If you are reading this book probably you or someone you know has had some type of brain injury. People who have suffered similar loss or hardship have immediate bonding and understanding. I hope you feel the bond we share as people who have undergone experiences few others will know. I hope my story helps you. Websites and books you read may have statistics that vary depending on when the information was gathered and printed. I have tried to find the most current for you.

In the United States alone, the statistics state that every 23 seconds someone is diagnosed with traumatic brain injury (TBI). You might also hear it referred to as mild traumatic brain injury (MTBI), closed head injury, head trauma or severe concussion. That total is over 2 million injuries per year or 100 per every 100,000, which is more than those diagnosed with breast cancer, HIV/aids, spinal cord injury, and multiple sclerosis combined. This comes with an estimated cost of $56.3 billion per year; yet most people know little about this type injury; fewer still understand it. Of those 2 million each year, 52,000 will die, and 70,000-90,000 per year will have lifelong impairment which also includes dramatic change in the course of one's individual life, profound disruption of family, and enormous loss of income and earning potential. (National Institutes of Health at nih.gov, Brain Injury Association of America at biausa.org, Centers for Disease Control and Prevention at cdc.gov). TBI is significantly under diagnosed by the medical community. In many cases the victim does not even realize that help is needed. The numbers of brain injuries have increased significantly in recent years and will continue to rise with the ever growing population and fast pace of our lives.

You won't find TBI, MTBI, or closed head injury in the dictionary, although they are used interchangeably. You will, however, find concussion. What is concussion? The Merriam-Webster online definition is as follows:

Stunning, damaging or shattering effect from a hard blow; especially a jarring injury of the brain resulting in disturbance of cerebral functions. In addition, a mild brain injury has been defined as being a brief change in mental status and a severe injury affects the patient for an extended period of time.

Signs and symptoms can be subtle and may not appear until days or weeks following injury. This period of delay for the onset of symptoms can be longer for children (Nih.org Consensus Development Statement October 26, 1998). Brain injury can cause epilepsy and/or increased risk of Alzheimer's disease, Parkinson's disease, and other diseases that are prevalent with age.

Of the cases reported, 50% are the result of a car or bike accident, 20% from some kind of violence, 21% from falls, and 9% reported from sports accidents (300,000 a year per cdc.gov). Injuries from sports are not reported 90% of the time, so the sports injury is actually much higher (thebrainmatters.org 2005 and NIH Consensus Development Conference Statement October 26, 1998). In fact, in 1904, United States President Theodore Roosevelt threatened to outlaw football after 19 college players were killed or paralyzed from brain or spinal cord injuries.

Traumatic brain injury is the leading cause of death and disability worldwide, the leading cause of death of those under 45, and the leading cause of seizure disorders (nabis.org August 12, 2006). This injury is twice as likely to occur in males (NIH consensus Development Conference Statement October 26, 1998). I believe this is so because males are more likely to participate in risky behavior. The highest incidences for traumatic brain injury in the general population are those 15-24 years of age and those over 75.

There is no cure. Of those injured, 85% do not receive treatment or the needed counseling to help with long term difficulties (headinjury.com update of December 12, 2005). The high cost of rehabilitation has placed help out of reach of many who would otherwise seek help. Even those with insurance, over time, experience a dramatic drain on finances from copayments for so many appointments or from maxing out the limits of insurance coverage. There may also be fees from doctors or specialists that do not accept insurance or aren't on your particular plan but whose expertise is needed if you are to recover.

Having received this injury, you are in it for the long haul. I know you meant to sign up on the other list but now that you are here, you can't leave. We must help each other through this experience by passing along the little tidbits that helped us along the way. God Bless you on your journey.

I hadn't really ever known anyone diagnosed with a TBI, MTBI, closed head injury, or a concussion or severe concussion with any long term problems from an injury. (Shall I say problems that are related back to the injury.) These are all terms I have come to know that seem to be used interchangeably. Almost everyone knows someone who fell or whose child was taken to the doctor and told he or she has a concussion. Instructions are given to take the child home and watch him or her closely for the next 24 hours. Usually the child has a headache and it's over, nothing more said.

Then there are the many stories like the man who fell and landed with the screwdriver in his head. It was a WOW story! Television news showed pictures and highly trained surgeons performed complex surgery. Amazingly he recovered quickly, and was just as quickly out of the news. What a lucky guy, all better now. That's what all those following the story would think. Well I am sure that just like Paul Harvey would say "then there's the rest of the story."

This is the rest of my family's story. It begins with our son: Having the knowledge now about TBI, I am able to look back and tell you where it started in my house undiagnosed. I am not sure which hit was significant until the last. We were told that once you have a TBI each additional hit builds on the other. What I can tell you is there were signs all along that went unnoticed. Why? We didn't know what they were. It wasn't that we were totally negligent or oblivious parents. We did see a doctor on a regular basis when there seemed to be what we considered a medical problem.

Knowing there was a problem was a different thing. Some people don't realize there is a problem, especially with a child at a young age. We were among those people. People like our son may just think that something is hard for them. They don't want to draw attention to themselves or the fact that they seem to be different. Maybe they don't know how to verbalize it; maybe they fear that others will think they are just being dumb. There are many reasons that the injury goes unnoticed. Many of those reasons also relate to the doctor who doesn't understand TBI. Many relate to the patient and their family who don't communicate what's going on among themselves or even know to bring it up to the doctor.

Strapped in a child carrier on a bike at the age of 18 months, our youngest son encountered his first incidence of head trauma. When they were turning a corner the bike slid on gravel. Our daughter, the driver fell clear. Our son being strapped in, slammed his head into the curb. We rushed him to the doctor. The diagnosis was a severe concussion. We were to not let him sleep for more than 1 hour for the next 24. We set the alarm and woke him up and tried to engage him for about 10-15 minutes every hour all night. There didn't seem to be much concern about it once he made it through that night. No one said anything to us to watch him for any other signs during his development.

When he was age four, we were at the park; I was on the other side of the slide with his sister when a little girl came up behind him. She threw a large rock that hit him on the back of the head cutting it open. Where the rock hit it bled and developed a large bump. We went home, iced it, and gave him some baby aspirin. (Today, years later the bump is still there although smaller.) The complaints of headache or soreness lasted about a week. As parents of five, we took it in stride that children are going to get hurt. We did not notice or know to look for anything that we would have thought to be related to this incidence.

While bike riding during his fifth year, once again he crashed, slamming his head into the mailbox post, made out of railroad ties, taking a chunk out of his ear. Again there was pain, ice, aspirin, and complaints that disappeared after a few days. Within 6 months, again on the bike, he experienced another crash, slamming his head into the street, requiring 6 stitches. No one at the hospital informed us of anything to watch for long term, and we didn't piece together the incidence of injuries he had sustained over the five years of his life until later when it was pointed out to us.

Fourth grade came along. Up until that point the grades were high, but not without some struggles. Spelling was tough; reading was hard; and the math—well you get the picture. We had moved a couple of times and the teaching styles were different. We had no idea at the time there might be some other problem. He was put into a special reading group twice a week. His teacher spent extra reading time with him twice a week. We purchased Hooked on Phonics(r) to help him at home. We were thinking somewhere along the way he just missed something basic. Within weeks of all the added training the complaints started about the headaches.

After a thorough eye exam we were told "it's no wonder your child is having problems. He has a tracking disorder, and an accommodation disorder." The doctor was surprised he could read and remember anything at all. To put it simply his eyes were getting the words from three sentences in no given order. About the time his eyes would focus on a page it was time to look away from the page at the teacher to discuss the lesson and vice versa. Eye therapy was recommended. There are many children who have eye therapy in elementary school. We knew of quite a few that our children had gone to school with. He went twice a week in the beginning. Then, as improvement came, his therapy visits were reduced to once a week; they stopped because of his progress after about a year. This seemed to help quite a bit. We also made up games to help with the homework. Spelling tests were taken orally with almost always a 100%. On paper was a different story. Reading and writing remained a challenge. We later learned that eye problems are very common with head trauma.

In my research I found that often children who have had an injury may not show signs of a problem until months or years later (nih.gov Consensus Development Statement October 26, 1998). The reason for the lengthy delay has to do with the growth patterns of childhood. In the early years, a child is learning and growing at such a fast pace that he or she is able to accommodate the basic new knowledge without showing the results of trauma. This happens because the child is being helped along by their teachers and family and doesn't do much work by himself. If the injury is not too severe, the child's brain can follow along with this individual instruction that is common in kindergarten and the first two grades.

It isn't until the 3rd or 4th grade that most children are really challenged past the basics: they have more independent work; they are applying what they have learned and doing more complex tasks on their own. Then the symptoms become apparent. When this happened to us, no one asked about any previous injury, and we didn't know to offer this information, didn't even think about it.

Eye therapy led us through the rest of fourth and into fifth grade. Early in the sixth grade school term, I came upstairs from the basement to start dinner to find my son running and sliding on the kitchen floor in his socks. I told him to stop before he hurt himself. I reminded him that if he fell and cracked his head it would be at least 4 hours in the ER, and "I didn't really want to do that tonight." I turned around just in time to see him making one last slide before I could stop him. WHAM! He hit the refrigerator. One second he was up, the next flat on his back, just like a cartoon. It really was comical looking, one of those times you laugh when you shouldn't. Now, I am usually a very sympathetic Mother, but this was one of those times; and I was laughing, not knowing how badly he was hurt. He sat up and the blood started gushing from his head. Four hours and six stitches later we were on our way home. Diagnosis: cracked head on corner of fridge, will have pain for several days, come back and get the stitches out. Life goes on.

There were serious changes in attitude in the sixth grade following his injury, nothing major that couldn't be explained away with things like new teacher, first time male teacher, entering the changes of being a teenage male etc. These attitude changes lessened somewhat over time, but resurfaced intermittently, and were one of the deciding factors that led to home schooling in the early part of seventh grade.

October 2002, three and a half years later, coming out of the doctor's office with my son and getting into the car: somehow the car door struck the right side of his head. This time he was hit so hard that he was dazed. He laughed, I laughed, hard. It again was like a cartoon with the little birds circling around his head. I tried to get him to go back into the doctor's office but he insisted he was fine. We sat there for about 15 minutes just to make sure he still thought he was fine and went home. He never said anything else about it.

School for him was a struggle. We home schooled through high school and were to go through graduation that May with others who also used home schooling. During this time, we were getting ahead of the ball game by taking some community college basics that would transfer easily. In his math class, up until October 2002 of his senior year, he was maintaining an A: and then he started dropping. We also experienced some changes at home. Even friends commented about how he was changing. At that time I thought that we had just hit the time when that teenage male thing kicked in. Selective hearing seemed to be one of my biggest aggravations or at least that's what I thought it was. He would go to his room to get something he forgot when we were about to leave, and not come back, forgetting why he was there or that we were waiting to go. I could repeat myself numerous times and be told that he didn't remember my saying that. He didn't want to remember; that's what I thought. There were problems with his sleep—at times not enough and always tired, and yet at the same time he couldn't sleep. It didn't make sense.

In December I took him for a hearing test. He said that ever since he hit his head on the car door he couldn't hear out of that ear. Why didn't he tell me before? How did it happen that I didn't notice? He turned the stereo speakers up louder and mostly to the right, resetting all the dials in the car and in the house. Every time someone wanted to listen to something, he or she would have to reset everything. When I questioned him about it the response given was he wanted the sound on the side he was on. He had the beginnings of a cold when we went to the doctor's appointment, so they wouldn't do the hearing test. It was rescheduled for January.

Nobody wants to think there is something wrong with her child. At that time I felt my son was not acting like my son; there must be something going on. I was actually hoping that they would find something to explain at least the hearing part. Nothing could be worse than being punished for something you have no control over. (Being scolded for bad grades—was it lack of trying or lack of paying attention? Having others irritated at him for having to repeat themselves when he really didn't remember them saying anything in the first place.) Remember, at this point we hadn't even suspected that there was any type of long term injury. Our son was struggling. We were running out of ideas and we didn't know how to help him. We have always had a great relationship, and while it was still really good, there were definitely moments when I just thought "I don't know who this kid is, he's not acting like my son." There's something going on, it's in my house and I don't know what it is. We were on the cusp of discovering just what that "it" was, we just didn't know it yet.

"I laugh, I love, I hope, I try, I hurt, I need, I fear, I cry. And I know you do the same things too. So we're really not that different, me and you."