December 28, 2005, 10:10 am

New Year's Resolutions

Every New Year we make our annual resolutions of how we will improve and enrich our lives over the forthcoming year. Our New Year’s resolutions may involve taking off those extra pounds, starting a fitness regime, spending more time with children or loved ones, giving up a bad habit or learning a foreign language. With each New Year’s resolution there is the risk of a failed promise. How can we keep ourselves on track to accomplish what we set out to do in our New Year’s resolutions?

Here’s some ideas to consider:

Set realistic goals. For example, if weight loss is your goal, should the goal be the total weight you want to lose or an attainable number of pounds? It’s easier to achieve success if the goal is realistic. This requires creating steps so that you can move towards your goal. Identify the resources you’ll need to achieve your goal.

Establish a plan to achieve your goal. We often fail in our goals because we don’t identify a plan. Start by defining a plan that’s compatible with your life, and one you can add to your daily routine. A good example is exercise. It’s easier to add 20-30 minutes of exercise per day, such as walking with a friend or family member, to your daily routine than working out in a gym where you may not feel comfortable at first. You may want to use the stairs in your office rather than the elevator or take a nightly walk with your dog to add exercise to your life. As you succeed in your plan, you add to the scope of your activities and begin working out in the gym on a daily basis.

Support your plan by making changes to your life that are enjoyable. If your goal is improve the quality of time you spend with your children, then select an activity that you mutually enjoy. This may be a good opportunity to try something new and different and for everybody to be a new learner.

Establish measures of your success. This may not be always be numbers, but solid indications to yourself about your progress. Use weekly and monthly measurements to track your success and celebrate each step towards progress.

Don’t let the thought of change keep you frozen. We may plan to initiate change for ourselves, our families and loved ones in our New Year’s resolutions. You should expect that the process of establishing new habits and life patterns will require your attention and devotion. Learn to accept some frustration and anxiety and look forward to enjoying the new aspects of your life. Remain flexible in your outlook and keep your options open.

Making changes is a two-handed process. A person cannot simply stop an old habit without considering what to do in its place. Smoking is a good example–it’s a hard-to-break habit because it involves so much our daily routine. What can be substituted for a cigarette break? Identify an activity that you like which you can consciously substitute for the old habit which you are trying to eliminate. When you reach for that cigarette, it’s time for the substitute.

Don’t expect change to occur overnight. Allow yourself the time and resources you need to begin making change. Anticipate that some frustration will occur. It is important that goal setting be realistic, attainable without turning your entire life upside down.

Seek support and help. It is hard to make change and often support and help may be needed. It is not a sign of weakness to turn to friends, family and even professionals for help. There are many self-help groups which can offer support for a variety of changes. Look for resources in your community and consider professional support and help to assist you in achieving your goals.

Have fun with yourself. Break out of the mold and try something new. We” get stuck” in many of our habits in life because we haven’t considered that alternatives are available. Reframe how you think about solving a problem and add “fun” to the solution.

Learn to manage stress. It is important to manage stress on a daily basis to avoid the cummulative effects. In the development of your plan, add activities which are relaxing. Give yourself opportunities for private time, even one to two minutes of a de-stressing activity several times a day can allow you an opportunity to manage stress by maintaining your perspective on your life.

Take care of yourself. That includes, your physical, psychological and spiritual health. All are equally important and all are inter-related.

Take a breath, the New Year is coming in several days and you can succeeed in acxhieving your goals by developing a sound plan.

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, 8:42 am

The Blight of Soap Opera Comas

It’s no surprise to most healthcare workers that television and film consistently misrepresent the reality of brain injury, but now a new study shows how soap operas portray comas in a hazy, unrealistic light that may cultivate public misperceptions.

When a coma occurs in a soap opera, the survival rate is 89%, versus 50% in real life. Fictional characters emerged from comas without any impairments 91% of the time, while the figure is 1% in non-fiction settings. Soap operas also misepresent the demographic reality of brain injury, having them mainly occur to young white women, who are actually less likely than the general population to experience a coma.

To debunk your own misperceptions about comas, start with this interesting article from Medpage Today.

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December 22, 2005, 9:41 am

Stem Cell Research and Brain Injury

Stem cell research continues to yield exciting possibilities for individuals with severe injuries and disorders. Recently, the University of Texas has approved a study that will address stem cell treatment for children with traumatic brain injuries.

Taken from bone marrow, the stem cells are thought to offer reparative therapy to the brain. Currently, our only means of treating a brain injury is by prevention, but if we can offer some means of repairing damaged brain tissue, we could well be on our way to diminishing the awful conditions faced by many survivors today.

To read more about UT’s stem cell research, click here.

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December 14, 2005, 2:51 pm

Living with the Effects of Multiple Mild Brain Injuries

Today I had the opportunity to speak with an old friend whose son has been living with the effects of multiple brain injuries from competitive sports. He never received rehabilitation and was sent home from the emergency room following his last injury, even after the physicians confirmed that he had injured the frontal lobes of his brain.

Today, her son lives by himself with his dog and is basically isolated from his community. He holds jobs for brief periods and loses them when he has a temper outburst. He is unable to maintain friendships and is alone. He has written several plays, including one which has been produced, but his life is filled with his concerns of “being crazy” and feeling that he cannot control his emotions and conduct.

Although his parents provide him with financial help on occassion, he earns some money through his short-term jobs, enough money, in fact, to prevent him from accessing Medicaid and other assistance programs. He has been denied Social Security disability because he is not “disabled enough”. Yet, he cannot maintain employment, his seizures are under poor control and he is depressed. A physician in his community sees him on occassion to follow his seizure disorder and evaluate his medication. This physician provides his services without a fee.

This young man is eager to get on with his life and find solutions to his seizure disorder and depression problems. Unfortunately, he is caught in the gap. In the eyes of those who administer programs for individuals with disabilities, he is not disabled. He is not eligible for Medicaid because his income was $60 a month above the cut-off. He is an extremely bright person, creative and craving a life with work, friends and activity to replace being alone. The resources he needs are not forthcoming. While the brain injury literature addresses the not-so-mild effects of Mild Traumautic Brain Injury and outlines the needed course of rehabilitation and psychological support, there has been no real trickle down of this knowledge into public access programs. As a result, people with Mild Traumatic Brain Injury often slip between the cracks and end up receiving no services to assist them in returning to productive lives.

Here’s a person who knows the full extent of his problems and is willing to participate in treatment and rehabilitation with the prospect of getting his life back. In the years, I’ve been involved in Brain Injury rehabilitation I have heard this story many times before. It gets harder to understand over time and especially in a situation where I have known the young man and his family for almost forty years. Professionally and personally, it troubles me that “the system doesn’t work.”

One of the things each of us can do as individuals is to join the Brain Injury Association in our state, or to offer them organizational support. The association, in turn, can lobby for greater efforts in statewide treatment of brain injuries. Find out more about the BIA by going to biausa.org.

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, 10:33 am

Choking Game a Real Nightmare

In case you’ve been paying attention to the news, an old menace is gaining popularity among children and teens that involves choking each other as a means of getting high. It’s called The Choking Game and it has recently claimed the life of 11 year-old boy in Philadelphia.

While deaths resulting from the choking game have been covered by the press, we don’t know much about the youth who suffer permanent anoxic brain injuries as a result of this game. Anoxic injuries to the brain are some of the most complicated and severe injuries in the world, and it is a genuine tragedy to see a life altered so needlessly. Children who engage in repeated oxygen deprivation to the brain should be immediately evaluated by a neurologist to determine if any damage has occurred.

As with many other brain injuries, prevention is the key to avoiding a lifelong disability. If you’re a parent or teacher, talk to your children or students about the choking game and its dangers.

To read more about the Choking Game, read stop-the-choking-game.com

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December 6, 2005, 9:14 am

TBI Case Manager: An Inside Tip

This morning, I walked into my office and listened to a dozen case-related messages, half of them completely new to me. I have just enough time to jot them all down before I head off to a morning meeting, where we discuss what’s going on with our current patients and what their treatment holds for them. When I return to the office, I start returning calls from the East coast, and begin making my way westward to compensate for the time difference.

By lunch, I’m nearly done returning calls, what with all the phone calls and emails I receive in the meanwhile. In the afternoon, I find time to respond to all the cases that endlessly accumulate. The problem is never finding a facility–it’s finding a facility that has an opening. Brain injuries are happening at such an astonishing rate, that waiting lists are becoming the norm everywhere.

Over time, I’ve developed an eye for the facility that is flexible and responsive–a place that is willing to work through bureaucracy and insurance obstacles. Unfortunately, those facilities are few and far between. So, for the survivor, family, or case worker who is trying to find a TBI rehab, here are a few tips to consider:

–Look for a rehab that has a high staff to patient ratio as a rule of thumb, not as an exception.
–Ask how many patient beds the rehab hospital has. The more patients they treat, the more you should ask yourself: is a large, sprawling, active setting what I need? Or am I looking for a smaller, soothing, responsive environment?
–Be willing to go out of state. Most people with a moderate to severe TBI are forced to find treatment hundreds of miles from home because treatment is so specialized.
–Ask if there is someone on staff who acts as an advocate for pending patients. If you’re like most people, you will need someone willing and knowledgeable to call insurance companies, Medicaid contacts, and DHS caseworkers.

Most people with TBI are happy just to have a few choices in treatment. By asking the right questions, it’s better to have a couple of great choices than lots of inappropriate ones.

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