One year after suffering a severe brain injury, Nhlelo Chauke (3) has astonished healthcare professionals with her remarkable progress, proving that whilst rehabilitation takes a lot of time and effort, it’s worth it.
Nhlelo was travelling home from a family visit in Limpopo with her mother in January 2021, when their vehicle was involved in an accident, leaving her completely unresponsive.
Paramedics had to resuscitate her at the scene.
After three weeks spent fighting for her life at Netcare Montana Hospital, Nhlelo was transferred to Netcare Rehabilitation Hospital in Johannesburg.
Nhlelo’s father, Mzamani Steven Chauke, is a paramedic and when he received the call he did not know if his little girl would even make it through resuscitation.
“Upon arriving at Netcare Montana Hospital’s emergency department, I was informed that Nhlelo had a very slim chance of survival. There was nothing we could do but pray, and our prayers were truly answered. Nhlelo survived and by her second week at Netcare Rehabilitation Hospital she started to recognise me again. That’s when I knew something positive was happening.”
Prof Andre Mochan, a neurologist practising at the paediatric unit of the rehabilitation facility, says: “She had suffered a diffuse brain injury, where due to the impact of the accident the nerves and cells had been badly shaken, resulting in bleeding in multiple parts of the brain. On arrival, she was completely non-communicative, had difficulty responding to visual stimuli and her movements were totally uncoordinated. She was not able to sit up or hold up her head.”
According to internationally recognised scoring systems Nhlelo’s scores were very low, but her ability to move her limbs and open her eyes were hopeful signs.
Prof Mochan says each brain injury patient is different, and it’s almost impossible to predict what the outcome in the rehabilitation process might be.
“When a human brain has been damaged by injury or a tumour for example, the rehabilitation process is a bit like rebooting a computer after crashing, opening program after program with the team closely observing to assess where problems may lie. This is a delicate process and you do not want to overstimulate the brain as that will risk ‘crashing the computer’ again. This is important for both healthcare professionals and family members to understand. We have to go step by step, at the pace at which the brain is able to recover.”
Charne Cox, Nhlelo’s physiotherapist at the rehabilitation hospital, says: “Successful treatment of children depends heavily on the involvement of their parents who really do become a part of the treating team, as they get to know us all and receive ongoing emotional support from the social worker and psychologist.”
According to Cox, Nhlelo’s brain injury was so severe that they had to go back to the basics of baby movements like doing tummy time, learning to roll, and learning to sit.
“As therapists, we almost always work together through all treatments, so that our patients have the benefit of not only therapies by a multi-disciplinary team but also interdisciplinary involvement. For example, when the speech therapist was working on feeding strategies to build oral strength for Nhlelo, I as the physiotherapist would also be present to ensure that she was correctly positioned for swallowing her food and ensuring that the lungs are clear once the feeding has finished.”
Apart from a tilt table to familiarise Nhlelo with the sensation of standing again, and Eyetek’s Neural Optometrists assisting with visual concerns and visual stimulation exercises to strengthen her eye muscles, the speech therapist also worked on imitating gestures to encourage Nhlelo to communicate.
These included waving, reaching and smiling. “Within the first week, we began to see improvements in her scores and as she progressed, she became increasingly engaged and enthusiastic,” says Cox.
Although Nhlelo enjoyed the hydrotherapy with floating toys, the hospital visits by TOP Dogs and the baking groups, she was happy to go home sooner than anticipated. She had been booked into Netcare Rehabilitation Hospital for 12 weeks, but her progress was so exceptional that she was able to go home on 12 April 2021, after just eight weeks. Cox says children have amazing mental strength and can adapt more quickly and easily than adults, provided they have the appropriate support.
Today, Nhlelo attends creche and her father says he sees her recovery as a miracle.
She still has some difficulties with her balance due to an ongoing issue with her ear, but she is continuously improving.
“She’s very smart and loves counting, reciting the days of the week and the months of the year, and is fascinated by colour,” he says.
When it comes to children’s brains, the rehabilitation process is particularly complex compared to that of the adult brain which is already fully developed, says Prof Mochan.
In a child, injury disturbs normal development, which needs to be addressed in addition to the recovery from the injury itself.
Children with brain complications need to be referred to a rehabilitation facility in order to do an in-depth evaluation and to develop a rehabilitation plan accordingly.