Brain Injuries: The Trauma You Can’t See

Mary Beth Sallee

Jobe Publishing, Inc.

 

If someone breaks an arm, a cast is placed, and others would notice that the person has an injury with which they are coping. However, some injuries aren’t always visible, specifically brain injuries.

Wesley England, his wife Katrina, and their family know this all too well.

On April 9, 2019, Wesley was involved in an Emergency Medical Services (EMS) auto accident. At the time, he was an Operations Supervisor and Critical Care Paramedic with the Hart County Ambulance Service.

Wesley suffered severe injuries as a result of the accident. He was diagnosed with a T12 spinal fracture and inflammation from compression, as well as a concussion, followed by Acute Post-Concussion Syndrome, Chronic Post-Concussion Syndrome, and Frontal Lobe Impairment. As a result, he spent seven days at Vanderbilt Hospital in Tennessee.

“When I first got the phone call that he was injured, I assumed he had simply strained his back, and that he would miss a few days of work,” Katrina said of her husband’s accident. “When I got to him, I knew it was bad.  He was completely distraught and was screaming and writhing in pain…There was worry of spinal cord damage, which thankfully wasn’t the case…”

“I worried about a head injury at first because he repeated himself over and over again, and he wasn’t making much sense, but when the scan of his head and neck came back normal, I naively assumed that meant he had no injury,” Katrina added. “I didn’t know at the time that concussions and many other head injuries don’t necessarily show up on scans. Even after we received the diagnosis of a concussion, I wasn’t overly concerned. All I knew of concussions came from sports, when athletes would sit out a game or two, and then would seem fine. I had no clue there is a much more sinister side that’s never discussed.”

According to the Brain Line website, an individual who suffers a brain injury may experience significant emotional and behavioral changes. The frontal lobe of the brain controls impulsiveness and personality. If this part is damaged, there is often no braking mechanism for self-control such as with anger, aggression, or inappropriate comments.

A concussion is a mild traumatic brain injury that typically occurs after a hit to the head. This sometimes results in post-concussion syndrome. The Mayo Clinic website explains this syndrome as a complex disorder in which symptoms last for weeks, months, and even a year or longer after the initial injury. Symptoms of post-concussion symptoms may include headaches, fatigue, irritability, noise and light sensitivity, and loss of memory.

Wesley spent weeks in physical therapy for his back injury and months of cognitive rehabilitation and migraine management.

“For me, everything after the accident is very surreal,” Wesley said. “I don’t remember much about 2019 at all. A few things I do remember, but other things I have no memory of at all. Some things I can vaguely remember, but I’m not sure if I’m remembering them correctly, or if I’m just remembering the way I understood it at the time.”

Much like a broken bone requires rest and time to heal, the brain is similar. At that time, however, Wesley’s concern was his back injury and physical pain, as well as the burden he felt he was placing on his family.

“My initial worry was just getting back on my feet so I could get back to work,” Wesley said. “And then once I realized it was going to cause more pain and problems than I hoped, my worry shifted to whether I could physically make it to my retirement.  I didn’t want my family to have the financial burden of me not being able to work.”

Although Katrina was concerned for her husband’s physical ailments as well, her biggest concern was helping their entire family cope with the difficulties that followed his brain injury.

“I was concerned with the emotional trauma our kids were experiencing,” Katrina said. “It impacted them on every level, too. At our daughter’s preseason tournament last year, the buzzers in the gym and the lights reflecting off the floor caused Wes to have a migraine. So, the only other games he attempted to go to were homecoming and eighth-grade night, and that was just specifically for her because she was involved in both.  At the time, our son was three and had to learn to not make loud noises. Toys with loud sounds were thrown away, and even flashlights were put up because even the light flashing around from flashlights would trigger a migraine.”

Katrina explained that even the smallest change in schedule or daily life would upset Wesley, causing him to become angry and lash out at everyone, only to have no recollection later. She described this entire period in their lives was like living through a tornado.

“Theoretically, my kids and I all heard the sirens and ran for cover,” Katrina said. “While it was looming over us, I knew it was bad, but until the storm was over and we could step back outside to survey the damage, none of us realized just how bad it had been and just how much had been destroyed. When we were standing alone in the wreckage of dreams and goals that had once seemed so important, it was very hard to see anything positive at first. That was tough.”

Although she tried to be vocal with others about how much Wesley was struggling, Katrina came to a grim conclusion: very few understood.

“Brain injuries are one of those things that you can’t understand unless you’ve survived one as a family,” Katrina said. “I will forever be thankful for the support we were shown right after the accident and right after we got home. The outpouring of love and support from our community was completely humbling.”

“The unfortunate side that no one talks about is that eventually, as time goes on, people stop calling, stop checking in, and support dwindles away, even from the places you would most expect it,” Katrina added. “Sadly, that’s when families need support the most, but once that initial spotlight is gone, everyone quickly forgets and moves on.”

Not only did Wesley’s injuries affect him and his family, but also relationships with others.

“We lost a lot of friends along the way, especially over the summer and in the fall (of 2019), because even though I felt like I was screaming at the top of my lungs that he had a head injury and that he wasn’t himself, people would get angry or upset over things he would do or things he would say,” Katrina said. “…Many people disappear when life gets messy, and it breaks my heart to think of other families facing it alone like I did…It’s heartbreaking.”

Because much can be unknown when pertaining to a head injury, even specialists could not give a definite answer to when Wesley’s brain would heal. The entire ordeal was mentally and psychologically exhausting.

“From the beginning, I was told by his doctors and neurologists that it takes six to twelve months to heal from a concussion, sometimes up to two years, and sometimes not at all,” Katrina said. “That’s a very tough scale to have to wait on. I didn’t know if what we were going through would run its course in a couple of months or a couple of years, or whether it was something we would permanently face for the rest of our lives.”

Although 2019 was traumatic for the England family, 2020 became a year of hope for Wesley’s recovery. Katrina stated that all of the typical behaviors associated with a frontal lobe injury subsided.

“After Christmas was when I saw the biggest improvement in him,” Katrina said. “That was really the first time I think he became aware of just how injured he was and just how bad things had been in the summer, fall, and early winter (of last year) …So when in January he seemed to improve, it was very noticeable. February was a little better. March was better than February, and by April he was acting just like his old, sarcastic, witty self again.”

While Katrina does attend all of Wesley’s doctor appointments due to his little to no memory of last year, he stated that the physical changes remain the biggest challenge for him personally.

“I can’t do some of the things I used to be able to do,” Wesley said. “There’s still a concern with my back. I still hurt daily. Exercise keeps the pain manageable, but my whole worry the entire time has just been to be able to stay on my feet and continue working.”

“I had to work hard on my right leg to build up strength in it because it gave out on me a couple of times, once when I was on the tractor,” Wesley added. “I know my family was more impacted by the aftermath of my concussion, but to me all of that is a blur. The physical limitations and just getting tired so easily have been the hardest things for me to accept. I lost a lot of things that were important to me in the wake of both injuries.”

Employed by Louisville International Airport Fire & Police and Buechel Fire & EMS, Wesley said he is blessed with understanding coworkers.

“In my career, God put me in a position where I accepted a job that I consider a once-in-a-lifetime opportunity,” Wesley said. “I was blessed enough to receive a position that only thirty-four other people in the state hold. I needed it because it’s easier on my back, and it’s easier on my body…It’s allowed me to expand my knowledge of emergency services, allowed me to finish my degree, and opened up doors that I never thought were possible. Never in my wildest dreams did I imagine that my three passions could merge together to allow me to simultaneously operate as a critical care paramedic, an aircraft rescue firefighter, and a certified police officer.”

Wesley is also still employed part-time with the Hart County Ambulance Service, still caring for those who will always hold a special place in his heart.

“I am grateful for the years I was able to provide service to the citizens of Hart County in a full-time setting,” Wesley said. “That is still the one thing I miss on a daily basis, and now when I get to pull a shift back in Hart County, it reminds me of the great people we serve in our community. Serving the people of Hart County is and always will be my greatest passion, and personally knowing and being able to help citizens I’ve known my whole life is something I miss.”

Although his family experienced one of the most traumatic chapters of their life, Wesley said the accident and aftermath allowed them to appreciate one another more.

“Before the accident, I worked a lot. I was away from home a lot,” Wesley said. “My family didn’t get the time or attention they deserved. This injury forced me to slow down…Being home more with my family has made me realize how much I missed out all those years I was working two and three jobs at once.”

“I have a teenage daughter who grew up on me while I was at work,” Wesley continued. “I missed a lot of my son’s first years. I didn’t choose to have to slow down, but it’s made me realize how important my family is to me. I think we had all put each other on the back burner before, and the people who should have gotten the best of us got what was left over. That doesn’t happen anymore. I am grateful that now I have the time to spend with my family so that I can be the father and the husband that they need.”

For more information regarding brain injuries and awareness, visit the Brain Line website at www.brainline.org or the Brain Injury Association of America at www.biausa.org.