Pain

For my last post, I thought I would talk about something we recently covered in class, pain.  We talked a lot about the differences in chronic pain and acute pain.  We learned that acute pain is the pain that is associated with something like braking your arm or cutting a finger with a knife.  Acute pain is often easy to diagnose and often straightforward in treatment.  Chronic pain, on the other hand, is more complicated.  Chronic pain can have many causes and be difficult to treat.  Chronic pain can be a pain such as chronic headache or chronic back pain.

Chronic pain often occurs with a traumatic brain injury.  There can be many different types of pain in many different places, and most cases are difficult to find the source and just as difficult to treat.  In certain cases, such as a car accident, the pain can have nothing to do with the brain injury itself, but may be due to a crushed knee that had to be reconstructed after the accident.  Headache is a very common complaint, and can have numerous causes.  In some cases, it could be due to sinus issues that are a direct result of the trauma sustained to the head.

In many cases of head injury, the head is not the only part of the body affected.  Many other parts of the body can sustain trauma and need treatment.  There can be spinal cord injuries and broken bones, internal bleeding and torn ligaments.  So, in many occurrences of brain injury, patients go through both acute and chronic pain.  In addition to both chronic and acute pain, emotional pain can be just as devastating for a person who has received a brain injury.  The loss of functions that were previously taken for granted are a huge blow, such as being able to walk and think normally.  The loss of friends, the loss of a job, and the loss of independence can lead to a devastating depression.

Working with people who can experience pain everyday can be challenging and rewarding.  It's hard to see someone in pain and know that there is nothing one can do, but it's also rewarding to see them have a good time.  In closing, I just want to remind everyone that brain injuries are preventable.  Always wear a helmet when there's a risk of falling, such as on a bike, when snowboarding, or when playing contact sports, always buckle up and make sure everyone in your vehicle is with a proper seat belt, never drive distracted (texting, tweeting, and talking on the phone while driving are bad!!), and never ever drive intoxicated.  These are simple things that can make a world of difference to both you and the ones that care about you.

For more information on prevention of TBI, click here.

To Vote or Not to Vote

One issue I had never considered until November 2nd was how TBI could affect voting.  For many clients, voting is something that just slips off their radar.  But for some, it remains an important civic duty that must be taken seriously.  However, many things can complicate this process.  There's one issue that I don't entirely understand, and that's how legal stuff can impact clients' abilities to vote.  Some of the clients I work with are not legally responsible for themselves.  Another issue is being registered on time.  A lot of clients aren't very good at planning, due to injuries of their prefrontal cortex.  They may forget to register on time or even forget the process altogether.

Another concern that I have but haven't been able to see a whole lot of is convincing clients to vote for a candidate without really exploring their other options.  I have heard rumors and stories about campaigns going to nursing homes and similar establishments and just telling the residents that a particular candidate is the right choice.  I do know that through TBI sometimes the values clients have can change, and sometimes they remain intact.  Some clients are able to stick with the same party both before and after a traumatic brain injury, but sometimes things that happen  can cause changes in the way someone thinks.  Some clients are able to choose the candidates that they would like to endorse, but others often forget names and can become easily confused with the amount of information presented via TV, signs, and even online.  To further complicate matters, it's often difficult to get clients to their voting places.  The vast majority of them are not able to drive, and it can be difficult when a client suddenly decides they would like to go vote, when things need to be scheduled ahead of time.

I myself find voting to be a difficult process on occasion, and I can't imagine trying to do it with a brain injury. However, the feeling of participating in something that could promote change in our country is something that I don't think anyone should be denied.  I know that clients get that same sense of importance, and next time I will know to plan ahead for such an occasion.

Trick or Treat?

With Halloween coming and going and Thanksgiving on the way, this time of the year is filled with a lot of sweet foods.  This can mean a lot of sugar in the form of candy, pies, and other desserts is in abundance.  There are a lot of facts, and also a lot of myths surrounding sugar, and it is pretty easy to get confused about how much is too much or how much is enough.  A lot of the clients that I work with are diabetics and are kept on a diet to control their blood sugars.  This means they do not get candy and rarely get desserts, except when they order them if they go out to eat.  When they do get dessert, it's easy to tell that they really enjoy it.

I recently came across a blog in Psychology Today that talks about the way candy can be good for you, and I was pretty excited because I know I love candy.  It mentions a study done showing that modest candy consumption, such as once to three times a month, is associated with a longer life.  I have candy more than that, so I was relieved to read that it people who ate candy more often lived longer than those who didn't eat candy at all.  The blog also mentions that sugar can help restore willpower, and consuming sugar can help you maintain focus.  In addition, it was found that people who regularly consume chocolate had a lower risk of heart disease, which couldn't be explained by any other factors such as age, sex, calorie intake, smoking, or fruit and vegetable intake, among others.

So this just goes to show that maybe a treat won't be the worst thing for you, of course there is plenty of other research that disagrees, and situations that may not be the best for candy consumption, like diabetes.

Cars

Over half of all traumatic brain injuries are the result of automobile accidents, according to traumaticbraininjury.com.  I see this in my personal experience, as I know most of the clients I work with were injured in automobile accidents.  Two kinds of brain injuries can result from an automobile accident.  The first is a closed head injury, which involves no open wound to the head.  Trauma is a result of direct or indirect force, and the brain may collide with the inner skull.  Contusions (bruises on the brain) and bleeding.  The second type is an open head injury, which involves penetration of skull with direct injury to the head.
Car accidents are very scary things, and something I am currently keeping in mind as I search for a new car.  Crashworthiness is applied to describe the ability of a structure to protect occupants in an impact.   Crashworthiness is something that automobile manufacturers must consider in their cars, as it is the first line of defense in an automobile accident.  Cars go through a lot testing for safety, and the results of this testing should be considered when looking for a car.  I have been comparing about three cars to each other in my decision to purchase one, and of course the main factor that goes into deciding which one is cost.  The most economical car that I've been looking at does not have the highest safety ratings of the bunch, which may deter me from getting it.  I'm looking at very small cars, so safety is going to matter when I'm on the road.  Of course, I will always be wearing my seat-belt when in the car!

Helmet up for safety

Living in the city, I know that many people rely on bicycles to get from place to place quickly and efficiently.  I thought I might take this opportunity to stress how important helmet use can be.  I actually haven't been on a bicycle since I was young , but I can remember thinking at that time that a helmet wasn't necessary.  I thought that since I felt proficient at bike riding and rarely toppled over I just didn't need one.  I'm sure that many kids also share this view, but it simply isn't true.  Helmets, like seatbelts, are important for safety.  Even though they aren't exactly a fashion statement, helmets can go a long, long way in the prevention of a traumatic brain.  According to the Council on Brain Injury, 1.4 million people sustain traumatic brain injuries a year, with the leading causes being falls, motor vehicle accidents, collisions with moving or stationary objects, and assaults.  The brain injuries can range from mild to severe.

If you or someone you know and love is riding a bike without a helmet, give them some facts! The Council on Brain Injury's website has some videos, extra information, tips, and even a personal plea from someone personally affected by a brain injury from an accident without a helmet.  You can also find other safety information there as well, in addition to other information about traumatic brain injury.  Last but not least, (since we're students and on a budget) a link for reimbursement of a helmet! If you have an Independence Blue Cross Insurance plan, you may qualify for a reimbursement for up to $25.  

TBI Blues

Yesterday I had the privilege of taking some clients to the Paoli Blues Festival, which is basically just a fair-type of event with live music, food, vendors, lots of people, and even dogs.  Although getting around in crowds can be difficult when you're traveling with 5 people in wheelchairs, once we were able to stay put and listen to the music it was fun.  I was hoping for some blues that I'm familiar with and enjoy, but the bands played mostly original music, which wasn't bad because they sounded pretty good.  Most of the clients really enjoyed themselves and were happy to be there, with the exception of one (there's been some behavior issues with this client recently, maybe I'll go into more detail about them in another post...).

Music is something that all our clients enjoy on a daily basis.  For the most part, they are fans of the music they grew up with, just as most people tend to be.  At work, most listen to Classic Rock all day, and it's fun to hear them singing, humming, and clapping to it.  One client seems to know every word of every song that comes on 102.9, and claims that while she was in her coma, this music was all she listened to, so she memorized every song.  I have found that if you're dealing with her and she's in a bad mood, just turning the radio on can work wonders.  Music can make my job a lot easier and a lot more enjoyable, for both myself and the client.  Another client can hardly stand to ever be without music, and I feel terrible that this client missed the Blues Fest because he's been sick in the hospital.  Anyway, he sleeps with the radio on, listens to music while eating, listens to it at work, and will just sit and listen to it during his downtime.  It's a huge part of his life.  He also can play the guitar, which he is quite proud of.

So, in conclusion, music can be therapeutic if it's something that a client is into.  Clients differ greatly, just like the regular population, in the types of music they listen to and just how much they listen to it.  I have a lot of fun when going to events like I did yesterday with the clients I work with, because in some cases you can see a different side to them you haven't seen them before.  It's also a great opportunity to build a stronger relationship with them and just have fun while on the job!

Lol

It has been said that humor is the best medicine, and even though it might not be an actual cure for most ailments, I think that this saying is quite true.  Humor is an important part of most people's lives, and people with traumatic brain injuries are no different.  That's why we try to include fun and funny things in their daily lives.

This week I took some clients to the movies to see You Again.  While some of the clients tend to have trouble focusing on one thing for an extended amount of time, most of them enjoy going to see a funny movie.  However, I have a feeling that some jokes go over their heads, but they all enjoy a good laugh.  In fact, many of the clients respond best to humor in stressful situations.  It can divert their attention away from the bad things they're thinking about and get them started on something else in a better mood.

The kinds of jokes and humor enjoyed varies widely from client to client, and it can be really important to know what type of humor is appropriate and what is not.  While some clients enjoy the dirtiest of jokes, others might be deeply offended by them.  So it can be a good idea to stick to the general types of jokes until you really know what will fly.  When you get familiar and comfortable, you can really joke and have a good time.