Repair for Traumatic Brain Injury, Open and Closed

TBI, Traumatic Brain Injury, affects as many people each year as are living in the city of Detroit. There are two basic types of brain injuries: Open skull and closed skull. My injury, which I believe started multiple sclerosis to take hold in me, was closed skull---the pick-up that hit me threw my head against the street curb, causing momentary amnesia and a split to my skull.

The recent attack on congresswoman, Gabrielle Giffords, was an open skull injury. The bullet went into her head, skull, brain, and back out. She has crossed some very crucial time lines for open skull injuries and her doctors grow more optimistic with each passing day. By day 5, if she still is improving, then we look toward weeks and finally years of improvements, along with chronic damage.

Reports are that the bullet entered her upper left side of brain from the rear and exited same stage front. This is good. It means it did not cross the brain hemispheres, limiting damage to one side. I think of the JFK assassination and reports were mixed as to whether the bullet entered left or right or even where it exited. His brain matter was said to have covered his wife, so that bullet did a lot of damage. With the technology and knowledge of brain repair in the 1960s, JFK didn't have a chance. Giffords does.

First off, she was lucky to have a man nearby who immediately put pressure on the bleeding while raising her head to prevent her from drowning in her own blood. Then a fast medical response and her skull was quickly cut open to allow for swelling to not press her eyes or brain against her skull, doing more damage. Then a coma was induced to allow her brain to go to work on the ONE area it was most needed---fix the damage, build new cells; and the brain wants to do this, after all, it exists to survive! Like a daily runner's heart, her brain was in good shape---she has much on her side.

Having multiple sclerosis, I am always interested in how our brains handle trauma, damage, how it rights itself. I want to know what kind of damage cause what kind of changes in the brain. Will her brain atrophy? Will it show black holes? As a small-time blogger, I have little time for research, no assistants, and all I read today about holes in my brain left me more confused than when I started. There are so many contradictory articles. (I do try to stick with medical journals and articles from universities whose names I KNOW.)

One thing I read, which was quite encouraging, was that doing repetitive voluntary movements can direct cells or/and (and/or!) make new pathways in the brain that will then begin involuntary motor skills to resume! They (at Oxford) used thumbs in their research. HA! Bingo! That is exactly what I did with my left thumb. The thumb the occupational therapists wrote off. I kept moving it every day, up, up, and slept every night with it extended over my lift chair arm rest. After about a year, I began to be able to lift it on command. There, I did it just now.

When I moved to my assisted living home two years ago, I could not shuffle cards, could barely hold 13 cards in my hand, where I used to hold 20 and shuffle like a pro. In the last 6 weeks, I have noticed I can shuffle cards again! Holding 13 is no problem. Wait, let me see if I can twiddle my thumbs. AH HA! I can! Take that, all you occupational and physical therapists who wrote me off. Was I not important enough? Was my insurance too lousy? Were they just lazy or poorly trained?

Congresswoman Giffords will have the best care, the best rehab, reports will be written, future brain trauma victims will be better off. My neurologist once told me not to worry about my brain shrinking, "You will still have more left than me." I took that as his joke, but I think I know now what he meant. If I could hold Ms. Gifford's hand, I would say, "Don't worry. Soon you will be able to do much more than me."