2-15-2022 The brain can be its own worst enemy

 (Tricia)

As Marilyn mentioned, Ed and I did take a break Sunday night to watch the Superbowl with friends. I have lost my love of football since the much-hated and hateful Stan Kroenke moved the Rams from St. Louis to LA. A crushing Rams loss would have brought just a little light to my heart! But, unfortunately, the universe could not deliver. My sincere condolences to Cincinnati. :-)

I was able to visit Linda late Sunday afternoon, and Ed and I went last night. With the hip injury keeping her bound to her bed and wheelchair, Linda has become increasingly sad and withdrawn. When she had been trying to walk on her own just before she broke her hip, we had tried to warn her that an injury could set her back weeks, or even months. And that is exactly what has happened.

Whether it's the residual effects of the anesthesia from her surgery four weeks ago, the new medications she is on, or some combination of both, she has not regained the mental function she had had just before the surgery. Most of the progress that she had made in her cognitive abilities has been lost.

For example, over the past two visits, I have tried to do a memory exercise with her to try to help her re-establish those connections. The exercise asked her to memorize the pictures of three animals, then turn the page and find those same pictures among a larger group of animals. I expected that she would not be able to do this right now. My intention was to take a few minutes each night to walk through the exercise with her, so that she could get better through repetition over many tries. That was the approach I had taken using similar exercises prior to her surgery, and she had improved over time.

But I did not expect Linda's reaction. After giving Linda some time to study the exercise, I realized that she was having trouble picking out the animals on the second page. I said something like, "That's OK...let's go back and work through them one at a time." This time, she shut down, closing the book and saying she didn't want to do it anymore. When I asked why, she responded, "I don't want your help. I want to do it on my own!"

In one respect, this is not surprising. Linda has always valued her independence and self-reliance above almost anything else. Unfortunately, her brain injury has magnified this trait, which leads to her fighting off most attempts to help her. As she often says, she doesn't want people "telling her what to do." Whether it's getting out of bed, doing therapy, or working on a puzzle, she wants to do it on her own.

The problem is that right now she can't. The only way she can get back to doing anything on her own in the future is to allow other people to help her now. But her brain injury has taken away her ability to make that logical connection, which is one of the saddest parts of this.

Before we left last night, she once again was trying to get up, although right now her hip still keeps her from succeeding. When we told her we would have to call the nurse in to help her, every emotion crossed her face: frustration, anger, sadness. She told us how much she hates being at the nursing facility. We reminded her that she needs to allow people to help her practice the skills she needs, so that we can get her out of there. But her response to that is usually either that she doesn't remember refusing anyone's help or that she doesn't care because she wants to do things on her own. 

We're trying to remain patient and hopeful, even though that's difficult to do right now. She was here before and she got better, so we're continuing to hope that she can do it again. But we also know that she absolutely cannot withstand another fall and injury, so our focus will be on figuring out how to keep that from happening.