OVERLAPPING VOICES Is it morning, afternoon or night? And can you tell me what day of the week it is? Had a pretty severe brain injury. Can you open your eyes? You're at a place called ABI, which is Acquired Brain Injury. PIANO MUSIC MAN LAUGHS (LAUGHS) Oh. Sorry. It's part of my brain injury, why I laugh so much. Sometimes traumatic brain injuries can cause off-kilter emotional responses. With 22-year-old Te Kaha, he can't stop giggling. TK was admitted to ABI Rehabilitation with a traumatic brain injury due to a car accident that nearly killed him. Making a plan. So the` makes the decisions. Yeah. After six months of intensive therapy, it's nearly time for him to leave this safe haven. We want to know where you're at in this point in time. I want to walk outta here, but I can't walk yet. Every 15 minutes, a NZer has a traumatic brain injury. The most severe come to ABI Rehabilitation in West Auckland, where they undergo up to six months' rebuilding their lives. Every morning, without fail, Eltje heads for the gym. It's all right. You can do it. Slowly. Six months ago, Eltje was knocked off her bike. This traumatic event caused such widespread brain injury doctors are amazed she survived. The right leg feels like somebody's leg, whereas my left leg is my leg. Right leg is just crazy. I've been a very independent-living woman before and, uh, anything like` Like, this year, I'm so dependent now with every little thing. Even going to the toilet, I've gotta ask somebody. Terry. (MUMBLES) Terry, I'd like to do a bit of work with you today. OK, thank you. Would that be all right? Yes. Could you roll over? Brain injury affects everybody differently. So far, Terry's progress has been worryingly slow. That's good. He was involved in a truck accident several months ago, and he's stuck in a fluctuating state of confusion or delirium. Can you sit on the side of the bed for us? He also has post-traumatic amnesia, he's disorientated, and can't recall simple information from one moment to the next. Push up, Terry. Terry's physiotherapy sessions, vital to his recovery, must be kept short and very simple. Good. Support yourself there, Terry. OK. Ready, steady, standing up. No, don't push. He can get up if he wants to. Can you try stand up, Terry? Try again? (MUMBLES) We'll give you a hand, mate. Yeah. Yeah? OK. Yeah. OK, ready, steady, standing up. Stand up. 'He can stand up; he has the strength. 'It's just his confusion, his dizziness ` they're all the barriers to progressing.' Standing up. That's it. Good. Well done, mate. Nice and tall, Terry. Yeah. That's it. Yeah. And just hold on there. Can you stay standing for us? Feel ill. Oh. OK. Put your arms back. Arms back. Can you move your bottom up? Yeah, thank you. Lift your bottom. Terry's lack of sleep at the moment, that definitely is contributing to the amount of restlessness that he is having and his confusion. I mean, if any of us weren't getting any sleep apart from one or two minutes at a time, um, we'd be pretty confused. That's good. Although TK's legs aren't damaged, the part of the brain that talks to them is. OK, we're going a bit higher up. Relaxing right through your leg. I kind of feel there. < Good. Yeah. I used to play rugby and basketball, and I used to do everything with my legs. And now I can't even walk. In a couple of weeks, TK will leave ABI Rehabilitation. He's eager to walk out of here without any help. Ah. Yeah, I can feel your back just a little bit. So get your feet into a good position, ready to go. OK, we're not gonna` You're off. OK. Gonna let go, TK? I wish I could walk, but I can't, which sucks. Focusing his brain on balancing and making his legs respond is exhausting and can be frustrating. It's all right. Get your feet together again. Set yourself up. Doing well. Yeah. Weight forward, weight forward. Well done. When I first came here, I couldn't even stand up. Yeah, cos when I first came here, I only weighed 55. How heavy are you now, TK? > I weigh 74. Eltje's progress is astounding. Generally, most of the recovery from brain injury is within the first six months of injury. GENTLE MUSIC Eltje knows time is of the essence, so she uses every opportunity, even outside of her scheduled therapy sessions, to work on her recovery. (GRUNTS SOFTLY) In Eltje's first weeks here at ABI Rehabilitation, her situation seemed bleak. (GRUNTS) The amount of rehab I have done got me from a care case, not conscious, only staring at you but not knowing who you are, to a normally thinking person. My memory is still very bad, but other than that, I'm myself, I'm Eltje. So, these are some difficulties that people experience after their frontal lobe is damaged. Yeah, but I also took the impact here. But I think, um, as they say, whenever your head hits something, it's not only those part where you hit it but it's also the rebound effect of the brain in the skull that can cause damage. Exactly. Your brain is sitting in, like, a fluid, yeah. Fluid, yeah. > So when it moves around, it can hit against different parts of the skull. And so you're right ` that's why there's sometimes lots of points of damage, yeah. So is it actually important for you which part of my brain is damaged? Maybe I could give you a copy of your CT scan, Eltje, and we could go over it and have a look at it. Yeah, I would like that. I'm better with knowing than the not knowing. Yeah. Now we're gonna look a little bit more at your memory and your recall, OK? Not very good. (CHUCKLES) That's OK. So, the reason that we do this assessment, Eltje, is because if you get distracted really easily it's gonna be hard for you to participate in conversation. If you forget things that people have said to you, you might ask them repeated questions, or you might repeat the same topic over and over. So that's really why we look at these skills. So, the new words are walk, sun and green. Walk, sun, green. OK. Yeah, right. So I want you to hold on to those, OK? Cos I'm gonna ask you what they were in a few minutes, all right? OK. > OK. So, Eltje, can you tell me what season follows winter? Spring. > How many days are there in a week? Seven. And what were those three words that I asked you to remember? Sun, green,... Mm-hm. uh... Can't remember the fourth. Not run... Huh? It's not run but... Starts with a W. Walk. That's right. Great, good. Yeah. So walk, sun and green, OK? Yeah. What's the first month of the year? January. < And what were those three words? Walk, green and sun. < Perfect. Well done. ACOUSTIC GUITAR PLAYS # Brown eyes beautiful. Music has always been a big part of TK's life. # I saw you stand there. Now it's helping him with his recovery. # ...and I don't want to get too near. So, we started out by holding the guitar on his lap while he lay in bed. And he'd just be able to make chords with one had, but he couldn't even reach the strings with the other. And it's one of those therapies that really increases people's well-being, makes people feel very good. And of course, if you're not feeling well and you have regular doses of increased well-being, then you'll hopefully start feeling a lot better. (PLAYS CHORDS) # You're the girl of my dreams. # I see you and I just don't wanna leave # because you make me believe in love. # Brown eyes beautiful. # (CHUCKLES SOFTLY) So, we've only got today and one more after this. One more session. Yeah. And then you're out of here. Yeah. Terry and his wife, Andrea, live in Kaikohe, a four-hour drive from Auckland. Andrea has a business running dog kennels, but she travels to see Terry once a week. Morning. How are you? Morning. Good, thanks. GENTLE GUITAR MUSIC For some time now, she's been showing him photos of family or his favourite things, desperately trying to jog his memory. Unfortunately, she's not seen much improvement. Good morning. But in the last few days, that seems to be changing. What's that picture of? That truck is my truck. Yeah, it is, isn't it? This is your Big Mac truck, isn't it? Yeah, it is. Who's that? That's you and Jase. That's right. When we went and picked him up from kindy that day, wasn't it? Oh, is it? OK. Yeah. Remember how happy he was? Yeah. Do you remember that big ice cream we go? Yes, I do. Yeah, I do. In Whenuapai. That's right, yeah. Yeah. You OK? Yeah, I'm OK. You wanna carry on watching or...? Yeah. Where's that? Do you know where that is? Uh... Do you think it might be the Puhoi pub? It could be too. Yeah, I remember them explaining, um, think of your brain as a filing cabinet, and you've tipped all the files out in a big pile and you've now gotta put them back in the right place. HOPEFUL MUSIC TK's mum, Vanessa, is living in a house truck across the road from ABI so she can be on hand to help her son. Yeah, I love my mum. She's taking time out of her life to stay here with me. I didn't even ask her to stay here. In her mind, she felt like she needed to stay here. A parent just wants to do good by their child. I'm scared for him going out, leaving ABI. I... Just the isolation of his condition. I feel... I feel excited, but I feel... I just feel scared cos he's a young boy in this life, and... and people don't know how to take him. You know, cos he has changed. But in some senses, for us he hasn't. He's just essentially Te Kaha. This is a journey that the clients don't go through alone; the whole family goes through this journey. And they, as a family unit, they go through those different challenges, those highs, those lows. And, um, I think the strength that we've seen in our families, in their willingness to learn and their dedication to their loved ones in terms of progressing them forwards has just been huge. I think the value of having whanau, family involvement here is just so central. 'My journey walking alongside Te Kaha has been... 'just the most profound journey I've ever been on in my life. 'It's like having a child again, helping them learn to connect with their world, 'connect with themselves and their body, with their minds, with their emotions. 'It's been hard watching TK struggle with accepting what's happening to him.' I haven't` I haven't cried too often, but when I've` when I've had my private moments of crying, it's because we lose a sense of that person. It's a huge grief to... watch part of that person slip away. And it's not that I'm not hopeful, it's not that I'm not doing everything within my capabilities to give TK the opportunity to return to his former self. It's better now because now I'm almost walking, and now I'm almost stretching out my arm. I've made massive improvements, which I reckon is good for her. And, um` Because I'm not a vegetable any more. You know? In a week, TK will leave ABI and go home to live with his mum. 'My biggest fear for Te Kaha is that he will be judged by his, um, disability. 'Uh, I think that, um, his friends won't understand 'that he can't do things like drink or anything like that.' The most frightening thing about leaving here is, um` is what the world is gonna be in store for me when I leave here. Like, is the world gonna be good or is it gonna be bad? So, Terry, OK... Do you remember I've been asking you some questions each day? Um,... hmmm... Yeah. Sort of. Sort of, yeah. Yeah? Mm. We're just trying to get back some memory, aren't you? That's right, yeah. OK. Can you tell me, how old are you, Terry? I'm 20-something. 25. 25? That's quite young. 30. Or 30? Am I 30, Andrea? Andrea can't help you with these questions. I'll give you the right answers when we're finished. OK. Have you got grown-up children? Yes, I have. So if you're 25, do you think that's gonna be right? Um... Hmm, no. Mm. Terry's now progressing to a stage where he is actually less restless, less agitated. He's starting to recall some memories and hold and retain the memories and the information. So he's improving quite a bit. We're now able to engage him in therapy, walking him, starting to shower, toilet. So, this is the main pathway that is controlling the movement in your arm and your leg. It's related to injury which is further up, probably up here in the cortex, so in the outer part of the brain. Eltje will be leaving soon. She wants a full recovery and is anxious to learn how much improvement is possible. You will improve it by exercising, by practising, but it's not going to return completely to normal, unfortunately. You know, you will have some slight weakness and slight problems. Do you dare to give it a percentage number? (LAUGHS) Do I dare to give it a perc`? I don't know. What do you think? You obviously don't know, but what do you think? I` I don't know, but I think, you know, what we know about this type of brain injury is that things do generally improve. There are studies showing that people continue to have improvements in their strength and coordination, even up to 10 years after an injury. Yeah. So do you think there is a chance I'll be riding a normal bike at some stage or not? I think that we're talking about a slightly different problem. It's not a weakness problem; it's a coordination problem. Yeah, it is. Balance. That's all. Balance. And that is` I think if you were to try riding a bike again, it would carry significant risks for you. Yeah. Oh, OK. So I think` I think the reality of the situation is that you're looking at riding a three-wheeler. You know, you're going to need a modified bicycle to ride successfully. So you can buy my two-wheeler. Thank you. That's very nice of you. (LAUGHS) It's a really good racing bike. Terry has turned a corner. Finally, doctors are seeing improvement ` and so is his wife, Andrea. Rang up on Saturday to see how he was going, and, um, they said that he was` the restlessness had really slowed down and that he was sleeping a lot better. He'd slept from` I think it was 11 till 5, which is the most he'd slept for four weeks. Yeah. I realise how sick I was. Mm. You know what's wrong? I was really sick, eh. Do you know what's wrong with you? It was dangerous. Mm. You had a truck accident, didn't you? Yeah, that's right. Mm. So you've got a brain injury. Yeah, that's right. When he did his speech therapy yesterday, she went round the room, and every item she picked up, he got it right. So. Um, the deodorant, it took him a little bit longer, but he just said, you know, 'This goes under my arms.' (CHUCKLES) Did say he only uses it twice a year, but. (LAUGHS) Is it true? > (LAUGHS) No. But, yeah, no. He was` Like, the showed him straws and toothbrushes and shavers, and he got all of them right. So that's a huge improvement as well, so, mm. Part of the rehabilitation is helping clients to reclaim their independence and integrate back into a normal life. We could make mini quiches or we could make a pie or we could make a salad. Let's just make an omelette. An omelette? OK. So do you want to find a recipe for an omelette, then? Yeah. Wh` How do you spell omelette? There's some already coming up. (LAUGHS) A peanut butter omelette? Yeah. You and your peanut butter. So, how much money do you think we're going to need to buy those ingredients? Dunno, $15? Yeah. POIGNANT MUSIC Good work. What's the first thing on your list, TK? Eggs. Oh, I don't have eggs. My right leg is so weak. Do you need a break? No. Nah. MUSIC CONTINUES ELTJE: Everything you do is a learning experience for a brain. So if you go to a cafe, that's a learning experience as well. So, one iced coffee, large, yeah? < Yeah. Yes, please. 'All this hopefully will help my brain to come` come all right, or come better again.' MILK SPLUTTERS, GENERAL CONVERSATIONS How can I help you? Hi. Um, I would like a cappuccino, large. Certainly. Can you imagine that you would be working in a place like this all day with that amount of noise? (LAUGHS) No, I'm serious now. Yeah, no, I know. They get used to it, though, eh. What are you doing today? Leaving this shithole. OK. BOTH CHUCKLE Leaving ABI. TK's last day at ABI has finally arrived. Yeah, I can't believe I'm leaving this place. I mean, I've been here now for five months. And, um, I'm excited that I'm leaving. < Yeah, I've got you. Go closer. I like looking at life as a challenge. Well, I reckon in time I'll fully recover. Cos everything's time. But at the beginning, I won't be myself fully. I'll just` I'll just have to live with that for however long it takes. And then once I become my old self, I'll be back to my old ways. Huh. I see him, um, being able to possibly give talks to young people to educate them about not wearing a seat belt. Because he's very aware he wasn't wearing a seat belt and that life could've been a lot different for him. I see that` all going well, that he will have a full and capable and loving life. I see wonderful things for Te Kaha. Absolutely. Oh, the best thing about leaving here is that I get to live my life again, that I'm still alive. That's what I love, that I'm still alive and that I get to leave this place and live my life outta here, which I wanted from the beginning. Hey, everyone. I just wanna say thank you for, um, being so kind, and, um, we know that you guys are all good people and, um, I wish I was never here, I wish I never had the accident, and, um, I wish all of you weren't here. But, um, that's what life is. And, um, I just have to say thank you for being so supporting. Yeah. PEOPLE CLAP ACOUSTIC GUITAR MUSIC You got it. You got this. This is your goal. You've got it. You've got it. MUSIC CONTINUES Oh, I c` I've got you. I've got you. Balance. You got it. You've got this. My goal was to walk out of here, and I'm not gonna leave ABI without walking into the car properly. Like, I fell over a few times when I was walking to the car, and this time I just wanna walk in the car and go. Yep. You've got the safety of the car here. That's it. MUSIC CONTINUES Get your balance. I feel real good about leaving. I'm gonna miss physio here. But I did walk outta here. TINKLING, HOPEFUL MUSIC I'm OK like this. Yeah. In our next episode, it's time for Eltje to leave rehab. But she's not sure if she can live on her own at home. This house takes a fair bit of modification. And ABI Rehabilitation welcome one of their youngest clients ` 15-year-old Jared. You know why I'm doing this? No? www.able.co.nz Copyright Able 2016