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September 15, 1997


The long road back

  by Deborah Stone
   They are often called the "walking wounded" because they can go about their lives for some time without realizing they've been seriously injured and to all outward appearances, they look perfectly fine. It may take a few days, weeks or even months before they discover that things aren't normal any longer. Simple tasks become difficult, retention and memory skills weaken and communication is a large hurdle they must confront daily. They may wake up one day and not know who they are, where they are or what they're doing. They are overwhelmed with fear, helplessness and a sense of panic that life may never be the same for them. They are the brain injured.
   Before May 1996, Roy Milbrandt of Woodinville, was an out-going fifty five year old man and an established painting contractor who had built up his business over the past thirty years through hard work and long hours. He was a scuba dive master who loved to travel the world, seeking new and beautiful waters in which to pursue his hobby. He was engaged to be married, involved in the community and life couldn't have been better. Milbrandt remembers very little of what happened that day in May, sitting in his car waiting at a stoplight. The impact from the car behind sent his vehicle through the intersection and he recalls waking up slumped over his steering wheel and seeing faces staring at him. Other than some severe bruising, an emergency room visit revealed no apparent serious injuries.
   Two days later, he was driving in Auburn when he received a call on his cell phone from his fiancee who wanted to know where he was. "I had to look at a sign because I had no idea where I was or what I was supposed to be doing," says Milbrandt. After a series of extensive testing, the doctors discovered that he had sustained a severe concussion and brain injury.
   The accident left him unable to remember simple details, perform math calculations (the mainstay of his job), express himself clearly and communicate with people effectively. His executive skills were totally gone. "I didn't even recognize my family members and friends for awhile. I'd just walk away from people because I just couldn't deal with them. Other times I'd become furious with something and not know how to control my anger. I was depressed and seemed to have lost lots of emotion other than crying," says Milbrandt. His business suffered because of his inability to communicate and his memory loss. He'd make repetitive orders for the same supplies because he didn't remember making the initial order.
   The doctors connected him with Evergreen Hospital's HIRE (Head Injury and Rehabilitation Center) program, a unique outpatient facility that provides services for people with brain injuries. Counseling, testing physical, speech, cognitive and occupational therapy are provided and therapists work with patients in the clinic, their homes, workplace and out in the community. The goal of the services is to help people relearn skills which will allow them to become competent and independent once again, able to reenter society. "They zeroed in on my injury," says Milbrandt, "and helped give me my memory back. It is an excellent program and I don't know where I'd be at without it."
   Therapist retaught him to add and do the necessary calculations for his job. They also helped him to learn how to retain conversations through use of a tape recorder to make oral notes to himself and through a daily planner to keep track of details. He was also encouraged to read the newspaper often to bring his vocabulary level back up to speed. "A therapist accompanied me to work several times a week for quite awhile to check on how I was doing and to provide feedback for me. She still periodically comes with me now. I was also taught how to draw my own line with my temperament and to step back if I feel I can't resolve something at the time or if I can't deal with a conflict," says Milbrandt. HIRE has helped him to not be ashamed of asking for clarification or assistance. He adds, "I have learned that total truthfulness is the most important way of dealing with this, but it's been hard. Try telling someone that you're less than you are. It's embarrassing, particularly with clients, but it's necessary."
   Milbrandt's family and friends have been very supportive and helpful through it all and continue to be there for him, although it has not been easy for them. He says, "I'm a different person now. My personality is different and I know these changes have been really hard for everyone."
   His brother Richard works for him as does his fiancee and the business is doing well. They and others assist in filling in the gray areas of his memory by showing him photos of past events and by telling him about his habits and preferences before the accident occurred. "I was told I used to like to eat red meat, but now I don't particularly like it," says Milbrandt. Although he feels that the worst is over with, Milbrandt still has days that are difficult. He says, "I never know when I'll have one of those cloudy days or when I'll experience a moment of anguish because I don't recognize someone. The memory loss is so painful, but I feel it coming back each day on a greater scale." Doctors tell Milbrandt that his prognosis for a full recovery is guarded for at least the next two years. He must continue with his therapy and undergo tests periodically to determine what areas are strengthening and which ones need further help. "It's a long road back," says Milbrandt. "You don't just wake up one morning and say I'm back to myself. I have learned to rely on having a positive attitude and to use humor to get me through the day."