August 31, 2006, 11:47 am

The Cyclical Nature of Brain Injury

Last week I came home to an urgent message from the mother of a person who has had multiple “mild” brain injuries. I’ve known the mother for nearly forty years and had become reacquainted with her son over the last several years. When I returned the mother’s call she told me that her son had become despondent and threatened suicide and that a friend had taken him to the local hospital where he was committed for a period of stabilization.

“Sean” had just started a new job, and his mother couldn’t understand his sudden reversal of mood. She related to me that she hoped that the depressive episodes which her son experienced and his seizure control problems would be addressed through this hospitalization. When we spoke again she reported that the physician’s were not addressing the seizure issues, but rather were focusing on his depression and the related suicide attempt.

Her son had become angry with her and other family members and had isolated himself from her phone calls. She was feeling extremely frustrated with the healthcare system, her son, his brain injury and the problems of the last ten years. She was expressing concerns over her inability to get him the help he needed.

Several days later she called back. Her son had been discharged, his mood brighter and he hadn’t lost his new job. Once again we spoke about addressing his seizure disorder with a comprehensive work-up, but that option moved towards the distance as he was once again functioning in a job and back into his life.

What continues to strike me in situations like this is the cyclical nature of the problems, the emergency response, the stabilization and resolution phase followed by the return to “life as before the crisis”. Often the crisis cycles deepen and the periods of time between crises shorten. Ultimately the problem does not get resolved, sometimes due to a lack of available resources, and often due to the need of the person and their family to get on with life and to forget about the crisis until the next time.

For the person with a brain injury, the passage of time may mean fewer resources and supports which are available to them. Caregivers become older, families move away and life creates time and distance barriers. Yet each crisis brings us together, albeit for a short time to solve the problems we can, and to defer on those which we cannot solve.

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August 25, 2006, 7:10 am

Brain Injury in Nebraska

This week finds me in Lincoln, Nebraska. I stopped by Madonna Rehabilitation Hospital to visit with Judy Harvey, CCC-SLP. She earned all three Cs in Nebraska and focuses her care on the brain injury patients at Madonna. After a delightful lunch in a nearby bowling alley, Judy took me on a tour of the facility.

Madonna is big. I think it may have gajillions of beds, plus or minus a gajillion. Judy told me that average length of stay is about 20-25 days on the brain injury unit, and that they’re more “hospitally” than their brain injury rehab neighbor to the east, QLI–Quality Living Incorporated, a sprawling campus-like rehab for high-functioning TBI patients.

While touring the facility, we walked through the pediatric unit where I noticed a small boy working deliberately at a coloring book. He had a glistening red wound on the crown of his head, round, the size of a quarter. The boy stayed hunched over his book, not even looking up as we passed by.

It’s easy for us who work in rehabs to forget that TBI affects individuals. As I continued walking through the halls, then out into the parking lot, and later into a cafe in Lincoln’s Haymarket district, the image of the boy’s wound stayed with me. The solace is that he’s in a great place, getting great care, but I wonder where he’ll be twenty-five days from now.

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August 21, 2006, 9:07 am

Blast Injuries Dealt a Bad Hand

A couple of weeks ago, an article appeared in USA Today that relayed some scary information. Congress may be about to slash funding for the most the treatment of brain injured veterans:

Congress appears ready to slash funding for the research and treatment of brain injuries caused by bomb blasts, an injury that military scientists describe as a signature wound of the Iraq war.

House and Senate versions of the 2007 Defense appropriation bill contain $7 million for the Defense and Veterans Brain Injury Center — half of what the center received last fiscal year.

Proponents of increased funding say they are shocked to see cuts in the treatment of bomb blast injuries in the midst of a war.

“I find it basically unpardonable that Congress is not going to provide funds to take care of our soldiers and sailors who put their lives on the line for their country,” says Martin Foil, a member of the center’s board of directors. “It blows my imagination.”

Apparently, the DVBIC requested an increase of their operating budget and instead met with plans to reduce it.

In a time of budget cuts, Congress may be about to deprive thousands of American troops of one of their most valuable assets. I have to agree with Foil: the proposed measure is unpardonable.

Click here to read “Center faces budget cut” in USA Today.

UPDATE: Thanks to aggressive advocacy, Congress not only awarded the DVBIC its requested funding, but also increased their budget significantly!

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August 17, 2006, 7:22 am

Epileptic: The Comic Book

Random House has issued a comic book Epileptic, which is garnering rave reviews in the world of the graphic novel. According to the website, Epileptic is:

An honest and horrifying portrait of the disease and of the pain and fear it sowed in the family, Epileptic is also a moving depiction of one family’s intricate history.

In much the same way Ray Robinson’s book Electricity brought us an insider’s look at epilepsy, Epileptic promises to be rich with similar honesty.

It’s exciting to see the art world open itself to real issues faced by real humans–issues like brain injuries and neurological syndromes. These are not stories about unreal supermodels and phony celebrities. These are stories about being human.

Click here to read about Epileptic.

Thanks for the tip, Mindhacks.

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August 11, 2006, 2:43 pm

Catch us at the Conference!

In the next couple of months, we’ll be visiting cities all over the country making presentations and visiting with caretakers, survivors, and professionals. If you plan on attending any of the conferences below, make sure you stop by and say hello:

National Association of Head Injury Administrators NASHIA - Baltimore, MD Sept 6-9
Attended by Michael Mason

North American Brain Injury Society NABIS- Miami, FL, Sept. 13, 14, 15
Attended by Michael Mason

Colorado Brain Injury Association-Vail CO Sept 27-30
Presentations by Dr. Rolf Gainer, CEO and Pamela Washbourne, Program Director

Southwest Conference on Disability-Albuquerque, NM Oct. 4-6
Presentations by Dr. Rolf Gainer and Michael Mason

We look forward to meeting you!

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August 2, 2006, 2:19 pm

International Issues in TBI

When it comes to TBI survivors, things are tough all over. The Australian government was recently excoriated by the Brain Injury Foundation president for their lack of awareness:

“Foundation president Peter McCullagh says while the state, territory and federal governments argue over who needs to provide more support to the country’s medical services, brain injury patients are suffering. “

Although I’ve done plenty of complaining about how American healthcare doesn’t take care of its own brain injured patients, brain injury is an underfunded, underacknowledged crisis throughout the rest of the world as well.

The BIA has an entire library full of helpful documents about TBI, and among them is a small booklet that affords an international perspective. If you’re interested, check it out at https://www.lrsssl.com/biaa/bookstore.asp

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August 1, 2006, 12:32 pm

Ariel Sharon Deteriorating While in PVS

Last week, news sources around the globe reported that Israeli leader Ariel Sharon was transported to emergency care due to kidney failure–troubling news that also coincides with continued conflicts between Israel and Lebanon. One has to wonder what course history may have taken had one small stroke never occurred.

Although Ariel Sharon’s predicament is more dire than ever, his brain injury should be a reminder of just how far-reaching a catastrophic injury can be. When a TBI occurs within a small family unit, the effects reverberate through every aspect of life, and often spread out to individuals who never anticipated that a brain injury could affect them so deeply. Ariel Sharon’s TBI should create a greater awareness of the social implications of TBI, but like most other survivors, his condition continues to be kept under wraps.

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