Battling a Traumatic Brain Injury, Ella Tomita Continues Recovery, Looks Forward to College
Ella Tomita was 7 years old when she fell in love with horseback riding. But everything changed two years later when she fell off a horse and suffered a traumatic brain injury.
“It was my favorite thing to do. If it was up to me, I would be riding horses all day and every day at that age,” recalls Ella, now 18. “I still love them. The whole thing was kind of a freak accident. I don’t blame the horse.”
While riding, a bird flew by and startled her horse. Ella was thrown off and hit her head on a wooden fence post. She lost consciousness and was taken to a hospital near her home in Hilton Head, SC.
“She couldn’t move her legs. We thought she might’ve broke them. We went straight to the hospital,” said her mom, Ashley. “The entire time is a blur to me.”
Ella did not break any bones, but she remained in intensive care for four days as additional symptoms gradually emerged, including memory loss, feeling dazed and confused, headaches, dizziness and vomiting.
A week later an MRI revealed the extent of her head injuries. She had suffered an intracranial epidural hematoma – bleeding which has more or less clotted between the skull and the outside lining of the brain. In addition, Ella also had a deep brain bleed and widespread injuries that included both her frontal and parietal lobes.
Ella had already been moved to an out-of-state hospital the night of the accident, but with these MRI findings her doctors advised Ashley and her husband, Yasushi, to take their daughter to a hospital with better resources.
Finding Cincinnati Children’s, Ongoing Treatment
Through online research, they discovered Cincinnati Children’s and brain injury doctor Brad G. Kurowski, MD, MS, a specialist in concussions and acquired brain injuries who is currently co-director of the Brain Health and Wellness Center.
“Dr. Kurowski’s name came up repeatedly,” said Ashley.
Originally from Cincinnati, she knew of Cincinnati Children’s excellent reputation as a leading pediatric hospital. Traveling 700 miles for the care her daughter needed was the clear choice, she said.
“With your kid, you are going to go where the best is. For your child, it doesn’t matter. I would’ve gone anywhere in the world, to be honest with you.”
According to Kurowski, Ella’s pattern of injury is common after moderate and severe traumatic brain injuries (TBIs) and indicates the “whole” brain is often affected after injury.
“We want to take a whole-person and family approach to optimize recovery early after injury — and later,” said Kurowski. “Recovery after a brain injury occurs on a timeline of years, with a good chunk of recovery occurring during the initial two years after injury. However, in children they are continuing to grow and develop, so we really wanted to continue to focus on optimizing brain health and wellness long-term.”
For Ella, this included continued monitoring and management of her chronic attention and concentration problems post-injury. Early on after the accident, she slept upwards of 20 hours a day, and when awake she struggled to form her words and speak coherently.
“I remember not being able to get of bed and my head pounding,” said Ella. “I knew what I wanted to say, but it was such a struggle to articulate what I wanted to say.”
She slowly improved but was unable to watch TV, read books or even go out to recess with the rest of her classmates. Ella soon found solace in her love of music.
She had started playing the violin in the first grade, but when her third-grade teacher noticed how lonely Ella was not being able to play at recess or go to gym class, he started teaching her piano lessons during his free time.
“Every day we would practice. I picked it up pretty quickly. And now I play five instruments,” including the viola, cello and bass, said Ella.
Heading to College, Special Thanks to School Intervention Specialist
According to Kurowski, Ella’s recovery over the years has involved a mix of treatments, including medication, follow-up imaging to understand her brain’s recovery, and neurocognitive / neuropsychological testing to understand how her thinking was recovering after the injury. The Brain Health and Wellness Center treats the physical, mental and behavioral health of children who have concussions or traumatic brain injuries.
“It was thinking about what she would need from multiple perspectives to optimize her recovery and health and well-being,” said Kurowski. “This included thinking about medical, behavioral, cognitive, school, sleep, and physical activities.”
Initially, there was a focus on Ella's more acute medical and brain injury related symptoms. Over the years this shifted to more behavioral, school and general interventions to help her, such as her Adderall medication to help with focus and concentration.
Later this year, Ella will attend George Mason University's Honors College to study criminology with a concentration on law and society. Her career goals were inspired, in part, by Ryan Hanna, school services specialist at Cincinnati Children’s, who began working with Ella in the 10th grade.
A former teacher, Hanna is aware of the classroom misconceptions associated with brain injuries and how some educators may underestimate their effects.
“What I explain to [educators] is that a brain injury causes metabolic chemical changes within the brain,” said Hanna.
He works with schools, including Ella’s high school, to help staff understand the emotional and cognitive impacts beyond the physical effects such as headaches, fatigue or vision trouble.
“A lot of what I did with Ella and her family is just be a resource to talk through some difficult situations, provide my insight and suggestions, and also obtain clear information from the school officials when needed,” said Hanna. “All so Ella and her family had all of the appropriate facts in order to make academic decisions.”
In particular, Ella and her mom are grateful to Hanna for his help in securing Ella more accommodations when taking the SATs. Just another element of what makes Cincinnati Children’s special, said Ashley.
“Nothing goes unnoticed by them. They are there for the brain, but it’s connected to everything. They don’t just focus on the brain injury, but [also] how it affects the person and family as a whole.”