Post traumatic confusional state

[Zarahm]

My partner fell from his bicycle on 7th July. A freak accident falling at a depression in the road which he didn’t see.

Now nearly 6 months on .....he woke up at about 12 weeks. He is now able to walk with assistance he is eating 3 meals a day and able to talk.

However this week is my lowest point he is being given a drug for ADHD they increased the dosage last Monday.

He is very confused, shouts a lot. He’s locked in his wheelchair for his own safety. He’s constantly on the move grabbing onto anything that will assist. He uses his feet to move himself ‘punting’ . He is angry and has no ability to focus for more than a minute.

It is very distressing. I would say that he has been confused - not sure he recognises me entirely and does not know the day or date - for about 8 weeks.

Does anyone have a similar experience and how long I could expect this to go on for?

It is heartbreaking to see.

[cat3]

How awful for you both Zarahm ; I'm sure you must be exhausted with the months of worry and now this behavioural issue. But three months on from gaining consciousness is a relatively short period in brain injury terms, so there'll still be many months of readjustment ahead.

Changes in personality and anger issues is a subject we see on the forum often ; it's sometimes addressed with cognitive therapy, when the time is right, or medication. But hitting on the appropriate meds can be a fine balance in achieving compatibility.

Can you tell us which ADHD drug your partner was prescribed and whether you've seen any improvement in him at all ?

And have you accessed the relevant information on the Headway site discussing challenging behaviour after brain injury. Or you can phone the helpline on 0808 800 2244 for print-outs.

Regards, Cat x

[Zarahm in reply to cat3]

Hi Cat thank you for your reply.

I know there is a long road ahead and I’m prepared for that and given the initial prognosis it’s a far cry from where we were.

He was initially on Amantadine which had the desired affect in that he woke up but they stopped that as I think that seemed to be making him agitated and they’ve since been using methylphenidate which was initially started on a low dosage I think 5ml and that has been increased in the last week. The lower dose seemed to be ok but the higher dose just seems to have sent him off the scale and he constantly got his hands down his front, It certainly hasn’t given him any more ability to focus which is what it is supposed to do. I believe the dose was going to be increased again but they have decided not to do that given his behaviour.

I’m sure he will come through this confused state but it will be a while yet I think.

How your life can change in a flash. I find it extraordinary that in this day and age they don’t know more about the brain.

2019 will be another challenging year that’s for sure.

[Hidden]

Hi,

A few thoughts...

+ Try alternative drugs

+ Check if he's in pain - might need drugs for this

+ Increase assisted walking frequency - being locked in probably very frustrating

+ Reduce lighting, minimise noise - over stimulation can cause aggression

+ Write down his daily routine for him

+ Think of ways to give him some simple choices so he feels more in control

+ Make sure he's sleeping well - brain only cleans itself of plaques/heals during sleep - try meds for couple weeks if not

+ Try to focus on sensory - music, stress balls, weighted blankets, lavender oil, massage hands/feet/head, hugs

+ Eat healthily & keep hydrated - avoid e numbers

+ Try to get him to read short articles that help him understand his condition

+ Always distract rather than confront and argue until he reaches the stage when he starts to self regulate his emotional responses again

+ Bring him in an ipad/tablet with short comedies or even cartoons downloaded that he can watch whenever he wants - sounds too simple but you're retraining his brain with positives (don't forget to put a child proof cover on it in case gets thrown!)

+ And very important - don't forget to look after yourself! Remember the emergency flight rule - always put on your own oxygen mask first!

It can be a long journey, but it will get better. Hope you're ok.

xx