It's not the career she trained for, but Amy Krogh loves her job running part of the food service at Sandy Senior Center so much that she travels 2 1/2 hours each way to get there. She takes TRAX and two buses, and the money's not what she was used to. But she's delighted to be working.

In her late 30s, she suffered a severe stroke. And the road back has been difficult, with both setbacks and victories.

Long-term recovery from a brain injury, whether traumatic, disease or stroke-related, is the subject of today's Deseret Morning News/Intermountain Healthcare Hotline. From 10 a.m. to noon, speech-language pathologist Mark Fox and certified vocational specialist Barbara Bills, both of Intermountain Outpatient Neuro Rehabilitation, will take phoned-in questions.

One of the biggest challenges is getting back into the work force, Bills said, because after the body is healed, there may be hidden, but life-changing, deficits left from the brain injury, including processing challenges, short-term memory deficit, communication problems, loss of inhibition and/or judgment and others. People may not be able to return to their former line of work, even though they're as intelligent as ever, because their brains work differently.

She focuses on finding the right match between the client and an employer, then she goes along for a while to job coach and help break tasks into workable pieces. Some clients need a picture-type book that reminds them what to do. They work on strategies to compensate for their disability. And they battle insecurity. It is frustrating and esteem-shattering to struggle with tasks that were once easy, Bills says.

One of the toughest parts is breaking the ice with an employer, who may be reluctant to take on someone with unique challenges. Those who do, she says, find they have excellent employees who are anxious to work. They have unusually good attendance and work hard.

"A lot of employers don't want to deal with problems that they think goes with this. But once I convince one to hire, I've had them call back and say, 'Do you have anyone else?"'

Fatigue is common after a brain injury and tends to be perpetual. It takes a lot of energy to do things that used to be simple. Fox says getting ready in the morning can be exhausting.

Transportation is another barrier. Most people who have the after-effects of a brain injury can't drive and rely on public transportation.

The other barrier is money. Insurance will cover all sorts of medical bills, but it doesn't cover vocational retraining, usually. Their program is a vendor for Vocational Rehabilitation, and since most of the patients have a recognized disability, they usually qualify and Voc Rehab pays for the retraining.