1 INDISTINCT OVERLAPPING VOICES CONTEMPLATIVE MUSIC Pretty severe brain injury. You're in a place called ABI, which is Acquired Brain Injury. Copyright Able 2016. OK, Terry. So, what we're gonna do is just get you to sit on the edge of the bed, and then we're gonna put the belt on, OK? Take the blanket off first, Terry, so you don't trip over it. Terry Tansey sustained a massive head injury in a truck accident three months ago. Sit. No, no, Terry, can you sit on the side of the bed for me? Sit on the side of the bed. Sit on the side of the bed? No, I` (CHUCKLES) Sit on the side of the bed? Come on in, Sam. He's been in a state of confusion with post-traumatic amnesia. Is it in your drawers or is it in your cupboard? I don't remember having hair like this. So, do you know what's on your head? Just white jelly shit. It's actually a bandage. The complex nature of brain function makes it one of the most difficult injuries to recover from. Get that set up first. Yeah, OK. When somebody does have an injury to the brain that involves, say, a fall or an accident, the whole of the brain has been shaken up, but specific parts of the brain impact on the skull, um, so there isn't a great deal of protection for the brain in general terms. The brain is a very fragile organ. It has a lot of delicate machinery in it, if you like, and very important functions that are concentrated in very small areas. No worries, mate. OK. So we're gonna go ready, steady, stand, OK? OK. Ready,... You ready? ...steady,... Ready? ...stand. Are you ready? We're ready. Good. The Kaikohe truck driver is one of 30 patients at ABI Rehabilitation, one of NZ's leading facilities for people with traumatic brain injuries. One. You want me to count to what? 30. 30. 30. One. One, two, three, four. Get by. Yeah, get by. (CHUCKLES) That way. Yep. OK. Yeah. Terry came here soon after his accident three months ago. Right. Right. Are you right? Out the door. Out the door. This way, mate. Are you holding it? Only in the last few days has Terry known who he is or where he is. Down, sir. Brakes are on. Most people will be here six months before they are well enough to go home. You all right, Terry? Yeah. Let's get you warm. Each year, 36,000 NZers have a traumatic brain injury. Do you go dizzy when you're walking? A little bit, yeah. Patients transfer from their local hospital to a rehabilitation centre as soon as medically stable. At Auckland's Middlemore Hospital, 15-year-old Jarrod is recovering from a brain injury caused by a spontaneous heart attack. Jarrod was playing basketball when his heart stopped. It took eight minutes to revive him. During that time, his brain cells were starved of oxygen. I got the call at home, said he had collapsed, didn't know it was... I thought it was just from exhaustion from the day at paintball and then going on to basketball. We walked in to seeing him have people performing CPR and everything on him, so that was frightening. > And it seemed like it took forever for them to be... for him to be stable enough for them to move him. But I didn't feel it. No, you didn't feel it. And then I died. Yes. But you had some very very helpful people that brought you back. Eh? Not really dead. One doctor said, you know, if he was to make the call that day, that he would say it was a... unsurvivable brain injury. Mm. So that's what we were, kind of, dealing with. We understand that there is a good chance he may not be the boy that we had before this all happened,... but, um, you know,... we're thankful for... whatever we have with him. Jarrod's lucky to be alive. But because he's young, he has better odds for recovery. His mum, Kelly, has been by his side since the accident. But she's torn between the many demands on her time as a mother of young children, who also has a full-time job. (CHUCKLES) BIRDS CHIRP All right, Eltje. Oh, not too bad. Eltje has already been at ABI for six months, but the impact of her accident lingers. Eltje was cycling on a rural road when she was knocked off her bike. Doctors were amazed she survived. You all right? Which foot are you gonna use? Right foot? But they've realised throughout her time here that this is one tough lady. I put so much effort into... into my exercise and walking,... and that I don't... seem to get the reward. Part of it is because,... um, the area where my injury is, which is the cerebellum,... um, is known not to respond too well... to rehab. She'll soon be at the stage where she can leave rehab and head home. How have you been today? (SIGHS) Well, as usual,... I did my bike ride at half past 7. Her friend John has visited almost daily. He's taking Eltje back to her home for the day, the first time she's been there since her accident. There is some anxiety, because we feel that you are still gaining a lot from the intensive therapy that you get at ABI. Mm. Yes. Have you thought about the place, uh, with the slow stream rehab that you may go to in Hamilton? The place doesn't quite encourage you for walking, and walking, after all, is one of... one of the basic things that I want to do. I... I think the main thing wherever > you are is what you do yourself. > And I... I... I believe, and I'm kind of proud to say... that I'm... there where I am now because I've been pushing for it myself. < Keep it up. You're improving. Yeah. GENTLE MUSIC The brain absorbs a lot of the body's energy. It's about 20% of the body's energy intake, and it only weighs about 2% of the total body weight. But while it's healing, the, uh, energy requirements of the brain is significantly increased. And so it's in those circumstances that basically, the human brain is sucking all of the energy out of the body. (SNORES) Jarrod's now transferred from hospital to the rehab centre. His morning therapy has left him exhausted. His brother Jason is now helping Mum by staying close to Jarrod. The next few weeks are the most critical in Jarrod's recovery. We've, yeah, always had a close connection, because... (SNORES) ...he, sort of, looked up to me, being the older brother, yeah. Yeah, it was quite... quite emotional... to be doing so young... and him being so young and... (SNORES) ...so physically active and... that something like this would happen. (SNORES) Let's just hope you... (SNORES) ...get back to how you were before, eh? Growing up, he was quite the character, just always positive about where he is, what he's doing. Jarrod is laid-back, but you can also sense that he is motivated to wanting to do something with his life. There was years through high school and intermediate he has picked up the cheekiness and the... the humour, and I'm just here to help him... and get him back to how he used to be. Get your rest. Do you know what happened? No, I was asleep. (CHUCKLES) You thought you were asleep for only two days, but Mum told you were asleep for two weeks. Was I? Yeah. That was long as. (CHUCKLES) Two weeks, eh? No. Yeah. Not that long. Mm. Jarrod has a hypoxic brain injury. The part of the brain that's been affected is the occipital lobes, which is at the back of the brain. And those are the areas of the brain that are particularly involved with vision and what are also called the visual association areas. So not only is it the areas that you see, but it's also where you make sense of what you see. Made you some breakfast, Jarrod. He's had trouble, for instance, with identifying people's faces, and that's a particular type of syndrome that can occur in those circumstances. Ready for some porridge? Yep. It does get frustrating at times. He has to... start all over again, if you will. The legs? Porridge? Is it nicer than the ones in the packet? Mm. Antony is the youngest of Terry's two sons. He calls in to see his dad after work most days. The conversation is always confused. The family is starting to realise Dad is no longer quite the same guy. It's all quite quality stuff, eh? What's that, your building? Yeah. Yeah, yeah. < Yeah. Yeah, yeah. Building a couple of hiluxes, 1960s. Oh yeah. Yeah. But we'll get there. Yeah. You can't rush these things, eh? (CHUCKLES) No. You can't rush these things at all. We're pretty close, pretty good mates, eh? Yeah. Dad taught me a lot in life,... how to build houses, eh? (CHUCKLES) Yeah, that happens. Just one of those things that just doesn't happen just like that, eh? > Nah, I'm all right. I've got a tissue. (CHUCKLES) You do realise what's more important in life, I suppose. Certain things happen. Like, something might break at home or something, something that would really wind you up, but I guess in that sort of sense, you realise that, you know, life and family and whatnot is all that matters really. We'll have build some more buggies when you get out, eh? Yeah, we'll build heaps of them. Yeah. Mm-hm. GENTLE MUSIC BIRDS CHIRP The King Country, a four-hour drive from Auckland, is Eltje's home province. Her dream of an active life in the countryside is the reason she moved from Germany to NZ 15 years ago. It's starting to rain, which will make the steps slippy. However... The short home visit is a test to highlight how her home needs to be adapted now that she's less mobile. I'm OK like this. Yeah. BIRDS CHIRP Independence is what I had, but dependence is what I have now. It's just a huge difference. Yeah, it's kind of slippy. I have to see it... as an opportunity,... uh, that I was given,... uh, that I can... construct my life again. And obviously, it has to be quite different. What do you think? The place is... My bike... that I crashed with. And it... it's just standing there like it's fine. > Yeah. You know, when you... when you see the bike, you would never think that... Mm. ...somebody made a mess of themselves like I did. Yeah. Yeah. Mm. And... here I have a little lake. I hope they make some form of lift... in order to access the house. All the glass is... is potentially dangerous. Like, if I... if I lose my balance, so I go through glass probably. The cycling ones, these are Masters Games medals... from the NZ Masters Games. Um,... this was, uh... I think it was a race in Hamilton. I can't remember, to be honest. But I can't... (SOBS) I can't,... um, let go of cycling. ACOUSTIC GUITAR MUSIC MUSIC CONTINUES BIRDS CHIRP How are you? I'm good. And you? You're looking marvellous. I'm looking marvellous? You're looking pretty marvellous. Yeah? Oh, good. That's great. How are you feeling today? I'm not too bad. Yeah, not too bad. What do I do? A bit of this, a bit of that. (CHUCKLES) I'm your occupational therapist, Terry. Yeah. That's right. You are. OK. We're just gonna sit on the edge of the bed first. OK. I've just been sort of sleeping on the edge. Daily therapy aims to stimulate and use recent memory and encourage him to think again. It's tied around there. You take this off and all day. Yeah, I know. You don't want it. There you go. But Terry, before we start, what do you need to do? Um, well, what do we need to do with this? We're gonna go walking. Oh, we're just gonna go walking, yeah. We need to watch where we're going. Do we need to put something on before we go? Yes, uh, footwear. Which ones do you want to put on today? Um, those ones over there'll be all right, yeah. Terry's rehab has been delayed due to the post-traumatic amnesia that lingered for six weeks. OK. Put a bow in that so you don't trip over it. Yeah, I should do. The main predictor that we use in terms of long-term outcomes in the community is, uh, what's called post-traumatic amnesia duration. So that's the amount of time that a person is in a confusional state; they're disorientated; you know, they don't know what day of the week it is or where they are. Um, and where you've got, um, people who are in that state for, uh, prolonged periods of time ` um, and typically, here would probably be around a month of so would be average ` those people tend to do less well on return to the community. Do you remember where the kitchen is? Yeah, that way. OK. So do you want to lead me there? Yep. Do you wanna go there now? Yeah. Is that all right? Yeah. We can go. We can go there now if you like. Take your time. Don't walk fast, Terry. OK. And just remember to watch for the side. Yeah. OK. Try not to walk too fast. Knock, knock! (KNOCKS) Good morning, Jarrod. (CHUCKLES) Therapists know rehab's hard work. Speech and language therapist Ashley Stone tries to make it interesting for Jarrod. Have you ever played Mad Libs before? It's called, um, kind of, verbal generation. Right? So sometimes after a brain injury, it can be hard for you to think of things that you wanna say, hard to think of those words, think of those ideas. And this is just important for, you know, when you're talking to people, thinking of what you can say, thinking of those words, being able to retrieve it out your brain and use it. < All right. So the first thing we need is a silly word. Can you think of a silly word? Like wobbly? Wobbly. I like that one. (WHEEZES) All right. So now we need a noun. Like outside. Perfect one. BOTH CHUCKLE (WHEEZES, CLEARS THROAT) ALL CHUCKLE I think it is very difficult on the individual. I would say that you sometimes get very pleasant surprises, people who seem to have a very bad-looking scan seem to do very well. Unfortunately, age is a significant factor in terms of recovery, um, and certainly, above the age of 40, it's known that recovery is slower. And, um, uh, with elderly people ` and we're talking about people above the age of 65 ` recovery can be, um, very seriously impaired by what appears to be a relatively minor type of brain injury. Eltje is 53 years old, but her high level of motivation will help her to achieve the maximum recovery. Cycling is her passion, but she's damaged her cerebellum, the part of her brain which contributes to coordination, precision and timing of our movements. Guess we'll just, uh... It's broken. Yeah. Yeah. Can you stabilise me? Yeah. Having seen her old bike at her home, she's more determined than ever to learn to ride again. Oh yeah. Oh yeah. Yeah. Is it tight? Yeah. I've been cycling or 15 years or more. How's that? Good. Even if I have... to get a tricycle,... that would be OK. It's more or less... the ability to go out there on your own,... feel the fresh air and... just get rid of whatever your worries are. Get your feet in. Get out here, hey? Get your feet in. Yeah. Uh, slow down. Eltje. Eltje's got double vision, so she has no perception of depth, which makes it hard to judge stopping distances. Tricycles would fall over ` you can't, you know. One of the first things she said to me when she emerged from consciousness, I... I heard a voice shouting out from her room at ABI,... 'John, put me back on my... will you put me back on my bike?' So this is really satisfying that we can... get towards that. That was my first outdoor ride... since half a year. My brain, at the moment,... has to process quite a fair bit of information. So, hopefully, that will... that will be the beginning of something else. Hey, Terry. Hey, mate. How you going? Morning. Come to see me today? Yes. How are you? Terry's made a giant step forward. His physical function is returning, but the confusion remains. So, I thought what we'd do today is, um, assess you on stairs. Oh, OK. Just I heard that you've got a few steps to get in and out of your house. All right. OK? OK. Well, let's go, then. We're off. All right. Do it one step at a time, OK? OK. OK. Take my hand. We're gonna go up. You can do alternate, mate. Quite safe doing alternate steps. Wow. That was really good, mate. Have a rest here, mate. I'll set up something, eh. OK. Thank you. It's, um, high concentration, especially when you're trying to learn how to walk again. OK. When you're ready. Yep. All right. Well done, mate. Pick up the cone. Yep. Hand it to me. Yep. Step off the foam cushion. Turn around. OK. Well done, mate. Because you made it look so easy, I'm gonna challenge you even more. Yeah. What I want you to do next time is balance that ball on this racket while you're doing the course. When you're ready, mate. Yeah. Yeah. So, stand up. I used to be good at badminton. Oh, did you? I used to be, yeah. All of the patients wear handling belts. A second fall would be catastrophic. Might be better with the other hand. Turn around. Terry's wife is pleased staff are testing him on stairs. Terry's a motor-racing fan, and she plans to take him out to watch the Bathurst 1000. (CHUCKLES) Have a seat. Nah, it was good. On Sunday, you know how you wanna watch Bathurst? Yeah. You're allowed to go to Jessie's with Anthony and watch Bathurst there. Oh, am I? OK. Yeah. Will that be good? Why's that? Eh? Cos they've got Sky, and you can go and watch it on Sky. Oh cool. (CHUCKLES) That's good, eh? Yeah, yeah. Things are going, yeah, real good. Yeah, that's why we had to test you on the stairs, to make sure you're OK to go up Jessie's stairs. I'm not as bad as people think I am. Pardon? I'm not as bad as people think I am. No. Heading back to your house, and you can have a rest, mate. OK. Thank you. Terry has got some specific problems, but they're more around memory and confusion. Terry's getting towards the stage where he could be discharged, but he will need to go on to a community based rehabilitation programme, and I think that's probably going to be quite, uh, prolonged. Hi! Eltje's made a massive recovery well beyond what doctors expected. Eltje is certainly one of the most determined people that I've been involved with. She certainly has been a pleasure to work with, because she just wants to keep on working and working all the time until she gets the results that she wants. She's ready to leave ABI Rehabilitation and transfer to another facility, where she'll practise living independently. How are you going? I'm in the middle of getting my things together, my packing. OK. Eltje can't go home till her house is modified to make it safe for her. It's just time to move on. But hopefully the other rehab place will be OK as well. I find it's going to be a big challenge,... because I leave this safe bubble,... and I have to look after myself more. And I'll also have to take... more initiative to get my therapies... and do my therapies. That shouldn't be a problem, though, because, um, I've always done sports. And I would just see it as an exercise routine or something,... um, which I'd do in addition to the therapies that they give me. So, we've got a little bit of food here, so you just... Aw! Look at that! ...just ABI doesn't have many small plates, so... That's all right. We've got burger and chips. Yeah. < Oh yeah. Uh, cutlery maybe. John's invitation. > Thank you to you all. And, uh, John and I... wanted to shout you a little bit of lunch... to show our appreciation. And, um, I know that you... all are only... doing your job,... um,... but to me, it was much more. And I wanna thank... all of... all of you as a team. And I think you're an awesome team, and, um,... brain injury is known or patients with brain injury... are known to be very forgetful,... but I will remember you. Thank you. (SOBS) Just got a few hours to go. (CHUCKLES) Well, at least I'm walking out of here,... not... not in a wheelchair. Turn that left foot. In our next episode, Jarrod takes his first steps. Sit down? OK. Just have a seat there. So arms back. And Terry's excited his memory is returning. I see Terry in the mirror, that guy that used to have a truck accident, but he's coming right now, so, yeah. Captions by Faith Hamblyn. Captions were made possible with funding from NZ On Air. Copyright Able 2016. We're closing in on the 2016 Attitude Awards. This is our ninth year, and we've mixed things up. Get ready for new categories and fresh ideas. We're striving to make this year's awards bigger and better than ever before. You'll experience unique stories of Kiwis achieving, mixed with phenomenal performances.