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Answers to your personal questions from someone who
cares........ 
DEAR PAT: Six
weeks ago my son was in a boat accident. His two friends were killed and he
received severe brain trauma and other physical injuries. There were questions
as to whether he would live. He did, and he opened his eye approximately 1 1/2
weeks later. We were told that if he lived, he would have little quality to his
life. Two weeks ago my son was transferred to a skilled nursing care facility.
We were told he would be able to transfer to a rehab program in 2 to 4 weeks. He
made it in 12 days. My son is coming along physically though there is permanent
physical damage. He repeats things, and has made some comments on his own. We
are told he is now in stage 4 of six stages. He has become very agitated. I
could tell when I talked to my daughter-in-law last night that she is very
stressed. She is only 26 and has much to deal with. My questions is, what is
this stage four? Can my son become stuck in it and never make further progress?
What is the next step after this aggressive stage? One thing I have learned is
that the only thing certain about brain injury is that nothing is certain. This
makes it very difficult to ask questions because I have been told doctors give
the worst scenario so that family won't be disappointed. I've also noticed that
the SICU perspective and the rehab perspective is different. It was the doctor
at SICU that was so negative about my son's recovery prospects. I'm so happy to
find this site. This situation breeds loneliness and isolation. I must put on a
happy face for the benefit of elderly parents, etc. Thanks so much.
PAT'S RESPONSE: Boating accidents are an increasingly common problem
and I'm sorry to hear about your son's tragedy. I doubt the doctors were
intentionally providing the "worst scenario." However, they do want to
provide a realistic picture of a person's risks. Sometimes people beat the
odds, but the doctors need to be honest and tell patients and family members
when the odds aren't good. In your case, it sounds like your son is doing
better than expected.
I'm not sure which "stages" you are referring to. People have come up
with several ways to rate recovery from coma or traumatic brain injury. One
of the most commonly used scales is the Rancho scale which includes eight
stages.
Understanding the eight Rancho Levels can be helpful to track patients
following traumatic brain injury. The levels and descriptions are listed
below. Keep in mind that some people may plateau at a certain level and
there is no way to accurately predict how fast someone will progress or
where they may plateau.
The Rancho levels:
I. No Response
II. Generalized Response
III. Localized Response
Patient responses are specific but inconsistent, and are directly
related to the type of stimulus presented, such as turning head
toward a sound or focusing on a presented object. He or she may
follow Simple commands in an inconsistent and delayed manner.
IV. Confused-Agitated
The patient is in a heightened state of activity and severely
confused, disoriented, and unaware of present events. Behavior is
frequently bizarre and inappropriate to his immediate environment.
Patients are unable to perform self-care. If not physically
disabled, they may perform automatic motor activities such as
sitting, reaching and walking as part of the agitated state, but not
necessarily as a purposeful act.
V. Confused-Inappropriate, Non-Agitated
Patient appears alert and responds to simple commands. More
complex commands, however, produce responses that are non-purposeful
and random. The patient may show some agitated behavior, but it is
in response to external stimuli rather than confusion or distress.
The patient is highly distractible and generally has difficulty in
learning new information. He or she can manage self-care activities
with assistance. Memory is impaired and verbalization is often
inappropriate.
VI. Confused-Appropriate
Patients show goal-directed behavior, but rely on cues for
direction. They can relearn old skills such as activities of daily
living, but memory problems interfere with new learning. Awareness
of self or others begins to re-emerge.
VII. Automatic Appropriate
The patient goes through a daily routine automatically, but this
is robot-like with appropriate behavior. He or she will have some
recall of activities and superficial awareness of his or her
condition. The patient requires at least minimal supervision because
judgment, problem solving, and planning skills are impaired.
VIII. Purposeful - Appropriate
Patient is alert and oriented, and is able to recall and
integrate past and recent events. He or she can learn new activities
and continue in home and living skills, though deficits in stress
tolerance, judgment, abstract reasoning, social, emotional, and
intellectual capacities may persist.
DEAR PAT: Two and a half years ago, my best friend
from childhood sustained a severe brain injury to her brainstem. All of her
motor skills were affected and although she has been in Rehab for the past two
and a half years, her Rehab team decided to stop therapy for a while due to a
plateau in her recovery. As with all brainstem injuries, her motor skills were
affected. She has no use of her left arm, and her right arm has significant
tremors, interfering with functional tasks. She has made significant gains in
her trunk and legs, however, her goal of walking has not been obtained (yet).
Her speech was also significantly impaired, but she does speak and can
communicate her needs. The remarkable thing throughout all of this, is that her
mental status and intelligence were hardly affected by her injury. She has
minimal short-term memory loss, and she does process things slower than usual.
My question to you is, now that therapy has decided to take a break, do you have
any suggestions of other activities or treatment strategies that the family
could look into? Any info would be very helpful. I would hate to see a healthy
mind and healing body be forgotten in the midst of health care that wants
immediate results. Her family is very involved and willing to try anything.
PAT'S RESPONSE: I'm glad to hear your friend has so many people that
care and show her love and support. Probably one of the best things you can
do is to continue to be such a great friend - social support and
companionship are very helpful. As for continued rehabilitation, it may be
helpful, but based on the length of time post-injury, improvements will
likely be slow and gradual. Some people find that persons with balance or
motor problems can build strength by exercising in a swimming pool (although
consult with her physician first!). Playing video or board games that
emphasize memory and/or motor skills can be helpful and fun. Talk with her
physician and/or a physical therapist about activities that will help to
build strength and maintain good health.
The best thing to do now is to focus on your friend's strengths. From
what you wrote, she has made tremendous progress over the past 2-1/2 years!
Encourage her to set goals and to develop her interests and hobbies. Work
with her to identify things she can do and enjoys doing. What can she do to
help her feel more involved and productive? Since you say she communicates
well, talk with her about what she would like to do. What future goals does
she have? How can those goals be achieved? Let your friend guide you into
what activities she would like. With friends like you, I know she's in good
hands.
DEAR
PAT: My son's Social Security Disability was cancelled 3 years ago because
they state he is able to work. However, he has not been able to secure a job on
his own and what work he has had was through employment agencies. Even though
these are supposed to be open to full time employment at the job sites, he is
always told he is no longer needed. The longest he was kept was 10 days. He
always works when told to report but I suppose he is inappropriate in someway.
We need advise in securing SSI or other financial support. He wants and needs to
be independent.
PAT'S RESPONSE:
- Talk with his physician about his condition and prognosis. In order
to qualify for SSDI, you will need a doctor to describe the patient's
problems and state that he is unable to work.
- Talk to your son or his former employers. Finding out why he cannot
hold a job is essential for determining if this is due to a disability,
behavior problem, or some other reason.
- Investigate the possibility of having your son evaluated by a
psychologist, psychiatrist, or neuropsychologist. Documenting behavior
problems may help to qualify for SSDI - but more importantly may suggest
some treatment options to help him improve his behavior and allow him to
keep a job.
- Contact your state's Department of Rehabilitative Services. Most of
these programs include return-to-work training and supportive employment
services to help people successfully re-enter the work force. Perhaps
they can suggest some programs that may be able to help your son.
- Contact your state's chapter of the Brain Injury Association and ask
if they have any information to assist people in your son's situation.
Also, you may find some useful advice in the FAQ section of this
website.
DEAR
PAT: My 26-year-old son was involved in a motor vehicle accident on 11/7/99.
He was rear-ended while at a complete stop and suffered a serious head injury
that required over a dozen stitches. Since that time he has had many ailments,
headaches, huge swollen glands, viral attacks, but the latest is the most
upsetting. He is experiencing severe joint pain. It started in his left ankle,
then his right, both knees, now his right wrist and elbow. When he awakens, he
can not walk or function until he has taken aspirin or pain medication. He has
seen a neurologist who says all is well. Now he is scheduled to see a
rheumatologist since my family doctor thinks he has rheumatoid arthritis. I
think this is trauma related and here is why. Prior to the accident, Jeff was
running 10 to 20 miles daily. He held two jobs, one at a fitness center where he
was a licensed personal trainer, certified spinning instructor, etc. The other
job is as a track coach at a private boys' school. He had been training
seriously for the Boston Marathon for over a year and had planned to compete in
the Philadelphia marathon on November, 1999. He has lost his job at the gym
since he is unable to perform. He is becoming very depressed as am I since I can
not seem to help him in any way. I do believe that this is related to the
accident and/or head trauma. Do you have any similar case histories or anywhere
to direct me for help? Thank you for your time.
PAT'S RESPONSE: Hm... Sounds like a complex case. I'm not sure I can
be of very much help since arthritis and diagnosis of joint pain are not
within my area of expertise. I can tell you that it is more common to have
musculo-skeletal pain after a traumatic injury - such as pain in the muscles
of the neck and back.
Keep in mind that just because two things occur at about the same time
doesn't mean that one caused the other. In other words, if he developed
arthritis, it could have been independent of his accident and only a
coincidence. Below is a link to a site with LOTS of links and information
about arthritis. You can read about suspected causes of arthritis (including
the possibility of infections or genetic factors) as well as current
research and treatments.
http://www.pslgroup.com/ARTHRITIS.HTM#Disease
DEAR
PAT: My son of 16 1/2 months died of a traumatic head injury. His whole
brain was swollen and the cause of death was subdural hematoma, cerebral edema,
and blunt impact to the brain. I was not home with my child. My husband was home
and is now in jail. I can not put my son's death to rest because I do not know
how any of this happened. The prosecutors told me it was from slamming or
shaking. My husband told me he fell out of the crib and later on fell off the
couch. I don't know what to think. I miss my little boy and little boys of his
age shouldn't have this happen to them, they are so pure. Is there any
information you can give me that might ease my mind on what might have happened?
PAT'S RESPONSE: I'm sorry for your loss. Nothing is more tragic and
heartbreaking than the death of a child. Unfortunately, I'm afraid I can't
ease your mind very much. It is questionable that those types of injuries
would occur from the minor falls your husband described. Even if he is
telling the truth, one has to consider whether your son was being properly
monitored by adults if he can sustain two serious falls within a short
period of time. However, this may also be a case of child abuse or Shaken
Baby Syndrome. The doctors that examined your child should be able to
determine if his injuries are consistent with falling. Injuries from child
abuse are usually quite different from those sustained "accidentally" and
the medical evidence will probably hold the answer to your questions. Please
see Pat Column #11 for more detail on Shaken Baby Syndrome (Click the
"Archives" link at the bottom of this page).
DEAR
PAT: My grandfather recently experienced a massive hemorrhagic stroke, from
which the doctors predicted that he would not survive. He was in a coma for
almost two weeks and much to everyone's surprise "woke up" one day. He was
transferred to an acute care traumatic brain injury cognitive rehab in New York
and has made great progress. At this point, he is able to recognize family and
friends, nod yes or no to questions and even attempt to speak. He needs
cognitive, physical, occupational and speech therapy. He is going to be
discharged from the acute care facility and we were advised to find a long-term
care traumatic brain injury certified facility to have him transferred to. I
have done some exploring for facilities in New York and New Jersey but seem to
have hit roadblocks with each potential facility I find. Is there a resource I
can use for a listing of appropriate and available facilities in the area. Thank
you very much for your help.
PAT'S RESPONSE: It's not clear to me if you are looking for a
rehabilitation hospital. This is a medical facility that will provide
rehabilitative therapies such as physical, occupational, and speech therapy.
If this is what you are looking for, please see the answer to the next
question.
On the other hand, if by "long-term" you are looking more for residential
facility that can also provide medical care, you may want to explore the
following websites:
This is a website with long-term care information for New Jersey. It
contains a locator for long-term care sites in the state.
A similar site for New York
This is the website for a national organization of long-term health care
facilities.
DEAR
PAT: My brother is 45, 4 years post-injury. He is in a 1/2-day outpatient
program for the past 3 years. This has been great, but I feel that he needs much
more at this point in time. The usual resources (voc. rehab) have not had much
else to offer. Are there any intensive in-patient rehab facilities in the
eastern U.S. for people that are a few years post-injury, that concentrate on
vocational issues and moving past the "typical" outpatient rehab services?
PAT'S RESPONSE: It's very unusual for a person to be admitted to an
inpatient facility several years after discharge without some type of
deterioration. Certainly if you can afford the costs, you can probably find
a facility willing to admit your brother and provide intensive services.
However, keep in mind that 4 years post-injury, further improvement is
likely to be gradual. In addition, it is unclear whether a person will
actually benefit from intensive therapies that many years post-injury. In
some cases, too much therapy can leave patients stressed and fatigued,
possibly even slowing further recovery. My advice is to talk these issues
over with your brother and other family members. If your brother agrees that
he would like more intensive therapy on an inpatient basis, you may want to
investigate full-day treatment programs or having in-home therapies before
you consider the very expensive option of an inpatient placement.
As for locating rehabilitation facilities, the following links may be
helpful -
A checklist of questions to ask when looking for a Rehabilitation Center
A listing of some rehabilitation sites in the United States (This is far
from exhaustive, but might be a good starting point).
Rehabilitation facilities should be accredited by either CARF or JCAHO
(but not necessarily both).
To check on a facility's accreditation with JCAHO, visit their website
at:
For a list of CARF accredited rehabilitation facilities, contact CARF at:
DEAR
PAT: After a person has been injured in a car accident and suffers a
traumatic brain injury, who determines they are "of sound mind" to sign any kind
of legal papers? To ask for a divorce? When is that determined? At what point is
it discussed? I'm referring to my brother who suffered a closed head TBI nine
months ago. He has been home from the hospital for five months and his wife
treats him with zero respect. She constantly talks down to him and I'm afraid of
how she treats him when I'm not around. He begs me to take him away from her. I
don't know what to do. I think he is "of sound mind" now. Thank you for your
excellent work. I don't know how I would have survived without you during these
last few months.
PAT'S RESPONSE: You need a sound mind to get divorced? You sure don't
need one to get married! Actually, you are asking a legal question. You
should consult an attorney for more specific information and I can only make
general comments. Decisions about someone's competence for making legal
decisions (like divorce) would likely be made by a judge, although judges
often decide to follow the guidance of a medical or mental health
professional who may do an evaluation. Competency is usually task specific.
That means that you are neither "competent" nor "incompetent." Instead, you
may be competent to do some things, but not others. For example, a person
could have the capacity to decide his or her medical care, but not to make
financial decisions. It sounds weird, but people could have a deficit in a
specific area (like math or reading) that would affect their ability to make
some kinds of decisions but not others. In most cases, the individual
determining "competence" will attempt to determine if the person understands
the issues and alternatives in making a decision for that specific issue (in
your brother's case, divorce).
Probably the place to start is simply for you or your brother to make a
phone call to a divorce attorney. He or she will be able to guide you
through the laws and procedures of initiating divorce in your state. It may
be that competency will not even be an issue if either your brother's wife
agrees to the divorce, or if your brother is capable of making an informed
decision.
A final note. If you believe that "zero respect" crosses the line into
verbal or physical abuse, there are other avenues to pursue. Spousal abuse
is against the law regardless of gender. Contact an attorney or social
services for more assistance.
DEAR
PAT: My husband had a traumatic brain injury in 1996. He has responded very
well to therapy. He walks with a walker, speech is somewhat impaired, however,
we can understand him. He is still incontinent and gets very frustrated about
this. Is there something that we can try to help this situation?
PAT'S RESPONSE: Incontinence is a frustrating and embarrassing
problem. Your husband should consult his physician to determine the cause of
the incontinence (for example, is it due to lack of muscle control, lack of
sensation, or some other reason). Your physician may be able to recommend
some medications that can help. There are millions of Americans who suffer
from incontinence, and many use adult diapers or protective underwear to
help with this problem. Try to be supportive and understanding. Ask your
husband's doctor to talk with him about this problem. Counseling may help
him to deal with his frustration and to understand that incontinence is a
very common difficulty affecting millions of Americans.
DEAR
PAT: I'm glad to see so many people being able to ask you for help, but I
didn't see many about TBI in children... Do you know of an educational program
or summer camp or something specifically for head injured children?
PAT'S RESPONSE: There are rehabilitation programs specifically for
children with brain injury. Programs and support groups may be available
through a local children's hospital. Call and find out if they offer any
outpatient programs for children with brain injury or if they can refer you
to someone who does. You can also contact the Brain Injury Association and
ask for help locating resources.
If you've read Pat's column before, you know that existing programs for
"special needs" children (e.g. learning disability) can sometimes be
modified in a way to assist a child with brain injury. Talk to people
involved with these groups in your community and find out if they can be
modified to assist a child with brain injury.
DEAR
PAT: My brother died from anoxia due to an accident last year after living
in a vegetative state for 3 months. Although at first in an ER, he was later
transferred to a long-term care facility. I was shocked to see how many young
people were there. My questions arise out of sheer curiosity: how many young
adults nationwide live in a persistent vegetative state? what percent of them
recover? How many facilities exist nationwide that care for young adults in
vegetative state?
PAT'S RESPONSE: These are excellent questions. Estimates I have seen
indicate that between 10,000-25,000 people exist in a vegetative state in
the United States. Exact numbers are hard to determine because of
disagreement about diagnosis, the relative rarity of the condition, and the
fact that people with brain injury may "progress" out of a vegetative state.
I am unaware of any statistics on the number of facilities that care for
patients in a "vegetative state." Partly, this would depend upon whether you
included trauma hospitals, or whether you are only considering long-term
facilities of patients in persistent vegetative states.
For more information (probably more than you really want) - check out
this website:
DEAR
PAT: My 18 year old sister was involved in a serious car accident on
December 21, 1999 and sustained serious head injuries. She was not breathing on
arrival at hospital and was put on life support for 2 days. Three weeks down the
track she still has Post-Traumatic amnesia, but not seriously. She can remember
most things long term, although without a lot of emotion as we lost our mother
in a car accident in October 99. She is still in rehab now although insists
stubbornly all the time that she wants to go home, and has to go back to work. I
feel that she used work as a means to cope with mums death but what the family
is finding difficult is that before the accident she was a loving, caring person
but now she doesn't care how others feel, ignores visitors and constantly tells
us that no-one visits. She says that we are just family and have to be there
even though we have been with her everyday, with a loss of money and time etc. I
love her dearly and am at a loss as to how to find the sister she was. Is there
anything I can do apart from going crazy?
PAT'S RESPONSE: Well, please don't go crazy. That won't help anyone.
Probably the most important thing to remember is that your sister's brain
injury is probably affecting her behavior. Neurophysiological changes after
injury can results in symptoms such as difficulty controlling emotions (or
showing no emotion), altered perceptions, difficulty with memory, or
distorted sense of time. For example, even though you visited yesterday, it
may seem like a much longer time to her. In addition, she has had a serious,
traumatic event and this can cause a strong emotional reaction. She is
likely reacting to her trauma, wondering about her future, and frightened
that her life may never again be "normal." Also, she may be grieving now
both for your mother and for parts of herself she's afraid are gone. Try to
remember not to take the behavior personally, and just remember that this is
a normal part of her injury. Also, if she was just injured on December 21,
1999, she has a VERY recent injury. Brain injury recovery is a long-term
process, and it is unrealistic to expect her "back to normal" in just a few
weeks. Be patient and give it some time.
Pat has one last piece of advice! Don't expect your sister to be grateful
for your "lost time and money." Being a member of a family is sometimes
about making sacrifices. Just ask yourself if your sister would do the same
for you if roles were reversed. From what you describe about her before the
injury, it sounds like she would.
DEAR
PAT: I have a niece, 18 years old, who lives in Cali, Colombia. Last October
she was in a very bad car accident, and was in a coma for over 2 months. She
woke up 4 weeks ago. Her recovery so far has been extraordinary, she can walk
with help, can talk, and understand things pretty well, she has no short memory,
and has some tremors in the left hand and head, she takes medication for it. I
was very glad to see your site as I will e-mail my sister so she can access it
too. A question I have is this, In Colombia they have no access to any
rehabilitation centers or programs as we do in the States. She has been told to
come to the States for further help. (She received physical therapy, and they
have consulted with various specialists.) All recommend for her to come here.
Because they don't have insurance, all have to be pay by cash, my sister is not
rich, but the prizes for the services in the States are astronomical. Do you
know of any organization, or entity that could help with some financial
assistance? I want to thank you for the help you have given and the amount of
information this web site offers.
PAT'S RESPONSE:I would start by contacting the Brain Injury
Association and asking if they have any ideas or if they can offer some
help. Try contacting charity organizations such as the Red Cross, United
Way, or religious organizations to see if they might be willing to provide
funds. States have provisions for indigent care, so you might find out if
your niece would qualify in your state (contact a state funded hospital -
such as a teaching hospital at a University). You might also ask your own
religious group (church, temple) for help. I wish I could give you better
advice. I hope things work out for her!
DEAR
PAT: My son had a car accident in Aug of 1994. He has a Traumatic Brain
Injury with short-term memory loss and a speech deficit. We are trying to find
him a job and the Department of Rehabilitative Services has been very helpful,
but we are hitting brick walls right now. As soon as an employer finds out he
has a deficit they say, "We'll call you!" We live in Chester, Virginia and I am
trying to find a place where he can get out and see other people other than our
family! Do you know of anyone available in the area or who I can ask in the
area? Thank you for your help!
PAT'S RESPONSE: Pat has several ideas for you! A visit to a chapter
of the Brain Injury Association of Virginia (in Richmond, 355-5748) can be a
helpful source of support and education. There are also brain injury support
groups in the Richmond, Virginia area. The Brain Injury Association will be
able to provide you with contact information (I know there are groups that
meet at Sheltering Arms Rehabilitation Hospital in Richmond). If you believe
individual and/or family counseling might help, you could try contacting the
Department of Physical Medicine and Rehabilitation at VCU at 828-9055 (They
maintain this website). They offer counseling services on an outpatient
basis and have experiencing in working with people struggling with
return-to-work issues.
DEAR
PAT: I have made friends with some people who have brain injury and live in
a nursing home. The home is privately owned and for profit. Staff turnover is
non-stop, and it appears that the residents, who are confined to one hallway
with a locked door, are not getting opportunities for community integration and
vocational services. What can I do? I volunteer at the home and have become
friends with many of the residents. They tell me that they feel trapped, that
they would like to move out in an assisted living situation, and that they would
like to work and get out in the community more often. The case managers seem
uninformed regarding the opportunities and when I inquire, they tell me that I
can not meddle due to confidentiality issues. However, the residents have
trouble remembering to ask questions and advocate for themselves. Many of them
do not have any concerned family member involved. I am really frustrated and I
want to help, but I don't know where to go for the help!
PAT'S RESPONSE: You sound like a really good person who is trying to
give to others. And you work for free? Can we clone you?
One thing you could look into is whether you could locate a church or
civic group to organize volunteers to spend extra time with the people at
this home. You may even be able to organize an outing if you can get the
permission of the facility. Try to find an ally among the case managers or
staff. If you can find someone with some authority that also would like to
increase the opportunities for community involvement, you will probably make
some progress.
Although you have good intentions, also keep in mind that you do not have
access to medical/psychiatric records. Many patients in nursing homes may
have significant cognitive deficits that are not evident to a lay person.
Seizures, high risk for stroke, or other health complications may require
intensive observation and low stress levels. Some patients may have periods
where they are alert and aware, but may also have episodes of confusion or
delirium. Some may even be prone to aggressive or violent outbursts if
frustrated, frightened, or overwhelmed. Remember that nursing homes are very
controlled environments with regular routines. Pat has seen patients that
look "OK" in nursing homes, but were completely unable to function outside
of a very controlled environment. Without access to medical records, it's
impossible to know the medical or psychiatric issues involved.
Nursing homes are usually overseen by state agencies and/or accredited by
outside agencies. You might want to research your nursing home's
affiliation. If you believe that patients' rights are being violated, you
could contact one of these agencies and make a formal complaint.
DEAR
PAT: My mother had a seizure, and was found to have a large mass last month.
An MRI was not helpful because the swelling was so great, they cannot see what
is inside. She doesn't have insurance, so she was sent home from the hospital
and ordered another MRI three weeks later. The swelling had remained the same,
but with a new pocket in a new location. She has an appointment to see a
neurosurgeon next month. No angiogram was done, and besides the MRIs she has not
seen a doctor since being released from the hospital. Worse, her doctor does not
return our calls when we have concerns. I am concerned that she is not getting
proper care because of her lack of insurance. She was in a car accident in
October, and it is possible that this is a related injury from that incident.
What will happen to my mom if this swelling continues to increase? Are there
other diagnostic tests to see what it could be? I am afraid for her, and I don't
think this case is being treated with the appropriate urgency. Am I
overreacting, or is this normal for brain injuries?
PAT'S RESPONSE: The person with the most information about your
mother is her doctor. Pat certainly can't comment on the specifics of your
case. If your mother has a "mass" (often a tumor or growth), a few weeks may
not make much difference to her physical health. In fact, sometimes
"growths" are evaluated over a period of months to see if they are growing
or not. Also, if it is a growth, it is unlikely to be associated with her
accident. My advice is to wait and see what the neurosurgeon says. Carefully
monitor your mother, and if you see any further seizures or witness changes
in her behavior (such as disorientation or confusion), take her to the
Emergency Room.
As for returning your phone calls, doctors should always communicate with
patients and family members. However, remember that medical information is
confidential and is not to be released to anyone but the patient. Some
doctors follow this more strictly than others, and laws may vary from
state-to-state. However, if the doctor is not returning calls or providing
adequate explanation of your mother's condition to her - then change
doctors. It is essential that patients feel comfortable with their
physicians and physicians have a clear responsibility to keep patients fully
informed of their medical condition.
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