Taking it One Day at a Time

A.E. was unable to talk, walk, breathe, or eat independently. This was not the strong, 16-year-old girl that had been involved in track and field, power lifting and four wheeling prior to her motor vehicle accident. Suddenly, this vibrant, social, outgoing, fun-loving girl was no longer that same person. A.E. had been with friends and was on her way home when she suddenly lost control of her car and it slid over an embankment. A.E. was ejected from the car, suffered a loss of consciousness and was unresponsive at the scene of the accident. She was intubated and airlifted to a trauma center.

Upon initial examination and CT findings, A.E. was diagnosed with a severe brain injury, rib fractures, spleen and liver lacerations, clavicle fracture, C1 fracture, pelvic fracture, a hemopneumothorax requiring a chest tube, and extensive facial and skull fractures. A later MRI also revealed significant bleeding in her brain.

After A.E. was medically stabilized, she required an open reduction internal fixation surgery to repair her broken pelvis. Due to the severity of the fractures, additional immobilization was provided via an external fixator, which is a series of pins and clamps that are secured to the bone on either side of the fracture and held to the skin via rods and clamps. A.E. affectionately referred to this device as her "towel rack." Medical complications arose while A.E. was in the hospital. She required a blood transfusion, a G-tube to supplement her nutrition, and the drainage of fluid from her left lung.

Approximately, one month after A.E.'s injury, she was admitted into an acute rehabilitation center for further treatment of her severe brain injury. Upon admission, she was incontinent of bowel and bladder, had difficulty eating, was confined to a wheelchair, experienced disrupted sleep, agitation, emotional lability and expressed minimal vocalizations.

After one month of acute rehabilitation, A.E. was admitted to Centre for Neuro Skills®, a post-acute brain injury rehabilitation center in Irving (Dallas), Texas. A.E.'s goals upon entering CNS-Irving were to graduate from high school, independently walk, drive, and attend college. Therefore, her treatment program emphasized endurance, balance and coordination, visual problems, cognitive skills, and adjustment to disability. In accordance with this, A.E. was involved in therapy six hours each day in the areas of occupational, physical, cognitive, speech, and education therapies, and counseling.

A.E.'s rehabilitation was complicated due to alexia (the inability to identify letters), pre-morbid personality traits, weight loss, severe visual field deficits, internal bleeding from the removal of her G-tube, word finding problems, decreased attention, distractibility, memory deficits, and decreased ability to sequence a series of steps in a task. These complications can delay progress in rehabilitation and had the potential to affect A.E.'s ability to achieve her goals.

However, A.E. had a "never give up" attitude that drove her through the physical and emotional pain of rehabilitation. Her mantra was "Take it one day at a time." Always move forward and never go back." After 4 months of inpatient treatment, 2 months of day treatment, and 2 months of part-time outpatient treatment, A.E. had graduated from high school, had her G-tube and "towel rack" removed, was able to walk without assistance, had completed some college courses, and was preparing to take a driving assessment to be cleared for independent driving. A.E.'s next goal is to become a veterinarian. She is volunteering at a vet's office and is involved in hippotherapy, a therapy which involves horses, as she has always loved working with horses.

Everyone can learn a life lesson from A.E. regardless of who we used to be and what path we were on, we need to "Take it one day at a time. Always move forward and never go back."