-seizure medication and make it ineffective.
  • During a seizure:
    •  Keep calm.
    •  Don’t hold your family member down or try to stop his or her movements.
    •  Loosen ties or anything around the neck that makes breathing hard to do.
    •  Clear anything hard or sharp from the surrounding area.
    •  Put something flat and soft under the head.
    •  Turn the person gently onto one side. This helps keep the airway clear.
    •  Do not try to force the mouth open. 
    •  Stay with the person until the seizure ends.
CALL 911 if your service member/veteran experiences:
  • Difficulty breathing during or after a seizure 
  • Seizure lasting more than five minutes
  • Second seizure that happens immediately after the first seizure
  • Difficulty waking up from the seizure or a second seizure without waking up in between

Some things are triggers for seizures. These include: 

  • Stress 
  • Overuse of alcohol and/or other drugs 
  • Being overworked and/or tired

Help your service member/veteran to avoid these triggers.

Driving laws for people with seizures vary from state to state. Check with your Department of Motor Vehicles to find out what the rules are for your family member if he or she has a seizure disorder.

Related Information:
Headaches
Other Physical Effects
Glossary
Frequently Asked Questions
"In the very beginning, I didn’t want to know anything because I was so scared. But a little while later… the doctors would throw out tidbits to me, like he might never speak again and he might never walk again… but I couldn’t understand why. So then I wanted to understand the part of the brain that was injured and why he was having these symptoms or why he was having this diagnosis." -  Patty H.

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