Helping Patient Get Their Life Back

by Marissa Fratoni of Holisitic Nurse Mama

Brandy (not her real name) is a 30-year-old woman who will tell you that she once had the world at her feet. Always an overachiever, she had been working in her career as a marketing manager in a large advertising firm for about five years following her magna cum laude finish from a local university. Everything was going remarkably well for her until she veered her car at high speed into oncoming traffic — she was checking a text on her cell phone while driving. She wanted to respond to her best friend who was confirming dinner plans for that fateful evening when she looked up through her windshield in time to witness her own disastrous mistake. She struck an SUV head on, causing the hood of her small compact car to xylophone. Airbags exploded from her steering wheel and dashboard, burning her face and hair. She blacked out at that point and had no recollection of anything until she woke up in an ICU bed two days later.

The accident left Brandy with a head injury, whiplash, and a broken left ankle. Her life was spared, as were the lives of the four people in the SUV that she struck. The family of four included two small children — all were alive and well with only a few scratches on the parents who occupied the front seats of the vehicle. They didn’t press charges. Brandy cried when she received this news. She was relieved to hear that everyone was alive, thanked her lucky stars, and decided that she would never make such a significant, life-threatening mistake again.

While in the hospital, Brandy was placed on a pain pump. She was able to administer a dose of morphine at regular intervals to reduce the pain she experienced post-accident. All with the push of a button, directly into her vein. She noted how well the morphine worked and was grateful for the pain relief. On her way home, the nurse who discharged her provided a couple of prescriptions written by the attending physician — oxycodone for pain, another for Ativan as Brandy had been experiencing anxiety and panic during her time in the hospital. The nurse recommended that she use the oxycodone for as long as she needs, but to switch to Motrin when she’s starting to feel better. “You don’t want to use those pills for any longer than you have to,” said the discharge nurse.

Brandy’s head injury left her with constant headaches and vision changes.Her ankle was held together with pins and screws now — she had orthopedic surgery shortly after being transferred to the hospital following the accident. She didn’t remember anything about that. She was released from the ICU within a few days and spent another day on a step-down unit until she was discharged the following morning. Brandy’s parents brought her home to her apartment — she was ready to get back to her life and move on from this horrific event. Her mother stayed with her for a couple weeks until she was a bit more stable. Little did she know that this accident would be the start of a new life that was unrecognizable to not just herself, but everyone who knew her.

Within a few days of being home, Brandy attempted to dig back into work and realized that for one reason or the other, she couldn’t find the solutions her team was seeking from her. She couldn’t see a task through to completion, nor could she communicate well via email. It took her a half-hour to write one email.

Concerned, she deferred to her Mom who reassured her, “You have a concussion sweetheart. You shouldn’t be thinking about work or looking at computer screens right now. Just rest. Don’t worry right now.” Brandy’s Mom always found a way to make her feel better.

Several weeks later, everything was a still a struggle for her. It took her twice as long to get up and ready in the morning as it had prior to the accident. She not only had to negotiate using crutches to get around, she also couldn’t force herself to work through any particular task in an efficient manner. She would start the coffee pot only to realize after a few minutes that hot water was dripping into the pot — she never placed a filter or coffee in first. She left the faucet in the kitchen sink running for an entire day at one point. Brandy also forgot to close the refrigerator door before leaving for work on a particularly bad day, causing an entire grocery shopping’s worth of food to spoil. And the worst part was finding her rental car in the garage after work. She would walk around and around and around, clicking the key remote in hopes that it would cause the car to beep. She had this car for weeks and she could never seem to remember where she parked it in a familiar garage.

When she visited her primary care doctor, she expressed her concerns about these lapses in memory, but her doctor brushed off her concerns and stated that head injuries take time to heal. He suggested seeing a neurologist if she didn’t see any improvement in a month. Unfortunately, Brandy’s employer didn’t feel the same way after nearly two months of what they considered, unproductive, lack-luster performance. Brandy tried her best, but she admitted her best post-accident was pitiful compared to her performance pre-accident. Ten weeks post-accident, Brandy was laid off from her job.

Brandy didn’t know how to move forward. She updated her resume and sent it off with a cover letter to all of the marketing and advertising firms in the vicinity. No one responded, not even an email to say “thank you for your interest” was received. She continued to take her oxycodone and Ativan daily. Sometimes she took more than the prescribed dosage on the bad days, but didn’t think much of it. These medications made her feel better and so much in her life was upside down, she felt she needed to take both on a regular basis. So she frequented her doctor’s offices for refills on her prescriptions. Her primary care doctor referred her to a pain clinic when he realized Brandy was not about to accept “no” for an answer. At the pain clinic, she was able to acquire a regular supply of oxycodone as long as she agreed to regular physical therapy for her ankle. She rationed the ativan, splitting it up into tiny pieces so she could take little bits with her oxycodone.

Brandy collected unemployment and put an ad on social media for a roommate. She made going to physical therapy and the pain clinic her job, committing herself to every appointment without fail. She did this to ensure her supply of oxycodone would continue, a realization that came much later she admits.

Four months post accident, Brandy’s bills were piling up. Her parents paid her rent in an effort to help. Brandy still couldn’t afford to pay anything other than food and utilities with her unemployment check. She had to return the rental car because she couldn