My son had an AVM on January 23, 2013. He was sent to a Physical Rehab Hospital 1 month ago. He is always sleepy. Is this a cause of the brain injury or could it be something else, like depression. His physical therapist and speech therapist have a hard time keeping him awake for his therapy sessions. we cant keep him awake long enough to show him pictures and tell him stories. His doctor at the rehab facility prescribed him Ambien at night. We thought if he has a good nights sleep he would be more alert during the day, but this has not helped.
Thank you for your advice Ann. He did have some depression issues before his brain injury, so maybe the injury is making his depression more severe. I always try to sound upbeat and positive when I talk to him. I always tell him "your getting better everyday" and "I'm proud of you for doing such a good job in your physical therapy". I tell his friends and family to say positive things to him too.
Thanks again Ann and God Bless you. I will be praying for you.
Hi, Both fatigue & depression are often common symptoms during recovery, though from your description it doesn't sound like the 'typical' fatigue.
Have you addressed his symptoms with his neurologist or neurosurgeon?
I hope you find answers & a reasonable solution(s) to help him on his road to recovery.
Best wishes to you both.
Hi Hope23. Is your son on anti-seizure meds? Many of those cause people to be lethargic. There are varying dosages of Ambien. Could the dosage be too high? I know it seems like an eternity. However, it has not even been 6 months yet. Please have faith that things will improve and keep us posted.
Hi Barbara, I just looked at his paperwork and the hospital is giving him 1000 mg of Levetiracetam and 1000 mgs of Keppra. Wow, that does sound like too much. I'm going to talk to his doctor.
I think it could be a combo. Both depression and lethargy are very common after any TBI (with or without an AVM or even a hemmorhage). I skimmed through the comments, didn't read most of them, mostly just yours. Keppra and Leveblahblah are the same drug, leve- is the generic of Keppra. I take 1000 mg 2X a day and for the first 6 months to a year (post-bleed/crani and on Keppra) I was very angry and even more depressed. Keppra, from what I've read on this site, is pretty popular for causing some emotional instabilities. I am still very depressed but at least the anger has subsided...finally...for the most part.
I don't know why his Dr. would prescribe Ambien. I have taken the med two times and both times I hallucinated and blacked out. The commercials say something about not taking it if you are depressed or have a history with depression as it may cause suicidal-like behavior. You should ask his Dr about that maybe?
My question would be his behavior. Is he just sleepy? Or is he acting as though he is frustrated? How old is he? Does he have any new deficits? It's very difficult. I ask because sometimes words of encouragement may not always be enough and it sometimes, from my own experience, it compounds the issues. Especially when your words of encouragement are accompanied with an "endearing" or "sympathetic" tone. As a disabled person...I hate both of those tones. Especially when I was in rehab. I didn't feel at all encouraged or suspended by everyone else's positive thinking. I felt the opposite. Because I don't know the specifics, I'll throw this out there just in case:
He might be looking for the independence he might feel he lost and you hovering over him could make him feel like he lost it forever. Again, I don't know his age or the full situation so I'm just throwing that out there because of my own experience. I was 27 and I felt I had finally found my independence, or a stronger sense of it; and having the bleed and the resulting surgery and now this hemiparesis that apparently won't go away...it was very hard to even try to learn to accept my fate and lack of independence. I haven't accepted it still, 2 years later (today marks 2 years since my crani, yay!) and I'm not sure I ever will but...I've been trying and that's the best a lot of us can do.
Oh, and since I apparently lack tact, I wasn't trying to be mean or suggest anything rude or be rude. Apparently I have to clarify that with every post I make to others' threads....
My son just turned 24. He cannot walk or talk or do anything on his own. He lost all his motor skills. I'll try to remember not to talk to him in a sympathetic voice. Most of the time I don't, because I don't like people to talk to me that way. When I talk to him I try to sound positive and I just talk to him like I did before his TBI. Thank you for the advice! I don't think you lack tact. Good luck to you Kristi! I'll keep you in my prayers.
Ok. I hate having to add in that last part but a lot of times I come across as rude or offensive when I'm actually trying really hard not to. It can be very difficult when you lose so much. Granted, I've been blessed with only losing half of my physical abilities and still keeping the rest of my ability to talk (pretty sure people wish that had been taken, I'm very long winded AND opinionated LOL). I remember when I was in rehab and I just felt like the end of the world was upon me and I was so frustrated mentally and physically. I had a bit of a break down but it was somewhat contained because my mom and husband were there and even in my state I had this feeling like I had to protect them from what was really happening to me. It made things worse because I bottled it all up. A therapist told me about it being OK t mourn and I was like "mourn what?" and he told me..."You." That was all it took. I had lost everything that made me...me and I wasn't in a spot to understand that that was where a lot of my depression was coming from. People here are lucky enough to have a bleed, get a few treatments and go home with no reminders and no AVM and then there's the rest of us who will always have reminders. Some of us will have daily and constant reminders and it's very difficult to face everyday but the independence, and at 24, that's a big loss. And learning to live with the "new" you on top of that is very....it's just very difficult. I'm hoping for the best for you and your son. He will find his way, we all do/did. Some of us just need extra support.
My husband was my support and I can tell you it wasn't easy. One of the biggest things that helped us was him learning my boundaries. He learned not to push me out of the way to do something for me, he learned to let me try first. He learned to just let me cry when I needed to and talked me through the rest of it after the tears stopped. If I am upset, he lets me limp off into a bedroom and just let it out rather than fighting me. He's given me bits of the independence I lost back and I think that is very important as a survivor. Independence, to me, is a sense of individualism and as a person with disabilities on a few different levels, it can be difficult to maintain this sense of individualism, to feel as your own person, to feel you don't have to have people constantly around you "just in case." I sympathize deeply. Again, I hope for the best for ya'll. :)
Hi Hope and welcome to the group. Has your son's AVM been removed? As others have said, brain trauma can certainly cause fatigue. If he had a bleed and then a craniotomy, the fatigue is compounded. He is still very early in his recovery so it should get a bit better but never quite back to where he was before this. His brain has to work extra hard to do the things it used to do without problem. I am almost 5 years post bleed and craniotomy. I still get exhausted by the end of the day. Definitely talk to his doctor about his medication and how it may relate to his fatigue and depression. If there is a neuropsychiatrist near you, it may help to have your son meet with one. That could help him. I wish your son the best.
Thank You Trish, My son's AVM has not been removed. When he was in the hospital, the doctor told us that he may need surgery but that they first needed to do an MRI. The doctor said that they cant do an MRI until my son can communicate and cooperate with the procedure. He is not seen by a Neuropsychiatrist. I dont know that a Neuropsychiatrist could help him because my son does not speak yet. He only blinks his eyes to answer our questions.
Hope, I would look very carefully into the medication issue, given that your son cannot communicate, and perhaps get several opinions as to what should happen next. It is easy to overmedicate, and since your son cannot explain what is working or not working, it will be harder to tell if he needs an adjustment. If you ask for other opinions, ask about the MRI situation, too, because it seems very odd to me that an MRI cannot happen until your son can speak. If he can blink responses, then he can indicate whether he is able to cooperate, yes?
My heart goes out to you and your son in this very difficult time.
I didn't understand that your son wasn't talking yet, and agree wholeheartedly that the medication issue should be very carefully looked into. Given his prior struggles with depression I am so sad to think of what he must be feeling but is limited in communicating (blinking is a good start, but I hope time will bring back more abilities). Being too sleepy is awful and will only make things worse.
I also didn't realize your son was not able to communicate yet. My comment must not have made much sense to you in that case, my apologies. I agree with dancermom in that I would think that the doctors would be able to do an MRi as he is able to blink his responses. Let us know how he progresses.
Hope -- I'm puzzled. Levetiracetam and Keppra are the same medication. Are they double dosing him? Also, a search on keppra and drowsiness shows that many people experience severe drowsiness from keppra. There are other medications, so there should be a better fit for your son; it will be difficult to make progress in recovery while fighting drowsiness. Also, has he had seizures?
Hi Dancermom, If he's having seizures, they dont show up on the outside. He get's what I think are muscle spasms. His legs and arms get very tight and can't be moved. The left side of his body is the most injured side. His left arm and leg get very stiff and sometimes his left foot shakes when he's getting a spasm. He's also still storming. He's not storming as often as he was a few months ago, but he still does.
Ambien is not good to take for over 2 weeks , please be very careful with this stuff. Do a lot of research and you will throw it in the garbage can. Good luck :>)