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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.

Spasticity

An injury to the brain can cause an abnormal increase in muscle tone called spasticity. A spastic muscle does not easily relax the way a normal muscle does.

This effect is most common with a severe and/or penetrating brain injury.

Regular stretching, splints to keep limbs in proper position, and medications are common treatments.

Severe spasticity can be painful so pain management may be in order.

What you might see:

  • Involuntary muscle tightness and stiffness 
  • Muscle contractions 
  • Decreased range of movement and abnormal posture

How you can help:

  • The physical therapist will develop a stretching program for your family member. Ask the physical therapist to teach you this program.
  • Post diagrams of the stretches. Help your family member do the recommended stretches.
  • If splints are used, learn how to apply them. Find out how long they are to be worn each day.
  • Monitor your family member’s skin for pressure points from the splints. Alert nurses to areas of redness and breakdown.
  • Tell the health care team if the spasticity gets worse. This could be a sign of an underlying problem.
  • If spasticity is so severe that it interferes with comfort, positioning, and general functioning, ask the doctor about treatment options. These include implanting a muscle relaxant pump.
Related Information:
Headaches
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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