Tag Archives: lubbock

Grounding Identity

Living through the brain injury experience can represent quite the assault on a survivor’s identity.  Previously athletic survivors may now struggle to walk.  Previously active and industrious survivors may now be unemployed.  Instead of being in charge at the workplace,  a survivor now is given a list of externally defined rules to follow essential to his or her rehabilitation.  All of this can cause notable emotional strain on a survivor.  Contending with the inevitable alterations wrought by such an injury to the perception of  one’s own identity is no small thing.  Sometimes rather than focusing on all of these changes, it is worthwhile to instead concentrate on those aspects of the survivor’s identity that have remained stable in spite of the injury.  It is often helpful to write down these stable aspects to help visualize and internalize the truth that many of the attributes that have always defined the survivor’s identity at core remain just as relevant post-injury.

Here are a few of these aspects with strong potential to remain stable following an injury:
1.  Family relationships – An injury does not change the fact that a survivor holds family roles as a parent, child or sibling.
2. Life Experiences/Memories – An injury does not negate the many life experiences that a survivor has accumulated.  These experiences can originate in work, school, family or any other facet of life.
3. Interests/Hobbies – An injury is unlikely to change a survivor’s interests and tastes in things like music, food and sports.
4. Knowledge – An injury will almost never fully erase a survivor’s knowledge acquired over years of life experiences.  As example, a survivor who is a truck driver will generally remember all of the quickest routes across town.
5. Personality – An injury may not change a survivor’s personality.  For instance, a survivor who was a hard worker prior to an injury will very likely be just as hard a worker after.
6. Physical Characteristics – An injury may not alter certain physical characteristics.  A brain injury will not change the color of a survivor’s eyes or hair.  For many survivors, overall facial appearance does not change at all (or sees only minor changes) following an injury.
7. Beliefs – An injury will generally have no effect at all upon a survivor’s belief system.  For example, a lifelong Democrat will almost never suddenly begin voting Republican post-injury.

By spending time identifying and shifting focus upon the stable facets of survivors identities, survivors can better emotionally ground themselves as they navigate the brain injury experience.

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

 

 

 

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Frankie Muniz and Strokes

Actor Frankie Muniz is best known for his work in the hit TV show Malcolm in the Middle and recently has been competing on Dancing With The Stars.  Few know of a far more private battle that he has been fighting, though.  Muniz estimates that he has suffered as many as 15 mini strokes in recent years.  Doctors have not been able to identify a definitive cause for the multiple stroke events Muniz has suffered, but he does not let this stop him from succeeding in life.  He shares about his strokes and other health issues in the following article:

http://people.com/tv/frankie-muniz-secret-health-battle/

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 odder symptoms of a brain injury.  Briefly, left neglect is an attention deficit in which a patient’s brain essentially tells the patient to ignore the left side of the world.  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 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 with cases of left neglect.  Below is a list of these common left neglect signs:

1. The patient only eats food on the right side of the plate and does not notice the food on the left side of the plate.  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 fed half-sized portions since the food on the left is ignored.

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

3. The patient does not face people on their left, even when talking with these people.  Many times, the patient may begin the conversation face to face but slowly their head drifts to the right during the conversation.

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.  Often a patient will 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.

7. The patient will start all activities on the right side and not make it to the left. For instance, a patient may play Connect 4 and always place their chips on the right side of the game.  Similarly, the patient may squeeze all of his or her writing on the right side of the page while the left side of the page is blank.  The patient will often draw the right side of a picture.

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

9. In extreme cases, a patient may not recognize their left arm or leg as being their own body part.  When the patient sees their arm or leg but does not recognize it, he or she may make a complaint such as that a stranger is in their bed with them.

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

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

Open Communication

The brain injury experience is a remarkably complex one.  Overnight, so many things change and so many adjustments need to be made.  Throughout this experience, brain injury survivors have goals, concerns and aspirations.  Survivors’ loved ones will have their own goals, concerns and aspirations as well as they come to terms with their own roles in this new and dauntingly complex experience.  These two sets of expectations may or may not fully match up with one another.  Survivors and their loved ones will all try their best to achieve desired outcomes.  Sometimes  differences in respective desired outcomes can lead to conflict.  One of the most common contributing factors to such conflict is poor communication.

Family members, injury or no injury, tend to make assumptions about one another.  In fact, we all engage in some form of attempted “mind reading” in which we guess at what another person is thinking.  For instance, if one person pauses to look at a second person prior to walking through a doorway that second person may “mind read” and think, “The other person is looking at me because he wants me to enter the doorway first.”  There are no actual words spoken in this momentary exchange, only valid assumptions made.  This method will generally work well enough in simple situations, but problems  arise when we engage in such “mind reading” in place of actual open communication regarding more substantial and  important issues.  A simple look or smile does not say “I am hoping that a month or two after discharging from therapy I can return back to working and driving” or “I am worried that my son will want to return to mountain climbing where he could fall and suffer further brain injury”.

A good place to start open communication is with a family meeting explicitly organized to talk through the goals, concerns and aspirations of all involved.  The meeting should be planned in advance and all parties informed of its purpose.  This gives each family member time to organize his or her thoughts about pertinent issues.  Many survivors benefit from writing down a list of topics they’d wish to discuss at this meeting in order to ensure that they don’t forget to raise a given subject.  A meeting of this sort need not necessarily determine the final word on any topic.  In fact, it can be a good idea to state from the start of such a meeting that participants are in no way required to (and may not even be expected to) agree with what others are saying.  Particularly at the first meeting of this sort, it is not important to make decisions regarding the future.  Instead it is more important to open the lines of communication so each person can know what all others are thinking and “mind reading” can be avoided.  Opening the lines of communication in such a formal manner may seem awkward to some, but it helps ensure that the goals, concerns and aspirations of each family member will actually be discussed and addressed rather than being lost in any number of side conversations.  Once these lines of communication are opened and everyone has a chance to freely discuss thoughts and sufficiently convey perspectives, it is much easier in the future to re-visit these topics in a constructive manner.  Open communication will ultimately allow family members to walk hand-in-hand into the future with less conflict.

 

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

 

How Can I Support A Caregiver?

As modern medicine improves and our population ages, more individuals are able to live longer with serious health issues including permanent deficits resulting from a brain injury.  This notable demographic shift places more loved ones in the position of serving as long-term caregivers.  These caregivers need all available support from those around them but many of those capable of offering assistance are simply unaware of how best to help.  Here are a few quick suggestions on how to support caregivers:

1.     Call them and ask how you can help.  Caregivers may feel shy or embarrassed to initiate requests for help but are often far more receptive to assistance if it is offered.   This gives caregivers opportunity to request specific aspects of help most needed at a given juncture, and they will certainly be grateful for all help shared.

2.    Offer to have the caregiver and survivor over for a meal or to deliver a meal to them.  With all of the responsibilities that caregivers meet on a daily basis, having someone else take care of even a single meal can be a source of welcome relief.

3.    Be there to listen.  Many caregivers feel overwhelmed by their experiences.  A friendly phone call or visit with a supportive ear helps relieve some of this emotional burden.  Knowing that others care about their well-being is very important for caregivers in maintaining their own emotional health.

4.    Be a friend to the survivor.  After their injuries, many survivors find that their social circles quickly shrink.  Some caregivers can find themselves serving as the only social outlet for the survivors in their lives.  This can be a source of tremendous additional stress in the life of a caregiver.  Being a part of the survivor’s social circle reduces the need for the caregiver to fill all of these social roles.  Moreover, the survivor is sure to appreciate this as well!

5.    Offer to spend time with the survivor so the caregiver can spend a little time tending to his or her own needs.  As a result of devotion to meeting needs of a survivor, it’s all to easy for caregivers to end up neglecting their own.  A few brief hours just to cover an unhurried trip to the grocery store, hair salon or doctor’s office (or simply to enjoy a quiet cup of coffee on their own) can do wonders for a caregiver’s quality of life.

6.    Take a moment out of your day to send a card, e-mail or flowers.  Sometimes we don’t have a lot of time to spare for lengthy calls or visits but a quick note to say “hello” tells the caregiver that they are not forgotten.

Hopefully this list will give you ideas to start reaching out and supporting caregivers!

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

Life, Brain Injury and Repairing with Gold

There is a fascinating art form originating from Japan called “kintsugi” (a name formed from the Japanese root words meaning “golden” and “joining”).  In this form of art, broken pottery is repaired by using lacquer mixed with gold, silver or platinum.  Rather than being hidden, these cracks are instead highlighted, enhanced and made to reveal an entirely separate and distinct beauty.  Kintsugi is connected to the philosophy of “wabi-sabi” which means “finding beauty in broken or old things”.  This is not really a philosophy of items but a deeper spiritual concept informing a healthy approach to the world around us.

This idea of making the cracks more beautiful rather than trying to hide the break is an amazing metaphor for post-injury growth.  Survivors should not feel the need to hide or be embarrassed by their injuries.  Survivors never asked to have brain injuries, the events simply happened.  But there is a great deal of opportunity to use an injury and the rehabilitation process to take beautiful steps forward in life.  Some TLC patients have taken their experiences and used them to educate others about brain injuries.  Rather than shying away, they put themselves out front and center so as to benefit others in a powerful way that typical rehabilitation professionals do not have access to.  These survivors can speak from the authority conferred by actually having lived through the injury experience, lending their words an innate credibility that similar statements from health care and rehabilitation professionals can sometimes lack.  Other TLC patients have used their injuries as impetus to reach out to family and rekindle strained relationships.  Relatives who had not spoken for years were able to be reunited through response to these injuries.  Still other TLC patients have used their injuries to take their lives in healthier directions, such as returning to school, getting better jobs or cultivating sobriety.  Each of these steps forward is a way of taking the breaks in life created by brain injuries and repairing them with a “golden joining”, so that the survivors engage the world in an undeniably changed but potentially more beautiful and impactful way than before those changes wrought by their injuries.

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

 

Utilizing Music For Mood

Music has the amazing power to touch our hearts and souls.  The right song at the right time can move us in powerful ways, eliciting emotions ranging from brightest joy to deepest sorrow.  Harnessing the power of music can also help brain injury survivors (along with the rest of us) make it through their days more successfully.

It is a common sight at a gym to see the majority of participants working out with music in the background to help keep them motivated and driven.  This music tends to be upbeat and intense.  This workout music highlights the ability of music to boost our performance.  Survivors may want to consider using similar energetic background music while they are working out, whether in a gym or in therapy, to help them when they might be feeling low in energy.  However, it is important to ensure that the music does not distract the survivor.  An example of this pitfall to be avoided can be observed in a survivor suffering from substantial deficits in the arena of attention.  A catchy song could cause this survivor to sing along and devote a disastrous lack of attention to foot placement while practicing walking.  Finding the balance (whenever possible) between drive and distraction is important.  Energetic music may also help mitigate general fatigue that can occur at any part of the day.

Music has the ability to lift us when we feel down.  Following a brain injury, many survivors will display acute symptoms of depression or at the very least be significantly (if understandably) sad about their situations.  Survivors should identify songs that lift their moods and listen to that music when they find themselves feeling low.  These songs often tend to incorporate themes of hope and joy.  Religious music is also a very popular and effective source of this helpful form of mood modulation.

Many survivors also face serious difficulties with stress and anger.  Certain music can help individuals to relax and stay calm.  Soft, classical music tends to be popular to ease stress and anger though other types of music can do this as well.  Some individuals prefer listening to sounds of nature (such as waves lapping upon a beach) to reach a more calm state.  Meditation music is a hot market and there is a huge amount of excellent music available both in stores and online.

Not every song will help with every mood and sometimes the music that is most helpful may not be the survivor’s favorite song or from a favorite band.  What is most important is that the music in question leads to the emotional experience that the survivor would like to cultivate.  Technology has advanced exponentially over the last few years, and survivors should take full advantage.  A survivor can keep a playlist of songs to help influence his or her emotions on a smartphone, Ipod or other similar device that can then be accessed throughout the day.  Remember that music can be an important part of any recovery process!

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

 

 

 

It’s Ok To Do It Differently

When I was a senior in high school, I had a physics teacher whose outlook differed from that of most science teachers.  Early in the year she told us that when we answered questions on her tests, she did not care about how we came to a given answer.  As long as that answer was correct, the method by which it was arrived upon did not matter.  Work did still have to be shown as in any other science class.  Even if that work bore no resemblance to that which she had prescribed though, a result was perfectly acceptable provided that the answers matched.

In many ways a healthy approach to rehabilitation is similar to this outlook championed by my former physics teacher.  Due to their injuries, rehabilitation patients are often unable to complete tasks in the same manner as they did before.  For instance, a patient with only one functioning hand will not be able to cut vegetables for a salad as he or she did prior to the injury but utilizing a one-handed rocker knife produces the same results.  A patient who has trouble speaking may not be able to verbally place an order at a restaurant but typing the order into an Ipad speech app produces the same results.  As you can see, there are often multiple methods by which to accomplish a given goal.  Effectiveness is the most important measure of a method’s worth, not whether it is identical to a previous method.

The idea of reaching the same goal through different methods sometimes bothers patients and their families.  In some cases, patients and their families refuse to use alternative methods because they are focused on doing things in exactly the same way as they have in the past.  A patient completing minor tasks just as he or she did prior to an injury holds strong appeal as a signifier of a return to normalcy.  However, due to the injuries this may not be realistic either at this stage of rehabilitation or for the foreseeable future.  Accepting alternative methods consistently allows patients to be far more functional in both work and home environments.  These alternative methods often allow patients to be more independent whereas insistence upon pre-injury methods can  bring with it a dependence on others.  It is important that patients and their families embrace alternative methods of accomplishing daily goals so that patients can achieve at their highest levels.  This open-minded attitude often yields the best long-term therapy results.

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

Quick Points on Wheelchair Safety in Parking Lots

Following their injuries, many brain injury survivors are left depending upon wheelchairs to meet basic mobility needs.  This change in mobility creates new safety considerations that must be taken into account on a daily basis.  One of these considerations surrounds strategies for safely navigating a parking lot while in a wheelchair.

Most adults are between 5 and 6.5 feet tall.  They are accustomed to being easily visible to drivers distractedly circling a parking lot and through rear windshields as drivers back up vehicles out of parking spaces.  When sitting in a wheelchair though, normal adults are often effectively no taller than  young children.  Even the most conscientious driver can struggle while exiting a parking space to see a pedestrian in a wheelchair.  These survivors are also often harder to see by a driver making the turn from one parking lot lane on to another.  Due to this change in baseline visibility, survivors in wheelchairs and their families must be more vigilant of vehicle activity and the abilities at every identifiable moment of drivers to see the survivors.  They must spend more time looking around to observe vehicle activity, just as they would when in the presence of a small child who may slip the notice of nearby drivers.

Another issue regarding parking lot safety is that survivors in wheelchairs are generally slower than the average person would be while moving across the same parking lot.  Since it takes more time to traverse any distance, survivors and their families must add extra time in their calculations as to whether there might be enough time to safely cross in front of an approaching vehicle.   If the result of such calculations inspire even the suggestion of doubt, erring on the side of patience is always the best policy.  Sometimes, family and friends may need to push the survivors’ wheelchairs to help move quickly enough to safely avoid traffic.  Additionally, typical adults generally can step up onto the curb from the parking lot at any location they choose.  Survivors in wheelchairs must use curb cut ramps which often means that they have to take a longer route to get onto the curb and consequently spend more time in the path of vehicles.  Again, survivors and their families must be aware of this additional urgency when choosing a path across any parking lot.

These are just a few quick points on wheelchair safety in the parking lot.  I hope everyone has a safe time in their travels, particularly in parking lots!

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

 

The Problem With the Word “Should”

The word “should” may be one of the most hazardous words in the life of a brain injury survivor.  It tends to appear in sentences such as “I should be walking already” or “I should have been back at my job by now.”  The word confers a tremendous degree of expectation on the survivor and implies that somehow the survivor is a failure if he or she has not achieved what he or she “should” have achieved.  Often, this word sparks a cascade of statements by which survivors verbally punish themselves.  “I should have been able to walk without a wheelchair but I instead I fell.  I should be doing better with my mobility.  I am letting down my whole family!”  These “should” statements can easily lead to depression, stress and damaged self-esteem.

The reality is that each brain injury heals at its own rate and as a result each survivor is left with his or her own unique set of challenges.  After a serious brain injury, it often takes a survivor considerably longer than he or she may expect to reach goals due to the severity of the injury suffered.  An injured brain is not like a broken arm.  You cannot put a brain in a cast as you would put an arm, expecting that in a relatively brief period of time the brain will be healed.  Brain injury rehabilitation is a process that takes time and patience.  The only applicable “should” enters into consideration in emphasizing that the survivor should dedicate full effort to his or her therapies.  That is all anyone, including the survivor, can reasonably ask for.  As long as the survivor is giving his or her best effort, the survivor is doing everything in his or her power to get better.  The rest of the process will depend on time, the practicing and learning of new skills and how the survivor’s individul brain heals following a specific injury.  Recovery cannot be rushed or forced.  “Should” statements that imply that somehow recovery ought to have gone differently are thus plainly revealed as emotional snares best avoided.

 

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