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“One in sixty people in the U.S lives with a traumatic brain injury related disability,” says Kelsi Schiltz, a University of Utah �ǿմ�ý physical therapy doctor specializing in care for people with neurologic conditions. Dealing with the long-term effects of brain injury can be overwhelming and hard to understand. “Sometimes it can be a very difficult conversation with a new patient,” says Schiltz. “Some patients may have been told ‘you may never walk again’ or that they can’t return to loved activities. We remain positive, though, to get you up, moving, and back to your previous self as much as we can.”

The U of U �ǿմ�ý Sugarhouse �ǿմ�ý Center and Craig H. Neilsen Rehabilitation Hospital see a wide variety of traumatic brain injury (TBI) patients, often there due to vehicle accidents; sports injuries; serious falls; or physical assaults. Schiltz says patients are predominately males in their mid-teens to early twenties. “But it’s also common to see children under age four, and people 60 years of age and older who have suffered a fall.”

Traumatic Injury Long-term Effects

The long-term effects of TBI depend on where in the brain the trauma took place. “The frontal lobe or forehead area regulates reasoning, problem solving, judgement, impulse control, and planning, and damage there can lead to engaging in risky or inappropriate behaviors,” says Schiltz. “Trauma to the left side of your brain can cause problems with logic, speech difficulties, trouble understanding others or talking, versus right side injury, which can cause problems processing visual information, neglect, or apraxia - the ability to perform regular or familiar tasks. For example, if you give someone a comb, they can tell you it’s a comb, but they don't know how to use it.”

Head trauma long-term effects also depend on trauma severity. Severe TBI long-term effects may include:

• Memory loss
• Headaches
• Seizures
• Dizziness
• Visual changes
• Fatigue
• Paralysis
• Balance problems
• Reduced language skills
• Mood swings

“With increased severity we see a lot of physical impairments, but also cognitive impairments, problem-solving challenges, sleep disturbances, and depression,” says Schiltz.

Short-term Effects of Concussions

For milder traumatic brain injuries, like concussions, Schiltz says some may experience migraines, vision changes, dizziness, balance disturbances, fatigue, and concentration difficulties. “Recovery is usually within a 30- to 90-day window, with most people recovering from a concussion within days to weeks.” Possible short-term effects include:

• Headaches
• Light sensitivity
• Noise sensitivity
• Balance disruption
• Vertigo
• Mental fatigue or difficulty concentrating
• Confusion

“After a concussion, you might be in a conversation with someone and lose your train of thought or not be able to follow a conversation,” says Schiltz. “Or you might get a worsening headache or fatigue from physical exertion.”

TBI Treatment – Exercise and Holistic Care

“The biggest thing we want is for people to come in and get care/proper education, don’t wait,” says Schiltz. “Research shows carrying on a slight reduction in current routine, exercise, movements that don’t increase headaches, dizziness, nausea, etc., can get blood flowing to the brain and that drives neural recovery.”

Schiltz says the more work you can put in, often, the better the outcome. “We had someone come to us in a wheelchair after being told he may never walk again,” says Schiltz. “This individual was in care for two years, pretty intensively, and now he’s back to driving, walking, and living by himself. In his new normal he has difficulty speaking, but he’s come so far.”

Traumatic brain injury treatment includes work with physical medicine and rehab/physiatry, rehab psychology, physical therapy, occupational therapy, speech therapy, social work, and other medical providers, all communicating to enhance your individualized care. “We have so much here – from virtual reality gaming in our Brain Gym to our tech assist/outdoor adaptive recreation TRAILS program and even a driving program.”

Long-term Support and Caregiver Burnout

It’s important, Schiltz says, for caregivers and family members to talk about the level of support needed and when it might cause burnout. “I help run a traumatic brain injury support group for survivors, family

and caregivers, and medical professionals at U of U �ǿմ�ý Sugar House �ǿմ�ý Center. We dialog about brain injuries, learn some new things, and talk about living with TBI, building a sense of community.”

“Our support continues as long as you need it—for months, years, or throughout your life. And with Utah’s Traumatic Head and Spinal Cord Injury Rehabilitation Fund, if your insurance runs out, the cost of your physical, occupational, and speech therapy can be covered—as is specialized equipment. It’s really helping people get back to independence and their previous life.”