The Herald-Palladium, 10/18/2009

Coping with a new normal

Couple forms support group after own struggle with traumatic brain injury

By JEREMY D. BONFIGLIO
H-P Features Writer

BRIDGMAN – Dan Daniel remembers kissing his wife goodbye. He remembers strapping on the $400 motorcycle helmet that saved his life, and riding along a stretch of Red Arrow Highway.

“The next thing I remember, it’s seven-and-a-half weeks later,” he says, leaning on a cane in his Bridgman home. “I didn’t know I was in the hospital or why one of the biggest men I’ve ever seen in my life had his arm around me. As you can imagine there was a bit of a commotion there.”

On Aug. 7, 2008, according to a police report, Daniel was driving 44 mph when a car pulled in front of him and stopped. The ensuing collision left Daniel broken, bleeding and unresponsive on the pavement. The bleeding eventually stopped. His bones have since healed. But the crash started a chain reaction in Daniel’s head that forever changed his life.

It’s called traumatic brain injury, or TBI, a condition that can cause a wide range of functional changes affecting thinking, language, emotions and sensation. Although TBI has received more attention in recent years because of its prevalence in troops during the Iraq War, experts believe that the annual number of cases in the United States may be much higher than the 1.4 million estimated by the Centers for Disease Control and Prevention. That statistic, after all, is based solely on emergency-room visits. According to the Brain Injury Association of America, however, many people who sustain a blow to the head never even go to a hospital.

“One of the biggest misconceptions is that a bump on the head is no big deal,” says Susan Connors, president of the Brain Injury Association of America. “One bump on the head really can kill you. It doesn’t usually, but even the repetitive so-called mild concussions you see in sports can do as much damage as a major car crash. We like to say that no injury is too mild to ignore or too severe to lose hope.”

After the accident

Although Daniel, a veteran firefighter for the Lake Township Fire Department and paramedic for Medic 1 Ambulance Service, may not remember what happened in the days and weeks after his crash, his wife, Jayne, cannot forget.
“He was riding up to Coloma,” she says. “I wasn’t feeling well so I stayed home. I told him to be careful. He said, ‘I always am.’ A little while later I remember that his radio went off. Medics were responding to a motorcycle p.i. (personal injury) and a man who was unresponsive. And I knew. I knew it was Dan.”

Jayne Daniel was ready to go to the accident scene, but her sister Sheryl Hausmann convinced her to meet in a parking lot where they could go together. Hausmann’s husband, Jim, who also happens to be Dan Daniel’s best friend, had already received word that Daniel’s injuries were severe.

“I got into Sheryl’s car and she said that it was in fact Dan, that it was bad and we were going to meet them at the hospital,” Jayne Daniel says. “When we walked into Lakeland’s ER there was about 25 to 30 firefighters and medics lining the hallways. It was one of their own. You could see the concern. That’s really when I knew it wasn’t good.”

Waking up

Dan Daniel had an assortment of broken bones; ribs and hands, a shoulder blade and his sacrum. He had a badly torn artery, and a fractured pelvis, and three hematomas – bleeds in his brain.

It took four hours and 36 units of blood to repair his artery and a drill bit through his skull to relieve the pressure on his brain.

“They told me he had a 3 percent chance of making it,” Jayne Daniel says. “Three percent. I was numb. You can’t imagine what it’s like. To see him all bandaged up …” Her voice trailed off.

After surgeries and a blood clot in his lung that resulted in a coma, Dan Daniel opened his eyes on Day 14.
“There was hope,” Jayne Daniel says. “I figured he would come home with me in a few days or he would die. I wasn’t even thinking about rehab or that this would be a life-changing thing for all of us. I had no idea.”

As the rest of his body started to heal, Dan Daniel’s least-visible injury was just starting to surface. He asked who was babysitting his two oldest children, Mike and Jen, who are now 33 and 35. He happily and repeatedly ate cottage cheese, a food he had previously despised. He even referred to a sister not by her name, but by her telephone number.

“Right was left and left was right,” Jayne Daniel says. “Hot was cold and cold was hot. He would say ‘I’m hot, cover me up.’”

Dan Daniel remembers none of this. He doesn’t remember the accident or its aftermath. And he certainly didn’t remember Omar, the over-sized caregiver who was trying to steady a dizzy Daniel when “the lightswitch came back on.”

“It was like suddenly I was awake,” Daniel says. “I didn’t know I had been in an accident. They slowly filled me in on what had happened.”

‘Different forever’

There were other things Daniel had to learn, too. Things such as how to go to the bathroom and how to swallow and how to walk. Although his long-term memory was intact, the broken pathways in his brain meant he wasn’t always able to retrieve information.

Although he’s been able to live at home since Oct. 8, 2008, he still sometimes has trouble finding the right word. He no longer feels hungry so he has to be reminded to eat. He also doesn’t feel full so he has to be told when to stop.
“I came into the room one day and he’s watching ‘Gunsmoke’ instead of football,” Jayne Daniel says. “Now we’ve been married 25 years and I’ve never seen him watch ‘Gunsmoke.’ I said ‘Dan wouldn’t you rather watch the game?’ He said ‘No, I think I like “Gunsmoke.”’ That was new.”

Such changes are common with traumatic brain injuries. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age. It’s the personality changes, however, that are often hardest for families and friends to understand.
“The really hard part to accept for families is this new normal,” Connors says. “You really are a different person and are going to be different forever.”

“His laugh is different sometimes,” Jayne Daniel adds. “I didn’t expect that. So it does make you wonder what else is different. It can get a little frustrating. You’re never mad that they made it, you are just trying to remold your life. You never think in an instant your whole life can change.”

Coming together

Jayne Daniel remembers when Shelley Ruppel expressed that same sentiment when the two women were waiting as their husbands completed cognitive therapy at Lakeland Rehabilitation Center in St. Joseph. Dale Ruppel, a truck driver whose semi was rear-ended during a traffic jam on Interstate 94 in Indiana 20 months ago, also suffers from TBI.

“She didn’t know which way to turn,” Jayne Daniel says. “She was beside herself. Because I had cried those same tears and I know what it’s like to break down in the middle of the night, we started talking. You realize you’re not out there alone. This family was dealing with this, too. And there have got to be others.”

In July, the Daniels, Ruppels and Hausmanns formed the Brain Injury Association of St. Joseph. The support group, which is a new chapter of the Michigan Brain Injury Association, meets the first and third Tuesday of each month at Riverview Park Christian Church, 2929 Niles Road, St. Joseph. The group has gathered informational speakers, held a series of community fundraisers to help with mounting medical bills, and shared stories about their daily struggles.
Because of his brain injury Daniel lost his job with both Medic 1 and the fire department, where his 20-year-old son Andrew is now following in his footsteps.

“People all the time tell Dan, ‘you look great’ or ‘are you back to work yet?’” Jayne Daniel says. “They don’t understand. They couldn’t understand because he looks good.”

“Looks,” Dan Daniels adds, “are deceiving.”

The ‘invisible injury’

“It’s the invisible injury,” Connors says. “If someone has a broken leg, we can see that so we help open a door or whatever because we can see it. When a child has a stomach ache, we usually believe them. You can’t see the issue but we still believe it’s there. One of the most frustrating things for people with a brain injury is that people expect you to be ‘back to normal.’”

Daniel knows that he will likely never return to work, but that hasn’t stopped him from wanting to help others. One of the people who recently joined his support group recognized him as the paramedic who was on the scene at her accident 17 years ago. The Daniels also receive calls from hospital staff to help others who are going through the same struggle.

“Dan’s been caring for people for so many years this is a way that he could still help,” Jayne Daniel says.

“It’s a shoulder to lean on,” Dan Daniel adds. “I know I’m not completely well, but I know I’m lot closer than I was.”

jbonfiglio@TheH-P.com