For at least ten years, my neurologist and I tried to find the perfect pill. I wanted the pain to go away. It was a combination of things having to do with my left side. My knee hurt, my skin felt tight and tingly, and the muscle tone in my foot made my toes fan out. But I didn’t want to feel drugged. I wanted to do something about my lack of energy too. We tried this, that, and the other pill that was approved to treat epilepsy, Parkinson’s, and other neurological conditions. That’s because there is no pill for brain injury.
I had suffered upper motor neuron damage during a 1977 car crash. I finally understood that this was the cause of some of my pain while taking a course on Neuromotor Speech Disorders as a speech-language pathology graduate student in 2012. Oh! So that’s what it was! That and arthritis in my knee from walking around with one leg shorter than the other for nearly four decades. I had broken both legs in multiple places during that 1977 car crash too.
I could finally talk to my neurologist about the origin of the aches and pains. I learned more and could separate them in my mind. I understood that one pill wouldn’t do it all. I had diffuse axonal injury and had several things going on, so I needed the right combination of pills.
But then, my need for the right pills accelerated because I had some important work to do. As a speech-language pathology student, I would be participating in a clinical practicum at the McGuire Hospital VA Polytrauma Center in Richmond. It was going to be a challenge to stay on my feet and remain alert for a full workday. I needed the right medication to help me face the challenge.
When I arrived at the VA Hospital I felt more drugged than ever. But I observed what the soldiers and veterans were taking for their injuries. I talked to the doctors and pharmacist a little bit. Yep, there is no pill for brain injury and when you take medications, you need to stay away from ones that affect your thinking, your cognition. I started telling the neurologist exactly which meds to prescribe. I think I’m on a pretty good regime now.
In 2013, I started to facilitate a brain-injury support group. I discovered that group members were also pretty frustrated about their medications because, like me earlier, they also didn’t understand why they were taking certain medications and what the pills were supposed to be doing. The meds that persons with brain injury take are confusing and scary sounding mix of anticonvulsant, antispasticity, antidepressant, antianxiety, anti-impulsivity, antiparkinson, and anti-psychotic medications.
While attending a recent Brain Injury Association of Virginia conference, I was interested in Dr. Gregory O’Shanick’s presentation on medications for brain injury. When I sat down and looked at his handout before the session, I noticed that he wouldn’t be getting to the subject of medications until slide 11 and, as a matter of fact, he spent most of his allotted hour on those introductory slides.
After much discussion of how neurons and neurotransmitters worked, the take-away message was that there is no pill for brain injury! Since a different bunch of neurons are damaged in every brain injury, the cause and cure are difficult, if not impossible, to discern. Many people with brain injury adjust their medications continually through life.
In the acute phase of recovery, the person with brain injury hurts, is frequently depressed, has body parts that feel or act differently, is anxious or lacks concern. He’s a mess at the same time that rehabilitation professionals are trying to teach new techniques and coping strategies.
But, Dr. O’Shanick explained to us, rehabilitation will not be successful until issues with sleep, pain, nutrition, hydration, and exercise are stable. It is only when these fundamental needs are met that rehabilitation will be successful. He said that stable sleep patterns, alleviation of pain, a healthy diet, and regular exercise for the body and the brain contribute 65 to 70 percent of the difference we see in post-injury patients.
Yes, there are medications that can help. But Dr. O’Shanick didn’t want us to think that drugs would be the answer to the problem because there are other ways we can treat a patient that in the end will be just as important and don’t come in the forms of a pill.
When I talked to the members of the brain injury support group, some of them told me a similar story. They told me what did work for them: meditation, yoga, teas and herbs, massage and other body work. Interestingly, Dr. O’Shanick suggested some of these same alternative treatments. They are natural producers of the brain chemicals that reduce stress, pain, seizures, and more.
Based on my personal experience, I fully agree. Meditation and a good cup of tea are high on my list of “perfect pills” for chronic reminders of my long-ago brain injury.
Order Not What I Expected: My Life with a Brain Injury (I Didn’t Know I Had)