Caregiver, wife, and mother Cheryl Gansner shares her experiences and strategies for life with her husband with TBI and PTSD, especially the social and emotional stuff.
On a recent summer day, Cheryl and Bryan Gansner took their 9-month-old daughter, Emery, to a local park. Cheryl wanted to do a family photo shoot amidst a riot of huge, crazy yellow sunflowers. She took lots of Emery, then some of Bryan and Emery. He clicked a few of Emery and her. Out of nowhere, Bryan snapped. He shouted, “Get me out of here! Now!” That was it. He was done. It was as if a flip had been switched off — or on. He went from calm, quiet, sweet Bryan to angry, impatient, high-adrenaline Bryan.
July 28, 2006
Much has changed for Cheryl Gansner since 2006. She is a new mother, she has a different job working from home, and she knows more about caregiving than she ever imagined.
Cheryl and Bryan have been married for nine years. Their marriage took place between his two deployments in Iraq, in which he worked in field artillery for the Army. “Bryan was always a quiet, kind person. Someone who gravitated to observing and listening rather than being in the middle of things,” says Cheryl. “But he always an active guy, full of energy, always doing something — whether hiking, biking, skiing, or snowboarding or up first thing in the morning cleaning the basement or hauling things down from the attic. And he loved time with his family, and having his buddies over for burgers and beer.”
On July 28, 2006, six weeks before he was scheduled to return home, Bryan was severely injured when the vehicle he was riding in was hit by a bomb blast. His right leg was ripped open by shrapnel, some of the tendons in his knee were severed, and he shattered both his heels. He had hundreds of stitches and has had 16 surgeries. He also sustained a traumatic brain injury and suffers from post-traumatic stress disorder. Cheryl is a social worker, a helper by nature. She spent months by his side dressing his wounds, helping him learn to walk again, and learning to deal with the first stages of healing from TBI and PTSD. After 20 months, Bryan was medically retired from the Army. For Cheryl, the real work began when they got home.
The social and emotional impact from TBI and PTSD is often the most difficult part of living with TBI and PTSD for the injured person and his whole family. “It’s hard for me not to rely on who he used to be before he was injured,” she says, “and not being upset that he’s not that way anymore.”
Bryan is still the quiet, loving, cerebral guy he was before he was injured, but now, according to Cheryl, he is more reserved, more of a loner. “He doesn’t want to go out, he’s less active, he’s more isolating. He can get angry, but mostly, he’s sort of in a ‘blah” state a lot of the time; he doesn’t really get excited about much,” she says. “But things are slowly getting better, and we have strategies we’ve learned that work for us. We’re living our life, and it’s good.”
Tools and strategies
As families with a TBI and PTSD know, recovery is far from quick. But Cheryl and Bryan — with a lot of help from myriad specialists from surgeons to counselors — they have slowly chipped away at the challenges that have come in the wake of Bryan’s injuries. And although life is not perfect — whose is? — they have learned strategies to make their new normal work.
Take the photo-shoot-amongst-the-sunflowers incident, for example. “So, Bryan’s mood can change like that, going from 0-160 mph because of his TBI and PTSD. It doesn’t happen that often, but when it does it comes out of nowhere,” says Cheryl. When they got home from the park, when everyone was more calm, the couple talked about what had happened. Cheryl explained how his snapping at her and making them leave the park before she’d gotten the photographs she’d wanted was hurtful and frustrating. She asked him to try to work on giving her some warning, or to say what he needs in a more gentle manner. She also reassured him that she understood that his behavior was his TBI and PTSD, not him. “So, we both know that next time, things will be a step easier and maybe a handful of steps easier the time after that,” she says.
The couple has also started to return to more of a social life with the strategies they’ve learned and the experiences they’ve had. If they want to go out to dinner, they go on a week night instead of a weekend night, or on a late Sunday afternoon. They make sure Bryan gets a seat with his back to the wall and that the place is not too loud or over-stimulating. This way, they can talk and laugh and enjoy each other without hypervigilance taking over.
Secondary PTSD or caregiver fatigue
When Cheryl talks about hypervigilance or other symptoms like fear of crowds and loud noises, she is not talking only of Bryan but also herself. “I have always been an outgoing, social butterfly by nature, but over time I have sort of taken on some of Bryan’s post-injury qualities or symptoms,” she says. Secondary PTSD or caregiver fatigue, she explains, is quite common. “I have seen lots of other caregivers like me take on their spouse’s symptoms. For instance, if we suddenly find ourselves in a crowd, I start to get panicky because I know that Bryan’s becoming anxious. Or I’ll check exits when we enter a restaurant, things like that.”
As an antidote to caregiver fatigue, Cheryl makes sure she takes time for herself — attending church or going shopping or eating out with friends. “It’s good to laugh and step outside yourself sometimes,” she says.
Through her job with Hearts of Valor, where she has worked for four years, Cheryl has met a network of other caregivers who have become close friends and confidants. They have gone on vacations together, since none of their husbands want to. They turn to each other on tough days, and celebrate together on good days.
Hearts of Valor’s mission is to “honor the service and sacrifice of the people who care for our nation's wounded, ill or injured warriors by providing a community of support based on a foundation of empathy and mutual understanding.” Cheryl helps set up retreats that range from providing education and insight through courses on living with a spouse with TBI and PTSD to equine therapy to a weekend of activities that include journaling or intimacy workshops to cooking classes. “I have found our retreats incredibly healing and rejuvenating — for everyone who attends, including myself,” says Cheryl.
Through Hearts of Valor and in collaboration with other organizations, she also helps set up events and retreats for families. In July, for example, with four other military couples, Bryan and Cheryl went to Six Flags. With special parking and passes that allowed the group to bypass waiting lines and crowds, the weekend was a success. Other couples did the same thing in other amusement parks across the country.
Working as the program coordinator for Hearts of Valor allows Cheryl to work from home so she can balance work with life, including being a new mother, which she loves.
Bryan is sweet with Emery, he likes to lie her on his chest so he can talk to her and play with her tiny fingers and toes. “I think it was harder for him when she was in the infant/crying stage,” says Cheryl. “When the crying jags got long, he’d have to remove himself. I understood.”
Cheryl does not leave Emery and Bryan alone because of his short-term memory problems. “A week after her birth, I was starting to put together her baby book. I asked Bryan how he felt during his first week as a father. He said he couldn’t remember. I said, happy? He said, sure, I guess I was happy. I felt pretty heart-broken about that, but that’s the way it is.” She pauses. “He will be a great father. He will bring other things to her life.
“I’ve always been a very positive person. If I’m having a rough time, I will reach out to my caregiving friends since they understand, or call my mom to talk or laugh about something silly.” Then, Cheryl will breathe, look around at all she has to be grateful for and know that the next day will be new and that their family will continue to move forward.
Cheryl’s Caregiving Advice and Strategies
Support groups: You need to be your warrior’s best advocate. Even if asking questions and speaking up do not come naturally to you, find a way to get what you need. Finding others who have gone through all of this before will help with the steps in recovery — from the surgeries and rehab appointments to all the emotional stuff that comes with poly-trauma.
Counseling: Get your loved one and yourself into counseling sooner rather than later. It might seem worthless at first, but it builds and it really does help. Stop when you’re ready, you can always go back for a “tune up” if you feel you need one.
Nightmares: If your spouse has nightmares, find what works to make the night and the following morning less dramatic. What works for us is this: I don’t wake him up. I quietly leave the room. I don’t talk about it the next day if he doesn’t bring it up because usually he doesn’t remember and does not want to know.
Suicide training: Know the signs. Ironically, when I was in school studying social work, we learned about suicide prevention and had to practice with our peers. We had to look our partners in the eye and ask if they thought they might commit suicide. I’m glad that I had that training because I’m not sure I would have had the courage to ask Bryan that question during an especially dark period if I had not known what signs to look for, or what exactly to ask.
Explore all options: Not all therapies are covered by insurance, unfortunately, but we were able to get Bryan 80 sessions of hyperbaric oxygen therapy (HBOT) — 40 through a clinical study, 40 out of pocket. For him, HBOT was a pivotal time in his recovery. The effects of HBOT don’t last forever, but for Bryan, his depression scale went down and his cognitive function went up. There are many traditional and alternative therapies out there. See what works for your warrior.
Volunteer: I know this sounds crazy, but when things got really bad about three years after Bryan was hurt (he took himself off all his meds and didn’t tell anyone), I signed up to volunteer at a therapeutic writing academy. I worked with kids who had cerebral palsy, cystic fibrosis, and autism. It was so good for my spirits. I found that when all your chips are falling around your feet, it’s empowering to help others who have plenty of chips falling around their feet, too.
Find friends who “get it”: Make friends who understand what you’re going through. They don’t have to be other military spouses necessarily, though I have a few of those who are irreplaceable, I’ve also found a few older caregivers who have had more life experience who have become amazing friends. This nugget of advice is crucial. Having friends and confidants who understand truly lightens everything.
Love your life: Everyone has ups and downs, challenges, joys. You get what you get. Make the best out of it. There is so much goodness.
Click here to learn more about Cheryl and read her blog.