Tag Archives: tbi

TLC on TV!

TLC was on TV!  The TLC facilities in Galveston and Lubbock both recently acquired  innovative new robotic arm devices from Bionik Laboratories.  This partnership with Bionik Laboratories will allow TLC patients to use the latest cutting edge technology to improve rehabilitation outcomes.  This new technology is so innovative that Fox 26 in Houston did a segment at TLC Galveston on the robotic arm and it’s potential.  Click the link below to see TLC on TV!

http://www.fox26houston.com/news/new-robotic-arm-therapy-being-used-to-help-stroke-patients-recover

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

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Dylan O’Brien is a Survivor

Brain injury does not discriminate.  Even those most famous of Hollywood stars are not immune to being injured.  Maze Runner star Dylan O’Brien suffered a brain injury due to an accident while filming the third Maze Runner film.  He needed many months to recover from his injury before he could return to filming.  The most difficult part for Dylan was the emotional aspect of recovery.  The article below is an interesting read in which Dylan opens up about his experiences surrounding the accident.

http://www.vulture.com/2017/09/dylan-obrien-is-back-from-the-brink.html

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/

New Technology Can Lead To More Success

Technology plays an ever-increasing indelible role in our modern lives.  Just as our phones and televisions are enhanced by new technological advancements,  so does neurorehabilitation from brain injuries benefit in a similar fashion.

Technological advances and applications for that new technology in rehabilitation come from different sources.  There has been a steady improvement in proprietary technologies catering to therapists and doctors who treat individuals with brain injuries.  These new technologies aid in a wide range of therapies, from helping a patient to re-learn swallowing skills to improving gait training.  Two common such examples can be seen in a patient working on a task while wearing electrodes to stimulate particular muscle groups or one walking laps while a programmable hoist unloads a percentage of that patient’s body weight.

Separately but related, most patients now integrate smart phones, Ipads, tablets and other such technology into their daily lives.  These items can be very useful in compensating for certain deficits.  For instance, many patients use their smart phones to keep track of their schedules and to program reminder alarms for daily activities.  There are numerous speech apps that can be downloaded to Ipads which enable patients to engage in more effective communication with others.  The cameras now included as feature of virtually every cell phone and tablet PC prove useful in compensating for deficits in visual memory.

These new technological advances benefit patients in multiple ways.  Many of these technologies enhance the effectiveness of therapies.  This brings greater success in individual therapies and thus in overall rehabilitation.  Other technologies provide new ways to compensate for deficits.  This helps reduce the lasting impact of injuries on patients’ daily lives.  Additionally, patients enjoy certain technologies that can make the daily work of therapies feel more fun or interesting.  This helps keep patients motivated in those therapies.  The pertinent role of the therapist is to identify which technologies will benefit which particular patient as each patient is different both in therapy needs and in personal comfort level with new technologies.

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

Different Parts, Different Speeds

Brain injury survivors and their families often ask doctors and therapists about how long it will take for brain injuries to heal.  This would seem like a simple and straightforward question, but the answer to this question is actually quite complex.  One of the chief factors that makes any such answer so complex is that different parts of the brain may heal at different speeds.

We often talk about the brain as if it were one unitary body part, but in truth it is made up of many interconnected parts.  For instance, there are distinct left and right sides of the brain that are connected by a set of neurons known as the corpus callosum.  Each side of the brain can be split into many different component parts.  These parts function interdependently, but each part has its own unique purpose.

When a survivor received a brain injury, different areas of the brain may have been damaged at different levels of severity.  Which parts suffered damage at what levels of severity will differ from person to person and from injury to injury.   With so many parts of the brain being impacted differently by an injury, it is very common that a brain injury survivor will see improvements in some areas faster than in others.  For instance, if the part of the brain responsible for speech comprehension was less injured than the speech production part of the brain, that survivor will likely gain back the ability to understand verbal communication well before ability to convey information through speech returns.  If the part of the brain governing leg movement was less injured than the part of the brain controlling the arms, then that person is likely to see a return of the ability to walk through a doorway prior to being able to once again turn a door knob to open that door.  Ultimately, having different skills return at different rates of speed should be understood as a normal and expected part of the brain injury recovery process.

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

What Language Do You Speak?

 

There is an interesting phenomenon often observed in brain injury survivors who were bilingual to the extent of fluency prior to their injuries.  In these survivors who have post-injury language deficits the first (native) languages tend to return more quickly and fully than do their second languages.  This is true even in survivors who were fully fluent in a second language and used that second language extensively in their everyday lives.  As TLC is located in Texas, our staff tends to observe this phenomenon most often in Spanish-English bilingual patients.  Many of these patients now contending with language difficulties who learned English later in life find it far easier to name objects or follow directions when Spanish is used, while prior to their injuries they would have been comfortable using either language.

This return of the first language sooner than a second language can have a number of practical consequences.  Many survivors understandably become frustrated at an inability to speak that second language with the same skill once demonstrated.  Being bilingual is often a point of pride and may have previously allowed the survivor to excel in activities (such as import-export business transactions) that the average person could not.  This sudden significant skill gap may even prevent these survivors from returning to jobs in which a second language was utilized as a vital portion of everyday business life.  Moreover, if the survivor was previously the primary translator for the family this may cause difficulties in the family’s ability to interact with the outside world.  For example, the survivor may have previously served as point person to get information from school regarding a child’s performance as that survivor could easily speak to school officials (and the rest of the family may struggle with casual exchanges in English).  If the survivor is now unable to converse fluently in English, the family may now face significant problems interacting with the school.

There are also practical therapy concerns when a survivor struggles with a second language if that second language is the primary language used in the larger community.  In America, English is obviously the dominant language.  As such, most pre-therapy evaluations are conducted in English.  There are a limited number of health care professionals who are comfortable conducting evaluations in another language.  However, if a survivor’s first language is not English and that survivor is significantly stronger in his or her first language, that first language will need to be the language used in evaluations so as to get the most accurate measurements of the survivor’s skills.  The same is true in therapy.  If a survivor understands therapy directions significantly better in a first language, then therapy should be conducted in the survivor’s first language.    Additionally, therapists should always inquire as to which language is used in the home.  If the survivor’s first language is different than the language used at home (seen when someone who speaks both Spanish and English marries a spouse who only speaks English), then that second language will need extra focus or alternative methods of communication (e.g. pictures or hand signals) may need to be introduced.  At TLC, we have a number of Spanish-English bilingual staff and have a contract with a translation service if other help is needed.  Overall, rehabilitation professionals must be aware of survivors’ language skills and adjust evaluations and therapy accordingly.

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

 

A Little Note Goes A Long Way

As Thanksgiving approaches, many brain injury survivors are preparing for large get-togethers with family and friends.  Many of these family and friends have not recently seen the survivors in their lives and can understandably be extremely excited to be reunited.  However, there are often a great many changes that survivors have weathered which directly impact their experiences of Thanksgiving with these family and friends.  Close family members may be aware of these changes but extended family and friends may not be.  Email or similar communications can help spread necessary awareness to help ensure successful holiday celebrations.

These communications can be sent by the survivors or by close family members prior to any get-together. The goal is for individuals who are not fully informed of the survivors’ deficits to be given relevant information in order to help holiday celebrations run smoothly.  For instance, if alcohol is typically served at a Thanksgiving meal, friends and family need to know if the survivor is prohibited by a doctor from drinking.  If the survivor becomes agitated when there are too many people surrounding him or her, family and friends need to know to approach the survivor one at a time.  If the survivor can only tolerate food of a certain consistency, family and friends need to know which foods can or cannot be served the survivor.  These are just a few examples of useful information that could be included in a message sent to help avoid problems during a survivor’s Thanksgiving celebration.  Remember, a little note can go a long way toward success!

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

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/

 

Alcohol, Seizures and Brain Injury

A drunk driving accident.  A fight at a bar after a night of drinking.  A serious tumble at home after a few too many.  Many brain injury survivors received their brain injuries while under the influence of alcohol.  In fact, studies have shown that between 35% and 81% of traumatic brain injuries occur in individuals who had been drinking at the time of their injuries.  Doctors and therapists routinely recommend that survivors abstain from alcohol after a brain injury but some survivors choose to ignore this advice. Drinking after a brain injury though carries with it fresh and frighteningly dangerous risk.  Namely, such unwise behavior invites the post-injury seizure.

In general, brain injury survivors are more prone to developing a seizure disorder than are people without brain injuries.  Depending on the severity and location of a traumatic brain injury, research shows post-traumatic brain injury seizure rates to sit somewhere between 2% and 50%.  Similarly, post-stroke seizure rates range between 5% and 20%.  Both of these are significantly higher than the seizure rate found in the general populace.

Unfortunately, alcohol can increase the likelihood and frequency of post-injury seizures.  Clinical research has consistently shown alcohol to lower the threshold above which a seizure will occur.  Alcohol also interferes with the performance of anti-seizure medication, which of course increases the risk of seizure in those who depend on its assistance.  As a seizure is at base a potentially life-threatening medical issue, anything that might raise the likelihood of seizures should be avoided.

Overall, it is smart for many reasons to avoid consuming alcohol after an injury.  The enhanced risk of seizure stands alone among these reasons though in both gravity and consequence, and as such should be granted special consideration.

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/