Tag Archives: aneurysm

Goodbye, Kent

As much as patients learn from their d0ctors and therapists, their doctors and therapists learn from them.  Many brain injury survivors have generously given of their time and energy to help further research and understanding of brain injuries.  Kent Cochrane, known in the research literature by his initials “KC”, participated in many studies which allowed researchers to learn a great deal about memory.  Mr. Cochrane is one of the best known survivors to volunteer as a research subject and the field of brain injury has greatly benefited from him.  Mr. Cochrane recently passed away but his legacy will live on.

http://www.ctvnews.ca/health/famed-canadian-amnesiac-kent-cochrane-dies-at-62-1.1756363

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Exciting Research

As one of the leaders in post-acute brain injury research, the Transitional Learning Center is always looking to push the current boundaries of treatment.  A new area of research in the field of brain injury is the use of repeated transcranial magnetic stimulation (rTMS).  In a nutshell, rTMS involves using temporary, externally applied magnetism to change the functioning of the brain and improve recovery.  TLC Medical Director Dr. Brent Masel, Research Coordinator Jack Foreman and Physical Therapist Claudia Forshee recently presented several research posters at conferences demonstrating how rTMS helped a patient with a spinal cord injury recover hand function and improved mobility for a patient with a brain injury.  These are just a few of the examples of the rTMS research ongoing at TLC.  The research is presented below in its original conference posters format in powerpoint format.  Though this may be a bit technical for some readers of this blog, hopefully it will give you an overall idea of some of the groundbreaking research at TLC using this new treatment methodology.

rTMS Poster_final 

5Hz rTMS for iSCI Poster

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Returning To College

Many of our patients at the Transitional Learning Center were injured while in college.  Understandably, one of their goals is to return to school.  It is always a good idea to test out school skills prior to returning to school, as there may be new needs or difficulties that were not initially anticipated.  There are a number of good websites that allow anyone to take classes for free from college professors in a format known as Massive Online Open Courses (MOOC).  Some of the better known MOOCs are Coursera, Udacity and edX.  Generally, the classes are given in brief video clips with quizzes, tests and in many cases, assignments.  These classes generally last between 4-12 weeks and can take 4-12 hours per week to complete, even for students without injuries.  One of my favorite MOOCs for brain injury survivors to use when they first attempt to re-acclimate themselves to school is Open2Study.  The Open2Study courses are given by professors primarily from Australia and New Zealand.  The advantage to Open2Study is that the courses are only for 4 weeks and take 2-4 hours per class.  There is a one question quiz after each brief video and a 10 question test at the end of each week’s module.  If the student successfully completes the course, he/she is given a Certificate of Achievement.  The reason I prefer Open2Study is that it is a far shorter and less intense MOOC than others so it makes for an easier first step into a college environment without overwhelming the brain injury survivor.  It is a good forum for returning students to assess their needs post-injury in a relatively easier environment without the same level of stress of the other MOOCs but while still experiencing lectures from a real college professor.  Below is a link to the Open2Study website:

https://www.open2study.com/

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

What Is Traumatic Brain Injury Like For You?

Brainline, one of the best sites on the internet devoted to brain injury, currently features an interesting piece consisting of a compilation of thoughts on what it is like to have a brain injury contributed entirely by survivors themselves.  Click the link below to read  the compilation and be sure to also read the comments section where many other survivors have added their thoughts on learning to cope with the brain injury experience.

http://www.brainline.org/content/2013/08/traumatic-brain-injury-is.html

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Interview with Dr. Masel

The Transitional Learning Center’s Medical Director Dr. Brent Masel is a true veteran in the field of brain injury treatment and rehabilitation.  As an expert in this field, he is called upon to testify before government entities and has been interviewed by a wide variety of media outlets spanning the spectrum from ESPN to Ladies Home Journal.  Even though Dr. Masel is in great demand across the country, he made a point to make himself  available for local growing media star Chad Jones and his Chattin’ with Chad Show.  In the video below, Dr. Masel and Chad discuss topics ranging from specifics of brain injury treatment at TLC to Dr. Masel’s decision to become a doctor.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Perseveration Vs. Defiance

The brain controls every aspect of human skills and behavior. When the front portion of the brain (the frontal lobe) is injured, a brain injury survivor may develop a symptom called perseveration. Perseveration is when a person will persist in repetitive statements or actions seemingly involuntarily. The best way to understand perseveration is to think of the survivor’s brain as if it is stuck in a loop, like a broken record. For example, a survivor with perseveration may click his or her pen over and over to the point that it aggravates all others nearby. He or she may repeatedly wash his or her hands for ten minutes despite the fact those hands were clearly sufficiently cleaned after the first wash. Occasionally, perseverative behavior can present a safety risk. For instance, a survivor with perseveration may have difficulty stopping at a crucial moment when walking and walk right into a busy street.

Perseveration can cause a significant amount of confusion and distress for family and friends of survivors. They may watch the survivor engage in perseverative behavior and attempt to help by telling the survivor to cease the behavior in question. However, as perseveration is a symptom of the brain injury, stopping any such behavior is unfortunately never quite that easy. Even if the survivor says “Ok, I will stop” and makes a conscious decision to do so, this does not mean that he or she is going to be able to put a stop to the problematic behavior. Sometimes this inability to stop is mistaken for defiance. A family member may believe that the brain injury survivor is deliberately refusing to stop rather than understanding this expression of the symptom as a function of the injury. When this same issue comes up again in the future the family member may become even more infuriated, believing that the survivor is now making a habit of defying the family member’s requests. This frustration may even escalate into a confrontation between the family member and the survivor. Perseveration may also be mistaken for a lack of concern on the survivor’s part regarding his or her own safety or as a dismissal of the feelings of others as unimportant. One example involves a survivor repeatedly tapping his or her foot on another person’s chair. A family member may request that the survivor stop tapping in such a way. After the survivor fails to follow this request due to the effects of perseveration, the family member may come to believe that the survivor simply does not care about the feelings of the other parties involved. Lastly, the brain injury itself can even prevent individuals with perseveration from being fully aware of an offending behavior. Often in these situations the brain will send the message, “It is ok, this is normal” instead of recognizing the behavior in question as problematic.

Here are a few tips for working with a survivor coping with perseveration:

1. Patience, Patience, Patience: Remember that it is extremely difficult for this person to control his or her actions due to the effects of the injury. Perseveration is a function of the brain injury in the same way that the survivor may now face difficulty with walking or speech. Family and friends need to be patient with perseverative behaviors just like they are patient with newly impaired physical function.
2. Develop a Signal: For some survivors with perseveration, developing a signal (for instance, a key word or hand movement) for those around them to use as a cue to alert the survivor when perseverative behavior is occurring can be an effective strategy for combating that behavior.
3. Change of Task: For many brain injury survivors with perseveration, the only way to break out of a perseverative loop is to engage in a new and entirely distinct activity. For instance, a survivor may continue to move his or her arm up and down until tasked with a completely separate enterprise such as collecting pieces of paper.
4. Mutually Exclusive Direction: Another way of stopping perseverative behavior is to have the brain injury survivor complete a task that is mutually exclusive to the undesired action . For instance, if the survivor is walking in a perseverative manner, the family member may ask the survivor to hold on to a corner of the wall. Since a person cannot hold onto the wall and walk at the same time, holding on the wall may help stop the survivor from the unwanted walking.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Hot Off the Press

Vital to the core mission of the Transitional Learning Center is the conducting of research designed to enhance understanding of and improve treatment strategies for brain injury. The result of this research finds its home in publication in a wide range of top professional journals and chapter after chapter in books relied upon by the traumatic brain injury treatment community. Recently, TLC staff neuropsychologists Drs. Dennis Zgaljardic and Matthew Lambert along with staff occupational therapist Rebekah Miller published a paper on the reliability and validity of a newer test to determine naming deficits. Difficulty with the naming of objects (for example: saying “fork” when you mean “pencil), known as anomia, is not uncommon with patients who have brain injuries (particularly if the injury is to the left hemisphere of the brain). However since most tests of cognitive abilities are developed using members of the healthy population as a testing sample, it is unclear to what degree these tests might be appropriate when applied to other populations (such as patients with brain injuries). Identifying which tests should or should not be used with a brain injured population is an extremely important component of treatment. Using a test that is not appropriate for an individual with a brain injury can lead to misdiagnosis and based on that misdiagnosis, incorrect treatment.
The paper, titled Naming Test of the Neuropsychological Assessment Battery: Reliability and Validity in a Sample of Patients with Acquired Brain Injury, was published this past December in the Archives of Clinical Neuropsychology.  In the study, the researchers compared the Neuropsychological Assessment Battery (NAB) Naming test with various other neuropsychological tests. The Neuropsychological Assessment Battery is a relatively new group of tests designed to measure a wide range of cognitive skills including memory, attention and of course naming. For the NAB Naming test to be found appropriate for use in a brain injured population, the researchers first looked to see if the test scores correlated with scores on other similar tests that have been shown to be valid with such a population. For instance, a person who scores highly on the NAB Naming test should similarly do well on another naming test. The researchers found this to be true. Next, the researchers looked to see if the NAB Naming test scores were not correlated to unrelated tests. For example, a person’s score on the NAB Naming test should have nothing to do with his or her score on an attention task. This also was found to be true. Thus, the NAB Naming test was found to be an appropriate test to use with individuals who have brain injuries.

Below is a link to the paper abstract:

http://www.ncbi.nlm.nih.gov/pubmed/23714104

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Aphasia Advice

Aphasia, the loss of language skills, is relatively common after a brain injury to the left side of the brain.  The video below was created by a stroke survivor in order to give some tips on how best to communicate with someone who has aphasia.

http://www.upworthy.com/a-lot-of-people-find-it-hard-to-talk-to-laura-so-she-put-together-4-easy-tips-cg7-4a?c=ufb1

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Toys for Tots and Meaningfulness

The patients at the Transitional Learning Center in Lubbock recently made Christmas ornaments to be sold in order to raise money for Toys for Tots.  This is not just a great activity because it helps children in need.  It is also special because it focuses on what the patients can do to contribute in spite of their injuries rather than focusing further attention on those things that they’re no longer capable of doing.  This points to one of the most important aspects of promoting post-injury success.  Survivors, professionals and loved ones must identify what the survivor is still able to do following an injury.  This involves identifying both tasks that can be done independently and those that require the survivor to seek some level of help.  These activities can often be relied upon to bring meaning and depth to life when facing the many challenges that accompany learning to rebuild that life in the aftermath of a brain injury.  Below is a beautiful news story featuring the patients and TLC staff making the mentioned ornaments.

http://www.everythinglubbock.com/story/traumatic-brain-injury-patients-raising-money-for/d/story/J3VZNsthSk-qs50AWkXIMQ

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Congratulations Dr. Masel!

Dr. Brent Masel, President and Medical Director of the Transitional Learning Center, earlier this year was awarded the Sheldon Berrol M.D. Clinical Service Award from the Brain Injury Association of America.  This award honors distinguished contributions to fields directly related to patient treatment and also recognizes exemplary involvement in professional training and/or education over the course of an extended clinical career.  Congratulations Dr. Masel!

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org