Recovering From Head Injury. A Guide for Kids

Transcription

1 Recovering From Head Injury A Guide for Kids Katrina Rayls, Ph.D. Mary Bridge Children s Hospital and Health Center Wiley Mittenberg, Ph.D., ABPP Nova Southeastern University

2 Cover drawing by Ruth Powell, age 11

3 Recovering From Head Injury A Guide For Kids This booklet was prepared especially for kids like you who have had a head injury. Most children recover quickly and get going quickly. This booklet describes problems that children often have after they have had a head injury. It also gives you ideas and helpful hints about what to do when you have these problems. We know you ll be feeling better soon! We hope this booklet is helpful to you along the way. What Is Head Injury A head injury means that your brain has been hurt or injured in some way. Head injuries can happen many different ways. Some examples include car accidents, falling off your bike or skateboard, and being hit in the head with something hard like a baseball or rock. The accident Ouch Ouch My head What does your brain do? by McKensie Holthourser, age 10 Your brain is the most important part of your body because it tells every other part of your body what to do. Your brain is made of thousands of tiny cells that can only be seen with a microscope. These cells are called neurons and they all connect with one another. They communicate together, talking back and forth, and control everything you do. Different parts of your brain control how you walk, how you talk, how you think, and how you feel. When your brain gets hurt, it may not be able to do these things as well as it did before the accident. The good news is that your brain gets better quickly. 1

4 What happens when your brain gets injured? Your brain is protected from injury by your skull. It acts like a crash helmet and protects the brain whenever your head is hit. If you hit your head hard enough, the skull can break or crack. This doesn t happen very often, but your skull can break or crack like other bones in your body, like your arms or legs. A skull fracture is similar to these other broken bones and will heal with time. Your brain can also be shaken around inside the skull when you hit your head. Like many other parts of the body, your brain can become bruised and swollen. These bruises are no different than the types of bruises you get on your arm or on your leg. The black and blue marks and the swelling go away with time just like other bruises. Shaking the brain around can also damage or hurt the neurons, the tiny cells that control the things you do. When this happens, the neurons cannot send messages back and forth as easily and it may take you longer to do things. The good news is that these cells heal in time and many kids recover completely. This information is not meant to upset or scare you. Bruises, swelling, and damaged neurons are all very common in head injuries. They may also be responsible for some problems and feelings you might have as you get better. The important thing to remember is that many people have similar problems after a head injury. These problems don t last forever and they usually go away on their own with time. Worrying or stressing out about them will only make them worse. Keep in mind that any symptoms or problems you may have (e.g. headaches, tiredness) are normal and usually go away quickly. Forgetting by McKensie Holthourser, age 10 Are you sure this is my house? Are you sure this is my bed? What s my dog s name again? Yes Yes, you need to rest. 2

5 Getting Better How Long Does It Take To Get Better? This is a good question. Unfortunately, there isn t a good answer. Not everyone recovers or heals at the same speed. Some people get better faster than others. Some people take more time to get better. It really is hard to say how long it will take. Most kids rebound quickly and return to normal in a short period of time. You have probably already begun to feel better in the last couple of days and will continue to improve. Recovery can take anywhere from a few weeks to six months. Healing can take longer if you were knocked out or unconscious. Although some kids get better faster than others, everyone does improve. What Can You Expect As You Get Better? The table below lists some of the symptoms or problems you might have after a head injury. These are very common and are part of the normal healing process. These symptoms are signs that the brain is healing and may be the brain s way of telling you to slow down and take it easy. They are not signs of brain damage and do not mean that you are getting worse. Most kids get one or two of these symptoms, but you may not have any at all. No one gets all of them. You may not notice the symptoms right away. It could be a few days or weeks before they begin to bother you. If you do have any, it is OK and should be taken as a reminder that you are still healing and need to take it easy as you get better. The good news is that these symptoms often go away on their own without any special treatment. It takes a while by McKensie Holthourser, age 10 I hate not remembering Why are you sad? A few months later Wait and see I don t know 3

6 Common Symptoms in Children After Head Injury Fatigue/Tiredness Headaches Trouble Seeing/Blurry Vision Sensitivity to Bright Lights Sensitivity to Loud Noise Dizziness/Head Spinning Memory Problems Poor Concentration Trouble Thinking Irritability/Crankiness/Feeling Grumpy Anxiety/Feeling Worried/Nervousness/Butterflies in Stomach Sadness/Crying I remember! by McKensie Holthourser, age 10 I don t feel so sad My head feels better Angel your my dog! It just takes time 4

7 What Can You Do About THESE SYMPTOMS? The most important thing you can do is remember that these symptoms are part of the healing process. They usually go away on their own and do not require special treatment. You may think that your symptoms will never go away and you may find it hard to deal with them. These are really normal feelings, but there are things you can do to help. Trying to stay calm and not worry about your symptoms is the best way that you can help yourself. 1) Pay Attention to What Your Symptoms are Telling You If your symptoms get worse, or if you get new ones, this is a sign that you are pushing yourself too hard. It may mean that you are trying to do too much too soon. If you are feeling really bad, you should call your doctor. You may need to take school work, chores, and activities with friends one step at a time. Be sure to get all the rest you need. 2) Try to Avoid Stress One of the most important things to remember is that a head injury is a stressful thing to have happen to you. Keeping your stress level under control is a very good way to help yourself as you get better. This may sound silly, but it s true. Scientific research shows two things about stress and head injuries. First, feeling stressed out, feeling nervous, or feeling worried is very common after a head injury. Many kids, and adults too, feel this way. Second, stress can make many of your other symptoms worse. If you work at keeping calm, you are likely to recover much faster. The good news is that you are probably already feeling better. Staying calm and keeping your cool will make you feel even better. The stress of every day life can be hard. Below is a list of some things that many kids find stressful and hard to handle. Many kids who have never had a head injury stress out over these things and get the same kinds of symptoms you may have. It s harder to deal with day to day stress after a head injury. Stress can cause your symptoms to appear sooner and happen more often. Trying to do as much after your accident as you did before can be stressful. You may need to take it easy and build up your activities slowly. 5

8 Common Stressful Events in Everyday Life Problems with Friends Parents Arguing Becoming Seriously Ill or Sick Homework/Tests/Grades/School Chores at Home 3) Don t Worry About Your Symptoms Arguing with a Sister or Brother Death of a Family Member Death of a Friend or Pet Physical Appearance/Attractiveness Remember, worrying about your symptoms can stress you out. This can make your symptoms seem worse than they really are. Paying attention to something can make it seem bigger. For example, if you pay attention to your heartbeat or your breathing for a minute or two, you will notice that they become louder and you are more aware of them now than you were before. The same thing is true of a headache, a sad feeling, or being tired. The more you think about them, the worse they become. 4) Remember That These Symptoms are Common Many of the symptoms you have are a normal part of getting better. Everyone has these symptoms now and then even if they have not had a head injury. It s easy to forget that before your injury you may have had times when you had headaches, have been tired or irritable, and couldn t concentrate. The best thing to do is to try to deal with these things the same way you did before the accident. 5) Talk to Someone Lots of times it will help if you can talk to a grown-up about your symptoms. Sharing your feelings with a parent, grandparent, aunt or uncle can make you feel better. Someone you can also talk to is your teacher, sister, brother, or a friend. Sometimes just having those people close by or playing with your dog or cat can help you feel better. Remember, you don t have to deal with stressful times alone. You may also want to write down your daily thoughts, feelings, and experiences in a diary or journal. This may help you think things through and also serve as a reminder. 6) Keep Practicing Good Health Habits You need to have fun playing and exercising. Rest, relax, and get plenty of sleep. You should also eat good food. 6

9 Fatigue/Tiredness What Can I Do About SPECIFIC SYMPTOMS? It is normal to be tired after a head injury. The best treatment for being tired is rest. You should gradually increase your activity level and avoid wearing yourself out. Many kids have more energy in the morning than they do later in the day. Taking a rest break or an afternoon nap can increase your energy level. If you find that you re tired all of the time and your other symptoms are getting worse, it likely means that you are pushing yourself too hard. Slow down and take it easy. You may even call your doctor if you continue to feel tired. Headaches Headaches are common following head injury and are part of the normal recovery process. Like any headache, they can be painful and bothersome. They can also make you irritable and grouchy and may make it hard to concentrate after a head injury. Headaches can have many causes and your doctor can help in deciding if you need medicine for your headaches. This is usually not necessary. Stress and muscle tension are two of the most common causes of headaches after a head injury. This is usually the case when you start having headaches several days to several weeks after the injury. These headaches are likely a sign that you are trying to do too much. They often happen less frequently or disappear altogether if you take a break, get some rest, and relax. Adjusting or shortening your school schedule and activity level may be necessary if you continue to have headaches. Trouble Seeing If the things you see look blurry or if you see two of something, you should have your eyesight checked by your doctor. You may need to wear glasses. Blurry or double vision usually goes away by itself in most kids in a short period of time. Resting and closing your eyes can help the symptoms go away as well. 7

10 Bright Light Sensitivity You may notice that bright lights hurt your eyes. This is a common symptom following head injury, especially if you have headaches. Because bright light seems to hurt your eyes, you are likely to pay more attention to this symptom, which actually makes it worse. Paying attention to how something makes you feel can make the feeling seem more intense than it actually is. The less you think and worry about your symptoms, the faster they usually go away. One way to help may be to spend time in a room with low lights until your eyes feel better. Sensitivity to Loud Noise Like bright lights, loud noise may also bother you and hurt your ears. This is common in kids following a head injury. You are probably paying more attention to noise right now because it hurts your ears. If you try to ignore this and adjust to the level of noise around you, the symptom will likely go away much quicker. You can also keep noise levels low by turning the volume of the radio or TV down. You can also ask those around you to speak in softer tones. Dizziness Feeling dizzy is common after a head injury, but should be checked by your doctor to make sure that nothing serious is wrong with you. While these symptoms may bother you, they usually go away by themselves in 3 to 6 months for most kids. Some medicines treat dizziness and motion sickness. Your doctor will know if this is the right treatment for you. These medications can make you sleepy and make it hard for you to pay attention and concentrate. Some kids find it helpful to sit or lie still until the dizziness passes. Standing up and moving more slowly can also be helpful. 8

11 Memory Problems Having some trouble remembering things is very common after a head injury and can be caused by many things. Earlier, you were told that the brain can become bruised in a head injury. The most common area of the brain to be bruised is the part that stores memories. When bruises happen it can be hard to remember things. Like other bruises, these will heal in time and your memory will likely improve as this happens. Forgetting things sometimes happens to everyone, so try not to worry if you re having some trouble. The table below lists some things that kids often forget, even if they have not had a head injury. Things Kids Often Forget School books Homework Where they put a toy What their parents told them to do Brushing their teeth Chores What time their curfew is Why they went into a room Memory problems may be a reminder that you are pushing yourself too hard. Writing things down, using a pocket recorder, and asking people to remind you of important things are other ways of coping with memory difficulties. Poor Concentration If you find that it s hard to concentrate, you are most likely tired or stressed out. Taking a short break of 15 to 30 minutes can help. Relaxing for a bit can also help. If you still have a hard time concentrating you may have to cut back on the number of activities you are doing at home and at school. If this happens your parents and teacher can work together to find the right balance for you. Working where it is quiet may also help. Make sure that the TV and radio are turned off. These can be distracting and make it hard for you to concentrate. You also do not want to do too many things at once. Listening to the radio, watching TV, or talking on the phone while doing your homework is not a good idea. It is best to do one thing at a time. 9

12 Trouble Thinking This problem is usually caused by other problems you may have. Concentration problems, being tired, headaches, anxiety, and depression can all make it hard to think clearly. Like many of these symptoms, trouble thinking is probably a sign that you are trying to do too much too soon. Slowing down, taking more frequent breaks, and trying to do one thing at a time can help you to think more clearly. Irritability Being tired and feeling stressed out are two of the most common reasons that people are irritable and grouchy. It is much easier to get mad when you are tired and stressed. Getting enough rest can help you to not lose your temper. You may find it helpful to cut back on the number of things you are doing at home and at school. You can also try staying calm in aggravating situations. When you feel yourself getting angry, count to one hundred or take some deep breaths. Your mom or dad may need to help you notice when you are getting angry sometimes. Think about what is making you mad and how you can respond. Try to think of several different ways you could handle the situation. Pick the best solution and do it. Just seeing that there is more than one way to solve a problem can make it a lot less aggravating and irritating. Anxiety/Worries The main causes of anxiety for most kids are worrying about their symptoms and problems at school. Understanding and knowing that your symptoms are normal and part of getting better should make you feel less nervous. Getting enough rest and gradually increasing your activities can also help. If you are feeling anxious or nervous, it is likely because of fearful thoughts and ideas you may be thinking and telling yourself. Talking to someone such as a parent, teacher, or friend and telling them how you feel can make you feel better. Getting these ideas and feelings out in the open can stop the anxious thoughts and make you feel calmer. Teaching yourself to relax and stay calm can also help. Taking deep breaths, counting to ten, and picturing yourself in a pleasant and peaceful place are all ways to help. 10

13 For some kids, the kind of accident that happened when they hurt their head can also lead to nervousness or feeling scared. You may have scary memories of what happened that day that are hard to stop thinking about. Some kids can have frightening dreams, fear of doing the thing they were doing when they were hurt (like riding their bike), or have scary pictures in their heads. This is also a normal part of getting better. If you re having any of these kinds of feelings, make sure to tell someone. Talking about it with people or seeing a counselor or psychologist can help. Sadness Sadness and depression are common feelings after a head injury. These feelings are usually associated with thoughts and beliefs that you may be telling yourself. Thinking things that are bad or terrible can certainly make you depressed. For instance, thinking that your situation is terrible, that there is no end in sight, that you cannot do the things you used to do, that it s not fair, and that you re never going to get better are all depressing things to be thinking and telling yourself. This type of thinking can be habit forming. Usually, when people think and tell themselves unpleasant things all the time it is out of habit, not because those things are really true. In fact, things are usually not as bad as you might think. If you find yourself thinking sad thoughts, STOP! Simply stopping a depressing thought can make you feel better. Talk to a parent, a teacher, or a friend about how you feel and what you are thinking. They can help you see if what you are telling yourself is really true. People also become sad and depressed when unpleasant things happen to them. A head injury is definitely not a fun thing to have happen. We would all rather have good things happen to us because they make us feel good. An effective way to treat sadness is to make sure that good things happen to us. One way to do this is to plan enjoyable activities for yourself every day. You may have to discuss this with your parents to make sure that what you want to do is all right with them. Decide on something you like and be specific. Plan exactly what you want to do, where you will do it, and when you will do it. This will give you something to look forward to doing. You might even want to put enjoyable activities on a calendar as a fun reminder. Anticipating and doing enjoyable things each day will surely improve your mood. 11

14 Important Things To Remember 1. Always call your doctor if you are worried about any symptoms or if they get worse. 2. Talk to your doctor about when to return to activities, especially school and sports. 3. Talk with your teachers about any problems you are having at school so that they can help. Your parents may want to find out if developing a 504 Plan would be helpful in making sure that all your teachers understand the things that will help with your recovery. This book and your doctors can be helpful in figuring out what (if any) accommodations would be helpful. 4. Protect yourself from having another head injury - wear a helmet! Resources Your doctor. Any of the doctors who treated you at the hospital. Specialist in brain injury such as a neurologist, neuropsychologist, neurosurgeon, or rehabilitation doctor. Brain Injury Association of Washington (BIAWA) or Brain Injury Association (BIA) or Mary Bridge Pediatric Neuropsychology Program , option 2. About This Guide This booklet was prepared especially for kids like you who have had a head injury. Using the ideas and hints on how to handle your symptoms will help you feel better. Follow the suggestions or think of new ones. Remember, the most important thing to do is stay calm and stress free. Make sure to tell your parents if you are having these symptoms. * The illustrations in this book were created by kids like you. Very special thanks to all of the kids who shared their fabulous drawings. ** Thank you to Chris Ladish, Ph.D., Robert Beilke, Ph.D., and Jenise Jensen, Ph.D. for their contributions to this project. 12

15 Notes: This book was provided by the MARY BRIDGE PEDIATRIC NEUROPSYCHOLOGY PROGRAM If you have any questions, comments, or would like more information, please call , option 2

16 Allenmore Hospital Good Samaritan Hospital Mary Bridge Children s Hospital & Health Center Tacoma General Hospital MultiCare Clinics multicare.org