4 Things Not to Say to Someone with a Brain Injury

An IED blast. Traumatic brain injuries are most often caused by powerful blasts from improvised explosive devices. A roadside bomb explodes and the concussive effect violently shakes the brain inside the skull.

Traumatic brain injury (TBI) is one of those “hidden wounds” that goes unnoticed by many. It’s also one of the signature wounds of Iraq and Afghanistan war veterans.

And while many times the wound is not visible, a brain injury comes with real side-effects that make it difficult for the injured persons.

A recent article on brainline.org written by Marie Rowland, PhD, EmpowermentAlly, details 9 Things NOT to Say to Someone with a Brain Injury.

Rowland focuses her advice for the caregiver who, out of frustration and exhaustion, may say something to the brain injured person without realizing its impact. Here are Rowland’s top 4 Things NOT to Say:

1. You seem fine to me.

What does not show is the fatigue, depression, anxiety and pain that may accompany a brain injury. Something like a memory problem can be far more disabling than a physical wound like a limp.

2. Maybe you’re just not trying hard enough (You’re lazy).

Lazy is not the same as apathy (lack of interest, motivation, or emotion). Apathy is a disorder and common after a brain injury. Apathy can often get in the way of rehabilitation and recovery, so it’s important to recognize and treat it. Do beware of problems that mimic apathy. Depression, fatigue, and chronic pain are common after a brain injury, and can look like (or be combined with) apathy.

3. You’re such a grump!

Irritability is one of the most common signs of a brain injury. Irritability could be the direct result of the brain injury, or a side effect of depression, anxiety, chronic pain, sleep disorders, or fatigue. Think of it as a biological grumpiness — it’s not as if your loved one can get some air and come back in a better mood. It can come and go without reason.

4. How many times do I have to tell you?

It’s frustrating to repeat yourself over and over, but almost everyone who has a brain injury will experience some memory problems. Instead of pointing out a deficit, try finding a solution. Make the task easier. Create a routine. Install a memo board in the kitchen. Also, remember that language isn’t always verbal. “I’ve already told you this” comes through loud and clear just by facial expression.

You can read all 9 Things NOT to Say HERE as well as learn other tips for living with, preventing and treating TBI at Brainline.org .

VA Backlog of Benefits Claims Got Worse in 2012

Making it easier for veterans to apply for benefits and disability for traumatic brain injury, post-traumatic stress disorder and agent orange exposure served to swell the backlog of VA benefits claims in 2012.

The VA has processed about 1 million claims a year, but more than 1 million new ones keep coming in reported Quil Lawrence of NPR.

Hundreds of thousands of veterans who suffered injuries while serving in the military must wait many months for care and compensation. Slightly more than 863,000 people had pending compensation claims with the VA in December, according to a Dec. 17 report.

A Backlog Worsens

At the start of 2012, the department promised to cut into that big backlog of claims. But over the course of the year, that backlog has gotten worse, not better.

There is Recovery from TBI: One Army Sergeant’s Story

Army SGT Amber (Greer) Brooks in June 2011 three months after her accident. The medical team had to shave off her waist-length strawberry blonde hair to access her skull and save her life.

“The big shock to me was ‘Why am I not at work? Why can’t I go to work? I don’t understand why I can’t be around people I served with.’” Army SGT Amber Greer said. “It was a huge shock to me and something that was so foreign to me. I probably cried for about a week that I couldn’t go to work.”

That’s how Greer described her struggle to recover from multiple injuries including Traumatic Brain Injury after a traffic accident in 2011.

Thankful for her recovery and hoping to encourage others  traveling the same path, Greer (now Amber Greer Brooks) sent me this recent update:

By Amber (Greer) Brooks

Recovering from any major trauma is extremely difficult and takes a lot of time and patience. I spent from March 20, 2011-August 17, 2011 in the hospital only to end up in one of the Army’s Warrior Transition Units (WTU).

These WTU’s are designed for soldiers to go to heal and transition either back into the Army or back into civilian life. Fortunately for me, the Army decided that I met the standards of being returned to the Army.

Since then, I have married a wonderful man and will be taking a new job in the Army.

I am leaving for training in January 2013 to work for the Army as a contractor. I will be signing and negotiating government contracts on behalf of the Department of the Army.

I have also scored the highest on my Physical Fitness Test (APFT) ever (even before the auto accident) with a perfect 300! 46 push ups in 2 minutes, 80 sit ups in two minutes, and running two miles in 14 minutes 51 seconds.

Anyone can achieve anything, it just takes a lot of focus, motivation, and never giving up.

TBI: Testing Cognitive Skills of High School Football Players

Courtesy of SUNY Youth Sports Institute.

Before they put on their pads, before they strap on their  helmet, high school football players have to take a test in South Florida according to an Associated Press report.

The 20 minute computer test gives doctors a baseline to be able to determine if there’s cognitive impairment after a season of play. The testing begins Monday in Palm Beach County but similar testing has been ongoing for two years in Miami-Dade County.

And South Florida isn’t the only place high school football players are being monitored for concussions.

Purdue University released a two-year study in February in which impact sensors were embedded in helmets of an Indiana high school team.

Purdue found that players received 200 to nearly 1,900 hits to the head per season. Researchers also suggested that concussions are likely caused by repeated blows rather than a single jolt. Such evidence is why the Sports Legacy Institute and other advocates say a “hit count” is necessary to protect young, developing brains that are more susceptible to injury than those of adults.

Long term effects of blows to the head and concussions are a concern. Diana Brett, the mother of a 16-year-old who suffered numerous concussions and killed himself, is pushing for more more education and study of concussions in young athletes.

Judge Patt Maney Inspires Veterans Dockets in Florida

Judge Patt Maney and his wife Caroline when he was awarded Patriot of the Year (2010) by the Military Order of the Purple Heart.

This year, lawmakers gave Florida’s chief judges the power to set up a “Veterans Docket” for military members and veterans in minor legal trouble. Retired Army Reserve Brigadier General and Okaloosa County Judge T. Patt Maney advocated for the idea.

“We need to look at what the real problems are for the service members and the veterans and their families and to address those problems,” Maney said in an interview with WUSF. “And if they’re legal problems, we need to create a structure that will protect the public, save the public money and do justice to the veterans their families and the service members.”

Maney understands those veterans’ problems first-hand. His vehicle was blown up by improvised bomb when he was serving in Afghanistan in 2005. He spent almost two years in Walter Reed Army Medical Center in Washington D.C. recovering from injuries including traumatic brain injury or TBI.

In an interview with Bobbie O’Brien, Judge Maney shares what it’s like living with TBI symptoms where you struggle to accomplish even the simplest task like using a self-service gasoline pump or remembering a word.

JUDGE T. PATT MANEY: Literally, you’d get three or four or five words out and then have a 15 or 20 second pause while you tried to think of the next word. Those pregnant pauses make it hard for people who are listening also to keep track of the conversation. But, it’s very frustrating for the person who is speaking

BOBBIE O’BRIEN: At that point were you thinking I’ll never be able to sit on the bench again?

MANEY: Well, the Army had already told me they were going to medically retire me and I was convinced at that point I was not going to be able to go back on the bench because I did not at that point have the capacity to do the job.

People want judges not only who are fair but judges who listen, who remember and then apply law to the facts they’ve heard in evidence and I couldn’t do that.

O’BRIEN: That had to have been a terrifying time for you?

MANEY: But it all turned out very well and because of that experience. I am fortunate enough to judge in community that has a large number of veterans and a large number of active duty people. We’re the home of Eglin Air Force Base. And so, I started noticing in court defendants coming through that demonstrated in court some of the symptoms that I had lived. And so I started paying more attention to them and asking them if they were veterans and asking them if they had deployed and asking them if they had been blown up.

Concussions: Why Woodpeckers Don’t Get Them

Microscopic scan of a woodpecker's cranial bone. Courtesy of Science Life.

Humans could learn a thing or two about preventing traumatic brain injury (TBI) from woodpeckers according to an article in Live Science. Concussions and TBI have become a common injury for combat veterans.

Researchers in Beihang University in Beijing and the Wuhan University of Technology found that a woodpeckers beak pounds into wood at the force of 1,000 that of gravity. But, a thick boned skull, strong neck muscles diffuse the force and a third eye-lid keeps the eye from popping out.

Scientists are studying the sponge-like structure of the skull bone to find to find further ways to prevent serious brain injury and concussions by designing better headgear.

Microscopic photos of the bones and beak are part of the article in Live Science:

The findings could be important for preventing brain injuries in humans. Each year, more than 1 million people in the United States alone sustain and survive a traumatic brain injury, according to the Centers for Disease Control and Prevention. Another 50,000 people die of their injuries.

TBI Research: Nanoscientists Developing Detection Tool

Photo courtesy of UNCG.

A nanoscience assistant professor at University of North Carolina Greensboro, Marinella Sandros, is working with a team to develop a device that will measure blood proteins to detect moderate TBI, traumatic brain injury.

Sandros wrote an opinion piece detailing the journey of discovery and teamwork for the News & Record online:

Currently, there are no medical tools available to objectively diagnose mild traumatic brain injuries. Only subjective testing is available. For severe to moderate TBI, a physician can detect morphological changes in the brain using an MRI or CT-scan, but for an mTBI there are often no changes that can be detected using these devices.

Therefore, these medical diagnostic tools are not reliable. With the help of the device we are making, we can look at the chemical changes that occur in the brain. If the blood-brain barrier, or the cells that separate circulating blood from the brain membrane, is breached following an mTBI, specific proteins are released into the central nervous system and then into our bloodstream. This device will be able to monitor these proteins.

You can read Marinella Sandros‘ full opinion article HERE.

More information on TBI research, detection and treatment is available through the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

TBI: A Live Tweet on the Latest Diagnosis and Treatment

The Defense Centers for Excellence for Psychological Health and Traumatic Brain Injury (TBI) is hosting a “live Twitter event.” The idea is to have an hour-long Tweet discussion where you can ask your questions about TBI and get real-time answers.

The following announcement is from DoE:

As traumatic brain injury (TBI) has become one of the signature injuries of recent conflicts, it is imperative that health care providers, both in the military and civilian community who treat our wounded warriors and veterans, have the most up-to-date diagnosis and treatment information. The DoE works with a collaborative network of leading experts to develop and enhance provider tools.

DCoE will host a live discussion on Twitter, also known as a twitterview, March 28, 1-2p.m. EDT specifically targeted at health care providers.

Deputy Director of TBI Ms. Katherine Helmick will answer questions regarding tools available for the diagnosis and treatment of our warriors who have sustained a TBI.

What is Twitter? Twitter is a popular social media site founded in 2006 that allows users to post short messages limited to 140 characters or less, commonly known by users as “tweets.”

What is a “twitterview”? A twitterview is a live discussion on Twitter that allows users to tweet in their question to a specific individual/organization during a specified time.

To get involved in the discussion, follow @DCoEpage on Twitter or use the hashtag #DCoE.

Veterans’ Court Authorized by Florida Lawmakers

Veterans Treatment Court. Photo courtesy of the VA.

Florida is home to more than 1.6 million veterans. So, it’s no surprise that Florida lawmakers passed several bills this session that benefit military veterans and active duty service members.

Among the bills agreed upon was the “T. Patt Maney Veterans Treatment Intervention Act.”

Named in honor of Okaloosa County Judge Maney, the bill authorizes each judicial circuit to set up a Veterans’ Court or program to handle the cases of veterans with psychological problems like substance abuse and PTSD or traumatic brain injury as a result of their military service.

“Under the program a judge may sentence these veterans and service members in a way that addresses the severity of the condition through services targeted to the individuals’ needs,” said Steve Murray, spokesman for the Florida Department of Veterans’ Affairs. “It adds both misdemeanor and felony pretrial intervention programs as eligible treatment programs.”

TBI: A Department of Defense Special Report

A High Definition map of brain fibers. Photo Courtesy of News.Discovery.com.

Almost everything you’ll need to know about traumatic brain injury (TBI) including research, diagnosis and treatment: A Department of Defense Special Report.

• A study looking at treating mild TBI: The Study of Cognitive Rehabilitation Effectiveness, is examining the value of cognitive rehabilitation therapy treatment for service members with mild TBI.The goal is to find the best treatment for combat troops who are experiencing mild TBI symptoms — such as difficulties with attention, concentration, memory and judgment — three to 24 months post-injury.
• A study that looks at the link between TBI and PTSD: Service members who suffer mild traumatic brain injuries in combat and then struggle with depression, irritability, alcohol abuse and similar problems after they return home most likely are experiencing post-traumatic stress, rather than brain injury symptoms, according to a new study that tracked Minnesota National Guard soldiers during the last month of their 16-month deployment to Iraq, then again a year after they returned home.
• The Defense and Veterans Brain Injury Center provides links and resources to active duty members, veterans and their families: TBI Facts; how Family and Friends can help; information on Sports vs. Military concussions.

Although I found some of the articles were published more than a year ago, the resources and links of this aggregating page are useful: DoD Special Report on TBI.

For some great visuals that show the complexity of the brain’s nerve network in high definition, check out Discovery News online.