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Look Twice, Save A Life! Loud Pipes Save Lives!

Aug 8, 2019 | Awareness, News, Prevention

Many are familiar with the motorcycle safety public service announcements that resurface each year. With the beautiful Michigan summer in full swing, motorcyclists are eager to hit the roads, making these safety reminders especially important. Whether you are in a vehicle or on a motorcycle, taking extra precautions can keep everyone safe on the roads. For a refresher on safely sharing the roads with motorcyclists this summer, view this article from Michigan.gov. For anyone who prefers a motorcycle to a car this time of year, here are few simple, but important reminders to keep you safe this season.
  • Ride defensively: Always be aware of the vehicles in your surrounding area. At stop signs, take caution and never assume the other drivers will stop! Car drivers are often the cause of motorcycle accidents. With distracted driving on the rise, being defensive and aware while on a motorcycle is more important than ever.
  • Select the Right Ride: Purchasing a motorcycle that is properly suited for your height and size is essential. When selecting a motorcycle, ensure your feet are easily resting on the ground and the handlebars and controls are within easy reach.
  • Make Time for a Tune Up: In addition to tuning up your motorcycle, see if your riding skills are in need of a tune up as well. If your riding skills are a little rusty, sign up to take the Motorcycle Safety Foundation (MSF) riding course. This course covers the basics as well as some advanced riding techniques. As an added bonus, taking this course may qualify you for an insurance discount.
  • Dress for Success: Wear clothing that will protect you from wind, flying bugs, debris, and road rash. Avoid clothing items such as shorts, tank tops, and t-shirts.
  • Protect Your Head: Riders who do not wear helmets have a much higher risk of fatality. If you are injured in a motorcycle accident, you are also three times more likely to sustain a head injury if you do not have your helmet on. Helmets save lives; grab yours before hitting the road.
  • Protect Your Eyes: If you do not wear a full-face helmet, make sure you have the proper eye protection. You never know what you may encounter on the roads; take this small precaution to ensure your eyes are safe.
  • Avoid bad weather: Rain makes the pavement slippery, reduces your margins for error and decreases your overall visibility. Watch for road hazards including potholes, sand, gravel, wet leaves, and grass.
Following these simple, but important, safety tips can make the roads safer for everyone this riding season. This blog was prepared by Origami Brain Injury Rehabilitation Center, Speech-Language Pathologist and avid motorcyclist, April Toivonen, MA, CCC-SLP, CBIS.

Being Mindful on Independence Day

Jul 1, 2019 | Awareness, Caregivers, News, Support, Survivors

Independence Day can be a time to celebrate for many. It is a time to spend with family, enjoy rest and relaxation, and even revel in the excitement of fireworks. For those with a brain injury, though, this holiday may look and feel very different. Brain injury can bring many unpleasant symptoms, including physical changes (fatigue, pain), photophobia (light sensitivity), overstimulation to noises and crowds, and many emotional changes like anxiety and depression. Despite all of the changes that survivors feel on the inside, brain injury is often referred to as “an invisible injury” because others may not recognize the individual has sustained a brain injury. Many of the cognitive, emotional, and physical changes are unnoticeable to others on the outside. What used to be pleasant holidays and get-togethers, like Independence Day, may pose a variety of challenges for those with brain injury. Some individuals with brain injury may even be living with a mental health condition known as Post-Traumatic Stress Disorder (PTSD). PTSD can develop after exposure to a traumatic or life-threatening event, such as a car accident, a fall, or combat-related incident in the military. PTSD may mean that someone experiences flashbacks, nightmares, or is overly aware of their surroundings. For Independence Day, fireworks may be an unpleasant reminder of the trauma they experienced. The good news is there is hope for those with brain injury to endure and enjoy the holidays once again, with small changes to their usual traditions. Here are a few tips for individuals with brain injury, as well as their support system, for navigating this upcoming holiday. Tips for Individuals with Brain Injury
  • Plan ahead: speak with family and friends to identify a safe and enjoyable way to enjoy the holiday
  • Manage fatigue: be well-rested leading up to the celebration and take breaks when needed
  • Reduce sensory overstimulation: taking noise-cancelling earphones, sunglasses, or hats may reduce the sensory input during fireworks and around large crowds
  • Choose your location carefully: if you choose to enjoy a live celebration of fireworks, choose a seat furthest away from the action
  • Explore your options: forego the live fireworks and watch them from the comfort (and quietness) of your home
Communication Tips for Brain Injury Supporters
  • Ask first: ask the person with brain injury their preference for activities for the holiday
  • Offer support: if they choose to sit out on certain activities, join them and provide company
  • Find a balance: compromise on traditions and swap out events with new activities your loved one is most comfortable with
  • Have a back-up plan: identify alternative activities if your loved one is not feeling up to the festivities at that time
  • Plan your escape: in the event that your loved one is triggered by something during the activity, have a plan for minimizing distress and moving to a more comfortable place
These are just a few ways for everyone to show their understanding and support for individuals with brain injury during this holiday season. Dr. Amanda Lopez PhD, LP, CBIS
Psychology Supervisor
Origami Brain Injury Rehabilitation Center

To Drive or Not to Drive? Getting Behind the Wheel after a Traumatic Brain Injury

Jun 6, 2019 | Awareness, Caregivers, Education, News, Survivors

Driving is the ultimate symbol of independence and control. Losing the ability to drive after a traumatic brain injury (TBI) may feel devastating and can greatly affect a person’s quality of life during recovery. But considering that driving is one of the most dangerous activities we do on a daily basis, the decision of if and when to return to driving can be complex. Safe driving requires a number of skills which may be altered after a TBI including:
  • Visual acuity and perception
  • Memory to recall directions or destination
  • Hand-eye coordination
  • Reaction time
  • Safety awareness and judgment
  • Sustained and alternating attention
  • Range of motion and strength of arms, legs and neck
  • Confidence behind the wheel
  • Anxiety level
Research indicates that 50-70% of people with moderate to severe TBI will return to driving regardless of recommendations from their healthcare team or safety concerns (Schultheis & Whipple, 2014) (Classen, 2009). That’s why it’s important for TBI survivors to discuss and address return to driving with their healthcare team openly and honestly. As a first step in the path towards returning to drive, therapists are able to incorporate pre-driving skills into therapy sessions. These pre-driving therapy sessions focus on remediating, refining and strengthening any of the above skills that may impact driving ability or safety. Many rehabilitation providers offer pre-driving screenings or programming to jumpstart the process. After pre-driving skills are mastered, TBI survivors can benefit from working with a Certified Driving Rehabilitation Specialists (CDRS) for on-the-road training. These experts also assist in obtaining and practicing the use of adaptive equipment. Various types of equipment such as hand controls and adaptive steering wheels can be used if traditional foot pedals or wheels are not optimal. A CDRS can even help coordinate securing an adaptive vehicle with ramp access and modified seating if necessary. Safe return to driving after a traumatic brain injury is possible with the right training and resources. The first step toward safely getting behind the wheel after a traumatic brain injury is starting a conversation with the rehabilitation team.

References:

  • Classen, S. e. (2009). Traumatic brain injury and driving assessment; and evidence-based literature review. American Journal of Occupational Therapy, 580-591.
  • Schultheis, M. T., & Whipple, E. (2014). Driving after traumatic brain injury:evaluation and rehabilitation interventions. Current Physical Medicine and Rehabilitation Reports, 176-183.
Angela West, MSOT, OTRL
Occupational Therapist + Therapy Best Practices Coordinator
Special Tree Rehabilitation System

Brain Injury Association of Michigan: One-Sided No-Fault Reform Bill Doesn’t Go the Distance

May 9, 2019 | Advocacy, Caregivers, News, Professionals, Survivors

Association joins Gov. Whitmer and House Democrats in calling for strong consumer protection, permanent rate relief, and long-term solutions

FOR IMMEDIATE RELEASE For more information:
Janna Wilson
(248) 810.229.5880 LANSING, Mich. (May 9, 2019) – The passage of SB1 and HB 4397 may now be a reality, but those who protect consumers want more. In response, President and CEO of Brain Injury Association of Michigan (BIAMI) Tom Constand issued the following statement: “We thank Gov. Whitmer and House Democrats for standing up for Michigan consumers in rejecting the bill as written. Although it addresses the basic tenets of reform, it does little to ensure a permanent solution. Moreover, instead of allowing for constructive committee discussion and debate, this 82-page bill was railroaded through the House in the middle of the night with no opportunity for thoughtful deliberation.” “We are looking for fair, reasonable and sustainable legislation that provides strong consumer protections, offers immediate rate relief and protects benefits for the insured. This bill provides weak concessions that don’t ensure ongoing rate relief, provides a pittance of coverage options, and will leave survivors and their families even more exposed to the unethical and predatory practices of the insurance industry. We must do better than this.” About the Brain Injury Association of Michigan
The Brain Injury Association of Michigan is dedicated to enhancing the lives of those affected by brain injury through education, advocacy, research and local support groups, and to reducing the incidence of brain injury through prevention. Founded in 1981, Brighton, Michigan-based BIAMI is a national leader in its efforts on behalf of the approximately 200,000 Michigan residents who live with disabilities as a result of a brain injury.

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Brain Injury Association of Michigan
7305 Grand River, Suite 100
Brighton, MI 48114-7379
BIAMI.ORG

If you support Governor Whitmer, please add your name to our petition on Change.org.

What Is A Concussion and How Do We Treat It?

May 2, 2019 | Awareness, Education, News

One of the hot topics right now in the world of brain injury is Concussion Prevention and Treatment. In order to fully be able to discuss this topic, we first have to understand and answer this question: What is a Concussion? Newer research has shown that a concussion happens from acceleration or deceleration of the brain inside of the skull. This can happen from activities such as a hit directly to the head or body as in contact sports, falls, military activity, or motor vehicle accidents. This acceleration/deceleration of the brain causes stretching of the brain tissue and creates an excitatory response that places the brain in an energy deficit resulting in any of the below symptoms. Symptoms are typically temporary and usually dissipate by 8-10 days. What are some signs and symptoms of a concussion?
  • Loss of Consciousness (only occurs in ~10% of all concussions!)
  • Seizures
  • Delayed verbal/motor responses
  • Confusion/Disorientation/Memory deficits
  • Lack of focus/Concentration
  • Speech disturbances such as slurred speech
  • Balance/Incoordination
Sports are one of the leading causes of concussion resulting in approximately 3.8 million concussions per year in the United States. Rugby, ice hockey, football, and soccer are the top high-risk sports for both men and women due to the amount of contact. The large number of concussions sustained from sports has led to a push for prevention measures such as advancements to helmets. Research has shown that the use of a properly fitting helmet may reduce the risk of the severity of the symptoms of a concussion; however, there is lack of evidence supporting the use actually reducing the number of concussions sustained. Since concussions cannot be completely prevented, we now need to look at treatment! Due to the wide variation of symptoms that can present following a concussion, a comprehensive treatment plan should be utilized. The brain accounts for approximately 2% of our body weight and it takes approximately 20% of our blood supply! Why is this important? A concussion can temporarily reduce blood flow to the brain by up to 50%! This makes exercise one of the most crucial treatment options for an individual following a concussion. Treatment will be based on the presentation of symptoms and following Return-to-School and Return-to-Play guidelines and only moving to the next stage if they are symptom-free for 24 hours. What kind of treatments should be used?
  • Rest
  • Nutrition
  • Physical Exercise
  • Visual and Vestibular Retraining
  • Cervical Spine-Alignment and Musculature Issues
  • Balance Retraining
What does the Return-to-School and Return-to-Play Guideline look like?
  • Rest Initially 24 hours
  • Light Cognitive Activity
  • Half Day of School
  • Full Day of School
  • Clearance for Physical Activity
  • Light Non-Contact Sport Specific Activity
  • Higher Intensity Non-Contact Sport Specific Activity
  • Full Contact Sport
  • Return to Competition
An important fact to remember is that typical concussion symptoms dissipate in 8-10 days; however, the brain metabolic state (no longer being in an energy deficit) does not return to its own baseline until 22-30 days after an injury. Why is this important? Three words: Second Impact Syndrome. If there were to be another concussion prior to the brain reaching its metabolic baseline, the effects of the first concussion can now be compounded, thus placing the individual at an increased risk for permanent deficits or even death. Comprehensive Baseline Testing can assist with not only making sure all aspects of the individual's brain function, including both physical and cognitive aspects, have returned to their baseline. The testing also significantly assist clinicians in the Return-to-Play decision. Early comprehensive treatment of concussion can also decrease the time that symptoms are experienced thus reducing the likelihood of Post-Concussion Syndrome (where the concussive symptoms last greater than 2 weeks). In summary, a concussion can and should be treated with a comprehensive approach and in a collaborative effort between the individual and their family, a trained rehabilitation professional, a physician, school administrators, and coaches. This collaborative approach will help minimize the possible long-term effects of a concussion.

References:

  • Prien, Et al. “Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review” Sports Med. 2018 Apr:48(4):953-969.
  • Langlois Et al. “The epidemiology and Impact of Traumatic Brain Injury: A Brief Overview” Journal of Head Trauma Rehabilitation: September-October 2006: Vol21. Issue 5. Pg 375-378.
  • Patel, Et Al. “Aerobic vs anaerobic exercise training effects of the cardiovascular system” World J Cardiol. 2017 Feb 26:9(2):1324-138.
  • Viano Et al. “Concussion in professional football: biomechanics of the struck player part 14” Neurosurgery. 2007 Aug:61(2):313-327.
Karley Glashauser, PT, DPT, CBIS, CF-L1 Physical Therapist, The Lighthouse Neurological Rehabilitation Center

Karley graduated with her Doctorate of Physical Therapy from Central Michigan University in May of 2009. She has been employed at The Lighthouse Neurological Rehabilitation Center, Caro location, since July of 2009. Karley has continued education in the areas of Hippotherapy, NDT, and Concussion Management. Karley is also a CrossFit Level 1 Trainer at Davison CrossFit and Flint CrossFit with a special certification in Adaptive CrossFit.

Triangulation – What Is It and How Does It Apply to the Role of Caregiver

Apr 4, 2019 | Awareness, Caregivers, News, Support

As caregivers, we are each drawn to the work we do for a reason. It may be because we simply like to help, have someone in our lives suffering from a disease or an injury, or are just stopping along the way to get to another spot. Whatever the reason, our jobs involve helping people. This can be very rewarding and enriching – it can also be troubling, stressful and distressing. One tactic we come across in the world of therapy is triangulation – a form of manipulation where a person will not communicate directly with another person, instead they use a third person to relay the information to the second person – thus forming a triangle. Triangulation is a concept primarily used in trauma-based therapy, taught to mental health professionals specifically trained to work with individuals who have experienced a traumatic incident, such as a car accident, fire, death of a loved one, etc. The way these individuals perceive life and relationships can be drastically influenced by that experience.
This has much to do with how the brain is wired, through social and emotional experience, and how social experiences have affected the individual. The act of triangulation can be intentional or unintentional – a very complicated cycle that negatively impacts everyone involved. Triangulation can be common in many aspects of our lives, but as a psychologist in the world of brain injury rehabilitation, I see it quite often. To have a triangle, you must have three people: a victim, a persecutor, and a rescuer.
Victim: “The good guy”. No voice, no power. In this frame of mind, the victim does have power and a voice but are afraid to use them. Persecutor: “The bad guy”. The attacker, the one who bothers the victim. It could include allowing the victim to experience the natural consequences of their choices or behaviors. Rescuer: “The hero”. Swoops in and takes care of the victim’s problem – but at the same time ensures the victim never finds their own voice or personal power. Let’s use the characters in the movie The Wizard of Oz as an example... Dorothy – the victim. Riding in a house which drops and kills the Wicked Witch; obtains the Ruby Slippers. Wicked Witch of the West – the persecutor. Unhappy about sister’s death, but more importantly – wants the Ruby Slippers. Glenda the “Good Witch” – Dorothy’s potential first rescuer. Glenda is good, and tells Dorothy how to solve her problem but doesn’t do it for her. In the movie, Dorothy picks up potential rescuers along the way – the Tin Man, the Cowardly Lion and the Scarecrow – all victims of their own life circumstances. Each of them do their best to rescue one another from their fears. We also see several persecutors for the victims, each of whom are looking for help/rescuing from the Wizard of Oz.
“When we cast ourselves in the victim role, we often feel helpless, hopeless, powerless, inept, etc. Sometimes, we may think “I can’t do it, I need you to do it.”
Fast forward to the Emerald City, where the best rescuer is believed to reside – the Wizard. Dorothy asks the Wizard for help, but is denied. [Oh, no, that isn’t supposed to happen – the Wizard (rescuer) is supposed to help me.] For the Wizard, his role quickly transitions from rescuer to persecutor.
“Now the victim has to find a new rescuer.”
In the case of the Wizard of Oz, that person becomes Glenda. Glenda helps Dorothy rescue herself by finding her voice and enacting her power to dissolve the witch with a bucket of water, and with three taps of the shoes, we see Dorothy back home.
“Rescuers, understand: if you are not able to rescue your victim, the victim doesn’t like how you rescued them, or other reasons – you – the rescuer is now becomes the persecutor.”
So, how do we break out of the triangle?
  • Support, don’t rescue. If someone comes to you to rescue them, assist them in figuring out how to solve the problem themselves.
  • Refer the victim back to the person with whom they are having the problem.
  • Help the victim find their voice. Role play what they could say by using the “I” message concept:
When your [insert description of behavior], I feel [insert name the emotion], I want [insert description of replacement behavior]. Example:
“When you act like a jerk, you make me angry, I want you to stop” will serve to incite more conflict versus help resolve. A different approach might be “when you keep your headphones on when I am trying to talk to you, I feel frustrated. I would like you to take the headphones off.”
We can also use this method to communicate positives. “When you take off your headphones when I’m trying to talk to you, I feel appreciative, please keep it up!” Some helpful reminders:
  • When we say “I feel,” we’ve taken responsibility for our own emotions, versus when we say “you make me feel,” we give all the power to the other person.
  • Make sure the description of the behavior is without opinion or judgement.

References:

Kimberly McGowan, MA, LLP, CBIS
Limited License Psychologist
Hope Network Neuro Rehabilitation
Dignitas
Eisenhower Center
Special Tree
Community Connections
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Lightouse Neurological Rehabilitation Center