Posts Tagged brain injury

[BLOG POST] Conquer motivation after brain injury- tips from a survivor

Why it’s so difficult to conquer motivation after brain injury?

One of the most commonly reported symptoms of brain injury is fatigue. And I don’t mean tiredness.  Fatigue is something much worse. For me I can be willing, but my brain has other ideas. Sometimes I think my conscious mind and sub-conscious don’t like each other and are always having an argument.  The result might make me appear lazy to the casual observer, but that isn’t the whole story. The ongoing battle is within me, as I try to conquer motivation.

When I tried to return to work (and failed) my bosses tried to tell me I needed to take some responsibility for my recovery. My left leg and arm were very weak, and they were surprised that I hadn’t joined a gym to rebuild my strength. At that stage I had never been a gym goer. But the idea of trying to do something like that without being ordered to was unfathomable.  When I was suffering with so much fatigue, how was I supposed to find the motivation?

Even things like tidying the house took so much building up to. But over time I have noticed something about myself. I knew it before, but I hadn’t appreciated it’s power over me previously.

The impact on others gives me more motivation than the impact on me.

9 months after my accident I adopted my Dads cat Murphy, who he was struggling to care for. I knew Murphy was ill, and it turned out to be mouth cancer. I had known Murphy his whole life as I lived at my parents when Murphy first arrived. We were best mates, and so I moved him to the other side of the country with me so I could look after him.

He was skinny and very underweight. As he had no appetite so I spent all day, everyday chasing him with food, trying to make him eat. Murphy became one of my priorities. I knew he didn’t have time on his side, but I needed to make him as comfortable as possible. And it worked, I soon got him back to a healthy weight. He found new energy and found the motivation to explore outside several times a day. That made me so happy. He was my reason to get out of bed in the mornings, because he needed me more now than he had ever in his life. Earlier this year he lost his battle, but he knew he was loved.

Others well-being is my motivation

How I motivate myself now.

So if I need to tidy the house, I tell myself how it’s not fair on my partner James if I don’t. He works long hard days, so I can’t expect him to do it after work. Nor should I expect him to have to live in a pig sty. So I tell myself off and get on with it. (Followed by a impromptu nap.)

I did eventually join a gym and was doing really well. But that has fallen by the wayside, as it only helps  me. I don’t think this is about confidence or self esteem, just having a purpose. I was always a dedicated worker, but now I don’t work I’ve had to explore other ways  to motivate myself.

When I started this blog, it wasn’t as therapy for myself, it was to raise awareness. I felt people needed to better understand brain injury. Now I know there are other survivors who read this and in some small way find it helpful. So my responsibility is to you, and therefore you are my motivation to continue my ramblings. So my advice is if you struggling to get going think who really needs you to complete that task. It could be as simple as the birds in your garden need you to put some food out for them to ensure their survival. We make a difference to somebodies life every day, that is a most profound motivation for me.

If you need more ideas on motivation I found this article which is suitable for most people.

https://www.psychologytoday.com/blog/friendship-20/201605/5-ways-stop-sabotaging-yourself

Other related articles:

Source: Conquer motivation after brain injury- tips from a survivor

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[BLOG POST] How Relationships Can Change After a Brain Injury  

I want you to imagine someone who deeply loves you; how they make you feel when they smile at you and what it felt like to be around them. What if life changed in an instant, and they never looked at you the same way again?

Sadly, this happens to many traumatic brain injury (TBI) survivors, myself included. I have always been outgoing and had many cheerleaders who looked up to me. That look of aspiration turned into the look a wild animal would give after being caught in a trap for hours: frightened, helpless and hopeless. I remember seeing this look on people for a long time. Even when we were having a good time together, that look would be hiding deep in their eyes, waiting for my brain to scare them again. They would hug me as if it was the last hug they would ever give me.

My heart would shatter because in my mind I knew there was a chance they might be right; this might be the last time they hugged me. Even if I lived through the hospital stays and tests and “seizures” no doctor could diagnose, what if I forgot so many memories we shared that they couldn’t relate to me anymore?

When my TBI occurred it slowly began to bury every relationship I had. I have had a couple traumatic experiences in my life, and like a cat cashing in his lives, I have always bounced back. But with this brain injury I was not landing on my feet. That strong, confident, feisty woman turned into a helpless little girl who couldn’t even take a bath without supervision, or recognize family members. How do you relate to someone who has changed so drastically overnight?

Each brain injury is unique. Everyone can experience different symptoms, treatments and recovery times. However, there is one part of brain injury that is universal: the evolution of relationships. When the accident first occurs everyone tends to rally around you and cheer for a speedy recovery. When a limb is broken it heals, you rehabilitate, and life tends to move on. When there is damage to the brain or spine, the word speedy doesn’t come up during your recovery.

I remember being in the ICU when the symptoms of my TBI peaked in 2013. I earned myself a bright yellow “fall risk” bracelet, and my head was wrapped in gauze. I would wake up and have no idea who I was, or where I was. I wasn’t able to move the left side of my body and my head felt like it had been manhandled by a gorilla. My vision would be almost non-existent, and if I was really lucky I what I could see would be in doubles.

I would look around the room, not able to recognize my loved ones, a tear would roll out of my left eye and I would say, “Is my brain broken?” I would see everyone around me, dumbfounded on how to answer that question. My mouth would be so dry I could barely move my tongue to talk. “Was I in a car wreck?” I would utter out next. “No, honey, you weren’t in a wreck,” someone would usually confirm. I didn’t understand how I got there, or why I was in the condition I was in, although, they didn’t either.

I was sent home after five days in the ICU with no tools or explanation of what was happening. I would sleep for 14 or more hours a day. I was so weak and fatigued that I couldn’t sit for too long and my head would droop over as if a weight was tied to my neck. Sometimes my eyes looked like a zombie, just soulless. I couldn’t handle too much noise or light. If I reached my capacity with stimulation I would turn into an irritable T-rex that was seeking vengeance on anything that crossed my path.

I remember one day when my best friend sent me a text and asked if I wanted to hang out. I was overstimulated already when my phone began to buzz. He hadn’t heard the news about my condition yet, and unfortunately he found out through a text message sent straight from the wrath of my brain injury. I went off on the poor guy without realizing or remembering what I had done. He showed up to my house about a week later with a Disney puzzle in hand, and sulking sadness and confusion. I tried to explain what I could, as best as I could, and I saw his eyes tear up. He knew to some degree he lost his best friend Nikki, and she may never come back.

After I learned how I treated him on that text, I was immediately filled with regret, shame, and embarrassment. How could I be so cruel to some who cares about me so much? When he left I remember longing for the day we could go hang out again. I was also terrified — what if I said something worse to him, or said something I would never be able to take back?

I began slowly isolating myself from everyone so I wouldn’t be hateful to them, because I knew I wasn’t in a state to control it. I was also too embarrassed to be around them. Some days my speech was slurred and I would mix up my words. I can’t tell you how many times I called my dog a fridge, instead of Nyah. I felt worthless, like I was a burden to my friends and family. I saw the look on my friends and families faces that they would wear at my funeral. I didn’t have the emotional strength to keep facing that.

Significant time had passed and I was still working harder than ever to slowly get my life back. I had family members who would be critical of me because I hadn’t readapted into what they considered a normal life. “When are you going to get a job?” they would ask. Or my all-time favorite, “Is she just lazy?” I would get deeply offended. At the time I was going to 15 appointments a week to try to get to a stage where I could have some sort of quality of life. It took hours and hours of work just to come as far as I had and yet it still wasn’t good enough for them. They talked to me like a failure and a disappointment because I wasn’t healing at the rate they expected. It was ironic to me that all these people had opinions of how far along I should be, or what I should be doing, and yet not one of them had suffered from a brain injury. How could they project such a high standard at me, when clearly they had no education or experience that could relate to my circumstances? Why couldn’t they accept how I had become beautifully broken?

I knew that loss of relationships was a common after-effect of TBI but I was curious as to how common. I know of at least 37 survivors that have lost friends, family, and spouses as a result of their TBI. People who have vowed to be by your side, for better or worse, disappeared when the situation became “worse.”

Brain injury survivors once were nurses, mechanics, doctors, business owners. A brain injury can happen to anyone. Whether you are on your way home and God forbid get in a car wreck, slip on the ice, or collide while shooting some hoops. What would you do if everyone you loved started trickling away from you? Nothing hurts more than losing relationships with family, friends, and everyday life. While your lives have moved on and you pulled away I was still learning how to get dressed by myself.

If you want to support a loved one who has TBI, drop the expectation of what they are supposed to be. First off, unless you have been there, or have some sort of doctorate in the field, you are not qualified to tell me “how I should be progressing” in order to have you in my life. I have come to peace with my condition. I love every part of myself, even if that’s not good enough for you. I wouldn’t apologize for accidentally breaking my arm and I won’t apologize for accidentally breaking my brain. I am “beautifully broken” and I am proud of how far I have come, even if you don’t understand my journey.

If you ever do find yourself in a predicament like I was in, I hope you are treated with love and respect. That you aren’t abandoned by society because you don’t meet their expectations. I hope friends come by your side, and have patience with you even though you have failed to do so with them. If you find yourself in a situation similar to mine with no one around, know that you can reach out to me. I will be your friend and help you, even if you didn’t treat me with the same respect. Survivors are people that matter, and deserve to be treated as such.

Five Ways I am Different After My Traumatic Brain Injury

1. After my TBI I used to repeat myself often, and here and there I still do. I was OK with people calling me out for it, because it pointed out my much-needed growth. If someone was cold, or made fun of me it would make me feel mad and frustrated with myself. Sometimes it could put me in cycle where I would feel worthless.

I know it can be irritating to hear the same broken record, but it was sad to me that I was that record and couldn’t remember it. I may not have remembered telling the person, but I do remember some people’s reactions and it hurt. Saying things like “That’s right, you had mentioned something about that earlier, thanks for reminding me,” was really helpful. I know there were many times when my mom would pretend it was the first time she had heard something, even if I had already told her 10 times that day. I can’t tell you how grateful I am for her support. She was always kind, gentle, and encouraging; it has allowed me to mostly heal my injury.

2. When my brain would be overstimulated or something wasn’t functioning properly, I would turn into an angry wildebeest. My tongue would lash harsh phrases at people and I wouldn’t have a recollection of everything that I said or did. The brain goes into fight or flight (survival mode). It does what it can to survive.

By yelling and going off on everyone two things tend to happen. The brain produces different hormones and begins to change the chemistry of the brain, and a lot of times people would back away from me which brought down the level of stimulation. Arguing with me would only make the situation worse since my brain would go deeper into survival mode. Even if I was really hateful, I was fortunate enough that my parents understood. Them leaving the room and not arguing was extremely helpful, even if I was arguing something ludicrous like the San Francisco Bay Bridge was in the UK. I would also find a sanctuary in my laundry room. I was so hot (mostly because I was pregnant) and I would lay on the floor in the dark to let everything calm down.

3. Before my TBI I used to travel all the time. It has been a hard thing to not be able to just get on a plane and go. My brain is not able to adjust to altitude or barometric changes. When experiencing these drastic changes my head feels like it’s in a microwave and any minute it’s going to explode like overcooked leftovers. The pain is astronomical and I have cried when it’s too intense. I get extremely nauseous and irritable. I am exhausted by the time I get back to the altitude or barometric pressure I am most acclimated to.

4. I have a tendency to forget to do something easy like mail off a bill or make a phone call. It didn’t help the situation to have someone angry at me for forgetting. It wasn’t intentional and I am still very proud of all the things I do remember. Doing things like getting me sticky notes or organizing a calendar with me were very helpful. I also started relying heavily on my phone to track appointments, phone calls, and any other tasks I needed to do.

5. I have always been very confident and witty. I could crack jokes with the best of them. When my symptoms were really bad I couldn’t even understand a knock-knock joke, never mind tell one. I had a hard time relating to people because they were out doing so many things and I was always in the same routine. Go to appointments, and fight to heal the brain injury. I would eventually be vague with people because I was always telling the same ol’ story and I didn’t want to bore them.

Or I got reluctant to hear questions like “When are you going to be better?” or “When are you going to be back to normal?” I myself couldn’t even answer that question and I felt worthless. I have fought this hard to be where I am and I still didn’t feel good enough for them. Like you will only be by my side if I change back to my old self. And sometimes I would utter rude things to myself like, “Newsflash people, I don’t even remember who I was. How am I supposed to ‘get back to normal’ if I don’t even know what that ‘normal girl’ is anymore?”

I was able to build deeper friendships and relationships with the people that would keep encouraging me. If I disclosed a baby step of progression I would get positive affirmations like “awesome” or “I knew you could do it.” It encouraged me to keep fighting, and I felt some sort of self worth. Like I was finally climbing out of the darkness, into the light.

Follow this journey on My Traumatic Brain Injury.

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Source: How Relationships Can Change After a Brain Injury | The Mighty

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[WEB SITE] Life-Changing Mobile Apps for People with Brain Injury – BrainLine

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Almost every day, we hear of new mobile device applications (“apps”) developed for just about everything — from staying organized to finding pharmacies or restaurants while on the road. It’s hard to keep up.

The BrainLine team sorted through many resources to compile this list of apps for mobile devices for people with a brain injury, their families and caregivers.

Some of these apps have proven to be especially helpful for people with brain injury. The phone can be used to remind you of an upcoming appointment or to take medication, or it can be used like a traditional paper notebook to keep all your addresses, telephone numbers, calendar items, lists, and ideas. Please note that BrainLine does not endorse these or any specific products.

Organize and sort the mobile apps in this table by clicking on the title of the column you would like to sort by. Or view our slideshows of iOS apps or Android apps.

 

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Name Description Price Device Helps With
Audible Listen to books on your mobile device. Great for people who have trouble reading or who retain information more effectively by listening. Free iOS, Android Reading
Answers:YesNo Easy to use, affordable way for you to communicate with those around you if you are nonverbal. The app has two, large, color-coordinated buttons–one for yes, and one for no. Press either, and a voice will read you selection. $1.99 iOS Communication
Awesome Memory Card game to help you improve your memory. All of the cards are laid face down on a surface and players take turns flipping two cards face up. The object of the game is to reveal pairs of matching cards. Similar to the traditional game of “concentration.” * Paid version available that includes advanced levels and functionality. Free* iPad Memory
Behavior Tracker Pro Application that allows caregivers, behavioral therapists, aides, or teachers to track behaviors and automatically graph them. Option to record video of behaviors or interventions to later review with doctors, parents, teachers or therapists. $29.99 iOS Behavior
Breathe2Relax Hands-on stress management tool with diaphragmatic breathing exercises. Designed to help you with mood stabilization, anger control, and anxiety management. Free iOS, Android PTSD, Anxiety, Stress
Clear Record Premium Audio recording app that suppresses ambient, background noise allowing the user to record conversations in noisy environments while maintaining clear voices. Control play-speed without modifying pitch-quality. Slow down conversations to a manageable pace for the user. $0.99 iOS, Android Speech, Communication
Concussion Recognition & Response Helps coaches and parents recognize whether an individual is exhibiting/reporting the signs and symptoms of a suspected concussion. In less than 5 minutes, the app allows a coach or parent to respond quickly to determine whether to remove the child from play and the need for further medical examination. Free iOS, Android Concussion Screening
Corkulous Pro Collect, organize, and share ideas on virtual cork boards. “Pin” notes, labels, photos, contacts, and tasks. Group ideas visually on one board or spread ideas out across multiple boards. $4.99 iOS Organization
Cozi Family Organizer Family life organization app that includes a shared calendar, shopping lists, to do lists, family journal. This app allows you to stay in sync with your family. * Paid version available for advanced functionality. Free* iOS, Android Organization
d2u Dictation and Transcription Voice recorder with integrated transcription service* provides you with a comprehensive dictation and transcription solution. Record, edit, and upload a digital recording then have the file transcribed to text. HIPAA compliant. * Transcriptions are a paid feature. *Free iOS Communication
DialSafe Pro Learn proper phone usage and safety with an app that allows for hands-on practice. Learn these critical skills through the use of animated lessons, skill building games, practice sessions, and a realistic phone simulator. Free iOS Life-Skills
Dragon Dictation Voice recognition app that allows users to easily speak and instantly see their words on the screen. Send short text messages, longer email messages, and update your Facebook and Twitter statuses without typing a word. Free iOS Communication
Evernote Help remember everything across all of the devices you use. Stay organized, save your ideas and improve productivity. Take notes, capture photos, create to-do lists, record voice reminders, and make notes completely searchable. Free iOSWeb, Android Organization
Find a Pharmacy Immediately find the closest pharmacies to your location based on your device’s location or address. Free iOS Locating Services
Find My iPhone Location app for iOS that tracks wireless devices and enables a you to track where the devices are, where they have been, and enables you to send warning messages or tones to those devices. Free iOS Memory, Location Monitoring
Flashcards Deluxe Flashcard app which can be used to study just about anything you want. Built in dictionary, capacity to include pictures and sounds, zoom into pictures, and auto-repeat sounds on the cards. $3.99 iOS, Android Memory
Hello My Name Is Use your fingers to write or draw your own personalized “hello my name is” name tag. Good for conferences or situations where a digital name tag may help you stand out. Free Android Social Situations
iBooks with VoiceOver Search and instantly download thousands of popular book and magazine titles. iBooks works with VoiceOver, which will read the contents of the pages out loud. Free iOS Hearing, Reading
ICE (In Case of Emergency) Store all the information you might need in an emergency in one convenient location. Names of doctors, medications you are taking, medical conditions, allergies, and insurance information can be accessed with the tap of a finger. You can also use the app to find hospitals nearby in case of an emergency. $1.99 iOS, Android Emergency
iMazing Skill–based maze game where you must find your way through a challenging maze. Unlimited mazes created for you based on your skill level. Free iOS Problem Solving
Index Card Non-linear writing tool that helps capture your ideas and store notes as they come to you. Organize the flow of your thoughts by using a familiar corkboard interface and compile your work into a single document. $4.99 iPad Organization
Learning Ally Audio s downloadable DAISY formatted books. Learning Ally members can explore the library of more than 64,000 audiobooks that are designed for people with print and learning disabilities.* To use RFB&D Audio, membership is required. Membership is free for eligible people with visual impairments or dyslexia. Free* iOS, Android Reading, Vision
Lumosity Brain exercises targeting memory, attention, speed, flexibility, and problem solving. You can design your own personalized training, including “courses” with TBI- and/or PTSD-specific content. *Paid subscription available for advanced features. Free* iOS, Web Brain Training
MakeChange This app will show you the best way to count change so that you use the least number of coins. Slide and stack coins until you have the amount shown on the register display and check your answer. $1.99 iPad Life-Skills
Matrix Game Helps you develop visual perception skills such as visual discrimination. It can also help you to develop attention and concentration, spatial orientation and principles of classification and categorization. * Paid version available for advanced levels and more functionality. Free* iOS Problem Solving
n-Back n-Back is designed to improve your working memory through actively memorizing and recalling information. Free iOS Memory
Naming TherAppy Word-finding app to help people with aphasia and children with special needs practice important naming and description skills. Allows users to add their own images. $24.99 iOS Communication, Speech
Penultimate Handwriting app that helps you get the fast, tactile gratification of writing on paper, with digital power and flexibility. Take notes, keep sketches, or share your next breakthrough idea — in the office, on the go, or at home. *Advanced functionality and features are paid. Free* iPad Memory, Organization
Pictello Create visual stories and talking books. Each page in a story can contain a picture, a short video, up to ten lines of text, and a recorded sound or text-to-speech using natural sounding voices. $18.99 iOS Communication
Pic-Z Tag Nametag application that lets you identify yourself to others at a conference, business meeting, or any social gathering. $0.99 iOS Social Situations
Pocket SCAT2 This application is a shortened version of the SCAT2 test and is designed to be used in a field setting by coaches or parents to help identify possible concussions. Free iOS Concussion Screening
Proloquo2Go An alternative communication solution to help you if you have difficulty speaking. Natural sounding text-to-speech voices, high-resolution, up-to-date symbols, powerful automatic conjugations, a vocabulary of more than 7,000 items, and advanced word prediction. $219.99 iOS Communication
Proloquo 4 Text Text”‘based communication app that gives a voice to people who cannot speak. It offers a customizable single screen layout for easy conversation, free natural-sounding voices in 15 languages, word and sentence prediction and social media. $64.99 iOS Communication
PTSD Coach Designed for veterans and service members who have, or may have, post-traumatic stress disorder (PTSD). Education about PTSD, information about care, a self-assessment for PTSD, help finding support, and tools that can help you manage the stresses of daily life with PTSD. Free iOS, Android PTSD
Quick Talk AAC This app gives a voice to those who cannot speak for themselves. Quick and flexible app designed to help you talk as quickly as possible. $0.99 iOS, Android Communication
SpeakWrite Recorder Voice recorder that turns your phone into a fully functional dictation system. Record, edit, and send your audio. App integrates with SpeakWrite’s 24/7 paid transcription service. Compile your dictation, upload, and within a few hours receive your transcribed document. Free Android Speech, Communication
SoundAmp Assistive app that turns the iPhone into an interactive hearing device. Using the microphone or a headset with a microphone, it amplifies nearby sound making it easier for you to hear. $4.99 iOS Hearing
Spaced Retrieval TherAppy Facilitates recalling an answer over expanding intervals of time (1 minute, 2 minutes, 4 minutes, 8 minutes…) helps to cement the information in memory, even for those with impaired memory. $3.99 iOS Memory
T2 Mood Tracker Designed for service members and veterans, this app helps you self-monitor, track, and reference emotional experiences associated with common deployment-related behavioral health issues like post-traumatic stress, brain injury, depression, and anxiety. Free iOS, Android PTSD, Behavior
Tap2Talk Alternative means of communication app. Push pictures of items to have a voice speak them for you. Free Android Speech, Communication
TextTwist Word game app where you try to find the word that uses all of the letters on the screen as fast as you can. Crossword mode lets you complete a crossword puzzle using a limited number of letters. Word of the Day mode offers a daily puzzle. $0.99 iOS, Android Problem Solving
Today Screen One-stop app for quickly viewing your upcoming agenda, tasks due, and your local weather forecast. Tasks and events are intuitively highlighted based on date and time, so that what you need to look at right now stands out clearly. $2.99 iOS Reminders
Touch Calendar Touch Calendar makes viewing your calendars easy. See your whole calendar at a glance. No more flipping between different calendar views. Touch Calendar does it all from one zoomable and scrollable view. This app is especially useful for people with attention problems who do better with fewer steps. $3.95 Android Organization
Unus Tactus Developed to assist people of all ages with mild cognitive and/or motor deficits by allowing you to have an easy to use cell phone, with a simple set up. It utilizes a one–touch photo dialing system to generate phone calls using phone numbers from your existing contacts or those that you import directly. $9.99 iOS Communication
Voice4U Picture-based, augmentative and alternative communication (AAC) application that helps you express your feelings, thoughts, actions, and needs. $59.99 iOS, Android Communication, Speech
Verbally Comprehensive Augmentative and Alternative Communication (AAC) app for the iPad. This app enables real conversation for those who have challenges speaking. Just tap in what you want to say and Verbally speaks for you. *Premium features available with an in-app purchase. Free* iPad Communication, Speech
Visual Schedule Planner Customizable visual schedule iPad app that is designed to give you an audio/visual representation of the events in your day. In addition, events that require more support can be linked to an activity schedule or video clip. $14.99 iPad Organization
Voice Cards Are Not Flashcards Create voice flashcards with an autoplay and shake option. Create sets of flashcards just as you would with paper flashcards, except you create a voice recording of your questions and answers in sets of Voice Cards. You can “flip” between questions and answers by swiping or shaking the phone.* Two versions, lite with limited functionality, $0.99 for full version. Free* iOS Memory
Where Am I? View and share your location, including your city, zip code, telephone area code, and approximate street address as well as the times of sunrise and sunset and GPS latitude and longitude. Free Android Location
Word Warp Game with which you can create as many words as possible from a selection of letters. If you’re stuck, just press the “warp” button and it will help you out. Free iOS Brain Training

Pricing, availability, and features accurate as of the last update January 16th, 2014.

Share with us

Technology is always changing. New iterations of mobile devices and apps are constantly being released. Please share with us what apps have and haven’t worked for you in the comment section below.

Posted on BrainLine December 16, 2013

Source: Life-Changing Mobile Apps for People with Brain Injury | BrainLine

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[BOOK] Living Beyond Brain Injury: A Resource Manual – Vicky Hall – Google Books

Front CoverA brain injury can have a dramatic effect on all areas of a person’s life. This manual is designed to provide an understanding of some of the effects of a brain injury and how to manage them. It focuses on how brain injury may affect thinking skills (e.g. memory), emotions and other related areas (e.g. sleep, work and driving). This manual provides techniques based on psychological approaches, which have been shown to be effective with people who have experienced a brain injury. As well as being an important resource for mental health professionals, it will also be useful for families who wish to help a person with a brain injury. It has two clear functions: a resource manual for clinicians and carers / families to work through with brain injury survivors; and a self-help resource for clients with a brain injury.

Source: Living Beyond Brain Injury: A Resource Manual – Vicky Hall – Google Books

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[BLOG POST] Brain Injury and Sex: What Happens After a TBI?

By Xavier Figueroa, Ph.D.

http://www.msktc.org/tbi/factsheets/Sexuality-After-Traumatic-Brain-Injury

womens-brainsWhat is the largest sex organ in the body?

The brain, of course! (Followed by the spinal cord ganglia but let’s not judge).

Intimacy, desire, physical contact and pleasure, they are very basic needs in a relationship. Marriages, partnerships and friendships rely on this most basic link. But when a brain injury occurs, changes in desire and drive (hypo- and hyper-sexuality) can become apparent. Energy and mood can also be affected, which can induce a change in libido, interest and desire. Damage to certain portions of the brain may affect your ability to move, reducing spontaneity and self-esteem. Elements of coming to terms with the trauma, such as shock and recovery may take time, as well as recovery from physical rehabilitation. If the injury is chronic, other changes may become apparent, including cognitive and behavioral changes that shift how friends and partner interact with each other.

Much of these changes can occur days, weeks or even months after the injury, even in mild to moderate traumatic brain injuries. Knowing how to identify, adapt and overcome the changes associated with an ABI/TBI is an important part of recovery.

The most important information to take away from this post is the following: you are not alone, you are not abnormal and you will get better. Millions of individuals and couples have gone through the recovery of a brain injury and difficulties with reestablishing a functional sexual relationship. Hang in there.

What the Problem Looks Like

When we talk about sex, we are talking about something that is simple in practice, but complex in execution. Prior to the brain injury, a pattern of behavior between yourself and your partner was established. How you interacted and what you expected prior to and leading to sexual intimacy were established and anticipated. I wouldn’t call it a pattern (that’s not very exciting!), but a role in which you knew which part each one would play.

A brain injury directly affects the biggest and most important sex organ in the human body. It’s no wonder that sexual issues appear in 50-60% of people that suffer a moderate to severe TBI. In a recent article in US News and World Report (Health Day, April 29, 2013; Link) that reported on the study that appeared in NeuroRehabilitation: An International Journal:

‘The study found that 50 percent to 60 percent of people with TBI have sexual difficulties, such as reduced interest in sex, erectile dysfunction, pain during sex, difficulties in vaginal lubrication, difficulties achieving orgasm or staying aroused, and a sense of diminished sex appeal, Moreno said.

The research found that partners of those with TBI experienced personality and emotional changes, and a modification of family roles that can lead to a crisis, Moreno said. “For the spouse, the survivor becomes a different person, a person they do not recognize as the one they fell in love with in the past,” he said. “The spouse becomes a caregiver and this imbalance in the relationship directly affects sexual desire.”’

Even in cases of mild TBI, there are incidences of 25-50% of people experiencing sexual difficulties [1], especially in individuals exposed to bomb-blast injuries. Brain injuries are not mild…they can take a life of their own and totally transform who you are and how you relate to your significant other (spouse, partner or lover). Many of these changes can be divided into 5 major groups:

  • Decreased Desire (Hyposexuality): inability to become interested in sex.
  • Increased Desire (Hypersexuality): inappropriate sexual behavior; constant focus on sex.
  • Decreased Arousal: Difficulty in achieving erection/lubrication.
  • Difficulty or Inability to Reach Orgasm/Climax:
  • Reproductive Changes: Low sperm count; missed periods.

But these are just the changes that occur with sexual interaction (as if that weren’t enough). These are behavioral changes that hide deeper and more profound changes that can occur throughout the body. Changes in sexual desire are like the proverbial canary in the coal mine…it warns you that something is amiss.

That Voodoo That You do…

Damage to the brain can induce a number of changes:

Fatigue/Tiredness

Hormonal Changes

Emotional Changes

Cognitive Changes

Spasticity/Movement Problems

These changes can come from very specific damage to certain areas of the brain, such as your pituitary, the frontal and temporal lobes of the brain. When you get down to it, sex is a very complicated process…neurologically speaking! A number of body systems have to work together to make the engines of desire go vroom…and when one system is not working, then it can cause the engine to misfire and stall.

The Tiny Organ

The pituitary gland is a tiny portion of the brain… but don’t let its size fool you. It is a master regulator of hormones that, when damaged, can diminish your ability to regulate your blood pressure, sleep cycle and hormones.

tiny_organThe function of the pituitary is diverse, as it can affect a number of really important functions:

Hormones secreted from the pituitary gland help control the following body processes:

  • Growth
  • Blood pressure
  • Pregnancy and stimulation of uterine contractions during childbirth
  • Breast milk production
  • Sex organ functions in both males and females
  • Thyroid gland function
  • The conversion of food into energy (metabolism)
  • Water and osmolarity regulation in the body (which affects blood pressure)
  • Water balance via the control of re-absorption of water by the kidneys
  • Temperature regulation
  • Pain relief

If that weren’t enough, this can cascade into disease states that may not seem related to a TBI. One thing that we are seeing with returning veterans is pituitary dysfunction is present and undiagnosed or under diagnosed. Even with hormone or growth factor replacement therapies, a pituitary that is not firing on all cylinders will continue to cause long-term problems. Although changes in sexual interaction are the most visible and can be due to pituitary damage, they warn that the damage is more profound. The Big Organ (the brain) has a lot of functions related to behavior…and when it comes to sex, behavior is key (good or bad).

The Tiny Brain (Hypothalamus)

This portion of the brain, the hypothalamus, is a close neighbor to the pituitary. So close, they are friends with benefits. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland (another name of the pituitary is the hypophysis).

The hypothalamus is more of a region than an actual structure. It is composed of many groups of neurons (called nuclei) that control a wide variety of hormonal secretions and behaviors. In a recent small scale study of severe TBI, it was discovered that ~21% of study subjects suffered from hypothalamic-hypophysial dysfunction. In about 40% of male TBI sufferers, there was a detectable drop in testosterone levels [2], which can affect sexual drive and desire in men. About 15% of all patients with a TBI have some degree of hypopituitarism that can go unrecognized and could be mistakenly ascribed to persistent neurologic injury and cognitive impairment [3].

The reason for the hypothalamic damage being mistaken for neurologic injury and cognitive impairment are due to the very broad effects that the hypothalamus exerts on metabolism and brain function. If the hypothalamus is misfiring, it takes a very involved physician (or physicians), with training in neurology, endocrinology and/or experience with TBI to identify the problem. A lot of systems can malfunction in a brain injury.

The Frontal Lobe

The frontal lobe (in green).

The frontal lobe (in green) • tumblr

In head injuries, damage to the frontal lobe is thought to occur frequently. Car crashes (especially front end collisions, are thought to cause frontal and occipital lobe damage. Damage to the frontal lobe has been reported to cause individuals to behave inappropriately in response to normal social situations. Loud or overly-boisterous exchanges, inappropriate genital touching (in public) or fixation on one subject or person have been reported outcomes after a TBI. Changes in emotional affect (expression of emotions) that are felt may not be expressed in the face or voice. For example, someone who is feeling happy would not smile, and his or her voice would be devoid of emotion. This can be very disconcerting to a partner and can be experienced a loss of affection or interest. How a partner or loved one that is a caretaker of a TBI victim experiences the injury will have a direct effect on their own sexual desire and interest.

Along the same lines, though, the person may also exhibit excessive, unwarranted displays of emotion or poor control of anger. Poor anger management is associated with some forms of frontal lobe damage. Depression is not an uncommon outcome from a head injury, especially if there is frontal lobe damage. Also common along with depression is a loss of or decrease in motivation. Someone might not want to carry out normal daily activities and would not feel “up to it”. Sex might not seem as interesting or motivating.

Those who are close to the person who has experienced the damage may notice that the person no longer behaves like him or herself. The frontal lobe is the same part of the brain that is responsible for executive functions such as planning for the future, judgment, decision-making skills, attention span, and inhibition. These functions can decrease drastically in someone whose frontal lobe is damaged. A short list of behavioral changes associated with frontal lobe damage is given below:

  • Agitation
  • Explosive anger and irritability
  • Lack of awareness and insight
  • Impulsivity and disinhibition
  • Emotional lability
  • Self-centeredness
  • Apathy and poor motivation
  • Depression
  • Anxiety
  • Inflexibility and obsessionality
  • Sexual problems

Frontal lobe damage is only one part of cerebral cortex, but is the most common type of cortical damage due to a TBI. Other parts may be damaged as well. Frontal lobe damage is common and better associated with impulse and emotional control, making sufferers act completely out of character and unable to control or edit themselves or their responses.

Putting it Together

So, after reading all of this, what does it do for you? How does this help you re-establish the emotional, sexual and intimate relationship you wish with your partner? As a caretaker, or as a sufferer, the TBI is a big elephant in the room. It exists; it takes up space in your life, even though it can’t be seen. The person you knew is not present…they have not come back from their injury and they might not come back. Some do recover, others do not. But you can still create a new bond, a new relationship and a new life. And you can fight to repair the damage to the brain.

There are limited options for therapy in current medical practice. Mostly, it is focused on developing new skills, relearning old ones, developing coping skills or taking medications. That’s just for the TBI sufferer, not the caretaker(s). The complexity and variety of problems that pop-up when dealing with a brain injury are truly staggering and expensive. Fortunately, the majority of mild-to-moderate TBI’s do recover. Patience and persistence in therapy are required in order to make a recovery.

Unfortunately, for a portion of all TBI sufferers, recovery may take years. That is a long-time to wait. Therapies that help to re-build the brain connections (neuroplasticity) or restore blood flow to the brain hold promise for restoring function again. Hyperbaric oxygen therapy (HBOT) is one such therapy that has a good number of clinical studies to support its use for chronic TBI and PCS [4-9]. Near infra-red and infra-red technologies show promise for a TBI therapy, as well [10-13].

Nutritional support, such as Omega-3 fatty acids (DHA and EPA), has shown the ability to reduce the long-term neuroinflammation associated with a TBI [14-16] and help with white matter repair. Other nutritional therapies may exist to help mediate repair in a TBI.

The take home message is that there are potential therapies that are being developed to help treat the neurological damage of a TBI. Take heart that the “new normal” for yourself or your loved one may not need to be permanent.

  1. Wilkinson, C.W., et al., High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury. Front Neurol, 2012. 3: p. 11.
  2. Kopczak, A., et al., Screening for hypopituitarism in 509 patients with traumatic brain injury or subarachnoid hemorrhage. J Neurotrauma, 2014. 31(1): p. 99-107.
  3. Pekic, S. and V. Popovic, Chapter 18 – Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections, in Handbook of Clinical Neurology, M.K. Eric Fliers and A.R. Johannes, Editors. 2014, Elsevier. p. 271-290.
  4. Boussi-Gross, R., et al., Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial. PLoS One, 2013. 8(11): p. e79995.
  5. Wolf, G., et al., The effect of hyperbaric oxygen on symptoms after mild traumatic brain injury. J Neurotrauma, 2012. 29(17): p. 2606-12.
  6. Harch, P.G., et al., A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma, 2012. 29(1): p. 168-85.
  7. Lin, J.W., et al., Effect of hyperbaric oxygen on patients with traumatic brain injury. Acta Neurochir Suppl, 2008. 101: p. 145-9.
  8. Shi, X.Y., et al., Evaluation of hyperbaric oxygen treatment of neuropsychiatric disorders following traumatic brain injury. Chin Med J (Engl), 2006. 119(23): p. 1978-82.
  9. Wright, J.K., et al., Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen. Undersea Hyperb Med, 2009. 36(6): p. 391-9.
  10. Grillo, S.L., et al., Non-invasive infra-red therapy (1072 nm) reduces beta-amyloid protein levels in the brain of an Alzheimer’s disease mouse model, TASTPM. J Photochem Photobiol B, 2013. 123: p. 13-22.
  11. Gkotsi, D., et al., Recharging mitochondrial batteries in old eyes. Near infra-red increases ATP. Exp Eye Res, 2014. 122: p. 50-3.
  12. Quirk, B.J., et al., Near-Infrared Photobiomodulation in an Animal Model of Traumatic Brain Injury: Improvements at the Behavioral and Biochemical Levels. Photomedicine and Laser Surgery, 2012. 30(9): p. 7.
  13. Naeser, M.A., et al., Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study. JOURNAL OF NEUROTRAUMA, 2014. 31: p. 10.
  14. Pu, H., et al., Omega-3 polyunsaturated fatty acid supplementation improves neurologic recovery and attenuates white matter injury after experimental traumatic brain injury. J Cereb Blood Flow Metab, 2013. 33(9): p. 1474-84.
  15. Lewis, M., P. Ghassemi, and J. Hibbeln, Therapeutic use of omega-3 fatty acids in severe head trauma. Am J Emerg Med, 2013. 31(1): p. 273 e5-8.
  16. Hasadsri, L., et al., Omega-3 fatty acids as a putative treatment for traumatic brain injury. J Neurotrauma, 2013. 30(11): p. 897-906.

Disclaimer: I am not a medical doctor. I am not giving medical advice, diagnosis or treatment recommendations. The posts on this blog are my opinion. If you are thinking of following or using any of this information for any health related conditions, I would recommend you talk to your physician and seek guidance and help. I try to be as meticulous as possible in the information I use for these posts. I look for potential therapies that are low-risk/high impact. There are no guarantees, but knowledge is power and self-direction can lead you to uncover and do incredible things.

Source: Brain Injury and Sex: What Happens After a TBI? | Brain Health & Healing Foundation

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[BLOG POST] Brain Injury Medicine – Neuro Landscape

 

Brain Injury Medicine

Individuals who sustain brain injury face a unique challenge with their health professionals. Brain injury is now widely viewed as a disease in the medical field, however patients are not yet granted the benefits and opportunities in treatment as are necessary for disease management. Increasing awareness of brain injury as a disease, and exploring the challenges of brain injury treatment will help us reevaluate our current system.

Brain Injury as a Disease

A brain injury is remarkably complex. Emerging evidence suggests that, like cancer, brain injury may actually be comprised of a number of distinct diseases that vary by the etiology of the injury, the nature of the injury, co-morbid health conditions prior to and since the injury, and factors such as gender, race, age, for example.

When the brain is injured, consequential effects often occur within immune, endocrine, and autonomic nervous systems’ functions. Persons with brain injury can become very sick, very quickly, seemingly only heralded by relatively minor early symptoms. Though we do not fully understand why this heightened period of illness occurs, it is likely a result, in some capacity, of the changes to the body’s systems’ functions.

Challenges of Brain Injury Treatment

Medical professionals working within the confines of our current system are often unable to dedicate sufficient time to a patient with brain injury in order to address the full scope of his or her injury, which includes cognitive, behavioral, communicative, and/or physical disabilities. Furthermore, these medical professionals are rarely able to stay current enough on the case to identify advisable and inadvisable medical practice patterns, thereby increasing the odds of treatment-induced complications.

Patients and their families cannot assume that medical providers are alike in their knowledge and experience. For example, the notion that patients can be best followed by practitioners in their home community is seriously flawed. Locality does not replace the prerequisite for a practitioner with expertise on brain injury. In fact, many of these less experienced practitioners are unaware of the comparative medical fragility associated with brain injury. Many poor medical decisions could have been avoided had the proper brain injury specialist been consulted.

Additional challenges can be found in the person’s inability to fully and competently participate in his or her medical care and decision-making. Cognitive, behavioral, communicative and physical disabilities following brain injury can make it difficult, if not impossible, for a person to recognize changes in his or her health, convey those changes, recognize improvements, or a lack thereof, in health following a medical treatment or intervention, accurately convey medical history or the history of present health problem(s), obtain appointments for procedures or laboratory studies, obtain prescribed medications or otherwise properly adhere to a prescribed treatment regimen. One might conclude that the attendance of an advocate or family member to medical appointments will mitigate such difficulties, and while helpful, such participation often fails to provide improved results.

Reevaluating our Current System

In my career, I have seen many downstream medical decisions result in serious and, sometimes, deadly consequences. These have always been avoidable and unnecessary, and borne out of a lack of knowledge.

A general physician cannot reasonably manage a patient with a complicated cancer, and brain injury is no different in this regard. We need to develop mechanisms that enable a patient with a brain injury all the same benefits as those allowed patients with complicated diseases such as cancer or cardiovascular disease. Simply put, there is no substitute for an individual case being followed closely by an experienced brain injury specialist.

Source: Brain Injury Medicine – Neuro Landscape

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[VIDEO] Brain Injury and Depression – YouTube

Why do people experience depression after brain injury? Learn about the connection between traumatic brain injury and depression in this video. Dr. Frank Lewis, Ph.D., a cognitive psychologist and NeuroRestorative’s Director of Clinical Outcomes, addresses the symptoms and causes of depression following brain injury. He provides advice to family members and treatment options to help individuals cope with depression and continue to heal from their injury.

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[BLOG POST] 5 Things Every TBI Survivor Wants You to Understand – HuffPost

2015-03-04-1425489683-4035103-TBI5things.jpg

March is National Brain Injury Awareness Month, and as promised, I am writing a series of blogs to help educate others and bring awareness to traumatic brain injuries (TBI).

1. Our brains no longer work the same. 
We have cognitive deficiencies that don’t make sense, even to us. Some of us struggle to find the right word, while others can’t remember what they ate for breakfast. People who don’t understand, including some close to us, get annoyed with us and think we’re being “flaky” or not paying attention. Which couldn’t be further from the truth, we have to try even harder to pay attention to things because we know we have deficiencies.

Martha Gibbs from Richmond, VA, suffered a TBI in May of 2013 after the car she was a passenger in hit a tree at 50 mph. She sums up her “new brain” with these words:

Almost 2 years post-accident, I still suffer short-term memory loss and language/speech problems. I have learned to write everything down immediately or else it is more than likely that information is gone and cannot be retrieved. My brain sometimes does not allow my mouth to speak the words that I am trying to get out.

2. We suffer a great deal of fatigue.
We may seem “lazy” to those who don’t understand, but the reality is that our brains need a LOT more sleep than normal, healthy brains. We also have crazy sleep patterns, sometimes sleeping only three hours each night (those hours between 1 and 5 a.m. are very lonely when you’re wide awake) and at other times sleeping up to 14 hours each night (these nights are usually after exerting a lot of physical or mental energy).

Every single thing we do, whether physical or mental, takes a toll on our brain. The more we use it, the more it needs to rest. If we go out to a crowded restaurant with a lot of noise and stimulation, we may simply get overloaded and need to go home and rest. Even reading or watching tv causes our brains to fatigue.

Toni P from Alexandria, VA, has sustained multiple TBI’s from three auto accidents, her most recent one being in 2014. She sums up fatigue perfectly:

I love doing things others do, however my body does not appreciate the strain and causes me to ‘pay the price,’ which is something that others don’t see.  I like to describe that my cognitive/physical energy is like a change jar. Everything I do costs a little something out of the jar.  If I keep taking money out of the jar, without depositing anything back into the jar, eventually I run out of energy. I just don’t know when this will happen.  Sometimes it’s from an activity that seemed very simple, but was more work then I intended. For me, like others with TBIs, I’m not always aware of it until after I’ve done too much.

3. We live with fear and anxiety. 
Many of us live in a constant state of fear of hurting ourselves again. For myself personally, I have a fear of falling on the ice, and of hitting my head in general. I know I suffered a really hard blow to my head, and I am not sure exactly how much it can endure if I were to injure it again. I am deeply afraid that if it were to take another blow, I may not recover (ie, death) or I may find myself completely disabled. I am fortunate to have a great understanding of the Law of Attraction and am trying my hardest to change my fears into postive thoughts with the help of a therapist.

Others have a daily struggle of even trying to get out of bed in the morning. They are terrified of what might happen next to them. These are legitimate fears that many TBI survivors live with. For many, it manifests into anxiety. Some have such profound anxiety that they can hardly leave their home.

Jason Donarski-Wichlacz from Duluth, MN, received a TBI in December of 2014 after being kicked in the head by a patient in a behavioral health facility. He speaks of his struggles with anxiety:

I never had anxiety before, but now I have panic attacks everyday. Sometimes about my future and will I get better, will my wife leave me, am I still a good father. Other times it is because matching socks is overwhelming or someone ate the last peanut butter cup.

I startle and jump at almost everything. I can send my wife a text when she is in the room. I just sent the text, I know her phone is going to chime… Still I jump every time it chimes.

Grocery stores are terrifying. All the colors, the stimulation, and words everywhere. I get overwhelmed and can’t remember where anything is or what I came for.

4. We deal with chronic pain.
Many of us sustained multiple injuries in our accidents. Once the broken bones are healed, and the bruises and scars have faded, we still deal with a lot of chronic pain. For myself, I suffered a considerable amount of neck and chest damage. This pain is sometimes so bad that I am not able to get comfortable in bed to fall asleep. Others have constant migraines from hitting their head. For most of us, a change in weather wreaks all sort of havoc on our bodies.

Lynnika Butler, of Eureka, CA, fell on to concrete while having a seizure in 2011, fracturing her skull and resulting in a TBI. She speaks about her chronic migraine headaches (which are all too common for TBI survivors)

I never had migraines until I sustained a head injury. Now I have one, or sometimes a cluster of two or three, every few weeks. They also crop up when I am stressed or sleep deprived. Sometimes medication works like magic, but other times I have to wait out the pain. When the migraine is over, I am usually exhausted and spacey for a day or two.

5. We often feel isolated and alone.
Because of all the issues I stated above, we sometimes have a hard time leaving the house. Recently I attended a get together of friends at a restaurant. There were TVs all over the room, all on different channels. The lights were dim and there was a lot of buzz from all of the talking. I had a very hard time concentrating on what anyone at our table was saying, and the constantly changing lights on the TVs were just too much for me to bear. It was sensory stimulation overload. I lasted about two hours before I had to go home and collapse into bed. My friends don’t see that part. They don’t understand what it’s like. This is what causes many of us to feel so isolated and alone. The “invisible” aspect of what we deal with on a daily basis is a lonely struggle.

Kirsten Selberg from San Francisco, CA, fell while ice skating just over a year ago and sustained a TBI. She speaks to the feelings of depression and isolation so perfectly:

Even though my TBI was a ‘mild’ one, I found myself dealing with a depression that was two-fold. I was not only depressed because of my new mental and physical limitations, but also because many of my symptoms forced me to spend long periods of time self-isolating from the things — like social interactions — that would trigger problems for me. With TBI it is very easy to get mentally and emotionally turned inward, which is a very lonely place to be.

Also, check out my other blogs on the Huffington Post:
“Life With a Traumatic Brain Injury”
“Life With a TBI: March is National Brain Injury Awareness Month”

I invite you to join my TBI Tribe on Facebook if you are a survivor, or loved one of a survivor.

Source: 5 Things Every TBI Survivor Wants You to Understand | HuffPost

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[VIDEO] The Effects of Brain Injury on Memory – YouTube

How does brain injury affect memory? Learn about memory impairment following brain injury in this video featuring NeuroRestorative’s Tori Harding. Following a brain injury, the deeply embedded and long-term memories usually remain intact while short-term memory may significantly be affected. Learn about the three memory system areas and strategies that can help a survivor improve their memory.

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[WEB SITE] Can Ritalin Help Mitigate Brain Injury Symptoms?

 Question

My 54-year-old husband sustained a TBI when he fell asleep at the wheel while driving and hit a tree. The doctors say that he damaged all four parts of his brain. It’s been more than one and a half years and he’s still totally dependent on me to take care of him. Do you think Ritalin would help stimulate his brain?

Answer

Methylphenidate (Ritalin) is one of the commonly used brain stimulants in people who have suffered traumatic brain injury. It increases chemicals in the brain that have a stimulating effect (norepinephrine and dopamine).

After traumatic brain injury, doctors commonly prescribe Ritalin for low arousal or initiation, poor attention and concentration, depression, and slow processing speed. There is research that shows that Ritalin may speed recovery early after moderate to severe TBI. There is also research showing that Ritalin increases mental processing speed after TBI, which can improve memory function in some people.

All medications have side effects and the risks need to be weighed against possible benefits. One of the good things about the standard formulation of Ritalin is that it is short acting so if side effects occur they wear off in a few hours. Some potential side effects include keeping you up at night (if taken too close to bedtime), decreased appetite, headache, irritability, and paranoia.

In your husband’s case, his doctor needs to look at why he is so dependent. If arousalattention, and/or initiation are playing a significant role, a stimulant can be considered. Careful monitoring for effects and/or side effects is needed when starting this medication and it should only be done by a doctor who has experience in caring for people with traumatic brain injury. Ritalin and most stimulants are controlled substances and will require frequent visits to the doctor for prescriptions.

Source: Can Ritalin Help Mitigate Brain Injury Symptoms?

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