Tag Archives: aquired brain injury

Talking About Your Injury

One of the more stressful aspects of the injury experience is deciding how to answer questions about the injury experience. This can be particularly stressful as many survivors find themselves receiving a barrage of questions every time they return to familiar situations. Friends at work have questions, customers have questions, old high school classmates have questions, etc. For many survivors, it seems that they have been suddenly placed in an unfamiliar spotlight. Let’s go over some general ideas and some specific suggestions when talking about your injury.

First, let’s review some general ideas. Many survivors initially think that few people know about their injury. After all, if the survivors did not tell others, how would they know? The reality is usually different. Sometimes, the injury event was on the news. For instance, if a survivor was in a major car accident or shooting, it generally made the news. Also, following an injury, family members may make prayer requests through social media or religious institutions. In this case, everyone who is connected via social media or anyone is part of the religions institution is aware of the injury event. Moreover, a brain injury is a big piece of news. Once one person hears about it, they are likely to “share the news” with friends from work, school or other social environments. Overall, information often makes the rounds to people you know quite quickly. However, the information is often piecemeal and occasionally, inaccurate.

With this in mind, the guiding principle when talking to others about your injury should that you give honest information in a manner that will engender others to have appropriate confidence in you. In some cases, people may be truly confused or concerned how you are doing and are using questions as a sort of gauge of health. The better you handle the situation, the more likely the other person will walk away with confidence in you.

Here are a few pieces of advice regarding talking about your injury:

  1. Always keep in mind who the person is that you are speaking with. For instance, is this a friend or an acquaintance? Is this person trustworthy to keep information private or likely to share it with everyone? Do I have a personal relationship or a professional relationship with this person? These factors will influence what you will share (or not share) with the other person.
  2. Whenever possible, keep information short and with limited detail. Remember, once you have said something, you cannot take back the information and the person you are speaking with may share that information with many others. Also, the less details you give, the less opportunity you are giving the other person to ask probing, sometimes uncomfortable, questions.
  3. Be sure to have a good exit/”no thank you” line. Not everyone has a right to your information and there are times you will not want to talk about your injury. A good exit line usually involves saying something nice, making your request and ending with something nice. For example: “Thank you for your concern but I really don’t enjoy talking about my recent health issues. However, I really appreciate that you cared so much to check on me.”
  4. Always tell the truth. If you tell a lie, there are two possible unpleasant outcomes. One, if the other person finds out that you deliberately lied, this can ruin the relationship. Second, if you tell a lie and the other person realizes the information is wrong but falsely thinks that you actually believe the lie, the other person will assume that you are quite confused.
  5. Be aware that you know a lot of medical/health terms that other people will not know, will not understand or even misunderstand. The average person on the street does not know terms such as “hemiplegia” or ” homonymous hemianopsia .” Using terms that other people do not understand may overwhelm the other person. Also, there are some terms that others may misunderstand. For instance, if you say that you are in “rehabilitation”, other people may falsely assume that you have a substance abuse problem. It may be better to say, “I have been working on my recovery from my injury” or “I have been in injury rehabilitation” rather than saying “I have been in rehabilitation.”
  6. Do not exaggerate or embellish your injury experience. Your story is already powerful and does not need any help. Also, exaggerating or embellishing may make the experience seem worse and cause other people to lose confidence in you.
  7. Be careful about using humor. Many people will not find much humor in your injury experience and may take too much humor to mean that you do not appreciate the seriousness of your injury. Again this could lead to a loss in confidence in your skills.
  8. Always ask questions of the other person. If the other person gets to ask all of the questions and you have to give all of the answers, eventually the friendly conversation may feel like an interrogation. The best way to balance the power is to ask questions of the other person, such as how are things going for their spouse, children or job.
  9. Practice your responses. When you are asked questions, the way to engender confidence is to have great responses. The best method to ensure you have great responses is to practice, out loud, your responses. This way, you can hear how your answers actually sound when coming from your mouth (which often sound different than how you imagine them in your mind) and practice different potential responses. It is often helpful to practice with a trusted loved one and/or to record and review your responses. This will help you find the best and most natural responses to questions.

These were just a few ideas and suggestions when talking to other about your injury. Always remember the key principle of giving honest responses that engender confidence!

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

The Rehabilitation Partnership

One of the most basic truths of successful rehabilitation is that it involves a partnership between the patient and therapists/doctors.  It is important to understand what this partnership entails, namely that without both parties’ investments in the process the patient will only see limited improvements.  This also means that each side has a responsibility to the other side to ensure success.  The job of rehabilitation is a shared job between the patient and rehabilitation professionals.

There are a number of implications to this basic truth of the rehabilitation partnership.  A therapist/doctor cannot make a patient improve.  A therapist/doctor can only work with a patient to help the patient improve.  Keeping this in mind should dissuade rehabilitation professionals from imagining themselves to be like Superman, swooping in to save the patient from the patient’s brain injury.  Brain injury rehabilitation simply does not function like a comic book story.  This realization should also empower the patient with the knowledge that his or her thoughts, feedback and effort are a vital part of rehabilitation (without which success cannot be fully achieved). Professionals need the patient’s thoughts and feedback to best plan and implement therapy.  Every patient is different, so a method that helps one patient may hinder or even harm another.  There is no way for a professional to know this without feedback.  This should also dissuade patients from being too passive when engaging the therapy process.  Rehabilitation professionals cannot help a patient improve if the patient will not try to help him or herself.   They cannot do the work for the patient.

When this partnership between patient, therapists and doctors truly comes together, everyone becomes a vital member of the rehabilitation team.  However, it is important to remember who needs be recognized as “team captain.”  The patient is the “team captain” in the sense that the process is ultimately focused on the patient.  The patient needs to share with the team any and all goals, expectations and dreams.  When the entire team has this information (which has to be updated on a regular basis), the team can best determine the direction therapy needs to take.  For instance, if a patient was formerly a chef and dreams of returning to that former occupation, a great deal of therapy will be focused on activities in the kitchen.  If the patient never went in the kitchen outside of opening the refrigerator door, then therapy will clearly be focused on other activities.

A successful partnership will generally allow the patient and rehabilitation professionals to have a mutual understanding and appreciation of one another.  It will also foster openness, honesty and trust between the patient and the rehabilitation professionals.
Remember, teamwork makes the dream work!

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

Lessons from a Blind Man

We here at the Transitional Learning Center often host patients and family members that speak Spanish as a primary language.  Spanish-speaking TLC staff members are generally on-hand to translate during therapies and other necessary interactions, but on occasion TLC staff will have need to use a phone translation service (in a meeting updating family on progress, for example).  To utilize this service, a staff member will call the service phone number which connects directly to a translator.  The translator can then translate between all parties involved via speaker-phone.

When using such a translator, it is important to pause every few sentences so as to allow the translator to translate that which has just been stated.  On one memorable occasion a therapist spoke for too long without pause and upon realizing her error, stopped herself and apologized for not stopping sooner.  The translator agreed that to do his job effectively he would require more frequent pauses.  He then added that he cannot depend upon notes taken while someone is giving him information to translate because he is blind.  He was doing his job utilizing memory and language skills exclusively.

Reflecting upon this situation there is an important lesson to be learned for all individuals with disabilities, including brain injury survivors contending with long-term deficits.  A translator position is the perfect occupation for a bilingual blind person.  The job requires excellent speech and finely-honed cognitive skills, but in no way requires vision.  The job matches the person’s strengths to a central task while sidestepping the influence of any weaknesses.  After an injury, many brain injury survivors need to find new jobs because newly acquired deficits do not allow them to return to their previous occupations.  It is important during the job search process to honestly identify post-injury strengths and weaknesses in order to find jobs that rely on strengths while minimizing the impact of any weakness.  By taking this important step survivors are more likely to enjoy success in the working world, just like the blind translator from our story.

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

Signs of Left Neglect

Left neglect is one of the more curious symptoms of brain injury.  Briefly, left neglect is an attention deficit in which a patient’s brain essentially tells that patient to ignore the left side of his or her world.  For that individual, it is almost as if the left side of the world does not exist.  It is most commonly observed when a patient ignores items in the left visual field (even when visual acuity is perfect) but can also involve hearing and sensation on the left side.  Left neglect is due to an injury to the right side of the brain.  Different techniques (such as practicing scanning skills) are used to help manage left neglect.  For more general information on left neglect, please see these previous posts on the topic:

What is Left Neglect? https://tlcrehab.wordpress.com/2015/01/08/what-is-left-neglect/

Left Neglect vs. Field Cut https://tlcrehab.wordpress.com/2015/06/25/left-neglect-vs-field-cut/

What I would like to do with this post is to give a few signs that rehabilitation professionals commonly observe when diagnosing cases of left neglect.  Below is a list of these common indicators of left neglect.

1. The patient only eats food on the right side of plates and does not notice food on the left side.  Often the patient will complain that he or she is not being fed enough because the patient believes that he or she is only being offered half-sized portions (since food to the left is necessarily ignored).

2. The patient bumps against objects with the left side of the body or wheelchair.  For instance, the patient may catch the left side of a door frame as he or she attempts to enter or exit a room.  Typically, patients who are just beginning to understand their left neglect and have yet to become proficient in scanning techniques will have bruising visible along the left arm or leg.  Staff often have to monitor patients in wheelchairs who have left neglect to ensure that the patients’ left arms do not fall down and get caught in the wheels of their wheelchairs.

3. The patient does not face people to his or her left, even when talking with these people.  Many times the patient may begin a conversation face to face, but slowly during that conversation his or her gaze can be observed to drift to the right.

4. The patient only shaves the right side of the face, only washes the right side of the face or only puts make-up on the right side of the face.

5. The patient misses words on the left side of the page.  This can cause a patient to complain that the reading material he or she is given does not make sense because the patient does not realize that he or she is only reading words on the right side of the page.

6. The patient is unable to find rooms located on the left side of a hallway.  Sometimes a patient will claim that a room has “moved” or “disappeared” since the patient cannot find the room in question.

7. The patient will start all activities on the right side and not make it all the way to the left. As example, a patient may play Connect 4 and only place chips on the right half of the board.  The patient may also be seen squeezing all his or her writing onto the right side of a page while leaving the left side of the page entirely blank.  When drawing a picture, the patient may leave a similarly barren left side of the page upon completion.

8. The patient complains that he or she is losing hearing in a left ear even though audiological testing shows no hearing loss.

9. In extreme cases, a patient may not recognize a left arm or leg as being his or her own body part.  When the patient sees this limb but does not recognize it, he or she may even make a complaint such as that a stranger has joined him or her in bed.

I hope this post helps everyone understand some of the more common signs of left neglect that rehabilitation professionals often observe!

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

Frankie Muniz

We usually associate having a stroke as a medical condition of older age.  However, it is possible for a younger person to have a stroke.  Frankie Muniz, the 26 year-old actor best known for starring in the sitcom Malcolm in the Middle, suffered a stroke this past Friday.  The fact that his symptoms involved difficulties in language likely indicate that it was  a left-sided stroke, as language is generally controlled by the left side of the brain.  He appears to be doing better from the initial stroke and hopefully will see a full recovery.

http://www.foxnews.com/entertainment/2012/12/04/frankie-muniz-suffers-mini-stroke/?intcmp=trending

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

Sharon Stone Is a Survivor

Having a brain injury is often a very lonely experience.   Brain injury survivors may ask themselves, “Who else besides me has also gone through this?”  The fact is that many people have survived brain injuries, including some well known celebrities.

Actress Sharon Stone is a brain injury survivor.  The star of movies like Basic Instinct and Casino had a blood vessel rupture in her brain in 2001.  Through the herculean efforts of her treatment team, she survived.  Stone completed rigorous rehabilitation for her injuries, just like other survivors.  Post-injury, she was able to make a successful return to work, including earning an Emmy award in 2003. So if you ever wonder who else has experienced the struggles of recovering from a brain injury, you can always watch a Sharon Stone movie and know that you are looking at another survivor.

http://trib.com/news/local/how-doctors-saved-sharon-stone/article_cc6e25c9-ae62-5a25-9339-d91cc5197c52.html

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