Vision Problems

            Vision problems may occur after a TBI (traumatic brain injury).  Vision problems affect 20% to 40% of all brain injured people.  I have vision problems that I never had experienced before my accident. 

            I experience double vision when I look up.  This happens because the eyes are round and when I look up at something the image is hitting off the bottom part of my eye, making the second image look higher then real image. Something similar may be happening to you, if you have experienced a brain injury as well.

            People with brain injuries are very likely to experience vision problems because 40-50 percent of the brain is involved in vision.  Your vision is located in the occipital lobe of your brain, which is located in the back part of your brain.  The reason why so many people with brain injuries experience problems with vision is because when you get into a motor vehicle accident the brain can be detached from the skull, then momentum forces it back and forth making the brain collides with the skull.

            I went to the eye doctor to see if they could solve the problem with my eyes.  I was even going to accept surgery on my eyes if that was the only way to fix my double vision.  The only thing was that the doctor said surgery wouldn’t fix the problem because my cerebellum was very badly injured in my automobile accident.  Instead I received a pair of glasses, which I think is a better option than surgery. They help to alleviate the problem and I’m happy with the outcome.

The Toledo Mudhens

     I went to a Toledo Mud Hens game on Saturday the 10th of August. The Toledo Mud Hens are the Detroit Tigers minor league team. They played against the Indianapolis Indians, who are the Pittsburg Pirates minor league team.

     The starting pitchers were Jair Jurrgens for the Mud Hens and Jameson Taillon for the Indians. Both of the starters had let up 4 runs before they were pulled. The Indians pitcher had lasted 7 innings compared to the Mud Hens starter who only lasted 5.2 innings. From the showing of the numbers it looks like the Indians had done better then the Mud Hens. Ben Guez, who is a Mud Hen, hit a homerun in the bottom of the 3rd to tie the score up 3-3. In the bottom of the 4th the Mud Hens took a 4-3 lead over the Indians when Kevin Russo hit a ground ball to the right fielder, which scored Danny Worth. Kevin Russo, for the Mud Hens, was picked off from 1st base during the same inning, the bottom of the 4th. In the top of the 6th the Indians tied it up 4-4. It stayed tied and the game went into extra innings. The next run was scored in the bottom of the 10th by Danny Worth doubling and scoring Danny Dorn. The Mud Hens won the game thanks to a couple of Mud Hens players.

     The majority of the ball park was very handicapped accessible and easy to get around. The handicapped seats are good as well. I went all the way around the stands without a problem, and I went into the store with minimal difficulty. Some help was needed getting in and out of the bathroom because of the type of doors they have. Some help will be needed with the stall doors too. The stall door could not be closed because my wheelchair was too large for the stall. That was the only problem I experienced with the park and their accessibility.

Overall, I think it was a good game and a good learning experience for me. The Mud Hens had won the game 5-4 in the 10th inning thanks to Danny Worth and Danny Dorn. I learned to never assume a place is 100% handicap accessible, even if they are a big, well known place.

Memory After TBI

                Problems with memory are a very common problem for people who have experienced a traumatic brain injury (TBI).  A lot of people think of memory as being “good or bad”, but it is a lot more complicated then that.  There are a couple different types of memory I’m going to explain here.

                To start things off, I’d like to say that everybody has memory for taste and smell.  The majority of people know the taste of sugar and the smell of a rose.  More importantly there are visual memory and hearing memory.  Visual memory is what we see; it allows us to remember where we have been, where you’ve put something, or what you’re eating.  Visual memory is stored in the right hemisphere of the brain.  We have a special part in our brain for verbal or hearing memory.  This is stored in the left hemisphere of the brain. The hearing part helps a person remember what they have read because things we’ve read translate into language.

                Next, I’d like to talk about immediate memory and short-term memory.  Immediate memory doesn’t last to long. It might last just for a couple minutes.  You use immediate memory when a school teacher tells you a math problem and you have to remember it long enough to write it down immediately.  When a person has a head injury their immediate memory might not be affected, but most head injured people experience problems with short-term memory.   Immediate memory is something that is quickly “spit back”, but short-term memory is information remembered after 30 minutes. An example would be if the teacher said the math problem and it wasn’t written down, then the teacher asks if anybody remembered the math problem 30 minutes later. I would have difficulties remembering it, as would most people with brain injuries.  Short-term memory is what affects a lot of brain injured individuals.

                The last type of memory I’m going to talk about is long-term memory.  Long-term memory is information that is recalled after a day, a couple weeks, or even 15 years.  Long-term memory is the least effected by head injuries.  In fact, a lot of people with head injuries will say, I can tell you what important thing I did 15 years ago, but I have trouble remembering what I just did 15 minutes ago.

                Information flows in through the middle of our brain and branches out like branches on a tree.  Before the information heads off to the different areas of our brain, it is channeled and filtered by a system.  When the brain is injured, the middle areas that information passes through get pressed on because of swelling. The middle area of the brain is also resting on a bone in the skull.  Forward and backward movement of the brain in an accident can cause the middle areas to be ripped or scraped.

                What can we do to help us remember stuff?  It helps to get organized. For example, always put money in the same place.  This way the second you have to grab some extra cash, you know right where to look. Another way which will help, and I do it a lot, is to write things down.  I write down the groceries I need to buy throughout the week, this way when the day comes that I do my grocery shopping, I have my entire list right at hand. I do this because there is no way I could possibly remember it all.

Kayaking..Should I do it?

          Should I kayak?  That's the big question I'm asking myself.  There are a few pros and cons to doing it. I'm going to tell you about them in this article, so you should leave me some advice saying if I should go kayaking or if I should not go kayaking.

          I will start by telling you my pros about kayaking.  If I decide to go kayaking, it will be something new to me because I haven't been kayaking since my accident. It will also be a change of scenery because I would be on the water and doing something outside for a change. I would also be able to relax by the water.

          Now I will tell you about the cons. I don't exactly like getting wet, unless I am in the shower or something. I am so nervous about flipping my kayak because that I would defiantly  get wet that way, and it would be dangerous if I flipped my kayak. It will probably be uncomfortable sitting in a kayak having my legs all stretched out for the amount of time I'm in the kayak because my legs are used to me sitting in a wheelchair. Also the company says they have adaptive equipment, but I am unsure how they will make it so I can paddle with my right arm because I have trouble doing stuff with that arm.

          These are my pros and cons to kayaking. Now it would be much appreciated if you could help me decide on if my pros out weigh my cons, or if my cons out weigh my pros.

 

Thanks a lot,

B.K.

 

My Job on the Blog

          One of my jobs at Day Treatment Services, or DTS, is the blog.  There are many useful skills that are used while writing the blog.  Some of the useful skills include interviewing, concentration, and many more that I will talk about throughout this article.

          Creating a blog once or twice a week can be a very challenging task for me.  Skills are needed to write the blog, such as cognitive abilities.  These cognitive abilities include brain storming, spelling, forming correct complete sentences, and forming correct complete paragraphs.  I’m able to utilize the brain storming skills while coming up with article topics.  Concentration is another skill that is needed for the job.  It can sometimes be very difficult to concentrate with all the noise that could often be occurring in the background.  Stuff like other staff or a T.V. can be very distracting.  It can take a lot of energy or effort to stay concentrated on the task that I’m working on.   All of these things are good for my brain to handle because they can be tough.

          Another set of skills that is needed to work on the blog are some computer skills.   Knowing the keyboard can help a lot. Knowing where the letters fall can be very helpful. Your computer type must be known too.  For example, the type of computer that is being used must be known.  Like if a Macintosh computer is being used, or a computer that runs windows, determines the programming that must be known.  I work using Microsoft Word, and am comfortable with that program.

          Interviewing people is a required part of working on this blog too.  To interview people, a topic must be chosen.  After the topic is chosen, a question list must be created.  Then a person that is going to be interviewed must be chosen, whether the person is known, or it might be a totally random interview.  A good thing that comes out of this is that time management skills have to be pretty good, which is another thing the blog works on.  Creating a schedule and keeping to it is a great way to manage time efficiently.

          The way I work on this blog is I pull out a sheet of paper and a writing utensil and create a list of possible topics.  Next, I work with my job coach to determine if research is needed.  Then I create a story web using researched information, already known information, or past experiences.  Past experiences may include previous outings or activities that I was able to take part in.  After the web is created, my job coach and I work together on writing the articles.  I then type the story in paragraph form on the computer.   After typing the story, it is proof read by myself and my boss. Then I post it to the blog page and sometimes add pictures related to the topic.

          I enjoy doing the work for the blog.  The work that I do is like a therapy to me.   I am able to work on many skills that are beneficial to my brain injury rehabilitation.  I hope that you enjoyed reading about one of the jobs that Special Tree has to offer.

Dogs Can Help

          Dogs can be very therapeutic.  At the place that I’m staying at, we have a small dog, it is a Chihuahua.  Dogs can be very therapeutic because they can listen to commands.  You also need to be able to judge like when they have to go outside.  

          The dog at house I’m staying at is very nice.  It is very friendly and it will let you know when it needs something.  It does this by not leaving you alone until it gets what it wants.  If she needs something, like for you to let it out, she will keep bugging you and will run at the door.  If the dog is hungry, she will keep bugging you and run by her bowl.  The dog has learned how to deal with us.

          When it comes down to it, I personally believe that dogs are very

 therapeutic.  I think this because it is another living thing you must learn to deal with.  I also think this because it works on your judgment skills.  When I first moved to the house I thought the dog was just doing all of this to be annoying, but it actually does all this stuff because it needs something.

Wayne DTS at Toledo Zoo

            On Friday, May 10th, Wayne DTS made their way to the Toledo Zoo. At the zoo, we were able to see a lot of different types of animals and their habitats. The weather was beautiful that day, which made it even more enjoyable for the group.

    Upon entering the zoo, we followed a path that let us view some eagles. The next animals we saw were the elephants. The elephants have a new exhibit, which had opened up recently. While we were going through the zoo, close to the elephants, we came across two hippos. Apparently they were so comfortable they were catching some z’s in the water. We took our time getting to the reptile house, taking in the animals we saw on the way. Once in the reptile house we saw snakes and various other animals. When we were through the reptile house, we were able to see raccoons and monkeys. They both had newborn babies with them in the zoo.

    The weather outside was very nice. It was sweatshirt weather and it wasn’t raining either. It was overcast, so it was kind of cloudy that day, which kept the sun from shining on us and making it too hot out. The animals were active, since it wasn’t to hot out or to cold out for them.

    The zoo itself seemed to be well kept. It seemed to be clean, which is good because it lets you know that the animals are well taken care of. The zoo’s grounds were very well kept too. All the landscaping was appropriate for the animal that was being viewed. The zoo was also very handicapped accessible. The staff had no problems maneuvering multiple wheelchairs through the exhibits.

    All in all we ended up having a good time at the Toledo Zoo. Before leaving, we were able stop in the souvenir shop. A few clients were even able to purchase some goods at the store.  We were also able to have a good time at the zoo since the weather was nice which let all the animals be a little more active.

Warm Weather

                The temperature outside is going to be nice from here on out in Romulus Michigan, except for Sunday May 12^th and Monday May 13^th.  It is going to be in the 70’s and 80’s through June, which is a decent temperature.  It is going to be nice enough to do my favorite thing, fish.  I also like to watch baseball too, and it’s going to be a good temperature to be able to go to some games.

            I like to fish for fish that fight a lot. I even like to fish for carp, if I am in an area were you can either catch carp or bluegill.  Bluegill sure don’t fight very much, that’s why I like to fish for carp when I’m in that area.  Plus, carp are generally big.  I’ve caught a three foot carp before.  That thing almost broke my rod!  I hope some of my readers enjoy fishing and can tell me about it by leaving a comment.

            I also enjoy watching baseball too.  My favorite baseball team is the Detroit Tigers.  They are doing pretty good, so far this season.  At this point they are first in their division, with 19 wins and 11 losses. Their record makes them second in the American League, with a .633 winning percentage.  That is the second highest winning percentage right now in the American League.  I was scheduled to go to a game already this year, but it got rained out, and the game hasn’t been rescheduled yet as far as I know.

            There are plenty of fun things that can be done in warm weather.  Any kind of sport can be played or watched, as long as it’s not raining.  You could even fly a kite, if you are into that type of stuff. Any outdoor activity can be done in nice weather, except snowball fighting since we just got out of that season.

            I hope I was able to make you think about some stuff you would like to do in this beautiful weather.  If I forgot anything you could let me know by leaving a comment.  Hopefully some of you enjoy fishing as much as I do, or enjoy watching baseball like I do.

Spring Fling 2013

         

Written by Bret K.

The Spring Fling is an annual get together for all Special Tree clients and alumni.  It is a time where clients get to meet, have conversations, and enjoy each others company. This year’s dinner dance was held this past Friday evening, April 19, 2013. Clients from all over southeast Michigan traveled to Roma’s Banquet Hall in Garden City for the event. We were all very excited to see old friends as well as make new ones.

          The dance began at 6:00pm with a hearty dinner. Everyone enjoyed pork chops, stuffed cabbage, mashed potatoes, mostaccioli, salad and dinner rolls. For clients requiring food consistency changes, there were stations set up with blenders, food processors, and food thickener. In my opinion, the food was astounding and I am looking forward to next years festivities already. Dessert came at the end of the night. It consisted of delicious cannolis for everyone to enjoy. Sugar free cookies and cakes were provided for any diabetic clients in attendance.

          After dinner the band was able to get down and get nearly everyone out on the dance floor for some amazing dance moves.  Remedy, the name of the band, was able to make their 3^rd appearance at a Special Tree function. All in attendance couldn’t have been more elated. They covered a variety of classic rock jams that everyone knew, including Aerosmith and Lynyrd Skynyrd. Clients and staff alike were able to get their groove on throughout the dance!

          Towards the end of the night, there was a slight break in the dancing to hand out some amazing prizes. Names of all clients present were placed into a medium sized pale and drawn by chance to win a variety of prizes. Approximately a dozen gifts were handed out to the clients that had their names drawn. Winners from both Oakland and Wayne counties were overjoyed upon hearing their name called for a prize.  I was one of the lucky winners and got to roll away with a brand new Detroit Tiger’s windbreaker jacket. This will come in handy for me, since I am going to be attending a Tiger’s home game this week.

          The Wayne Day Treatment Services staff was there as usual to take photos of each client that attended. Photos were taken in a “prom” style around a spring themed backdrop, consisting of beautiful flowers and twinkling lights. They were printed out and placed in a special card and given to the clients to take home as their souvenir from the event.  One staff from the Riverview house was able to take candid photos of everyone enjoying themselves as well. Hopefully we will be seeing these photos soon.

          All in all this party was pretty fun for all involved.  We all got to eat a wonderful dinner, dance to some classic music, win prizes, and take a photo home to remember the evening. Who wouldn’t have had a blast participating? I’m already looking forward to the Fall Bash in a few months to be able to see old and new friends again.

Something New!

   written by Bret K. 
    Prior to my auto accident I loved going on long bicycle rides with my friends and family. We would go to local parks with bicycle trails as well as ride around the neighborhood. We would have so much fun together, racing, taking in the nature, laughing, and just enjoying each other's company. After my brain injury riding a bicycle quickly became a distant dream.

    But that is all about to change. This week I was able to receive a custom made tricycle, and I am very excited to open this new chapter of my life. The tricycle was custom built with foot sized pedals that are able to be strapped to my feet prior to riding. The gear shifter was moved to the left side of the tricycle so that I can shift gears with the push of a button. The seat position was custom to fit my body proportions perfectly. The brakes of the bike are usable on both handle bars, however I will only be able to access the left one.

     I got the tricycle not only for personal gains, but for gains with family and friends as well. Although in the begining I only wanted a bike for personal pleasure reasons, I will be able to utilize multiple therapeutic outlets as well. Not only will I be able to get out and enjoy a past time that I loved so much I will be able to work on increasing my endurance level, range of motion, and build lower extremity strength. It will take me a few months in therapy to master my ride, but I am determined to be out on the trails by the end of this summer!

    I have big plans for when I am able to ride out in the community. I am planning on riding my bike at some State Parks. My favorite ones are Sterling State Park in southeast Michigan and Maumee Bay State Park in Ohio. I am very excited to carry out these big plans with my family and friends.

April is National Stress Awareness Month

     written by Bret K

           Did you know that April is National Stress Awareness Month?  I was unaware that such a holiday existed until recently.  In light of attempting to manage my own daily stressors, I am going to inform you of some possible ways to assist in relieving stress.

            Not all stress can affect you in a negative way. There are some great outcomes from stress when it is handled appropriately.  Stress can lead to personal creativity, learning, and is essential for survival. So how can something that is supposed to help you end up hurting you in the process? The negative effects of stress can be seen almost everywhere today. It can become harmful to the individual when it interrupts the healthy state of equilibrium of a normal healthy body.  When a person is overwhelmed, this is becoming increasingly common; they are unable to face any stressors and can become depressed or anxious. Upon becoming overwhelmed with daily stressors, the body is flooded with chemicals to prepare you for “fight or flight”.  This natural instinct can be very helpful in emergency situations; however it can wear down the body when it is constantly activated by daily stressors. 

            There are multiple techniques used for relaxation. However, lying on the couch or sleeping is not a proper way to relieve stress.  The relaxation response in the body is a mentally active process that leaves the body feeling relaxed, calm, and focused.  Some ways to reach this state of relaxation would be to utilize deep breathing techniques, visualization, meditation, yoga, or rhythmic exercises.  You should try to set aside 10-20 minutes a day for proper relaxation. These exercises can give you an energy boost and improve your mood. 

            There are some important ways to choosing a proper relaxation technique for yourself. Be sure to consider your specific needs, preferences, fitness level, and the way that you tend to react to stress.  Make sure that your relaxation technique fits your lifestyle and you are able to focus your mind.  Consider alternating or combining different techniques for the best personal outcome. This may lead to provide the best results and to keep you motivated.

            Well I sure hope that I was able to give you some helpful hints to managing daily stressors. Remember to stay calm, even in most impossible situations and all will eventually work itself out.  If you have any stress relieving tips or comments please leave them below. Thank you for your participation. Have a happy day

Relationships after TBI

          Forming and maintaining meaningful close relationships after a traumatic brain injury can be very difficult.  You may not be able to recall who important people are in your life, such as your parents, siblings, significant other, or even your children.  I remember after I woke up from my coma, my father asking me if I knew who he was.  All I could do was respond with a very slow thumbs up.  I cannot recall the exact look on his face, but I do remember him being overjoyed with me knowing who he was. 

            Despite having a wonderful family by my side through my recovery, I still have a desire to build meaningful relationships outside of that close knit circle.  My biggest difficulty thus far has been expressing my thoughts and feelings to others.  This can be very common in survivors often leading to feeling misunderstood or feeling isolated.  It is also sometimes difficult for me to understand what others are meaning when they say certain things.  This is a huge barrier, often affecting all relationships post injury.  When participating in open conversation, I sometimes think that others are saying insulting things; this causes me to “emotionally” shut down.  I have read that other survivors can become irritated and may say or do things that they later regret upon misunderstanding a conversation.  Friendships often crumble upon repeated misunderstandings, due to lack of communication.

            Another significant barrier to building new relationships after traumatic brain injury may include difficulties living within a long term rehabilitation facility.   Difficulties in getting from place to place can make it incredibly hard to visit friends or do the things that were once enjoyable.  It may be almost impossible to decide to up and go to the mall for the afternoon, due to staffing issues as well as transportation. Participating in a work or recreational program on top of daily therapies can further restrict your time to partake in solo activities to build relationships.  It can also be intimidating to go out in the community with a large group of housemates.  I often find myself sticking with the group as I should, but reluctant to associate with others outside of the group.  Time restrictions put in place by the facility may limit visits with friends.  This can be aggravating to be an adult and have a curfew so to speak.  I’m not trying to knock living in these facilities, because I do, I just know there are some issues that will always arise. 

            The largest barrier to building relationships, in my opinion, is meeting new people.  This is a must to create any type of relationships, whether it is an acquaintance, or a potential significant other, you will never know if you never meet them.  After injury survivors often stop working, and partaking in community based events; such as sports, church, or other social activities.  This limits the amount of people that the survivor can come in contact with to converse and build a relationship.  Over time, friends and coworkers may lose contact with you, due to their own busy lives. This happens a lot, and if there isn’t a way to replace these relationships, the survivor can end up feeling alone and may become depressed. 

            Now let’s overcome these difficulties!  When conversing back and forth, try to ask open ended questions, so the person is more likely to give a detailed response, allowing you to elaborate on what they are saying.  This is a huge conversational pointer!  Try not to push away the people that care about you, instead let family and friends know your positive and negative feelings to allow them to assist you better.  Attempt to take the initiative to make an acquaintance a friend.  This can be done by inviting someone over for a visit that you regularly see but may not speak to outside whatever you usually do.  Keep in mind that it is much easier to get to know someone if you are participating in an activity that is enjoyed by both parties.    

            Once a connection has been established, it must be maintained and cultivated.  This takes intention, attention, courage, creativity, and love from both parties.  These things take hard work, but the rewards are rich and friends can make the intolerable tolerable. So get out there and make a new friend or get to know a new partner.  Having a positive relationship can help you feel satisfied with your life and give you a sense of belonging and self worth. Something we all search for in life.

Job Opportunites after Traumatic Brain Injury

           There are many work programs offered here at Special Tree’s Day Treatment Services program for persons with a traumatic brain injury.  The DTS program began working with clients about two years ago to get them back to working in the community after acquiring a TBI. The name the work program was given is InPro, standing for Innovative and Productive.  Some of the work offered requires light lifting, janitorial, writing, painting, maintenance, and utilizing your creativity.  

            The work at DTS includes quality support services, laundry, housekeeping, and Chapp’s oil. Quality support services and housekeeping are very similar jobs focusing on light janitorial tasks. The only differences are where the work takes place.  Quality support services are located at the Wabash Center, where housekeeping is located at the NeuroCare Center. There job tasks include sweeping, mopping, dusting, and disinfecting the buildings.  A laundry job is located at the NeuroCare Center. Clients are now working a morning and afternoon shift along side a natural support for guidance in this department. The tasks delegated to someone working in laundry would be to collect soiled linens, sort linens from clothing, wash, dry, and fold all garments, deliver clean linens to appropriate place, and hang client clothing in correct room.  The employee is able to ask for assistance from the natural support when necessary, providing a place for growth of employability skills in a controlled environment.  Chapp’s oil is a seasonal job that provides grounds keeping work for clients.  In the warmer months, clients are able to paint parking lines, parking blocks, light fixtures, and keep the gas station/truck stop looking immaculate. Seeing the great work that they have done, employees are able to get a sense of satisfaction out of their jobs.

            InPro offers a few jobs that work on fine motor skills, detail orientation, and following directions.  These jobs include labeling medical supplies, working at Goodwill Industries, or working at Lumicon.  Each job has there differences but the main similarity is that the employee is counting, sorting, and packaging goods for future use. They are also able to work with a job coach or natural support for guidance, instruction, and answers to their questions.

            Some more positions that InPro offers to its employees are the opportunity to work in the Ceramic Studio or in the Furniture Restoration/Woodshop garage.  The woodshop job builds some strength in the upper body from stripping paint from old wooden objects and sanding them smooth. The pieces are then stained or varnished and topped with a layer of polyurethane before being taken to the store to be sold.  The Ceramic Studio makes various decorative pieces. They mold each piece from wet slip and let it dry then sand the hard edges before placing it in the kiln for firing.  After the first fire, each piece is painted either to order or random and fired again. The pieces are then sold throughout the company and at local festivals and events. Right now, they are working on an alternate location for a store front, but pieces are still available for purchase through the Wabash Center.

            There are a few more work opportunities that InPro offers to its employees. They are working on the DTS Blog, the job I’m doing right now, working in the Maintenance department, and traveling to a local elementary school to assist the students.  Working on this blog, is very interesting. I am able to come up with subjects to write about, research them, and compose a short storyline for you all to read.  I enjoy working on this and feeling that I am some how helping others that are in the same condition as myself. The maintenance department employees service the NeuroCare center and the surrounding buildings and offices.  They perform any tasks needed to maintain the integrity of the building.  Employees that attend the elementary school are given the chance to tutor students that present difficulty in class. They also assist in the art room to keep the children focused on their tasks.  Employees that are part of the school, find their job both rewarding and sometimes difficult, depending on the students that day.

            These jobs are all offered by Special Tree’s Day Treatment Service program through InPro.  If you have a brain injury and can do these things, which almost everyone can, I suggest you give it a try.  They will always attempt to work within your means, disability and insurance will most likely not be affected.  We are always looking for ways to improve these services and more people to assist in getting back to work. Please let me know what you think of this by leaving a comment here on this story or any of my other stories.

College after a Traumatic Brain Injury

         Returning to college after a traumatic brain injury can be overwhelming and difficult.  You have to start out slow with an easy class.  At first try taking just one class. After a semester or two you can add more classes to your schedule.  For example, after my accident when I was ready to return to school I took a composition class for the first semester. After I completed the class successfully with an “A”, I took a pre-algebra class. When I finished this class with an “A” as well, I decided to kick it up a notch.

          I am currently taking English 1. This class is a lot more challenging because it is not an introductory class.  I have to study harder and harder and I have to write a paper almost every other week.  I am also tested regularly on the reading material assigned to the class.

          The class I am currently taking meets only once a week and is three hours long.  Luckily, I do not have difficulty with staying focused for this length of time.  If you happen to have difficulty staying focused for this length of time, many colleges offer sessions that meet twice a week for only an hour and a half instead of three hours.  I would recommend this type of class if you have attention span difficulties or are just returning to classes after a traumatic brain injury.

          Despite any difficulties in returning to school after a traumatic brain injury, there is still a light at the end of the tunnel.  Many good things can come from a class.  You get the opportunity to meet new people and obviously learn new things. Confidence is a good quality that can be gained from attending classes.

          By attending a class I was able to defeat many odds that were stacked against me. I am currently planning to continue my education and get a degree, even with my injury.

How Do You Get Around?

            After you experience a life altering event, you might find yourself getting around in different ways.  For example, you could find yourself getting around in a wheelchair or using assistance like a cane, walker, or a person to help you walk.  As in anything, there are pros and cons to each of these.

            One way you might be getting around is in a wheelchair. This could be a manual or power wheelchair. There are positives and negatives to both of these.  If using a manual wheelchair, you are given the chance to build muscle tone in the legs and/or arms while self propelling about. You may be able to transfer to a vehicle and ride in a passenger seat without any concerns because your chair can fold up or break down for storage. However, persons who find themselves in a chair that cannot fold down may encounter difficulties with getting into vehicles. They may require a mechanical lift or ramp to get from one place to another.  Wheelchairs, power or manual, could be too wide to fit through narrow doorways. The great thing about power chairs is that they can provide a way to get around even when a person cannot move themselves in any way. There are specialized chairs that operate by suction. The person can either blow or suck and the chair will propel forward, backward, or turn. 

            Another way to get around would be with the assistance of a cane, walker, or person.  A person may be needed for assistance in walking to reassure balance or pace for you. They could direct you if a step was coming or if the ground becomes uneven in any way. You could also be using a walker for assistance to get around.

There are many types of walkers; we will talk about a few of them. There is the standard walker that may not have any wheels at all, a walker with two wheels in the front, or one with a wheel on each leg.  The standard walker may pose a difficulty if you put a lot of weight onto your arms while walking.  Most can be folded up for easy storage; however, there are some types that cannot be folded.  Most people who use a walker or cane need a railing to help them walk up the stairs. Some people who require standby assistance will need a rail to grab onto for balance as well. A person using a cane or walker would have minimal difficulty when boarding a train, plane, automobile, or most other types of transportation, although they may need some assistance from a helper.

            These are some ways that you may find yourself getting around if you have experienced a life changing event.  It might take you a while to build up the strength to “graduate” from a wheelchair to a walker, or maybe you won’t even need a walker.  It will be hard work and you need to be determined to accomplish your goals.  Don’t ever give up; good things come to those that are willing to work their butt off!

Dietary Restrictions with Traumatic Brain Injury

               

Written by Bret K.

              Do you or somebody you know have difficulty swallowing, chewing your food, or both? If you have experienced a stroke, head or neck injury, cancer, cerebral palsy, or dementia this could be a side effect of your condition. Difficulty with chewing and swallowing can also be due to the average aging of a person.

                Difficulty swallowing and chewing of the food is clinically named dysphagia. Dysphagia should be evaluated and treated by a multidisciplinary team consisting of a radiologist, a speech pathologist or occupational therapist, a dietitian, and a nurse. When swallowing difficulties arise there may be a number of problems occurring. There are four types of swallowing difficulties; esophageal phase dysphagia, oral preparatory dysphagia, oral dysphagia, and pharyngeal phase dysphagia. Oral dysphagia is defined as presenting a difficulty controlling the food bolus while in the mouth. Oral preparatory dysphagia is defined as difficulty taking food, chewing, mixing with saliva, and creating a food bolus. Esophageal phase dysphagia is a difficulty with the food bolus when it reaches the esophagus. There may be a delay in action due to the person’s condition. Pharyngeal phase dysphagia defined is difficulty swallowing food due to it becoming trapped at the top of the pharynx of the throat. Aspiration, or the inhaling of food particles into the lungs, is a result of inadequate chewing and/or swallowing. It is said to be a major contributor to respiratory infections and pneumonia in adults that are institutionalized. This poses a large problem to the brain injury community as a whole.

                 If the person has a large difficulty swallowing, they may be on a non oral feeding method for the majority of their nutrients. There are three ways the person may experience a tube feeding. Mostly used for a short time to deliver nutrients to a person is the Nasogastric Tube, or NG. This is a long tube that passes through the nasal cavity and down to the stomach. Liquid nutrients are then given either several times daily or throughout the night while sleeping. As you can imagine, this is not very comfortable, which is why it is used only for short term. The second method is a Percutaneous Endoscopic Gastrostomy or PEG tube. This is used for long term delivery of nutrients directly into the stomach. Nutrients are given in the same manner as a NG tube would be. The only difference is that a PEG tube is surgically placed through the abdominal wall, directly into the stomach. The last way to receive nutrients into the body for a non oral feeding person would be through an IV. An intravenous catheter is placed directly into a vein and nutrients are pushed through the blood.

                After a person has experienced a life altering event that leaves them with a brain injury, they often find themselves with some sort of non oral feeding method in place. They must then work their way back to a regular diet of eating normally. But first they must go through many scans to see if the body is working properly to transport the food bolus from the mouth to the stomach. If difficulty arises in chewing of the food and transporting it to the back of the throat a puree diet may be put in place.  A puree diet is designed for patients presenting a difficulty chewing and swallowing food. All foods should be blended until smooth, and may need to be thickened with a gelatin based food thickener. Thickeners may be useful for adapting pureed foods to meet individual needs. When food is pureed a spoon should be able to stand up in the center without falling to the side of the bowl or cup it is served in. The person is allowed some foods and should avoid the following. Breads and crackers are typically not permitted while a person is on this diet. Nuts, dried fruit, seeds, and desserts that crumble should be avoided. Raw, tough, or vegetables with skins will not easily blend and should be avoided. Tough meats, cheese, and peanut butter pose a difficulty while blending and should be avoided as well while on a puree diet.  Some foods that are allowed while on this diet consist of pudding, yogurt without fruit pieces, applesauce, and blended canned fruit. You may need to thicken the applesauce and canned fruit after blending.  Well cooked vegetables without skin or seeds are allowed but may need to be blended and thickened to pureed consistency. All meats must be blended until smooth. Fish, poultry, and ground meat may be tender enough to puree well. Gravy can be used to maintain a smooth consistency while blending meat. These were examples of foods that may or may not be consumed while on a pureed diet.

                The next step up in dietary restrictions would be a mechanical soft diet. This diet is designed for individuals who have difficulty chewing food but are able to tolerate a wide variety of foods. It includes foods that are soft in texture, semi-solid, moist, and can stick together. Foods must be presented to the person in bite size amounts. A mechanical soft diet gives the person some chewing ability while eating. While on this diet bread is avoided along with dry, hard, crumbly, crispy, or sticky foods. Some foods that are allowed are sugar and sugar substitutes, bite sized, chopped canned fruit, bananas and juices. Watermelon should be avoided if the person on this diet also restricted by thickened liquids. Foods that should be avoided are jams, preserves, all candies, and any items with seeds, nuts, dried fruits, hard/dry toast, and French toast. You may change the consistency and texture of foods to fit this diet by cooking, chopping, mincing, or mashing them.

                There’s another step on the dietary restriction list. It is the edentulous soft diet. This diet is very particular as to what may be consumed by the individual. There is some debate surrounding this diet due to it being so similar to a mechanical soft diet. The only difference in the two would be the foods allowed and avoided. If you have been placed on this diet please ask your team of specialists for a list of foods you are allowed to have.

                After you have made the progress necessary you may be able to eat a regular diet without any restrictions. These foods would be prepared normally without any mechanical alterations necessary. But you may not be able to consume regular thin liquids.

                Often times when a person is diagnosed with Dysphagia they have problems with consuming thin liquids. These drinks must then be altered by a thickening agent to be consumed by the individual. Thin liquids may be thickened to nectar, honey, or pudding consistencies depending on the needs of the person. Nectar thick liquids are a bit thicker than thin liquids, much like a glass of eggnog, tomato juice, or peach nectar would look.  Honey consistency liquids are easily offered on a spoon to the individual. They may be controlled in the mouth easier than thin or nectar thick liquids. There are no natural liquids this consistency without a thickening agent. Pudding thick liquids are used when a person has little to no control over their tongue and mouth movements. These liquids should be given by a spoon to the individual; each bite should be no more than a half of teaspoon of the liquid. It should be kept in mind that there are many things that have “hidden” liquids. These items would be jello, ice cream, watermelon, and any other substances that possibly melt from a solid to a liquid. There are many ways to thicken thin liquids, utilizing bread crumbs, instant apple or potato flakes, instant baby cereal, instant flour, and instant pudding mix. Commercial agents such as Thixx, ThickenUp, and Thick It, may also be used to thicken up foods and liquids.

                If you or somebody you know is having difficulty swallowing or chewing food, I hope this article gave you some insight as to what could be happening.  If you have any questions please see your doctor or speech pathologist to confirm or deny any type of dysphagia. I wish you the best of luck in the future with any difficulties swallowing or chewing food or drinking liquids.

           

Things To Do

            Looking for something to get you out of the house this weekend? I can tell you a bunch of ideas for things to do despite the cold. The following shows, concerts, and events are sure to get your blood pumping and keep you warm.  

            Let’s start with local events and festivals happening in Detroit and the surrounding area.  The North American Auto Show will continue to be on display at Cobo Hall through the end of this weekend, January 27, 2013.  Not interested in cars? No problem, in Frankenmuth there will be the 22nd Annual Zehnder’s Snowfest. This festival features ice carvings, multiple snow sculpture championships, a firework display, and many activities for children.  The cost to attend is free. The Ferndale Blues Festival will also be going on January 25 through February 2. There will be various venues throughout Ferndale participating in this event, hosting dozens of live bands daily throughout the festival. The Rochester Fire and Ice Festival will be January 25th through the 27th. Located on Third and Water in Rochester this festival is free to all attendees. They will also be featuring ice and snow sculptures, a firework show, dog sledding, tube sledding, and cross country skiing exhibits. The two firework shows will be Friday and Saturday evenings at 8pm.  Lastly the Ann Arbor Folk Festival will be held at Hill Auditorium in Ann Arbor on January 25 through the 26th. Admission for one night will cost $35 per person.  All proceeds will benefit The Ark, Ann Arbor’s non-profit home for folk,roots, and ethnic music.

            Want to do something else besides attend a festival? Try a concert! Detroit and the surrounding area have plenty to offer you this weekend! Nelly Furtado will be performing on January 26 at 9pm at Caesar’s Windsor. Cost to attend this concert will moderately cost you $40 per person.  The Filmore in Detroit has plenty going on this weekend. Concerts include FUN, Flogging Molly Green, and Soundgarden. FUN and Soundgarden are currently sold out, but Flogging Molly Green has some seats still available. The show will start at 7pm on the 25 and tickets range from $27 to $36 per person.  Harpos will be presenting the 10th Annual Metalfest on January 26. Doors are scheduled to open at 5pm with tickets costing $10 per person. If rock and roll is up your alley, the Magic Stick will have Emancipator/ Eliot Lipp performing on January 24 at 8pm. Tickets will cost $15 in advance and $18 at the door. They will also have The Darkness playing on January 25 at 8pm. Tickets for this show will cost $25 per person.

            If live shows and plays spark you interest, you’re in luck because there are plenty to see this weekend. Downtown at the City Theatre there will be a show called “Conned”. This show will be playing from January 17 through January 27. Tickets are available at ticketmaster.com and will cost between $32.50 and $37.50 per person. Also downtown this weekend at the Detroit Opera House will be the stage show Shen Yun. From Thursday January 24 through January 27 the show will start at 7:30 with additional matinees on Saturday and Sunday at 2pm. Ticket prices range from $80 to $180 per person depending on where you want to sit. The Purple Rose Theatre Company of Chelsea will be having a show called “The Meaning of Almost Everything” by Jeff Daniels January 10 through March 9. Tickets for this show will vary in cost with student prices being $21, seniors and teachers $39, and a regular adult ticket will cost $42. If you are in the mood to laugh Eddie Griffin will be performing at the MotorCity Casino on Thursday January 24 at 8pm. His stand up performance will cost between $27 and $30. A play named White’s Lies will be performed January 9 through February 3 at Meadowbrook Theatre in Rochester Hills.  At the Macomb Center for the Performing Arts you can see Luna Negra Dance Theatre at 8pm on January 25. You may also choose to view Midtown Men on January 26 at 8pm or January 27 at 3pm.  If you are trying to entertain little ones, Sesame Street Live will be performing at the Fox Theatre January 24 through February 18. Tickets will cost between $12 and $65.

            If nothing you have read above strikes you as something entertaining to attend, think about an expo, convention, or trade show. You can browse multiple vendors at these shows. The Novi Suburban Collection Showplace will be hosting the Home Improvement Show January 25 through the 27.  There will be a $5 parking fee for all vehicles as well as an admission of $8 for adults and children 13 and above, $7 for seniors. Children 12 and under are admitted for free into the showplace.   The Gibraltar Trade Center will have two events within their two locations this weekend. The Mount Clemens location will be hosting the WPC Winter Swap Meet on Sunday January 27. Admission will be $3 per person plus $2 per vehicle to park. To enter the event early it will cost you $10. The Taylor location will be hosting a Sports Cards, Antiques, and Collectables trade show over the course of the weekend. Admission will vary for this location with a $2 fee for parking.

            Last of all, we have sporting events. Although there will not be a nationally recognized sports teams playing in Detroit this weekend, you can still visit the Palace of Auburn Hills for a Cheer and Dance Competition. The festivities will begin at 10am on January 27. It will cost $12 for general admission in advance. Tickets may also be purchased at the door for $15. Keep in mind that children two and under will be admitted for free.

            I hope I sparked some interest in you with all this stuff you could do if you live in southeast Michigan. Whether you plan to head to the auto show or are going to the     Metalfest I hope you will have a blast. Please comment below if you attend any of these activities or have any other events to recommend.  

Power Vs. Manual Wheelchairs

     There are many advantages and disadvantages to both power and manual wheelchairs. For instance, power chairs can be used for longer distances than manual chairs but are often heavy and not as storage friendly. Whether you decide to get a manual chair or a power chair you should know what you are getting yourself into.
     There are many good things that come with a power chair. Power chairs have the ability to climb uphill with the least amount of effort put forth by the driver. They can travel over a variety of terrain with minimal difficulty. Power chairs are often designed for easier use by patients with limited range of motion. They may be built to suit their driver with customizable seat and back cushions. This can be a huge advantage if the user requires assistance with trunk control. Power chairs can also come with a tilt or recline option. This is a good way to relieve pressure for patients with inability to reposition themselves in the chair. When deciding to get a power chair, wheel placement is very important. Power wheels can be placed either in the front, middle, or back of the chair’s base. Keep in mind that the middle placement of power wheels offers the highest maneuverability. Power chairs can give their owners a sense of freedom from the manual chair if they have a difficult time moving about.
     Manual chairs also have a lot of advantages to bring to the table. They are generally more cost efficient than their power wheelchair cousin. They are lightweight and are getting lighter everyday with new designs and new metals being used in their construction. Manual chairs offer a coast option while traveling downhill, this offers a break in using upper or lower body strength. The manual chair user may be assisted by another person with built in handles for pushing. Manual chair users have the opportunity to build muscle strength while self propelling the chair, users also don’t need a designated hand to steer. They are more discreet by being smaller and quieter than most power chairs. Manual chairs are easier to be transported in a vehicle due to most of them being able to fold up and fit into an average trunk. They offer various seat positioning for the user to be able to self propel with either their arms or legs.
     While using a power wheelchair can conserve personal energy, there is always a chance the battery could die. They are larger and heavier than manual chairs which has been noted to decrease the user’s personal image. Power wheelchairs often cost much more than manual and require a special mechanic to repair any problems, costing even more money. These chairs also do not offer any type of exercise for their users. Power chairs pose a problem in some inclement weather, often getting stuck in mud or snow and spinning out on ice. These chairs are large and sometimes awkward to fit through average sized doorways and into bathrooms. Power chairs pose problems with transportation in a vehicle, often requiring a mechanical lift and they must be tied down with special tie-downs.
     Manual wheelchairs have a lot less disadvantages than power chairs. The largest disadvantage would be that they require a high endurance level from their users. The user may have a difficult time getting up inclines or ramps. This depends on the upper or lower body strength of the user and the level of incline present. A lot of people can exhaust themselves just by getting to where they need to go, with no energy left for the activity. There can be some negative long term health conditions such as shoulder injuries or back problems from poor posture that comes with the use of a manual chair over a long period of time. Despite these disadvantages, manual chairs are prevalent because of their cost effectiveness.
     Wheelchairs are a good thing whether you choose a power or manual chair. If you don’t see much benefit in getting a power chair then I would recommend a manual chair because of the cost. All in all, if you need a wheelchair, either choice would be beneficial to you.