Addenbrookes saved my life

This week we are following the story of Suffolk head injury patients who are treated in Addenbrooke's Hospital. In the final part of this series, features editor TRACEY SPARLING reports on what happens when its time to go home.

By Tracey Sparling

This week we are following the story of Suffolk head injury patients who are treated in Addenbrooke's Hospital. In the final part of this series, features editor TRACEY SPARLING reports on what happens when its time to go home.

NED Gemmill owes his life to Addenbrooke's Hospital, where he once lay in a coma with his parents praying for his survival.

Today he is a young man looking forward to life, he hopes to return to college and his ready sense of humour is still very much apparent.

June 26, 2004, is a date etched in his memory forever. That is when an assault outside an Ipswich nightclub saw him punched until he fell to the ground, where his head was 'kicked like a football', on his 21st birthday, as reported in the Evening Star at the time. He needed a titanium plate inserted into his head to replace the piece of skull removed in a lifesaving operation at Addenbrooke's Hospital in Cambridge, spent two weeks in a coma, and nearly three weeks in the neurosciences critical care unit which we featured on Tuesday. In total, he was in Addenbrooke's for more than six weeks, during which time his dad David, mum Jane, sister Jenni and brother Jack travelled from their home in Clare to spend every day and night with him. The metal plate was inserted a year later, to give him back his independence.

“I don't remember much of my time in Addenbrooke's” said Ned, who is now 22, but he recalls the moment he woke up from the medication-induced coma which doctors had put him under to minimise the workload for his injured brain.

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He said: “I remember the doctor sent my mum and dad home safe in the knowledge I wouldn't wake up that day, and I woke up that night.

“I didn't know where I was, it felt like a shopping centre, but I was in a bed and I couldn't understand. I pulled myself up and started struggling so the nurses had to hold me down.”

He laughed, as he said being transferred to a specialist ward weeks later gave him the chance for his first cigarette, for which he was desperate by that time. His dad stayed over nights, helping him get out of bed if needed - “I used to fall over!” laughed Ned.

“When I came out, I was missing a bit of my head, and suffered really bad headaches - I'd have to go and lie down. I couldn't do much when I first got home. I lost 50 per cent of my sight, and the hearing in one ear. It has also affected my ability to remember people's names - I have to think of other ways to remember them. Finding my way round new places is also hard, and conversation is difficult when I'm in a big group of friends, but one-to-one I'm fine.”

The attack had a profound effect on Ned and by July 2005, he was only just beginning to recover from the psychological effects. He had to leave his beloved job as a ground worker, and could no longer drive because his sight was damaged.

Some head injury patients in professions like bus, train and delivery driving find themselves unable to return to work but getting back to college to train for a job is now Ned's major focus.

He said: “I go to the gym a lot, and I'm looking at going back to college to do a foundation degree if I can, in countryside management.”

He also attends the Icanho centre in Stowmarket (see panel) where other young people suffering similar injuries, has been a source of great support to him.

Not everyone is as lucky. Just yesterday The Evening Star reported how motorcyclist Mark Stockwell, 40, from Lakenheath died from his injuries, at Addenbrooke's, following a road accident in Suffolk.

Head injury is a life changing trauma, and on top of the injury which can affect a patient's movements and coordination, a long time lying in a hospital beds leads to stiff, weak muscles which need to be coaxed back to fitness.

Senior physiotherapists at Addenbrooke's Hospital Will Winterbotham and Helen Hewlett know they have to be tough to be kind. Helen said: “We start by getting them to sit up unaided, then standing up and it can take a long time to do those things. When they take a step, or start to speak, it can be a very emotional moment for their family and for us too.”

Will said: “We do see these milestones, which start with patients sitting up and able to control their head, standing, transferring to a chair, walking a few steps, to climbing stairs.”

If the patient is able to talk, they ask about lifestyle and hobbies, and Will added: “Our job is to pick up the threads of their life, to get them back as close to how they used to be before the injury. We don't want a young person to say years later 'I've never been able to run after my accident.'”

They enlist the patient's family to keep them motivated, and reminded to exercise. “Motivation plays a big part. We set them goals and although we can't force people to do physiotherapy, we can help them see the reasons behind it, so we encourage them to do it.” said Helen.

“If you led a busy active life beforehand you are likely to be much more motivated to do this.”

“It is also to do with the richness of your neural matrix,” said Will. “Basically, if you used to lie on a sofa and watch tv all your life, before your injury, you won't have developed as many neuro connections. An active 70-year-old could have a more active brain and better chance of recovery than someone who hasn't exercised their brain.”

Helen added: “People can improve for a long time after the injury, especially in the right environment with the right support. It is really wonderful when they come back to see us.”

As increasing numbers of head injury patients survive due to better medical care, the challenge is on to ensure the best aftercare is available.

That is a priority for Clare Strang, head of continuing and complex care for Suffolk Pprimary care trusts.

If patients are too unwell to return straight home from Addenbrooke's, they are currently referred to specialist hospitals in London and Northampton for an agreed period of time, before coming back to Suffolk.

Clare said: “We draw on the expertise of a consultant for rehabilitation in Norfolk, but there is also a lot of very good expertise in Suffolk, and I am looking at how we can develop some residential care in the county to compliment the existing non-residential rehab services we have in Suffolk.”

She added: “We are very much focused on the individual's needs, when we draw up a package of care for them. That can vary considerably, because one patient might be a teenager who has been in a car accident, while another might be an older person who has had a stroke.

“Our aim is to get people back to as full and independent a life as possible, and rehabilitation is critical because there is usually an optimum window of opportunity to maximise their recovery.

“I get satisfaction from knowing that we are getting on to it speedily and all organisations are working together to focus on the patient's needs.”

Support comes from organisations including Optua, Suffolk Headway, Sue Ryder Care and the Icanho brain injury rehabilitation centre in Stowmarket. They help people to adopt to a new disability, relearn skills they may have lost, and work towards becoming as independent as possible.

They also support the carers and families of people referred to their services.

Weblink: www.suffolk.braininjuryforum.co.uk

After initial injuries to the brain have healed, the brain may not return to working normally for a long time. Survivors can be left with:>

Physical: Paralysis, poor coordination, tremours, loss of senses including touch, hearing, smell and taste, eyesight problems, headaches, tiredness, epilepsy, impotence.

Mental: Poor planning, organising, initiation, and multi tasking skills. Poor short term memory, slower thought process, attention deficits, spatial problems, loss of insight and awareness of changes and deficits.

Emotional and behavioural: Temper outbursts, lower tolerance, easily frustrated, rapid mood swings, crying or laughing more easily, lack of motivation, impulsiveness and no inhibitions, anxiety and obsession.

Weblink: www.headway.org.uk

Headway helpline 0808 800 2244.

Men are two to three times more likely to have a head injury than women. The age group most at risk of head injury is 15 to 29.

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