Neuro (Brain) Surgery

The following text is the injury diagnosis by my neurosurgeon after operating on my brain, which you can see in the adjacent image:

  • Right pneumocranium (air inside skull)
  • Fracture right parieto-temporal skull
  • Large 1.88 x 8.5cm right temporal extradural haematoma (blood clot)
  • 7mm left temporal subdural haematoma
  • 1cm contusion (bruise) right midbrain
  • Small traumatic subarachnoid haemorrhage right precentral sulcus
  • Multiple small contusions: Both frontal lobes & left temporal lobe
  • Base of skull fracture: right greater wing of sphenoid, extending into left middle cranial fossa & both superior orbital walls
  • Scalp laceration

Air Ambulance Journey

I unwittingly tracked my helicopter journey from Nantwich to the Royal Stoke hospital in Stoke-on-Trent via the GPS tracking app I used on my mobile phone.  Click on this link to view the contents of an air ambulance charity article which displays the flight path and duration.  

During

Making Progress

There was so much the rehabilitation unit staff did for me, I will always be enormously grateful to all of them.  The work they do may not be as glamorous as other clinical disciplines, however, they are as important as anyone to a successful recovery outcome.  I felt especially close to the rehabilitation folks as they were the first people I properly engaged with post-TBI.

I made the Lego rabbit in the adjacent photo while at the Haywood - it was intended for seven year olds, whereas I was aged forty-six.  I was exhausted from making it, we still have it to remember some of the challenges we faced.

Following my discharge from the Haywood Hospital, my NHS rehabilitation consultant sent a discharge diagnosis letter to my GP, it can be viewed by clicking on this link.

A Story of Hope

My Journey from Traumatic Brain Injury (TBI) through Recovery

Before

After

Road Traffic Collision

My name is David, I was a forty-five year old man on a leisure bike ride to Nantwich in Cheshire (England).  About fifteen miles from my home in Newcastle-under-Lyme (Staffordshire) I was struck at 40MPH by a car whose driver didn't see me.  In the following police incident photos, my head made the impression on the car's windscreen and my bicycle is underneath the front grill.  I lay comatose in the carriageway, foaming at the mouth and bleeding from my right ear - click on this link to view detailed information about the accident.  The incident, which happened on July 31st 2015, was reported in the local newspaper and can be viewed by clicking on this link.​​​

​​The surgeon needed to saw away part of my skull, starting at the upper right side of my forehead, to facilitate requisite drilling to relieve the pressure building up in my brain from bleeding.  The pressure was monitored using an Intra-Cranial Pressure (ICP) bolt, clicking on this link will take you to a page about ICP.  After surgery, the detached piece of skull was re-attached and secured with four nylon screws.  Three screws are under my hair and one is still (2020) partially visible on my forehead.

Black Friday

My life partner (Ruth) kept a diary of my first nine weeks in hospital.  Ruth recorded one particular day as "Black Friday", it was 7th August (a week after my TBI) when the expectation was that I wouldn't make it through the night following complications.  Click this link to view the transcribed diary, then click this link to see my neurosurgeon's own assessment of my "Black Friday".


​​​​Glasgow Coma Scale (GCS)
​"GCS, or Glasgow Coma Scale, is a measure of conscious level. You get a mark from 1–4 for eye response, 1–5 for verbal response and 1–6 for motor response, giving you a maximum total score of 15 if completely normal and a lowest possible score of 3 if you’re dead."  The preceding paragraph (the last statement was joking) was taken from a diary / novel by a former NHS doctor.  While accompanying my mother in an ambulance to hospital in 2018 after she'd suffered heart attack symptoms I enquired of GCS 3 during conversation with the paramedics who said something long the lines of "It basically means you are dead."

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​Between 31st July and 15th August 2015 I was assessed as GCS 3 - this data is from a neuro-psychologist's report who pieced together relevant information from my NHS records, click on this link to view it.  You can see a breakdown of my various GCS values recorded during my post-op hospital recovery phase by clicking on this link, there's also more background information on GCS in general. 


Locked-In Syndrome
My natural coma was followed by an induced coma, it was twenty-eight days before I emerged from comatose state.  The following words are taken from email dialogue I had with Ruth in January 2018 regarding the time I came out of coma in the critical care unit. "People's general perception is that you just woke up and started asking about simple matters such as sports is very different from mine. I went through a week when you were awake and looking at me but not talking or responding - and the nurses talking to me about the potential of 'locked-in' syndrome. Then, when they finally had you 'sitting up' it was slumped in a special chair staring at the floor. When finally you stuttered some words, the first thing I can remember you saying to myself and Chris was "it's been terrible..."
Click on this link to view clinical information about the syndrome, furthermore, clicking on this link takes you to a BBC documentary about a person with locked-in syndrome (it has a happy ending).​​​​


TBI Survivor
You can view my thoughts on my brain damage ​by clicking on this link.  I personally prefer the term recovering person to TBI survivor (the clinical term used) when considering my own particular outcome.  My rationale is that the term survivor only relates to the short term (say a few weeks) after the TBI, whereas recovering person relates better to the ongoing months and years.

​​​​Cognitive Function and Memory Testing

A neuro-psychologist assessed me in May 2016 (ten months after my TBI), producing a report which you can view in PDF format by clicking on this link.  I have bullet-pointed some observations which I personally found fascinating:

  • The learning disabilities range extends from the 2nd percentile to the 9th percentile.
  • David achieved a mental arithmetic evaluation indicating 99.9th percentile.
  • David’s scores for both immediate and delayed recall regarding his day-to-day memory abilitywere at the 5th percentile.​

​​The observations were accurate: my short-term memory is dreadful, but I never lost my very good maths skills which was the largest part of an engineering degree which I undertook between 1989 and 1993.  Clicking on this link takes you to a PDF of the maths exam paper I took, I graduated with first class honours.


Things I've Learned about TBI

  • You're unlikely to recover as you were prior to a TBI - accept yourself.  In the words of a friend I made during my recovery: "Things are still normal, it's simply a new normal".
  • Stop apologising to people who care about you, they recognise and accept your limitations.  In the simplest of terms - they get it!
  • You'll probably experience many worries and concerns, don't be afraid to share your anxieties.  Click on this link to view some of my anxieties which I noted prior to a meeting with my rehabilitation consultant.
  • When doctors discuss coping strategies with you (for whatever condition) listen to them intently and be prepared to try them.  Clicking on this link takes you to a page listing a few of my own coping strategies.
  • ​For short-term memory problems, stop testing yourself.  Click on this link to view some of my thoughts on self-testing.
  • Sleep is just as important to feelings of well-being and general health as diet or exercise, ignoring tiredness is counterproductive.
  • Set realistic (low) goals and expectations, baby steps is the sensible approach.  It is expected to want to get better rapidly, that is probably unrealistic.  Clicking on this link takes you to a "discharge note" I wrote for the NHS in 2019, it mentions managing expectations.
  • Recovery is non-linear (not a straight line).  You can have three good days followed by a rubbish day, it doesn't mean that you are back at square one, just like life in general.
  • You'll probably be a little different, but you WILL make it.  Clicking on this link takes you to a page describing some of my remaining limitations as a consequence of my TBI.


I Needed to be Needed
The name of this web site came unwittingly from my mother when she was articulating what she saw as the biggest influence on my recovery.  My mother had seen me find purpose in life through the various volunteering roles I had become involved in, her exact words were: "You needed to be needed".  My recovery could also be stated in a less cryptic manner: I desperately wanted to feel useful again.  Click on this link to view some of my thoughts on the importance of having a fulfilling purpose during recovery, and my hopes for what this web site might achieve.

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Contented

​​I have a positive outlook on life and consider every lived day beyond my TBI as a bonus.  I can sum up my recovery in a single word: contented - see link.


Chronological Summary
A simplified timeline of my hospitalisation, recovery and return to work can be viewed by clicking on this link.​


Post-Discharge Recovery
Click on this link to take you to a page leading you through the progression of my recovery.

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NHS Rehabilitation Centre

​​​​​​In my room at the Haywood Hospital, the message written by Ruth (adjacent image) was pinned to the wall at my bedside.  I probably read the note at least twenty times per day.  It helped enormously to know that people were out there who cared about me.​I didn't know what year it was, but my cognition was still intact as I was able to use my mobile phone to take a photo of the note.

​I needed assistance to walk safely, not due to any physical impairment, it was simply because my brain couldn't send messages to my limbs to do what I wanted them to.

​I had been doubly incontinent while in critical care.  I lost 42lbs (19kg) in weight during the nine weeks following my TBI.