Posts Tagged recovery

[ARTICLE] Sleep Disruption After Brain Injury Is Associated With Worse Motor Outcomes and Slower Functional Recovery – Full Text

Abstract

Background. Sleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes. Objective. This study aims to assess the relationship between sleep quality and motor recovery in brain injury patients receiving inpatient rehabilitation. Methods. Fifty-nine patients with brain injury were recruited from 2 specialist inpatient rehabilitation units. Sleep quality was assessed (up to 3 times) objectively using actigraphy (7 nights) and subjectively using the Sleep Condition Indicator. Motor outcome assessments included Action Research Arm test (upper limb function), Fugl-Meyer Assessment (motor impairment), and the Rivermead Mobility Index. The Functional Independence Measure (FIM) was assessed at admission and discharge by the clinical team. Fifty-five age- and gender-matched healthy controls completed one assessment. Results. Inpatients demonstrated lower self-reported sleep quality (P < .001) and more fragmented sleep (P < .001) than controls. For inpatients, sleep fragmentation explained significant additional variance in motor outcomes, over and above that explained by admission FIM score (P < .017), such that more disrupted sleep was associated with poorer motor outcomes. Using stepwise linear regression, sleep fragmentation was the only variable found to explain variance in rate of change in FIM (R2adj = 0.12, P = .027), whereby more disrupted sleep was associated with slower recovery. Conclusions. Inpatients with brain injury demonstrate impaired sleep quality, and this is associated with poorer motor outcomes and slower functional recovery. Further investigation is needed to determine how sleep quality can be improved and whether this affects outcome.

Introduction

Sleep disturbance is a common complaint after brain injury, including stroke, with a high proportion (30%-70%) of patients presenting with impaired subjective sleep quality and meeting the criteria for at least one sleep disorder.14 Sleep disturbance could be resulting from direct damage to brain areas, or due to secondary effects such as being in the hospital environment, depression, anxiety or pain, and could potentially have an impact on rehabilitation through reduced engagement or impaired learning and consolidation.5

There is some evidence for improvements in sleep quality from the acute to the chronic stage of stroke6,7; however, stroke survivors at the chronic stage continue to have impaired subjective and objective sleep quality and worse quality of life than controls.8,9 Interestingly, the longer the time since stroke, the worse the perceived daytime sleepiness becomes.10 This suggests that sleep disturbance may be persistent throughout the rehabilitation period for some, and changes within this time frame in patients with different types of brain injuries are yet to be determined.

The link between sleep quality and function after stroke and brain injury is currently emerging. Siccoli et al11 demonstrated a cross-sectional correlation between the National Institute for Health Stroke Scale (NIHSS) score and wake after sleep onset (WASO), in a small sample of acute stroke patients. A larger study12 found a cross-sectional relationship between subjective sleep quality and the functional ambulation score after stroke but had no objective sleep measures. Similarly, Kalmbach et al13 found that patients with subjective difficulties initiating sleep had lower function at multiple time-points over the first 6 months of recovery from traumatic brain injury (TBI). Sleep variables, such as total sleep time, WASO and daytime napping, have also been shown to explain significant variance in Barthel Index (BI) score at the acute stage of stroke,14,15 and the percentage of sleep stages I and rapid eye movement (REM) are negatively associated with NIHSS.16

However, there is little research to indicate whether sleep quality over the rehabilitation period correlates with outcome or change in function over time, and studies that are available are somewhat inconsistent in their findings. The presence of sleep-disordered breathing at the acute stage has been found to be associated with reduced modified Rankin scale (mRS) and BI at 6 weeks poststroke17 and other studies have demonstrated that stroke patients categorized with a “poor” functional outcome have a lower sleep efficiency, less REM sleep or a reduced REM sleep latency at the acute stage than those with a better outcome.16,18,19 In contrast, Joa et al20 found no difference in the change in NIHSS or BI between patients reporting sleep disturbance at 1 month poststroke and those reporting no disturbance. They did, however, find that the group reporting no sleep disturbance had a greater improvement in the Berg Balance Scale (BBS). This was particularly evident for the moderate-severe stroke patients compared with mild (on the basis of NIHSS score at 1 week poststroke), suggesting sleep may have a greater impact on functional recovery in those who have the most relearning to achieve. The studies by Iddagoda et al4 and Joa et al20 used only subjective sleep measures and many of the studies have divided participants into groups based on outcome or the presence/absence of sleep disturbance, rather than examining both sleep quality and outcome as a continuum which may be more sensitive to differences across participants. Studies that did assess objective sleep quality as a continuum are mixed in their findings. Bakken et al15 found no correlation between sleep variables in the acute stage and BI at 6 months poststroke whereas Vock et al7 found that higher WASO or lower sleep efficiency at the acute stage poststroke was associated with worse outcome (mRS or BI score) at discharge. Similarly, Huang et al14 demonstrate that total sleep time correlates positively, and sleep latency correlates negatively, with the change in BI with rehabilitation.

As there is no clear consensus on the relationship between sleep quality measures and the rate of recovery with rehabilitation, and it is unclear how sleep quality changes over the course of rehabilitation, we sought to conduct a prospective assessment of sleep quality in neurological inpatients and explore the relationship with neurorehabilitation outcomes. We therefore assessed objective and subjective sleep quality at up to 3 time-points throughout the rehabilitation period and examined the relationship between sleep quality and motor and functional outcome measures. Specifically, we aimed to address the following questions:

  1. Does sleep quality at a single time-point correlate with function/impairment at that time-point?
  2. Does sleep quality change over the inpatient rehabilitation period?
  3. Does objective sleep quality averaged over the inpatient rehabilitation period explain variance in motor outcomes over that explained by baseline function?
  4. Does objective or subjective sleep quality averaged over the inpatient rehabilitation period explain variance in the rate of recovery in addition to covariates such as initial independence, age, and time since injury?

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[VIDEO] Best Stroke Recovery Hand Exercises – Stage 2 – YouTube

Dr. Scott Thompson is back again to share the best stroke recovery hand exercises that you can do at home. Use these hand exercises and hand therapy tools to advance your stroke recovery. Check out these FREE exercises and blogs on hand recovery for stroke survivors:

https://www.saebo.com/blog/reclaim-yo…

https://www.saebo.com/blog/gaining-fu…

Download your FREE Saebo Exercise Guide here:

https://www.saebo.com/stroke-exercise…

Looking for hand braces and hand therapy equipment to aid with your recovery? Check out these Saebo products:

https://www.saebo.com/shop/saeboglove/

https://www.saebo.com/shop/saebostretch/

https://www.saebo.com/shop/saeboflex/

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Saebo, Inc. is a medical device company primarily engaged in the discovery, development, and commercialization of affordable and novel clinical solutions designed to improve mobility and function in individuals suffering from neurological and orthopedic conditions. With a vast network of Saebo-trained clinicians spanning six continents, Saebo has helped over 500,000 clients around the globe achieve a new level of independence.

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[VIDEO] Best Stroke Recovery Hand Exercises – Stage 1 – YouTube

Dr. Scott Thompson shares the best stroke recovery hand exercises. Use these hand exercises and hand therapy tools to advance your stroke recovery.

Check out these FREE exercises and blogs on hand recovery for stroke survivors:

https://www.saebo.com/blog/reclaim-yo…

https://www.saebo.com/blog/gaining-fu…

Looking for hand braces and hand therapy equipment to aid with your recovery? Check out these Saebo products:

https://www.saebo.com/shop/saeboglove/

https://www.saebo.com/shop/saebostretch/

https://www.saebo.com/shop/saeboflex/

Download your FREE Saebo Exercise Guide here:

https://www.saebo.com/stroke-exercise…

SUBSCRIBE AND FOLLOW US!

https://www.facebook.com/saeboinc

https://www.instagram.com/saeboinc/

https://twitter.com/saeboinc

https://www.linkedin.com/company/saeb…

https://www.pinterest.com/saeboforstr…

Saebo, Inc. is a medical device company primarily engaged in the discovery, development, and commercialization of affordable and novel clinical solutions designed to improve mobility and function in individuals suffering from neurological and orthopedic conditions. With a vast network of Saebo-trained clinicians spanning six continents, Saebo has helped over 500,000 clients around the globe achieve a new level of independence.

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[VIDEO] Best Stroke Recovery Hand Exercises – Stage 3 – YouTube

Dr. Scott is back again with another installment of Best Stroke Recovery Hand Exercises. This time he’s bringing strength and stability to your hand, finger, and wrist using items from home for exercise.

Check out these FREE exercises and blogs on hand recovery for stroke survivors:

https://www.saebo.com/blog/reclaim-yo… https://www.saebo.com/blog/gaining-fu… https://www.saebo.com/blog/stroke-han…

Download your FREE Saebo Exercise Guide here: https://www.saebo.com/stroke-exercise…

Looking for hand braces and hand therapy equipment to aid with your recovery? Check out these Saebo products:

https://www.saebo.com/shop/saeboglove/ https://www.saebo.com/shop/saebostretch/ https://www.saebo.com/shop/saeboflex/

SUBSCRIBE AND FOLLOW US!

https://www.facebook.com/saeboinc https://www.instagram.com/saeboinc/ https://twitter.com/saeboinc https://www.linkedin.com/company/saeb… https://www.pinterest.com/saeboforstroke

Saebo, Inc. is a medical device company primarily engaged in the discovery, development, and commercialization of affordable and novel clinical solutions designed to improve mobility and function in individuals suffering from neurological and orthopedic conditions. With a vast network of Saebo-trained clinicians spanning six continents, Saebo has helped over 500,000 clients around the globe achieve a new level of independence.

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[Myth #8] Recovery from brain injury only occurs…

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[ARTICLE] Transcranial Direct Current Stimulation to Facilitate Lower Limb Recovery Following Stroke: Current Evidence and Future Directions – Full Text HTML

Abstract

Stroke remains a global leading cause of disability. Novel treatment approaches are required to alleviate impairment and promote greater functional recovery. One potential candidate is transcranial direct current stimulation (tDCS), which is thought to non-invasively promote neuroplasticity within the human cortex by transiently altering the resting membrane potential of cortical neurons. To date, much work involving tDCS has focused on upper limb recovery following stroke. However, lower limb rehabilitation is important for regaining mobility, balance, and independence and could equally benefit from tDCS. The purpose of this review is to discuss tDCS as a technique to modulate brain activity and promote recovery of lower limb function following stroke. Preliminary evidence from both healthy adults and stroke survivors indicates that tDCS is a promising intervention to support recovery of lower limb function. Studies provide some indication of both behavioral and physiological changes in brain activity following tDCS. However, much work still remains to be performed to demonstrate the clinical potential of this neuromodulatory intervention. Future studies should consider treatment targets based on individual lesion characteristics, stage of recovery (acute vs. chronic), and residual white matter integrity while accounting for known determinants and biomarkers of tDCS response.

1. Introduction

Stroke is the second leading cause of death and third leading cause of adult disability globally [1]. With advancement in acute medical care, more people now survive stroke, but frequently require extensive rehabilitative therapy to reduce impairment and improve quality of life. For those that survive stroke, the damaging effects not only impact the individual and their family, but there is also increased burden on health unit resources and community services as the person leaves hospital, potentially requiring assistance to live in the community. Novel treatments that can enable restoration and enhance potential for stroke recovery are desperately needed and will have significant value for many aspects of stroke care.
True recovery from stroke impairment is underpinned by neuroplasticity. Neuroplasticity describes the brain’s ability to change in structure or function in order to help restore behavior following neural damage. Mechanisms of neuroplasticity are available throughout life but appear enhanced during critical periods of learning [2]. Across several animal studies, it has been shown that there is a period of heightened neuroplasticity that appears to open within several days following stroke [2,3,4] and correlates with rapid recovery [5]. In humans, the timing and duration of a similar critical period of heightened neuroplasticity are not clear, but it likely emerges early after stroke. Understanding the characteristics of a potential critical period of heightened neuroplasticity in humans is important for optimizing stroke rehabilitation and is the subject of current trials [6]. However, the importance of neuroplasticity for stroke recovery in humans is unequivocal, with imaging and physiological studies providing extensive evidence of brain changes correlating with improved behavior [7,8,9,10,11,12,13].
Transcranial direct current stimulation (tDCS) is a promising, non-invasive, method to induce neuroplasticity within the cerebral cortex and augment stroke recovery. Importantly, tDCS has potential to bidirectionally and selectively alter corticospinal excitability for up to one hour after stimulation [14,15]. Animal models indicate that tDCS modulates resting membrane potential, with anodal stimulation leading to neuronal depolarization and cathodal stimulation leading to neuronal hyperpolarization over large cortical populations [16]. Stimulation-induced changes may be potentiated by changes in intracellular calcium concentrations. For example, anodal tDCS applied to the surface of the rat sensorimotor cortex led to a rise in the intracellular calcium concentrations [17]. Local increases in calcium can result in short- and long-term changes in synaptic function [18]. In humans, pharmacological studies have also provided indirect evidence to suggest that tDCS after effects are mediated by changes in synaptic plasticity through mechanisms that resemble long-term potentiation (LTP) and long-term depression-like effects [19]. Oral administration of the NMDA-receptor antagonist dextromethorphan was found to suppress the post-tDCS effects of both anodal and cathodal stimulation, suggesting that tDCS after effects involve NMDA receptors [19]. Importantly, modulation of cortical activity with tDCS changes human behavior [20]. For example, in randomized sham-controlled trials, anodal stimulation of the motor cortex (M1) in the lesioned hemisphere was found to improve upper limb outcomes in chronic [21,22,23] and subacute stroke survivors [24,25,26], with behavior changes underpinned by increased cortical activity within the M1 [27]. Although much work remains to be performed regarding optimal stimulation doses, cortical targets and electrode montages, these studies provide some indication that tDCS may be beneficial in stroke recovery.
While there is indication that tDCS has potential to improve stroke recovery of the upper limb [28], there are comparatively fewer studies that have investigated tDCS for lower limb recovery after stroke. Lower limb rehabilitation is especially important, as the simple act of regaining the ability to walk has subsequent effects on the ability to engage in activities of daily living [29,30]. Furthermore, those receiving therapy targeting mobility have been shown to have reduced levels of depression and anxiety [31], which are important determinants of stroke recovery [32,33,34]. Therefore, novel interventions capable of enhancing lower limb recovery might improve not only lower limb motor performance but could have added benefit for stroke rehabilitation in general. The purpose of this review is to discuss tDCS as a technique to modulate brain activity and promote recovery of walking following stroke. Within this review, we will outline current studies that have investigated tDCS to improve lower limb motor performance in both healthy adults and people with stroke. Additionally, we propose a best-practice model of experimental design for lower limb tDCS to guide future application for lower limb stroke recovery.

2. Is it Possible to Modify Lower Limb Motor Networks with Transcranial Direct Current Stimulation?

One approach to modify activity of the lower limb motor network with tDCS is to target the M1, similar to studies involving the upper limb. However, targeted application with tDCS is challenging as, compared with upper limb representations, the lower limb M1 representations are more medial and deeper within the interhemispheric fissure (Figure 1). This presents two notable difficulties. First, the ability of targeted stimulation to the lower limb M1 within one hemisphere (e.g., the lesioned hemisphere in stroke) is challenging, as tDCS electrodes can be relatively large compared to the size of cortical representations, resulting in current spread that may inadvertently lead to stimulation within the opposite hemisphere. Second, the depth of the lower limb M1 representations may present a challenge to current penetration and depth with traditional tDCS applications. However, there is evidence to indicate that it is possible to modulate activity of the lower limb M1 with tDCS. Computational modelling has revealed that traditional anodal tDCS electrode montages (anode overlying the lower limb M1 and cathode overlying the contralateral orbit; Figure 1) can lead to the expected cortical excitability enhancement in the target cortex [35]. Indeed, reducing the size of the anode (3.5 cm × 1 cm) was found to improve the specificity of the current delivered to the cortex, while positioning the return electrode (cathode) to a more lateral position (T7/8 on the 10–10 EEG system) further improved current specificity, leading to greater changes in cortical excitability [35]. Experimental evidence also suggests that tDCS targeting the lower limb M1 can modify excitability. Jeffrey and colleagues [36] utilized an anodal-tDCS montage (2 mA, 10 min) over the lower limb M1 and found that motor-evoked potentials (MEPs) of the tibialis anterior muscle increased by as much as 59% compared to sham conditions. Along similar lines, 10 sessions of anodal tDCS (2 mA, 10 min) targeting the lower limb M1 was found to increase the amplitude of MEPs recorded from the paretic tibialis anterior compared to sham stimulation [37]. This empirical evidence provides some support to the computational modelling to suggest that the use of tDCS targeting the lower limb M1 can modify corticospinal excitability.
Although M1 has received attention as a stimulation target to modify excitability of the lower limb M1, there is potential for cerebellar tDCS to induce similar, or possibly more prominent, behavioral and neurophysiological changes. It is noteworthy that a computational modelling study that compared electrode montages targeting M1 and the cerebellum found that cerebellar stimulation produced substantially higher electric field strengths in the target area compared to M1 stimulation, suggesting the cerebellum may indeed be a suitable target for tDCS [38]. Behaviorally, the cerebellum contributes to motor planning, learning, and control; this influence is in part mediated by connections to M1 via the cerebellothalamocortical tracts, previously reported to play a key role in motor skill learning in mice [39]. Although this stimulation technique has received comparatively little attention compared to M1 stimulation, there is some indication that it is possible to modify cerebellar excitability in a focal and polarity specific manner [40]. Whether cerebellar tDCS is required to modify excitability of M1 for behavioral change is unclear. However, if a desired outcome was to modify M1 excitability with cerebellar stimulation, a pertinent challenge would be whether cerebellar tDCS can achieve the specificity required to precisely target the lower limb M1 in one hemisphere. Although speculative, one approach could be to pre-activate M1 through a contralateral lower limb motor task in order to bias the effects of tDCS towards those networks activated to perform the task. In support, there is some evidence in the upper limb that performance of a task during cerebellar tDCS does interact with the change in M1 excitability [41].[…]

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[WEB SITE] Brain Injury News – CNS

RESEARCH UPDATES, INDUSTRY NEWS, SURVIVOR STORIES

The world of advancements in brain injury knowledge and treatment is a rich composite of the progress being made by scores of dedicated people. The articles and reports below reflect current research, industry analysis, and stories of recovery. Innovations in patient care and the evolution of best practices in rehabilitation are among the subjects addressed by thought leaders, universities, and institutes noted here.

Categories:  Survivor  Stories  Traumatic Brain Injury  Concussion  Stroke  Aneurysm  Coma

NEWS & EVENTS ARCHIVES

via Brain Injury News

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[Abstract] An interactive and innovative application for hand rehabilitation through virtual reality

Physiotherapy has been very monotonous for patients and they tend to lose interest and motivation in exercising. Introducing games with short term goals in the field of rehabilitation is the best alternative, to maintain patients’ motivation. Our research focuses on gamification of hand rehabilitation exercises to engage patients’ wholly in rehab and to maintain their compliance to repeated exercising, for a speedy recovery from hand injuries (wrist, elbow and fingers). This is achieved by integrating leap motion sensor with unity game development engine. Exercises (as gestures) are recognised and validated by leap motion sensor. Game application for exercises is developed using unity. Gamification alternative has been implemented by very few in the globe and it has been taken as a challenge in our research. We could successfully design and build an engine which would be interactive and real-time, providing platform for rehabilitation. We have tested the same with patients and received positive feedbacks. We have enabled the user to know the score through GUI.

 

via An interactive and innovative application for hand rehabilitation through virtual reality: International Journal of Advanced Intelligence Paradigms: Vol 15, No 3

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[Abstract] What is the potential of virtual reality for post-stroke sensorimotor rehabilitation?

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via What is the potential of virtual reality for post-stroke sensorimotor rehabilitation?: Expert Review of Neurotherapeutics: Vol 0, No 0

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[BLOG POST] Hope Clark on “My new normal” following her brain injury – Jumbledbrain

Today I want to introduce you to Hope Clark. She is a talented writer, who has written about learning disabilities and has written a couple of articles for some local newspapers. Plus there are plenty of articles written about her. These articles can be found archived at the National Library in Ottawa.

Since her brain injury she wrote few pieces as part of her therapy. However, she has now decided to share them publicly and hopes (no pun intended) that they will help others.

“I am from SW Ontario, Canada.  My past like is filled with Management positions, Event Planning, Fundraising and Marketing with a side of Communications. Writing for me is something I find very cathartic. I acquired my TBI in March of 2018 and have been trying to reinvent myself ever since. I am not sure what I am going to do when I grow up, but if I can help someone with my writing then I feel I have done my job.” – Hope Clark aka HM Lemon

This is an extract of one of her articles. You can read the full version of My new normal which she has published on Facebook here.


As the thick veil of trauma has slowly been dissolving over the past year, nine months, 5 days (you get the gist) my life has been interesting to say the least. I have been the most alone I have ever been even though, unlike before, I have a loving husband and two beautiful children. Don’t get me wrong, I have been treated with great empathy, compassion and caring.

My road to recovery has been met with other trauma victims, doctor’s, specialists, treatment providers: I am never alone, yet, I am the most alone I have ever been.

Living with a traumatic brain injury and trauma really does lend itself to the saying, ‘if you have never experienced it, you just won’t understand.’ You try to be like your old self, or your normal and no matter what happens…something you’ve never experienced before rears its ugly head. It is true what they say, ‘Don’t take things for granted because you never know what could happen”, is taken to the extreme!

I can’t drop my kids off at school because the commotion of the people, vehicles, movement, noise – it makes me so sick to the point my brain feels like it will explode. My ‘level of tolerance’ as the treatment providers call it is about 2 hours. When I meet a friend for a lunch, little do they know that I must sleep for 2 – 3 hours afterwards just to recover. This coming from a woman who would get up at 6 am to workout before getting the kids up at 7 am and then not stopping until around midnight. This schedule repeated day after day. Some other wonderful side effects of an MVA are, yet not limited to, screen time (computer and television) gives me headaches; my wonderfully intelligent brain now struggles with sentence structure, word recall and spelling and even executive functioning. My love of music has been put on mute and my awesome dance parties with the kids have been put on hold. I keep hearing the term, ‘new normal’ – and that is very difficult to wrap my head around. Living 44 years is a long time. You acquire certain traits, characteristics and now to be told that that isn’t you anymore is a struggle. At the same time, I am being told that I am extremely high functioning. What does that even mean!? Lol! Until recently I didn’t understand this until my OT said something of brilliance.
Living with a traumatic brain injury and trauma really does lend itself to the saying, ‘if you have never experienced it, you just won’t understand.’

You try to be like your old self, or your normal and no matter what happens…something you’ve never experienced before rears its ugly head.

It is true what they say, ‘Don’t take things for granted because you never know what could happen”, is taken to the extreme!

I can’t drop my kids off at school because the commotion of the people, vehicles, movement, noise – it makes me so sick to the point my brain feels like it will explode. My ‘level of tolerance’ as the treatment providers call it is about 2 hours. When I meet a friend for a lunch, little do they know that I must sleep for 2 – 3 hours afterwards just to recover. This coming from a woman who would get up at 6 am to workout before getting the kids up at 7 am and then not stopping until around midnight. This schedule repeated day after day. Some other wonderful side effects of an MVA are, yet not limited to, screen time (computer and television) gives me headaches; my wonderfully intelligent brain now struggles with sentence structure, word recall and spelling and even executive functioning. My love of music has been put on mute and my awesome dance parties with the kids have been put on hold. I keep hearing the term, ‘new normal’ – and that is very difficult to wrap my head around. Living 44 years is a long time. You acquire certain traits, characteristics and now to be told that that isn’t you anymore is a struggle. At the same time, I am being told that I am extremely high functioning. What does that even mean!? Lol! Until recently I didn’t understand this until my OT said something of brilliance.

‘We can go our whole lives living a certain way and one little bonk to the brain and yep, you have to relearn your whole way of life and living.’ Crazy enough it made me feel a bit better. I understood what people were trying to tell me about my ‘New Normal.’ 

Living with a TBI, (traumatic brain injury) is your brain telling you that you just can’t!

What does that mean exactly? When my level of tolerance has been met my brain begins to feel like it’s on fire. You are most likely saying once again, what does that mean? Well, it’s like when you begin to get the flu and your head feels like you’re starting get a fever, that is what my head feels like – yet, without the flu. I begin to get foggy. My concentration levels start to fade. My ability to understand let alone comprehend what the person I am with is saying it to is slim to none and I am unable to make eye contact with whom I am with because my brain is too busy trying to keep up. Oh yes, comprehension has left the building everyone and thank gawd for spell check. This coming from the woman who has been published, interviewed for television, print and radio more times than I can count. On Mother’s Day 2019, I dropped to the floor in front of my family. Out cold I was, and an ambulance had to be called. I spent the day in the ER. Just before I was released the doctor came and tried to explain what was going on. We had a conversation and when she walked away, my mom said – honey, you did NOT understand a word she was saying. I was mortified. This isn’t the only time this has happened, and I was oddly humbled by the experience. The great news is that my memory is completely shot so the likelihood of me remembering these highly embarrassing moments are unlikely. 

Memory: I did have one almost 2 years ago. I had a great memory and my jobs reflected by ability to hold large amounts of information. Now, I forget to turn off the stove or close the fridge. I lose my thought(s) in mid-sentence, knowing there was something there and at the same time not having a clue what I was saying, doing, or what the topic was. Grabbing and putting the wrong lid on something is day after day. I forget my children’s names. In my defence, it is mostly when I am upset of my tolerance levels have been met and asking them to go brush their teeth or get ready for bed. My daughter just looks at me as says, ‘Mom, why are you telling me to go to the kitchen!? Don’t you want me to go to the bathroom, cause we’re already in the kitchen?’ My response, ‘Om-goodness, you understood what I am trying to say so please just go,’ Lol.

Honestly, looking at your brain injury with a positive outlook is the only way to be. The truth is that you can not control the future, only your present. You have no idea when and if you will be 100% and that is okay. It is okay because you can begin to reinvent yourself and how many people really get the chance to do that? Every step forward is a victory. Each and every day you can manage the pain, headaches and nausea is a bonus! You just push forward with whatever you have left. Be thankful for every moment you get to spend with your children and jump for joy that they were not in the car with you. And, even though you miss experiences and moments with your children – you get to be there with them in the small moments: putting them to bed, helping them brush their teeth, making dinner because all moments and experiences are important. You cherish and laugh out loud when your 6-yr old tells you to piss off; and, when your 8-yr-old daughter wants to just sit and cuddle with you for hours. And, this is where I leave you 1 year, 9 months, 15 days,…for now.

Other articles you may like:

Does this sound familiar to you? What has it been like having to accept what is your new normal following a brain injury?

via Guest post: Hope Clark on “My new normal” following her brain injury. | Jumbledbrain

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