Changes in her memory and speech after a traumatic brain injury were difficult losses for Bridgid Ruden. Formerly a busy nurse practitioner, she now found it hard to do even the simplest tasks and errands. Even caring for her children and managing the household were constant challenges and frustrations as she frequently lost items as well as words. So many losses changed her sense of self and were further compounded by seizures. Yet she has found a new purpose in life and is now a powerful advocate and speaker for the many voices of survivors.

I attended an educational conference once where the speaker spoke on individuals with disabilities and how difficult it can be for them to integrate in society and build community. He then went on to give an example on how acquired disabilities can make the task of building community even more difficult due to the individual remembering how they once interacted in community and how they were accepted in society prior to their acquired disability.

I began training for my first triathlon in 2008 at age 44, encouraged by my wonderful Pediatric Nurse Practitioner colleagues in Neonatology at the University of Iowa Hospital and Clinics. On May 24, 2008, I began to bike ride 14 miles with my dear friend, Angie Cookman, on a trail in Coralville, Iowa. We came to an area with a large downward and upward hill; we were not speeding and were both wearing helmets. At the bottom of the hill there was a six-foot section of water and mud. I unfortunately hit the muddy area and was thrown 25-30 feet and hit concrete on the right side of my head. The helmet was cracked all the way through on the right side for 1-2 inches. I immediately passed out and started bleeding from my right ear and nose.

One day when I was 15 years old I lied to my family about where I was going, got in a car with an inexperienced driver, headed for Detroit, and was broadsided by a city bus. I suffered a traumatic brain injury (TBI) caused by a depressed skull fracture. I went into a coma. The doctors who performed emergency surgery informed my parents that I was not likely to survive the operation. If I did, I was not likely to regain consciousness. If I regained consciousness, they expected me to be severely handicapped.

An undiagnosed brain injury can have many consequences for survivors and family. Ethel Dimont reveals how a “minor” car accident resulted in an undiagnosed brain injury that had serious consequences for herself, her family and her caregivers. Assuming that things will get better with time is not a substitute for early diagnosis, expert assessment, and proper treatment. Social, cognitive and behavioral changes after a brain injury may be less visible than physical injuries but they can have life changing effects on the individual. Early diagnosis and treatment are critical.

Cathy Borden’s brain injury shattered her life, her body, her face and her spirit after a terrible car crash that left her fighting for her life in the hospital. Describing the emotional trauma of her multiple losses as she progressed from coma treatment and emergency medical care through extensive surgeries and rehabilitation therapies, her will to survive overcame enormous pain and complications. Her long journey of recovery required emotional and physical healing. The damage to her face was devastating as she struggled to rebuild her sense of self and identity. The brain injury affected her physical, sensory, and cognitive abilities.

The importance of family support and caregiving during her numerous surgeries and extended rehabilitation helped her rebuild her life – slowly and painfully. Her story shows how a traumatic brain injury affects everyone in the family.

Anne Forrest’s account of her diagnosis, treatment and recovery from a so called mild brain injury shows how her life was completely changed by the trauma to her brain in a minor car accident. The cognitive changes resulted not only in the loss of her career, but made it difficult for her to simply get through the day. Looking “normal” made it hard for others to recognize her disability and needs for compensatory strategies and accommodations.

She says, “Looking back, I can see that I was exhausting myself trying to return to work and my normal life. My brain thought I was the old me, and I did not know I could not succeed at my old life with my now-injured brain.”

A traumatic brain injury forces Kimberly Carnevale to reevaluate what’s important in life as a survivor. Coping with the trauma of her brain injury, grieving her losses, losing her home – losing everything leads her to a new beginning as she rebuilds her life. Her daughter and her service dog become the priorities in her life as she clears her mind, builds a new path, and creates a new vision for living a full life as a survivor.

The journey to recovery for brain injury victims can be a lonely one. Most survivors do not look like we have a disability so others assume we have recovered because we look good. Family members do not understand the causes for changes in behavior, inability to think and reason clearly, short-term memory losses and personality changes. Bursts of anger, resentment and withdrawal make it even more difficult for them to provide emotional support. Depression can became a new partner and companion after TBI.

Growing up with a disability after a brain injury was a lonely struggle for J.R. Peitrowski. Long stays in the hospital and rehabilitation therapy made is hard for him to have friends. The physical changes that left him with a disability further isolated him from peers. Now an adult, he has found peers and social support in a clubhouse for people with brain injuries.