August 11, 2009
In reading Kathleen’s comments regarding journal keeping, I totally agree that this simple act lends so much meaning to the recovering patient. We recommend that families, friends, and/or caregivers keep a simple journal or diary not only to help the TBI survivor to piece together lost moments, but also to serve as a timeline for recording recovery. You never know when a doctor or professional may have a question that can be answered by accessing the journal entries. This is just another example of the importance of family and/or caregiver involvement in the recovery process. April 2009
You know, it's amazing how far research and technology has brought us in our abilities to address the aftermath of TBI. But, I am reminded that traumatic brain injuries have been occurring probably since dinosaurs roamed the planet. On a personal account, I was going through some old papers this week and came across a newspaper clipping my grandmother had given me. The article was dated March 18, 1923. The article was about my grandfather who had been trampled by a horse on their family farm in rural Indiana. My grandfather was 17 years old, and in fact, had not yet met my grandmother. The article read:
"Boy Partly Conscious"
Meredith S., who was severely injured by a horse the latter part of the week, is slowly recovering at the Huntington hospital, but is not yet able to talk and is not fully conscious. He seems to recognize his parents and to comprehend what they say to him, but is unable to talk. It is not known whether the horse kicked him, or whether he fell under the horse. He was badly trampled about the face and body and was unconscious when his father found him.
Obviously, my grandfather went on to recover, evidenced by the fact I am blogging this note! He told me he remained in a coma for weeks, and was unable to talk or use his right arm for a year after the accident. From a child's perspective, my grandfather was the sweetest man on Earth, who's love knew no depths. The signs of severe TBI were there though -- we just didn't know then, what I know now. Grandpa was a man of few words, who's eyes would tear up with emotion when his grandkids were around, and he would display rare but impulsive outbursts of anger. All classic symptoms of the fallout from the type of injury he sustained. I'm happy to report, that my grandfather lived a long and wonderful life, married for 61 years to the love of his life, my grandmother, and dying peacefully at her side at age 88. Grandpa & Grandma never heard the term TBI, but they lived it, survived it, and conquered it. March 2009
March is Brain Injury Awareness month! Our team is blogging this month on different areas of “awareness”.
The latest stats show that FALLS are the leading cause of TBI in the U.S. While most TBI’s from Falls happen to young children, or the elderly, anyone and everyone is at risk to fall. Some things to be aware of include:
- Poor lighting or throw rugs in your home can make you more liable to trip or slip. Remove anything that could potentially cause a fall (examples: books, shoes, boxes, etc…)
- The ordinary changes that come with aging, such as declining eyesight or hearing, can make you more likely to fall
- A decrease in bone density contributes to falls and the injuries that result.
- Illnesses and physical conditions, whether related to aging or not, can affect your strength and balance and contribute to a fall.
- Failure to exercise regularly can be a factor, too, because it results in poor muscle tone, decreased strength, loss of bone mass and flexibility.
- The side effects of some medicines can also cause falls. Medications for depression, sleep problems, and high blood pressure often make a person more likely to fall. Some medicines for diabetes and heart conditions can also make you unsteady on your feet.
Also, as the warm weather arrives, we see patients in the Rehab Center after falling from ladders while cleaning gutters, cutting limbs, or changing ceiling light-bulbs. We’ve also had patients injured from slipping on plastic bags & dryer sheets that have fallen to the floor.
Just some points to raise our awareness of how a TBI can happen to anybody. February 2009
This month we are blogging about clinical trials, current research, and recent trends in the treatment of TBI. I thought it would be a good time to post some new data on TBI too. Jake & I just returned from an international conference where these new numbers were revealed. While we know it is nearly impossible to get a true count of the number of people sustaining TBI’s, here’s the best guess:
- World-wide incidence - 10 million TBI’s per year
- U.S. - 1.6 million per year (suspect this is underestimated due to mild TBI not being reported in many cases – i.e. sports concussions)
- 1.2 million admitted to ER’s in U.S. every year
- 3.2 million living in U.S. with TBI
- 210,000 living with TBI, just in Florida
- 66% of service personnel in Iraq exposed to or injured by a Blast injury (this is a specific type of TBI & is the signature wound of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF))
- 40% of service personnel returning from OIF & OEF show signs & symptoms of TBI due to a blast injury
- These stats do not include the many civilians injured in Iraq & Afghanistan
So, you sustain a traumatic brain injury. What’s out there in the world of Rehab to help you? While each person’s journey through rehab is individualized, we do have some cutting-edge technology and pharmaceutical interventions to consider.
For patients presenting with swallowing disorders or limb paralysis/weakness, we can offer Neuromuscular Electrical Stimulation as a possible therapy option. This involves the placement of electrodes on the skin to provide a mild electrical current to the muscles of the involved area. For some patients, this technology may help with swallowing, walking, or using an arm or hand. We also have technology to assist with balance training as well as, assistance with weight bearing. In recent years, technology has been developed also to assist with vision. Some patients may experience difficulty seeing after a TBI due to a disruption of their visual field. We now have access to technology that “re-trains” the brain for vision. We even have technology that helps measure tongue strength. A detailed list of this technology is on our TMH Rehabilitation Center webpage
Much of this technology works on the principal of neuroplasticity (neurogenesis), or the ability of the brain to regenerate, or at least recruit (borrow) power from stronger, unaffected parts of the brain. Extensive research is underway worldwide to explore this subject. I’m a firm believer in neurogenesis, based upon my observations with multitudes of patients over the years.
In addition to the technology, we also have the benefit of some progressive pharmaceutical (medicine) interventions. Advanced research on the use of certain prescribed medications from the acute stages of TBI through the maintenance, or long term phases, are ongoing. Again, while each person’s response to the medications may vary, we have had many patients show positive outcomes with the addition of certain medications.
It is an exciting time in the world of research and rehabilitation for those of us working with TBI survivors. Part of the goal of our advocacy group is to get this information out there to help as many survivors as possible. Our belief is that with education comes empowerment. January 2009
I was thinking about how many calls we receive from our patients and their families after they go home. The arrival home usually consists of equal parts excitement, fear, and confusion. Suddenly all that was accomplished within the safe and supported confines of Rehab, now seems alien and unachievable in the real world. We advise perseverance and patience on the part of the patient and their families.
I especially remember when one patient went home. She faced a lot of challenges in her morning routine in the bathroom. She’s a girly-girl who was into modeling before her accident. Make-up, hair, and contacts were very important to her. It took her months to get to the point where she could close the door and do it herself without her mom.
For teenaged and young adult patients, there is a special concern for socialization. Many parents call me with concerns about their kids wanting to leave the house with friends. We usually advise the patient/family to maintain a close group of informed friends, who have been educated on the nuances of TBI. In-house socialization is encouraged in the beginning weeks and months. Sometimes the venture into the big world can be overwhelming to the TBI survivor.
The saying “it takes a village” really applies to the process of re-entry into the real world. I know our advocates are individually thankful and indebted to their families and close friends for all the support they received as they started their journey back to independence.