Pubdate: Tue, 03 Apr 2001
Source: Age, The (Australia)
Copyright: 2001 The Age Company Ltd
Contact:  http://www.theage.com.au/
Details: http://www.mapinc.org/media/5
Author: Chloe Saltau

ONE MAN'S DAMAGED BRAIN: WHAT STATISTICS DON'T SHOW

At first Frank Fabiani's family thought he was sleeping. Then they 
noticed his lips had turned blue and they called an ambulance. Surely 
a shot of Narcan would have him up and bounding around?

Nearly three years after he overdosed on heroin, Mr Fabiani's 
35-year-old limbs are gripped with spasticity. He can hardly 
communicate, and sometimes his eyes water - difficult to tell whether 
it's the effort of trying to make a point or the pain of reliving the 
day he suffered serious, debilitating brain injury.

His mother, Gemma, 61, dabs his eyes while his son, Ricky, 4, climbs 
over his wheelchair-bound body, rubbing his head against his father's 
chest.

He has listened while Gemma Fabiani explained how her son, a talented 
junior squash player, started smoking marijuana in his late teens, 
progressed to harder drugs, developed a mental illness and then, in 
the middle of 1998 when they thought he was clean, took a near-fatal 
dose of heroin.

If he had been upstairs at the time he would almost certainly have died.

"Maybe a good angel was looking after him," Mrs Fabiani said.

The occupational therapists who work with Mr Fabiani believe there is 
a growing number of heroin overdose survivors with severe brain 
injury, who don't show up in the statistics or reports on Australia's 
drug problem. "People think you get high or you die," therapist 
Michelle Tehan said. "There's no understanding among people who take 
drugs that this could be a consequence."

Her colleague, Michelle French, runs a small occupational therapy 
practice in North Fitzroy that sees one or two new overdose survivors 
with bad brain injuries every month. At the moment they have a dozen 
such clients aged between 20 and 43.

Ms French hopes a national accreditation program for occupational 
therapists, launched in Brisbane yesterday, will encourage more OTs 
to work with these victims of the heroin crisis.

"Most of the time it means they can't walk and they have severe 
communication problems. With one client it has taken two years to 
develop an eye-blink, just to say yes," Ms French said.

In Mr Fabiani's case, it is all he can do to utter the word "van". A 
few days ago he and his mother waited for five hours for a maxi-taxi 
to arrive to take them home after a doctor's appointment. The family 
is desperate for funding to buy their own van, having "fought tooth 
and nail" for State Government money to adapt a downstairs bedroom. 
Before then Mr Fabiani had spent months in a nursing home and two 
years in the living room at the family's Epping home.

The 71 hours a week of funded attended care recommended for Mr 
Fabiani (to get him dressed, showered, fed and for rehabilitative 
treatment) has been cut to less than 30 hours a week.

Brain damage can follow heroin overdose because of a rapid rise in 
blood pressure, sometimes causing the veins at the base of the brain 
to explode and depriving the brain of oxygen.

Ms French said the survivors were mainly young men. Often they had to 
manage their addictions as well as cope with the massive physical 
disabilities associated with brain damage.

There were few community options for young victims of acquired brain 
injury, she said, which meant they often lived in nursing homes 
ill-equipped to meet their special needs. For Mr Fabiani, the load is 
carried by his ageing parents, Gemma and 71-year-old Tony.
- ---
MAP posted-by: Josh Sutcliffe