- Associated Press - Friday, October 3, 2014

BETHEL, Mo. (AP) - Chris Allen remembers coming to in a hallway at the Rusk Rehabilitation Center in Columbia in the midst of the medical staff’s conversation.

“They were talking about this poor guy who had a hemorrhagic aneurysm,” Allen said. “I thought, ‘He must be in a hell of a shape.’ Then I realized it was me.”

The moment was Allen’s first clear memory in more than a month after suffering the aneurysm, a burst blood vessel in his brain, on Aug. 31, 2010, in the garage of his home, followed days later by a stroke.

The combination left the Bethel farmer with a brain injury, and four years later, “the brain still isn’t right,” Allen told the Quincy Herald-Whig (http://bit.ly/1ticJK2).

“I’m grateful to be alive, most times, but it’s a long-term thing,” he said.

A farmer loses a limb in a farm accident. Another suffers a spinal cord injury off the farm, is disabled by a stroke, or deals with debilitating arthritis.

Both want to stay active on the farm - and they can with help from the Missouri AgrAbility Project.

“They’re not going to let this disability or whatever is going on in their life stop them from doing what is their passion,” said Karen Funkenbusch, director of the program offered through University of Missouri Extension and Mizzou’s College of Agriculture, Food and Natural Resources.

The challenges to remain productive on the farm might differ, but “the common thread has been AgrAbility has helped them,” Funkenbusch said. “The second common thread is the Missouri Division of Vocational Rehabilitation has funded adapted/assistive devices for these farmers to remain gainfully employed in production agriculture despite their disability, and challenges or barriers have been removed because of those devices.”

She said a common misconception is that AgrAbility only serves farmers with severe physical disabilities.

But “having arthritis for some folks is just as disabling as someone who has a spinal cord injury,” Funkenbusch said.

The program provides services for any Missourian with a disease, disability or disorder who is engaged in farming, ranching or another agriculture-related occupation.

Funkenbusch said more women on the farm are seeking help from the program.

“They might have diabetes, heart disease, arthritis, or already trying to prevent a secondary injury and not wanting to get in the same situation as their husbands,” she said.

In jeans, boots and cap, Allen looks every bit a farmer. His speech is clear as he talks about getting ready for this year’s harvest, but he records a conversation on an iPad, a tool he calls his “portable brain,” to make sure he’ll remember it the next day.

“For me, short-term memory is the tough part,” Allen said. “You talk to somebody over the phone and remember what was going on. That makes it easy to plan the next day. If you get up the next day and can’t remember anything you’ve done the day before, it makes it impossible to plan stuff.”

The iPad that Allen carries came through the Missouri AgrAbility Project.

The brain injury changed Allen and his lifestyle, but not his love of farming.

Early in his recovery, Allen knew he needed to get back to the farm. He had crops to harvest and cattle to feed. Four years later, he continues to raise corn, soybeans, hay and cattle - with help.

A utility vehicle, once considered a luxury, became a necessity for Allen to get around the farm and haul equipment. Electric hydraulic vales on two pieces of equipment ease the wear and tear on his arthritic shoulders.

“If I’ve had a long day and am worn out, my memory is a lot worse,” Allen said. “There’s just a lot of things people take for granted. I know I did for a lot of years. I never wrote anything down.”

Most important on the farm is the computer, another luxury item that’s become a necessity to record things Allen might not remember.

“At harvest time, at the end of the day, I describe what I accomplish. I walk around the combine when I shut it down, say I need fuel, need oil, need to tighten this, need these wrenches. The next morning, I play that back, get the truck loaded,” Allen said. “I sing the praises of the iPad, but it’s a damn poor second” to his brain before the injury.

Allen remembers little of what happened in 2010, but his partner, Sherry Nelson, fills in the blanks. Alerted by a phone call from one of Allen’s friends, she found him that day on the garage floor and called the ambulance.

A social worker, Nelson already understood how the medical system works, and fortunately for Allen, knew how to advocate for patient care - once she got over the initial shock.

“You start to figure out what you need to do next, to ask the questions you need to ask and not take everything at face value,” Nelson said.

Allen spent 3 1/2 weeks at Barnes-Jewish Hospital in St. Louis before moving to Rusk in Columbia, where he spent 2 1/2 weeks. Convinced he was fine, Allen just wanted to get back to the farm, but “he didn’t realize how hard it was to do all that thinking stuff,” Nelson said.

Activities as simple as walking initially exhausted him. Communication remained a challenge.

“If I was talking to you and had something to tell you, I might get halfway through it and run out of gas, forget what I was going to say,” Allen said. “That was the way my brain worked at the time.”

He was home by mid-October 2010. Friends and neighbors harvested that year’s crop, pitched in to care for the cattle, and helped in other ways while Allen continued therapy.

However, the big strides made in the early days of his recovery began to taper off. It took more work to see improvements, and Allen was resisting spending more time in therapy.

“It got to a point where we were fighting more than making any progress, and I thought he just has to figure out he needs some help,” Nelson said.

Allen got through planting season in 2011, thanks to buying a bigger planter to speed the work, and then the harvest.

“Then he started talking about he needed more help. That’s when we went to AgrAbility,” Nelson said. “At that point, I don’t want to say he was whipped, but he was whipped enough. Part of it was he didn’t have the physical stamina he did at one time, and part of it was mental fatigue impacted his physical stamina.”

Plenty of reminders, large and small, indicated that things had changed.

That first weekend at home in 2010, the couple decided to grill steaks. Allen started the grill, like he always did, but had no idea how to cook the meat.

“It didn’t occur to me that maybe he didn’t remember how to do that,” Nelson said. “I ended up cooking the steaks.”

Trying to measure the length of a disk’s axle to get a replacement, Allen found he couldn’t read a tape measure, something he’d done since childhood.

Always working seven days a week and into the night on the farm, he’d be falling asleep in a chair at 5 p.m.

“He was getting better. He sounded like his old self. The behavior, the mannerisms were there, and yet it’s a different person,” Nelson said. “Where you see somebody who has a brain injury, maybe from a wreck or something that happened at birth, I don’t think you realize how much that has had an impact until you see a person who went from being 100 percent independent to being 100 percent dependent and they start moving back in that independent direction.”

Changes readily apparent to Nelson might be missed by others.

Six months after the aneurysm, a psychologist told the couple that if he hadn’t seen Allen’s records, he wouldn’t have known anything was wrong. Because Allen had no physical impairment, the brain injury’s lingering effects would have looked like quirks in his personality.

Allen’s short-term memory has improved, Nelson said, but it’s not what it once was. He still struggles with time and timelines. He can take things the wrong way in conversation and be easily misunderstood.

“He’s not very good in the morning. It just takes him awhile to where he’s functioning well enough,” Nelson said.

AgrAbility funding comes through the farm bill but is competitive among state projects. The Missouri project recently was funded again for four years.

“We’re a line item in the federal budget,” Funkenbusch said. “Congress wanted the AgrAbility program to increase the likelihood farmworkers with disabilities would experience success in production agriculture and prevention of a secondary injury.”

The program began in Missouri in 1994 and is available in 24 states, though Illinois is not one of them.

Funkenbusch wants to boost awareness of the program.

Just as important is making sure professionals understand what the farmers need to stay on the farm.

Allen has spoken to professionals at AgrAbility and brain injury conferences.

“A lot of people don’t understand brain injury. Doctors are saving a lot of people, and after a month, they decide the case is closed, he’s better, we saved him … but it’s a long-term thing,” he said. By working together, “we probably can help each other out and have a better idea of what might be a real help to us, be more efficient.”

The couple has been together for nine years. Unlike many others dealing with the challenge of brain injury, they’ve stayed together.

“We have our bad days, we have our good days. Apparently, the good days are still outnumbering the bad,” Nelson said. “It’s just not the same relationship it was at one time. Every once in a while, I see little flashes, but it’s real different from what it was.”

Allen continues to surprise her - even with his willingness to share his story at public events.

“It’s not, ‘You get over it.’ It’s there,” Nelson said. “It may improve. I think it’s continuing to improve still.”

___

Information from: The Quincy Herald-Whig, http://www.whig.com

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