Traumatic brain injury: A family perspective

Cassi Collier and UNMC physical therapy students gather for a group photo.

Cassi Collier, front row, second from right, and UNMC physical therapy students gather for a group photo.

By Karen Burbach, UNMC Public Relations

Watching the old family video, viewers see Cassidy Collier, a spunky teenager with a big personality, laughing alongside her best friend as they mimic each other’s movements.

And, while the video was taken years ago, you can see that endearing personality remains in her today, albeit masked behind a traumatic brain injury she sustained in a 2011 car crash along a desolate road near Bennington, Neb.

Her father, UNMC’s Dean Collier, Pharm.D., recently shared his family’s story with UNMC physical therapy students, many of whom have helped Cassi to literally get back on her feet.

His hope: To help the students become better health care professionals by having them understand the emotions and struggles patients and their families face during tragic events.

At the same time, it was an opportunity to say thank you.

Cassi was driving too fast the night of Nov. 21, 2011, when she and two Bennington High School friends crashed in her Volkswagen Beetle. Kylie Remmereid died. Samantha Steffes was seriously injured.

“Cass made a bad decision that greatly affected all of our lives,” said Dr. Collier, associate professor in the College of Pharmacy. “But, we’re so very grateful for the time and thought and effort you have given to her recovery. Your time is beyond value for us.”

Dr. Collier played a news clip regarding the accident, and then spoke candidly about its aftermath, including the family’s confusion, uncertainty, anger and relief as Cassi spent eight weeks in intensive care and six weeks in a coma before beginning a long rehabilitation program.

“In times of tragedy and stress, people can’t think like they normally would,” he said. “Your brain shuts down…We didn’t know what we didn’t know.”

He urged students to remember that, especially as they talk to, and explain treatment plans, to families in crisis.

During the presentation, he took cues from Cassi as she sat in the front row, occasionally putting a finger to her lips when the words became too painful, and later pumping her fist to show her resolve.

Within weeks of the accident, Cassi moved from an Omaha hospital to an acute rehab facility in Lincoln, which posed a new set of issues and worries, Dr. Collier said. The family, which includes her mom (an operating room nurse) and two brothers, had to adjust to the new reality of Cassi being immobile and uncommunicative with possible sensory and cognitive loss.

There was dread, pity and more anger, he said.

Traumatic brain injury patients, he said, often process information more slowly. Knowing that is important in conveying messages and, he said, in working through grueling physical therapy sessions when pain and sensation can be delayed.

For families, there is stress surrounding insurance companies and whether rehab will be covered and if so, for how long? Providers, he said, should know the language used in patient records often plays a role in whether a person’s rehab is continued, reduced or eliminated.

“Insurance will give up on the patient,” he said.

The Collier family did not; nor did the UNMC physical therapy student volunteers who began to work with Cassi nearly three years ago.

“She’s gained a lot from the physical therapy students,” Collier said. “She took her first step. She stood up. There were so many firsts – all because of the time these students gave to helping her.”

And, he said, he’s seen the students’ confidence grow, too, as they’ve worked with his daughter.

Cassi’s move to Quality Living Inc., in August 2012, brought the family a new wave of concerns. Was she progressing enough? When would she turn the corner?

“You can get too close to a situation and become complacent,” he told the group. “Guard against that.”

He said the family was “devastated,” when, seven months later, she moved from the acute rehab facility into QLI’s long-term care, which reduced her physical therapy time. “We worried about how she would get better and said there must be another way.”

The Colliers took on her physical therapy regiment.

“You learn how to motivate someone to do things they don’t want to do,” he said. “If you’ve worked with Cass, you know it’s by cheering her on. ‘You can do this. You will do this.’ ”

“I can do this,” Cassi said out loud from her front row seat.

Cassi got stronger, he said, and, enticed by chocolate ice cream, began to eat on her own.

Still, the schedule was taxing. “We knew that what we were doing we couldn’t keep up,” Dr. Collier said, and so he reached out to the UNMC students.

Success, he reminds them, isn’t always an ascending straight line. Often, it’s a jumbled mess that points north only after delays, persistence and determination.

“It’s hard,” Cassi said at one point during the presentation.

A student at Burke High School, Cassi is now 21 and preparing for yet another transition as she reaches the age limit of the school district’s disability services.

Still, she’s come a long way since that fateful day. As the presentation closes, Cassi shows exactly how far by walking across the room with her walker.

“Anything you want to tell them?” dad asks.

“Thank you.”

2 comments

  1. Penny Collier says:

    Thank you for the beautiful and heartfelt summary of Cassidy Collier’s journey. I hope it impacts peoples lives to drive slow, and be safe. Recovery is one breath, one step, and one more mile- finish line!
    Penny Collier, Cassidy’s Mom

  2. Ryan says:

    In 2009 I was brought to UNMC trauma by ambulance. I was unconscious, had broken bones and TBI. I can’t remember it, but I started my long road back here. I am/was BEYOND lucky to, eventually, return to the life I knew before that day. There isn’t a day that goes by that I, and my family, don’t thank and appreciate the help and work that those individuals in these positions do.
    Cassi is an inspiration by living and fighting and trying everyday! You know have an entire family who will be supporting and praying for you and your family

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