Brain injury

Specialist support that enabled Ben to defy the odds

Having initially been given little chance of survival after a brain haemorrhage, with the support of Nottingham Brain Injury Rehabilitation Centre, Ben now lives independently and continues to rebuild his life. Here, we learn more about his journey and why the support of the team at the specialist centre has enabled the young survivor to look to the future.

“I was in hospital and literally everyone was told the machines were being switched off.

“But my consultant barged in like an ex at a wedding - I’ve been told it was actually a phone call, but I like my version better! - and to cut a long story short, he saw something in me to let me live.

“My life was saved by this man, but my life was given back to me by the team at Nottingham.”

From the trauma of Christmas Eve seven years ago has come a near-miraculous turnaround for Ben - a survivor who has refused to give up at every step of his long and ongoing journey to recovery, and who continues to be indebted to the team at Nottingham Brain Injury Rehabilitation Centre for their support in that.

Aged only 17, Ben was admitted to Nottingham’s Queen Medical Centre with symptoms including headaches, vomiting and he had also collapsed at home.

Medics diagnosed a right cerebellar bleed and intubated Ben, who remained in a coma until February 2017. Despite the initial bleak outlook, and thanks to the intervention from his consultant as his machines were set to be turned off, Ben began to make progress that defied all expectations.

He was admitted to Nottingham Brain Injury Rehabilitation Centre’s high dependency Fernwood Unit in March. The centre, owned by Active Care Group, is a specialist neuro-rehabilitation site for adults with brain injury or neurological conditions.

An assessment found that Ben was in a vegetative state, unable to interact with his environment or communicate by any means.
Multi-disciplinary specialism, alongside nursing and care expertise, combined to devise a route to recovery for Ben - laying the foundations of the life he now enjoys today.

Ben underwent a tracheostomy to help his respiratory function and received percutaneous endoscopic gastrostomy (PEG) for his nutrition and hydration. He was completely dependent on the care and nursing staff at Nottingham Brain Injury Rehabilitation Centre - and through bespoke support, multi-disciplinary treatment and rehabilitation support, he continued to emerge from his vegetative state.

Reassessment gave a diagnosis of Minimally Conscious State Minus (MCS-) from which he continued to progress both physically and cognitively, with the support of his dedicated team.
His tracheostomy was weaned on site, and was successfully decanulated in August 2017.

As he continued to go from strength to strength, Ben was moved to Millwood Unit of Nottingham Brain Injury Rehabilitation Centre, a specialist in slow-stream rehab, for ongoing neuro-rehabilitation.
In early 2018, with the support of his occupational therapists, he joined a local wheelchair basketball club.

This gave Ben an important activity to be part of, both physically and emotionally, and he became a vital member of the club in supporting others in their ongoing journey of recovery.

Happily, later that year, Ben was discharged back home to live independently in the community without a formal care package.
He now only requires minimal assistance with his daily care needs and is able to prepare and eat a normal diet, communicate verbally and is even looking for opportunities to return to work.

For more information about Nottingham Brain Injury Rehabilitation Centre: To enquire about referrals, contact

referrals@activecaregroup.co.uk or 01732 779353.

Meet Michael Jones, Head of Therapies at Nottingham Brain Injury Rehabilitation Centre

Michael began his career as an assistant psychologist, working as an activities coordinator, and has been supported to retrain as an occupational therapist and work his way up to his current position. Here, we find out more about his role,
the work of the specialist service and what motivates him in both his personal and professional life

Can you tell us a bit about your career background and experience?
I’m originally for Shropshire and first came
to Nottingham in 1997 to study psychology
at Trent. When I graduated, I stayed in Nottingham with plans to continue my studies after a short break from education to get some hands-on experience of working with people. That is why I joined the organisation, and began working as an activity coordinator having applied for assistant psychology posts up and down the country.

During my seven years in this role, I began working with OTs and something clicked. They were using elements of cognitive psychology alongside practical interventions within a framework of function, and it just made sense and this was the unexpected fork in the road that set me off on a different path than intended.

The company supported me through re-training in Occupational Therapy at Derby University. Unfortunately at the time of qualification there were no available OT positions within the Nottingham area, so I briefly left the company to begin my OT practice. Two years later an opening for a OT became available at Nottingham Brain Injury Rehabilitation Centre, which I applied for and thankfully was successful.

I’ve worked my way up through the bandings to a band seven position, and then an opportunity arose to cover the Head of Therapies role, initially through a colleague's maternity leave, but eventually on a permanent basis.

Please give us an overview of the services that are provided at Nottingham Brain Injury Rehabilitation Centre
Nottingham has three units - Fernwood, our high dependency unit, where we treat individuals with high nursing needs. They may present with a disorder of consciousness, have respiratory
problems, tracheostomies or vents.
We also have Millwood, a slow stream neurological rehabilitation unit, and Rosewood, a long-term neurological
care unit.

What is your favourite thing about working at Nottingham Brain Injury Rehabilitation Centre?
I love the variety and that everyday is different, we have a wide range of individuals presenting with everything from patients with tracheostomies and vents to high functioning patients whose primary difficulties are cognitive, so the scope and range of treatments we offer keeps everything fresh. The thing I enjoy the most is the people I work with and the atmosphere in the centre, we have some fantastic staff here which is really important when you’re working with very complex residents which can present some challenging
situations.

What is your vision for the service in the short to mid-
term future?
We have some exciting plans to reshuffle elements of our environment to better suit our residents’ needs, provide clear treatment pathways for residents to progress and move through the centre as part of their recovery journey. I’d really like to see those come to fruition and for us to work towards being recognised as a centre of excellence for neurological care and rehabilitation both locally and nationally.

Finally, what do you like to do in your spare time?
Spare time?! I’m a proud father of two children (a two-year-old and a six-month-old) so as you can imagine spare time is a little
on the short side at the moment!
When I’m not being a dad, I’ve got a passion for photography and travel, both increasingly difficult now with a young family, but I’ve been lucky enough to travel to some very exciting countries and have some wonderful experiences, Cambodia probably being my favourite to date, but for the time being I’ve swapped backpacking in East Asia for long weekends at Center Parcs and I couldn’t be happier!

Meeting the experts in brain injury rehabilitation

NR Times learns more about Dr Maria Stein, programme manager for Reach, about her background, career and current role, and how she spends her free time

Doctor Maria Stein PhD, MSc, PGCert, LTHE, dipCOT, FHEA, is a highly qualified and experienced occupational therapist and clinical researcher in neuro-rehabilitation, and programme manager for Reach, helping head injury survivors to reintegrate back into community life.
Maria currently holds an academic post at Canterbury Christ Church University. Previously, Maria held clinical, teaching
and research posts at Brunel University and East Kent Hospitals NHS Trust. We asked Maria if she would give us a small insight into the journey that has spanned her life and career.

I had a humbling childhood, learning qualities and values that I have retained as I got older and brought up my own family. Growing up in Malta as the eldest of three siblings, I come from a very close-knit family where faith is important, elder generations are valued and respected, and helping others is seen as a virtue. I worked as a volunteer helping institutionalised children and young people with profound learning disabilities become more independent in activities of daily living.

The first in the family to attain a degree, I qualified in Occupational Therapy at the London School of Occupational Therapy in 1982 and I have a career spanning more than 40 years.

I am well travelled, having lived and worked abroad with my husband for many years, mostly in Europe and the Middle East (Qatar, Oman, Bahrain and Syria), where we also raised our young family.

During this time, I balanced my family life and my career, helping to establish occupational therapy in remote regions, amongst the indigenous people of the countries that hosted me. I worked alongside international organisations to provide professional services in a number of different settings, including acute hospitals, schools and residential institutions, sometimes in places that were not always very easy to reach!

In areas that may treat disability as a taboo, I strived to minimise the stigma associated with disability around that time, educating those around me and ensuring that everyone was treated with dignity and respect, regardless of their own culture, ethnicity or religious background.

I have very fond memories of this period, it helped me to appreciate what I had, learn to work with very limited and local resources, become increasingly resilient and proud to be helping others using all my occupational therapy skills. In return, I gained a wealth of experience, knowledge, and practical skills in the field of occupational therapy and client-centred neurological rehabilitation.
Research and knowledge exchange.

I have special interests in rehabilitation research, clinical and patient outcomes, and knowledge exchange, and I have a research track record that dates back to 1999, a time when rehabilitation research in occupational therapy and among allied health professions was still in its infancy.

I have collaborated and led on various clinical and educational projects throughout my career in research and academia, with the two most recent being ADAPT and MOTION. I was instrumental in developing and writing training packages for both projects, which were funded through Interreg Europe, one
of the EU’s key funding instruments for cross border co-operation and development between member states.

I regularly peer-review for international journals, such as the Journal of Medical Internet Research, and the journal Disability and Rehabilitation, in addition to a number of occupational therapy journals. I find this to be an excellent way of keeping up to date with current advances in the field of rehabilitation practice and research.
I have also presented at local and international conferences, and have published work in a number of peer reviewed journals. I have ethically reviewed several internal and external research applications, and have statistical expertise in the analysis of serial, longitudinal data using multi-level models.

As a strong advocate of research informed teaching, as well as the transfer of research into evidence-based practice, and blended learning, I enjoy both the research and teaching aspects of my work. I particularly enjoy the supervision of post graduate students and mentoring early career researchers. I have always enjoyed learning and studying and will continue do so, long after my career is over.
On the rare occasion that I am not busy, you will most likely find me in the garden tending to the flora, otherwise I may be baking or cooking a meal, people say that I am a very good cook!

As a vociferous consumer of literature, I often immerse myself in anything from newspapers to biographies, with the latter being a favourite. I love to read about real people and their life stories, their successes and failures, their experiences and learnings, and their travels.

I too confess to have the travel bug and very much enjoy traversing the globe, meeting new people, experiencing different cultures, seeing new sights and scaling great heights! I will often combine as many of these as possible, with recent trips to hike in the Canadian Rockies and to southern Italy, which were both fabulous!

I have two boys in their early 30’s and I like to travel with them at least once a year. This ensures quality time for us to spend together, as I don’t see them as often as I would choose. One of my sons has just left to work and travel in Australia, so one doesn’t need much of an imagination to see me travelling in that direction very soon.
One of my other great passions is dancing, which I find to be a great way to unwind. It is my weekly feel-good medication, a prescription that I would recommend to all.

Maria is a member of our highly experienced team of neuro-occupational therapists, serving Reach to provide both remote and home-based neuro-rehabilitation services for those with minor to catastrophic acquired brain injuries.