Jeffrey was in the Canadian Army Reserves for six years and then began working in construction. Today, he is twenty-seven years old and an acquired brain injury (ABI) patient at The Salvation Army Toronto Grace Health Centre (TGHC). His brain injury was caused by a tumor that was diagnosed in July 2016.
Maria, his mother, recalls that before the diagnosis the family had witnessed a discernible change in Jeffrey’s personality. After complaining about headaches and having a few fainting spells, he was prompted to visit the emergency department. A computed tomography (CT) scan revealed that Jeffrey had a tumor in his skull that projected into the third ventricle of the brain.
In early August of 2016, Jeffrey was admitted to Sunnybrook Health Science Centre (SHSC) for surgery. After operating for nine hours, the surgeon told Jeffrey’s family that the procedure was a success; however, because of the invasive nature of the tumor, the medical team were unable to remove all of it.
“The next three months at SHSC were challenging and difficult for Jeffrey and our family,” said Maria. He was monitored closely in the intensive care unit (ICU) to check if there were any signs of a stroke or brain hemorrhages. However, despite the constant monitoring, eleven days after his surgery Jeffrey suffered a stroke. Shortly after, Jeffrey needed to have a tracheostomy tube (ventilator) inserted to help him breathe, and because he was unable to eat food, he also required a feeding tube (gastrostomy tube or G-tube) to help nourish him.
A few weeks prior to being discharged, Jeffrey’s condition improved. However, although he was able to communicate his needs, he was still dependent on others to assist him with activities of daily living (ADLs): bathing, feeding and dressing. Performing such activities was difficult since, because of the tumor, his vision had become impaired.
Jeffrey was transferred to TGHC on December 24, 2016, for rehabilitation. During his first two weeks at TGHC, Jeffrey showed good physical improvement,” said Maria, “I noticed an immediate change. I recall that while in acute care, he was unable to move his left arm and leg.” In rehab, some movement returned.
Jeffrey remained at TGHC until March 2017, and made good physical progress. During this period, Jeffrey required behavioural rehabilitation, so he was transferred to a health care facility closer to his family home where he could receive therapy. In August 2017, Jeffrey was re-admitted to TGHC’s ABI Program for additional slow-paced rehabilitation.
Maria summarizes the past two and half years: “A lot has happened to Jeffrey — he has had two seizures. Also, an MRI a year after his surgery revealed that there is a small growth on the residual tumor, and Jeffrey to this day has not regained his eyesight.”
As a result of his tumor, Jeffrey occasionally exhibits outbursts. Maria is aware that Jeffrey’s behaviour and outbursts can at times be a challenge for the nurses and the health care team. She is grateful for the care they provide her son despite the challenges.
“All of the medical staff, both in acute care and the rehabilitation facilities, have worked hard to help my son get better. I would like to thank all the TGHC health care staff for what they do to help Jeffrey every day.” If Maria raises a matter about Jeffrey’s care, they listen to her and it is addressed. She feels the nurses understand. “They are my friends,” she says.
Jeffrey’s behaviour has, at times, caused him to be resistant to rehabilitation; other times, he willingly participates. It is believed that more behavioural supports will help improve his quality of life, and so Jeffrey will soon be moving to Hamilton, Ontario, for three months to participate in an intensive behavioural supportive program.
When he returns to the TGHC, the program will help behavioural specialists, nurses and the health care team better understand Jeffrey’s behavioural issues more clearly. The goal is to improve upon the strategies of the program to help Jeffrey manage his outbursts, giving him the opportunity to receive continuous rehabilitation so he can work toward a level of independence.