Corey Nowlin: Learning to Communicate

Corey Nowlin is a young outdoorsman who loves to hunt and had been riding horses since he was a young boy. Although he was an experienced rider, in April 2020, he had a riding accident and suffered a head injury. The 15-year-old was immediately taken to an acute care hospital near his hometown in Arkansas.

“He underwent surgery to remove part of his skull to allow for brain swelling,” said his mother, Cendy Nowlin. “He did really well and when we left the hospital, he was coherent and could walk and talk. He returned to most of his normal activities and was even learning to drive.”

In July 2020, he went back to the hospital to have the piece of his skull that had been removed replaced with a synthetic piece of bone.

“The physicians realized that there was something wrong with Corey during their post-surgery exam,” said Cendy. “He had suffered an anoxic brain injury and his brain had gone without oxygen for 30 minutes. He remained in the acute care hospital for about 3 months and was not responsive at all.”

While Corey was hospitalized, the family began researching and asking friends about the best rehabilitation hospitals for patients with brain injury. The family concluded that TIRR Memorial Hermann in the Texas Medical Center was where Corey needed to be.

“When Corey was admitted to the Disorders of Consciousness program, his parents were not aware of his true level of consciousness,” said Dr. Jean Woo, attending physician at the Brain Injury and Stroke Program at TIRR Memorial Hermann. “When asked, Corey’s parents reported they had not witnessed any signs of consciousness such as command following or purposeful movement.”

“On his first day we were able to sit Corey up at the edge of the bed,” said Amy Briley, PT, DPT. “Our neuropsychology team was present as well. He was able to demonstrate the ability to communicate with his head. We were able to show his mom that he could answer yes-and-no questions and she cried tears of joy saying, 'he's in there!’"

The therapy team customized treatments for Corey, incorporating his likes, interests and typical teen boy humor. “Corey celebrated his 16th birthday at TIRR Memorial Hermann and his occupational therapist, Megan, made him this beautiful card with University of Arkansas as the theme and I gave him a button to push with different fart noises to motivate him to move his hands and push it,” said Amy.

In addition, Corey loves country music so Amy would co-treat with music therapy. They would listen to a song and have him use his head to communicate which artist it was from a field of two choices (ie., Clint Black or Tyler Childers).

“Our biggest goals were attempting to provide as much available motion at his arms as possible to allow switch activation and improved comfort with self-care,” said Megan R. Cleveland, OTR/L II. “Keeping his head up without assistance was a big milestone because it allowed him to see his world without hands all over his face and provide a sense of independence. Occupational Therapy also worked on vision therapy because he entered the program with severe nystagmus.”

By the time he was discharged from TIRR Memorial Hermann inpatient care in December 2020, Corey was using a head laser to spell words and communicate with his family.

“Corey uses many different ways to communicate including head-nods and shaking for ‘yes’ and ‘no’ and facial expression,” said his speech language pathologist, Chelsea Miller, M.S., CCC-SLP. “Corey learned to communicate with a head-laser. We attached a headband with a laser along his forehead with an alphabet board across the room. Corey typed out different responses and spelled words to answer and ask questions. He even told us knock-knock jokes. Finding an effective and efficient means of communication re-opened Corey’s world. Communication is a fundamental feature to humanity, especially to a 16-year-old.”

“He left TIRR Memorial Hermann being able to track and localize on people/objects in his environment,” said Megan. “We knew he wanted to be home and felt with his supportive family, he would do really well being back amongst family, pets, and friends.”

Corey now goes to outpatient therapy back home in Arkansas two times a week and is continuing to make progress.

“All of the members of ‘Team Corey’ at TIRR Memorial Hermann loved working with him,” said Dr. Woo. “He is a fighter determined to get better. There were ups and downs throughout Corey's recovery as we would expect in patients with a severe brain injury, but he always overcame those difficult times and I could see him grow stronger. Corey is now back home in Arkansas with his family and his horse, which he said he missed the most.”

“We had such a wonderful experience at TIRR Memorial Hermann,” said Cendy. “I wish we lived closer so we could go there for outpatient therapy. I am just so appreciative of what they did for my son.”