The Rehabilitation Shift: From Case Manager to Case Mom – A Mother’s Story

Deb Crowe
Deb Crowe: The Rehabilitation Shift

It was a beautiful sunny Sunday afternoon in 2013. I’d just returned from a baby shower to meet with my family after their lovely day of boating on Lake Erie.

My daughter, Christine, was eager to get home and finish an essay due at school. She was rushing to pack the car and ensure she had all of her belongings, as her mind was fixated to get home, so she could meet her senior year academic deadlines.

Mothers have intuition. I believe it. I feel it. Before she left, I asked her to slow down! I reminded her that she had only a 1-hour drive to get back home and more than enough time to finish her essay and submit it online to her teacher.

As her car pulled away, I felt an intuition in the pit of my stomach. I looked up at the sky and sent a prayer to my father (who passed in 1987.) I asked him to please watch over his granddaughter as she drove home.

Twenty-five minutes later, my husband’s cell phone rang. It was the Ontario Provincial Police. An officer gave us the news that our daughter had been in a car accident and was now being transported by ambulance to the nearest hospital in Ingersoll, Ontario. My earlier hint of anxiety was now full-fledged, palpable fear … coursing through my body and spirit.

We learned that Christine had rolled her car into a ditch. My heart sank down to the bottom of my stomach. Our friends offered to pack up our boat and advised us to go … quickly! I was in shock. Was I Mom or case manager? This time it was not a client I’d be helping, but my own beloved daughter.

On the way to the hospital, we stopped at the accident scene to retrieve Christine’s belongings from the car. I was in shock. My case manager’s brain was pondering the logistics and the potential extent of Christine’s injuries. But my brain as a Mother was focused intently on keeping myself together so that I could be effective. My adrenaline-infused mind raced back and forth between logic and emotion as I pondered what I would see at the Emergency department.

When we arrived, the police officer was there, and we saw Christine on a stretcher wearing a neck brace. She was pure white – like a blank piece of paper – with cuts on her arms and hands from the broken windshield. Again, my mind shifted from being an objective case manager, fully knowing the steps that lay ahead for Christine, while also being a loving mother trying her best to be calm and keep it all together.

Christine was diagnosed with a serious concussion and sent home. Her CT scan was normal. But she did not look well. Nor was she acting like herself, complaining of neck pain as we hastened to take her safely back home.

The next morning: pain in her neck and a droopy left eye. Even more frightening, when she started to speak, the left side of her mouth showed a definite droop.

Enter case manager brain and off to Children’s Hospital Emergency we flew – for a fast MRI just 10 minutes after we arrived. The pediatric neurologist was very concerned. She diagnosed Christine with a mild traumatic brain injury (TBI) as she observed my daughter’s slurred speech, the look of her eyes, her sensitivity to light, and neck pain plus the ‘typical’ symptoms of mild TBI.

The next stage was having a teenager, struggling not to believe that anything had happened, and hoping to ward off any need for medical rehabilitation. Seeing your daughter’s personality change is heart-wrenching. The “F”-word was now a part of Christine’s everyday conversations.

Anger, frustration, depression, and all the emotional ‘feels’ that come with brain injury were present. It’s a much different scenario when it’s your child and not a claim number attached to a lawyer and insurance company. Along with the family, you are managing all. Your daughter is your every single moment, a 24/7 focus made all the more intense by not being sure about whatever is coming next. You live day-by-day and moment-by-moment.

Christine finally hit rock bottom and was ready to engage in medical rehabilitation in 2015 after her first attempt at post-secondary education. She attempted to try college and lasted a mere four weeks. Starting a claim and being immersed in the process is absolutely not fun. Everything is a fight. Nothing is easy. Now I know first-hand what my clients and their families have gone through along with the emotional and financial distress it caused them.

There’s no such thing as a non-biased medical assessment. One loses trust in the world and in medical practice in an industry that’s become jaded as various so-called professionals seek to manipulate the system as money win. The result these days is a long, drawn-out process with a sorry lack of trust by the very people who most need therapy and support within their first two years of recovery.

Working in the healthcare industry since 1990, I’ve seen a lot, learned a lot, and ridden the unsteady waves of provincial legislation. If you’ve had, as I have, the best education that the province can offer and the privilege of helping so many families, your general state of mind is to feel well versed and confident in your knowledge. But not when it’s your child, and you’re on the front lines vying for every possible form of help.

Fighting the good fight is exhausting and defeating. Before 2010, we had comprehensive automobile insurance policies. After the legislative changes that year, policies changed to a ‘base’ menu with “extras” you can purchase in an attempt to restore the original automobile insurance policy terms you once had. Having purchased all the extras does not necessarily mean, when you have a claim, that you actually can use them or be reimbursed. If you do the homework for you and your family, I’ll bet you’ll uncover the same disappointing result.

Simply having a claim is no guarantee: the people you expect to turn to for support for you and your family may not be there for you! Many families can relate to this. The insurance world is vast and connected. If you’re on the receiving end of negotiating with an insurance company, don’t be surprised if you experience some disappointment. That could start with your insurance broker. Think about who their customer really is. Hint: it’s not you!

Fast-forward five years to June 2018. Christine has permanent symptoms that require attention from professionals who know, understand and are well educated in vestibular rehabilitation. She wears hearing aids and prisms in her eyeglasses, fighting physical, cognitive and visual fatigue every day.

The good news is: she’s still here. She is a fighter. Her ongoing mantra is now about tenacity: to continue to grow, get better, and be the best that she can be each day. Her previous dream of being a trauma nurse working for Orange Medical Transport may no longer be realistic; however, with positive thinking and a mindset to help others in another capacity, she will continue to work towards her new dream.

We have worked as a family to love and support Christine along the way while cheering for every little milestone of progress. She has one year of college completed. Achieving that goal was hard, and at times super challenging, but one has to push to succeed.

She’s been accepted into university and her goals and dreams are still to work within some type of health-related field. We, as a family, know that she will succeed. Because when the medical rehabilitation team goes away—along with the physicians, specialists, lawyers, and insurance professionals—family is always there, ready to pick up the pieces and continue. That’s what most professionals don’t see or realize—what really happens behind the scenes. I’ll be an even better case manager now, because I’ve lived on both sides.

From 1990 to 2013, I worked in vocational rehabilitation, return-to-work, and case management. But I have truly learned more in the last five years from 2013 to 2018—using my case management skills to help my daughter—than I had from my 23 years as a professional helping other families.

My message to professionals and families reading this is to pause and reflect. Brain injury is quite serious. It comes with many symptoms—some that show up early and others that present as time moves along. Remain vigilant and aware of every treatment and the sequence in which they’re introduced. The neck is often forgotten. If your loved one has sustained a whiplash-associated disorder (WAD I or II), actively find the right experienced professional to assist you. It will make vestibular rehabilitation a lot smoother while decreasing symptoms and improving your loved one’s quality of life.

Christine & Deb Crowe

Deb Crowe now works as a Health Care Case Navigator helping families, legal counsel, and insurance companies work with challenging claims. She actively navigates the medical rehabilitation system to ensure that her clients receive the proper treatment despite financial hardship. She is a motivational speaker and published author. You can reach her at
Posted on BrainLine August 27, 2018.