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I was under the impression that if you don't see major improvements in the first couple of weeks, most of it won't come back.
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Don't you worry about that! Typically progress starts out slow and then increases at a faster rate. Moreover most progress tends to occur over a period of two years, and even after that late recovery is possible.
Now you've told me some more, I'm able to form a clearer picture. The damage does sound quite extensive, and I can see how the doctors have been hedging their bets. They don't want to give people false hope so they tend to be conservative in their estimates. I, too, don't want to give false hope and I am certainly not clairvoyant, but I think that at this stage you need a cognitive framework for coping; in simple terms: you need to know what you're dealing with, and roughly what you can expect. Moreover whereas the neurologists who treat your wife work in the acute setting (where people stay for a few months at most), I get to see people as they change and improve over the next
years. So whereas unlike them I have relatively little knowledge on acute medical management, I have more experience with functional recovery over the very long term.
I would expect your wife to be quite tired and confused for the first few months, and then to start making more substantial cognitive improvements. Currently she may still be in "Post Traumatic Amnesia" (PTA) --that period following brain injury when new memories will not be laid down, or not very well. She may not remember your visits, and be quite disoriented as to where she is, what day/time it is etc.
"Retrograde Amnesia" (memory loss of facts and events from the past) even going back as far as 10+ years, also is common and tends to resolve, although I expect she will never recover memories of the last weeks/days upto her injury (including childbirth --have those baby pictures ready!).
I advise you to start recording by all means, photos, camcorder, audio tape, the baby's progress until her PTA resolves, as she won't remember this period later and will want to know the sound of its first gurgle... You can help your wife reconstruct her past memories by talking with her about the past, showing her pictures etc. I tend to help families construct a "time-line": a long sheet of paper with a line spanning from, say "10 years ago" to "Now", with keywords of events and photos of family albums stuck on at the relevant chronological position, left on a wall in plain sight for the patient to see, so they can start organising the fragments of their memories.
She will be very spaced out and tired for now. She will not remember things, and feel easily overwhelmed. Her disorientation and fatigue will make her seem flat. All this will pass in time. That she is speaking clearly (even if she is experiencing what we call "phonological dysphasia" --saying 'crystal' instad of 'Kellogs') is a good sign: it shows higher cognitive function, and if her speech is not slurred, and not 'dysfluent' (i.e. not slurred or stuttering) that would suggest that her motor functions got off lightly. Due to her injury she may lack intonation in her voice however, and this also will make her seem flat.
Keep an eye on her movement; if this improves rapidly over the next month, she should have few movement problems in the long term. If they don't, she will need physiotherapy input and may be left with some residual problems. I am very encouraged though to hear that she is up and walking already! Even if this is only a few, slow steps with someone supporting her, the very fact that she can perform such basic activity (together with the cerebellum for balance, the basal ganglia are the main circuits involved in repetitive automatic actions like walking) bodes well for her recovery.
If you feel the need to talk more about brain injury, brain function and neuro-rehab, contact me by PM and I'll give you my e-mail and MSN. Hang in there.