It’s the most wonderful time of the year…or is it?

Some helpful tips for holiday cheer following a TBI

The holidays are fast approaching and are typically associated with excitement, family gatherings, music, delicious food and lights! While all of these aspects of the holidays are wonderful, they can be incredibly challenging for someone with a traumatic brain injury (TBI) to navigate and manage. Various symptoms of TBI can impact how one perceives the holidays: experience of sensitivity to light and sound, increased headaches or migraines, issues with processing information, challenges with energy levels, struggles with accurately interpreting social cues, trouble with controlling emotions, and difficulty with planning or initiation.
There is hope! Many steps can be taken to ensure the holidays are enjoyable for individuals with TBI and their family members. Here are a few identified by Brainline.org’s online community:
  1. Identify in advance - a quiet place to go at gatherings if you are feeling overwhelmed. This gives you a chance to take a break, and lets your loved ones stay involved in the festivities.
  2. Avoid crowded stores and order gifts online instead.
  3. If you are shopping in stores, remember to make a list in advance and plan your trips on week days - either early in the morning or late at night when there are fewer crowds.
  4. Wear a cap with a brim or lightly tinted sunglasses to minimize the glare of bright lights in stores or flashing lights on a tree.
  5. Wear noise-reducing headphones or ear buds. These are also great gift ideas for loved ones with TBI if they don’t already have them.
  6. Ask a friend to go with you to stores or holiday parties. They can help you navigate crowds and anxiety-producing situations.
  7. Plan in advance as much as possible. Ask your hosts what their plans are so you aren’t surprised by anything.
  8. Volunteer to help with the holiday activities that you enjoy the most and are the least stressful for you.
  9. Remember to ask for help and accept help if it is offered to you.
  10. Ask someone you trust to help you with a budget to avoid overspending on gifts.
  11. Take a nap if you need a break.
  12. Remember that it’s okay to skip the big parties and plan to celebrate in a way that makes you comfortable and happy.
  13. Check in advance to see if fireworks are part of outdoor celebrations - and skip them if they make you uncomfortable.
  14. If flashing lights bother you, ask your friends and family to turn off the flashing feature on Christmas tree lights or other decorations when you visit their homes.
  15. You can let your host know in advance that you may need to leave early. It will help you feel comfortable if you need to get home or to a quiet place, and it can also help avoid any hurt feelings.
The more support that family and friends can offer to a loved one when they are struggling or identifying what they may need for relief, the more successful they will be with effective implementation of these strategies. Here are a few tips:
  1. Have this list handy to help remind your loved ones of skills they can engage in, while also increasing your own awareness of what can be done to help.
  2. Keep an eye on them. If you notice they are disengaging, demonstrating signs of pain (i.e., holding their head, closing their eyes, tensing their muscles) or struggling with keeping up in conversation, gently suggest utilizing some strategies for relief.
  3. Be flexible. Often times your loved one may not know exactly how an environment will trigger them until they are there, even if they plan for it. Be open to plans changing a bit.
  4. Be available. As amazing as the holiday season can be, it will most likely pose some of the greatest challenges for your survivor. They may rely on your support to make it through.
  5. Ask for help yourself. You do not have to be the only one providing support. Let others know when you need a break.
Hopefully these tips will promote a safe and happy holiday season! If you need more support, consider reaching out to one of these local resources: https://www.biami.org/ https://www.apa.org/helpcenter/index.aspx https://www.brainline.org/ https://www.origamirehab.org/

Reference:

  • 15 Tips for Surviving - and Enjoying - the Holidays with Brain Injuries. (2013, November 21). Retrieved from https://www.brainline.org/article/15-tips-surviving-and-enjoying-holidays-brain-injury
Dr.Jayde Kennedy, PhD, LP, CBIS
Clinical Psychologist, Origami Brain Injury Rehabilitation Center

Dr. Kennedy graduated from The Chicago School of Professional Psychology in Los Angeles with a PsyD in Clinical Psychology in 2014. Her academic focus was primarily on treatment for children and adolescents. Her practicum, internship, and fellowship experiences allowed her the opportunity to work with a variety of populations including children, adolescents, teens, adults, and geriatrics. Dr. Kennedy has practiced in several settings including, outpatient, inpatient, community mental health, and residential treatment utilizing individual and family therapy modalities. She has been a member of the Origami Brain Injury Rehabilitation team since 2015.

Seizure Disorder and Brain Injury

November is Epilepsy Awareness Month, a time of the year to help promote awareness and educate the general public about epilepsy and seizures. One of the common challenges seen with brain injury is seizure disorder – more commonly known as epilepsy. Epilepsy and seizure disorder are terms often used interchangeably, but there are distinct differences. Seizures are the individual events of a sudden loss of control of functions associated with normal brain activity. They are sudden, temporary episodes of brain dysfunction, caused by the abrupt, non-purposeful discharge of electrical activity in the brain. Typically lasting 1-5 minutes, they are characterized by changes in sensation, emotional experience, motor control, and levels of consciousness. Epilepsy is the general term for a variety of neurological conditions characterized by recurrent unprovoked seizures – it’s the fourth most common neurological disorder in the United States. And, approximately 110,000 people in Michigan are diagnosed with epilepsy. In about 60% of cases, there is no known cause. Among the remaining 40%, brain injury is one of the most frequent causes. Most common with brain injuries are partial seizures, which typically arise from scar tissue from the injury. Partial seizures affect only one portion of the brain and have more limited symptoms such as visual distortions, odd sensations, unexplained emotional experiences, or non-purposeful behaviors or jerking movements. Sometimes, partial seizures spread and become generalized (Grand Mal), before they resolve. Grand Mal seizures involve a loss of consciousness and uncontrolled shaking as all muscle groups receive an overload of messages for movement. If a person has more than one seizure in a short period of time without recovering consciousness, or does not resolve a seizure episode within 5 minutes, it is called Status Epilepticus – and is a medical emergency. There are many types of seizures. Any initial occurrence of a seizure warrants medical attention as it is a sign that something is not right with the brain. Common causes are electrolyte imbalance, dehydration, fever, sleep deprivation or exhaustion, a new neurological injury such as bleeding or hydrocephalus, medication or illicit drug side-effects, or genetic predisposition. Some seizures are idiopathic, not known to be caused by anything in particular. Other times, seizures may have no clear physiological component, thought to be caused by neuropsychiatric features. Careful diagnosis of new-onset seizures is critical to appropriate treatment. Approximately 10% of individuals with brain injuries severe enough to require hospitalization have seizures. Seizures at the time of injury are quite common, but are not always an indicator of later problems with seizures. Seizures associated with the time of injury possibly represent a different type of convulsive phenomena. In later appearing seizures, those with open head injuries are associated with a higher risk. There are relationships between the severity and occurrence of injuries. Individuals with a severe traumatic brain injury are 29 times more likely than the general population to have epilepsy. When seizures appear later in recovery they are often more persistent, with 80% experiencing at least one more seizure. When seizures occur, or where sufficient risk factors are present, medication may be required to prevent or control them. In about 80% of cases, seizures can be controlled with medication. For others, surgery may be used to eliminate the likely source of irritation. Behavioral strategies associated with maintaining a healthy lifestyle such as good sleep, diet, hydration, and appropriate medication use are also critical. The effects of substance misuse, like alcohol withdrawal, and misuse of some types of medicines, can also increase seizure risk. There are many implications associated with seizure disorder including safety risks, loss of driving privileges, mortality risks, mental health vulnerabilities, as well as the social stigma still unfairly endured by persons with epilepsy and brain injury. Accommodations can help minimize these influences on adjustment. Support may include allowing additional time for tasks, pacing activities to limit fatigue, managing stimulation levels from noise or distractions, facilitating transportation or providing safe activity alternatives. Such supports help keep people with brain injury and seizures active and included, participating as part of their communities. First aid for seizures is largely supportive, providing protective monitoring with vigilance to provide assistive resuscitation in extreme events. While sometimes a frightening and challenging symptom to manage, people with epilepsy and brain injury have many resources and treatment options to support the successful management of these symptoms. Web Resources:
Martin J. Waalkes, Ph.D., ABPP(rp), CBIS-T
Licensed Psychologist
Director of Neuro Rehabilitation
Hope Network Neuro Rehabilitation

Rockin’ for Rehab 2018

While Rockin’ for Rehab has always been a hugely successful event benefiting our Lansing chapter, we’re working hard to re-imagine the evening of food, drink, music, and fun so that it benefits not just Lansing, but our Flint and Tri-Cities (Saginaw/Bay City/Midland) support groups as well! More good news: We’re also exploring how to provide transportation for survivors who wish to attend Rockin’ for Rehab. Details will be shared as soon as possible, but for save-the-date purposes, this year’s Rockin’ for Rehab will be held Friday, December 7, at the Michigan State University Club from 6:30 pm – 11:30 pm. Perennial favorite Dr. Fab and his Off the Couch Band will perform your favorite hits from the 1950’s – 60’s. Admission is $65 per person. For attendees desiring hotel accommodations, a block of rooms has been set aside at the adjacent Candlewood Suites. When making reservations, be sure to use the block name “Rockin’ for Rehab-BIAMI” and enter block code “RFR” to reserve a room. Candlewood Suites reservations can be reached at (517) 351-8181.

Quality of Life Conference 2018

BIAMI is excited to announce we’re expanding this year’s Quality of Life Conference to include four new, informative, and very timely sessions. Here’s a sneak preview:
  • Dealing with Phone, Mail, and E-scams, presented by the Michigan Attorney General’s office
  • Sexuality and Relationships after a Traumatic Brain Injury, presented by Deborah Adams from Eisenhower Center
  • Healthy Eating for a Healthy Brain, with Dr. Sarah Wice and Emily White from Origami Brain Injury Rehabilitation
  • Creating Your Recovery Based on Your Unique Talents, presented by Courtney Wang from Galaxy Brain and Therapy Center and survivor Barbaranne Branca.
As always, one of our major Conference objectives is to ensure all attendees have access to transportation services should they need it, regardless of location. We’ll pass along further transportation information as we line up sponsors. The Quality of Life Conference will be held November 5 at the Crown Plaza in Lansing from 9 AM to 3:00 PM. Registration is open to survivors, caregivers, and professionals, so make plans to join us for a positive and rewarding experience!

It Opened My Eyes: “Unmasking Brain Injury 2.0” Videographer Shares his Thoughts

As a videographer, a big part of what I do is capture moments and create experiences out of those moments through storytelling. As I build a story through editing, it’s crucial to carefully listen to each interview in its entirety to put together the most cohesive final product. Often times during my editing process, I cannot help but immerse myself into the story being told by that individual. Prior to each interview with the brain injury survivors, I wasn’t quite sure of what to expect, but what I learned is that you can overcome any adversity with great support and the desire to keep moving forward in spite of. I was informed during many of the interviews that brain injuries are sometimes undetectable to the average onlooker. Through the testimonies of these survivors, I’ve witnessed the obligations they have to reinforce to others that, even after their unfortunate causes and situations, they are still human beings who are capable of joy, love, and deserving of happiness. This project was special to me because it opened my eyes to a situation that is poorly represented and discussed. However, I am excited that these survivors have a platform such as the Brain Injury Association for Michigan to tell their story, inform the masses, and possibly give hope to other survivors just like themselves. This experience has been great for me and I am glad that I had the chance to be a part of it! Thank you, Sean Bowman Captured Screens Productions, LLC

TBI Survivors and Addiction Risk

Pictured above: Angela Haas, author of blog post

You have likely dealt with substance abuse before, whether it’s in your family, a friend of a friend, or someone you are working with now. If so, you know that substance abuse has an effect on everyone, but that effect is especially dangerous for those who have suffered a traumatic brain injury. For brain injury survivors, alcohol and drugs can increase the likelihood of seizures, and can also have dangerous interactions with individuals’ prescribed medications. In addition, alcohol and drugs affect our brains differently, and can have a much more powerful effect on someone with a brain injury. Just as importantly, alcohol and drug use may increase the likelihood of re-injury, as survivors under the influence are more likely to engage in behaviors such as impaired driving, or suffer difficulties with balance or impulsive decision making. Some of the most bothersome cognitive impacts of TBI include issues with decision-making (mentioned above), as well as problem solving, short-term memory, low inhibition, and decreased awareness. Alcohol and drugs can exacerbate all of these symptoms, unquestionably impacting recovery -- which is why complete abstinence from alcohol and drugs is the healthiest and safest choice to aid in brain injury recovery and sustainability.

Risk Factors for Addiction

  • Alcohol/Drug use or dependence prior to obtaining their brain injury
  • History of mood disorders
  • Current depressive disorder or symptoms of depression
  • Addiction to tobacco
  • Family history of addiction
  • Poor social skills
  • Poverty
  • Early use in adolescence
  • Stress at home
  • Unhelpful support group or lack of natural supports
  • Lack of health insurance or access to health care

Questions to ask if you fear that you or someone you love may have an addiction and need support

  • Do they go through withdrawals if/when they stop using?
  • Do they have to take larger amounts or over a longer time period than intended?
  • Has their use resulted in a failure to fulfill major obligations at work, school, or home?
  • Have they continued to use despite continuous problems with using?
  • Have they made unsuccessful attempts to cut down?
  • Do they have cravings, or a strong desire to use?
  • Have they given up important social, occupational, or recreational activities because of use?
  • Do they continue to use in situations where it is physically hazardous?
  • Do they continue to use despite knowledge of having physical/psychological dependence?
  • Do they spend a great deal of their time obtaining, using, or recovering from its effects?

Want help?

There are many avenues to find support, whether one has commercial insurance, Medicare, Medicaid, or no insurance at all. You can call your local Behavioral Health Authority, and talk to someone who can immediately assess your need for treatment and link you to the appropriate resources. Treatment can involve medical supervision, individual or group therapy, peer support, 12 step recovery, case management, family therapy, and psychiatric services. Below are several links depending on your need: If any of these apply to someone you know, show that person that you care, are concerned, and are there to support them! Understand that there are likely reasons they do what they do:
  • Self-medicate for severe/chronic pain from their injuries
  • Cope with the trauma that they have endured
  • Try to combat their symptoms of depression due to a loss they have experienced in their life
  • Escape from their new reality
  • Use due to an underlying mental health condition
You can use the resources above, or contact a professional who can help you get connected. You can also contact the BIAMI staff to help you connect with helpful resources. Stay strong, supportive, and realize that they may be doing the best they can, in this moment, to get through whatever difficulties they may be facing. Angela M. Haas, LMSW CAADC is a licensed master’s level social worker with her certified advanced alcohol and drug counselor certification. She works with Special Tree Rehabilitation Systems in their outpatient clinic in Midland and Saginaw.
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