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Doctors Discuss Knowing the Signs of Concussion in Young Athletes

By Adria Goins and Alex Onken, KSLA

 
Thousands of students in the Arkansas/Louisiana/Texas (and across the nation) began fall sports over the last few weeks.

However, with the new season here, comes a risk of injury. Football is the leading sport when it comes to concussions.

The signs of a concussion are headache, fatigue and nausea. Parents are advised to then bring their child to a doctor right away if suspecting a possible concussion.

“First diagnose it early and then after you diagnose it early make sure you avoid the triggers. So avoid extra screen time, over-exercising and just basically have 24 to 48 hours of cognitive physical rest,” said Dr. Kenneth Aguirre of Oschner-LSU Health Shreveport, who specializes in sports medicine.

According to Dr. Charles Webb, also with Oschner-LSU Health and a sports medicine specialist, the topic of concussions and the potential risks of football comes up often.

“I get that question a lot from parents. They want to know is it safe for my child to play high school or junior high, or even pee wee or popcorn football. and the question comes up because parents are worried about concussions. So my answer to them is if it were my child I wouldn’t let them play until they had an organized professional coach teaching them both how to hit and receive a hit.”

Young athletes are usually taught how to hit and receive a hit around junior high. Dr. Webb said parents should put their children in club soccer or flag football in contrast to popcorn or pee wee football.

“It’s much safer and you’re less likely to get hit in the head,” he said. “And you still get all the conditioning you need to play football later on in life.”

In addition, doctors say keeping children awake when they have a concussion is a common misconception. Sleep is actually very good for the healing process.
 

CLICK HERE to read the original article
 

Best Practices for Managing Stress and Anxiety During Times of Uncertainty

By Gary Seale, Ph.D., Regional Director, Centre for Neuro Skills

 
The COVID-19 outbreak has produced a great deal of uncertainty and unwelcome anxiety. It’s no wonder we feel distressed when our daily routines have been severely disrupted. Due to social distancing and business closures, most people are not able to visit their favorite restaurant, go shopping, or engage in a work-out routine at the fitness center. When you couple this with concerns about personal health, uncertainty about how long these changes will last, and information and directives that change daily, it’s no wonder that many of us feel diseased or anxious. Several credible sites have recently posted simple but effective strategies to manage stress and remain emotionally healthy during this time of uncertainty. Some of the most frequent suggestions by experts at the American Psychological Association, Forbes, the Harvard Business Review, HealthLine, and others include the following:

Differentiate between what is within your control vs. what is not in your control. Stay focused on the things you can do. Make a list and practice these regularly, and reward yourself for these practices. For example, you can:

  • Wash your hands, cover coughs and sneezes, etc.
  • Limit exposure to news. Manage stress by reducing (or eliminating) the number of times you check in to your favorite media outlet. The American Psychological Association recommends avoiding negative news right before bedtime.
  • Take care of your health (take your vitamins, get enough sleep, hydrate, engage in a daily exercise routine, etc.).
  • Practice your preferred relaxation technique if you feel stressed, such as deep breathing, yoga, mindful meditation, etc. If you don’t have a relaxation practice, now is a great time to develop one.
  •  

    Do the things that help you feel safe, such as:

  • Practice “social distancing” and limit exposure to groups of 10 or more people.
  • Give an “elbow bump” vs. a hug or a handshake.
  • Order out and have food delivered to your home or work; shop on-line and have items delivered to your home vs. going to a store or the mall.
  •  

    Rather than worrying about something that might happen in the future, stay focused on the present; maintain proper perspective.

  • Stay present and in the moment; focus on the task at hand.
  • If you feel yourself “borrowing trouble,” bring yourself back to the present.
  • Use a mindfulness practice (savor a favorite snack or meal; closely observe a pleasing object, such as a flower, etc.). If you don’t have a mindfulness practice, now is a great time to explore/develop one.
  • Put the situation into proper perspective (for example, as of March 24th in Houston/Harris County there are about 206 confirmed/presumed cases of COVID-19 and 2 deaths from this virus. Nineteen have fully recovered. Houston/Harris County has a population of approximately 6+ million. That translates into an infection statistic of 0.003%). Additionally, we live in a time and a nation of great abundance – an abundance of intellectual horsepower (some of the best minds in infectious diseases are here in the U.S. and are working on vaccines for this virus); an abundance of resources (the government has released over a trillion dollars to support research, product development and distribution, and aid to businesses); an abundance of entrepreneurs (companies re-tooling to overproduce cleaning supplies, ventilators, etc.).
  • This situation is temporary. As with other pandemics (MARS, SARS, H1N1, Zika, etc.), this too shall pass.
  •  

    Engage in proven positive psychology practices.

  • Start a gratitude list. Of all the positive emotions, gratitude is one of the most powerful and protective (from depressive symptoms). Simply start a list of all the things you are grateful for, large and small
  • Three Good Things. At the end of the day, list 3 good things that happened during the day. Once you have your list on paper, think about how you made those good things happen and reward yourself
  • Downward comparisons. Rather than thinking or saying to yourself, “I wish I…”, think or say to yourself, “I’m glad I…” For example, “I’m glad I work in the healthcare industry. I have a stable job, and in my work, I am able to help others.”
  • Connect with something larger than yourself. In the example above, you may find yourself feeling compassion for those out of work due to COVID-19, like servers in the restaurant industry. Ordering out from your favorite local restaurant and tipping big may help keep that business open during a time when the restaurant is closed to the public. Or you may want to visit a local blood bank and give blood as most all blood donation activities at large venues, like businesses, churches, etc. have been suspended for the time being.
  •  

    Get outside and enjoy nature.

  • During this time when we are practicing “social distancing”, we may feel “cooped up” which can result in feelings of anxiety. Getting outdoors and enjoying nature can lift your mood and help with managing stress. Walking increases heart rate and respiration, which is good for brain function and overall health. Spending time in the sunlight produces vitamin D, which improves the immune response. Being in “awe” (of nature) is another, very powerful positive emotion that can lift the mood and protect against depressive symptoms.
  •  

    Stay connected and don’t be afraid to ask for help.

  • Take this time to call friends and family and catch up.
  • Talk to a trusted friend about how you are feeling and all the practices you are using to stay healthy, both physically and mentally.
  • If you are feeling particularly distressed, reach out to a counselor or other mental health practitioner.
  • Talk to your supervisor or HR representative about your particular situation and any support you might need.
  •  

    Engage in resilience practices.

  • Think about a time when you faced a challenging situation and overcame it.
  • In your home or office, post some inspirational quotes, for example: “Never, never, never give up.” – Winston Churchill; “Failure is not an option.” – Gene Kranz, NASA Flight Director; “Tough times don’t last, but tough people do.” – Robert Schuller
  • Create a “resilience library” with inspirational books, videos, etc. For example, the book, “Unbroken” by Laura Hillenbrand, or the movie, “Remember the Titans”.
  • When possible, find “positives” (i.e., lower gas prices, safer commutes to work/less drunk drivers on the road, etc.), or lessons learned from the situation.
  • Use humor as appropriate.
  • If you have one, engage in your spiritual practice.
  •  

    CLICK HERE to read the original article
     

    ISRIB molecule—image by the Adam Frost lab at UCSF

    Drug Reverses Age-Related Mental Decline Within Days, Suggesting Lost Cognitive Ability is Not Permanent

    By Good News Network, December 27, 2020

     
    Just a few doses of an experimental drug that reboots protein production in cells can reverse age-related declines in memory and mental flexibility in mice, according to a new study by UC San Francisco scientists.

    The drug, called ISRIB, has already been shown in laboratory studies to restore memory function months after traumatic brain injury (TBI), reverse cognitive impairments in Down Syndrome, prevent noise-related hearing loss, fight certain types of prostate cancer, and even enhance cognition in healthy animals.

    In the new study, published Dec. 1 in the open-access journal eLife, researchers showed rapid restoration of youthful cognitive abilities in aged mice, accompanied by a rejuvenation of brain and immune cells that could help explain improvements in brain function—and with no side effects observed.

    “ISRIB’s extremely rapid effects show for the first time that a significant component of age-related cognitive losses may be caused by a kind of reversible physiological “blockage” rather than more permanent degradation,” said Susanna Rosi, PhD, Lewis and Ruth Cozen Chair II and professor in the departments of Neurological Surgery and of Physical Therapy and Rehabilitation Science.

    “The data suggest that the aged brain has not permanently lost essential cognitive capacities, as was commonly assumed, but rather that these cognitive resources are still there but have been somehow blocked, trapped by a vicious cycle of cellular stress,” added Peter Walter, PhD, a professor in the UCSF Department of Biochemistry and Biophysics and a Howard Hughes Medical Institute investigator. “Our work with ISRIB demonstrates a way to break that cycle and restore cognitive abilities that had become walled off over time.”

    Rebooting cellular protein production holds key to aging

    Walter has won numerous scientific awards, including the Breakthrough, Lasker and Shaw prizes, for his decades-long studies of cellular stress responses. ISRIB, discovered in 2013 in Walter’s lab, works by rebooting cells’ protein production machinery after it gets throttled by one of these stress responses—a cellular quality control mechanism called the integrated stress response (ISR; ISRIB stands for ISR InhiBitor).

    The ISR normally detects problems with protein production in a cell—a potential sign of viral infection or cancer-promoting gene mutations—and responds by putting the brakes on cell’s protein-synthesis machinery. This safety mechanism is critical for weeding out misbehaving cells, but if stuck in the ‘on’ position in a tissue like the brain, it can lead to serious problems, as cells lose the ability to perform their normal activities, according to Walter and colleagues.

    In particular, their recent animal studies have implicated chronic ISR activation in the persistent cognitive and behavioral deficits seen in patients after TBI, by showing that, in mice, brief ISRIB treatment can reboot the ISR and restore normal brain function almost overnight.

    The cognitive deficits in TBI patients are often likened to premature aging, which led Rosi and Walter to wonder if the ISR could also underlie purely age-related cognitive decline. Aging is well known to compromise cellular protein production across the body, as life’s many insults pile up and stressors like chronic inflammation wear away at cells, potentially leading to widespread activation of the ISR.

    “We’ve seen how ISRIB restores cognition in animals with traumatic brain injury, which in many ways is like a sped-up version of age-related cognitive decline,” said Rosi, who is director of neurocognitive research in the UCSF Brain and Spinal Injury Center and a member of the UCSF Weill Institute for Neurosciences. “It may seem like a crazy idea, but asking whether the drug could reverse symptoms of aging itself was just a logical next step.”

    Signature effects of aging disappeared literally overnight

    In the new study, researchers led by Rosi lab postdoc Karen Krukowski, PhD, trained aged animals to escape from a watery maze by finding a hidden platform, a task that is typically hard for older animals to learn. But animals who received small daily doses of ISRIB during the three-day training process were able to accomplish the task as well as youthful mice—and much better than animals of the same age who didn’t receive the drug.

    The researchers then tested how long this cognitive rejuvenation lasted and whether it could generalize to other cognitive skills. Several weeks after the initial ISRIB treatment, they trained the same mice to find their way out of a maze whose exit changed daily—a test of mental flexibility for aged mice who, like humans, tend to get increasingly stuck in their ways. The mice who had received brief ISRIB treatment three weeks before still performed at youthful levels, while untreated mice continued to struggle.

    To understand how ISRIB might be improving brain function, the researchers studied the activity and anatomy of cells in the hippocampus, a brain region with a key role in learning and memory, just one day after giving animals a single dose of ISRIB. They found that common signatures of neuronal aging disappeared literally overnight: neurons’ electrical activity became more sprightly and responsive to stimulation, and cells showed more robust connectivity with cells around them while also showing an ability to form stable connections with one another usually only seen in younger mice.

    The researchers are continuing to study exactly how the ISR disrupts cognition in aging and other conditions and to understand how long ISRIB’s cognitive benefits may last. Among other puzzles raised by the new findings is the discovery that ISRIB also alters the function of the immune system’s T cells, which also are prone to age-related dysfunction. The findings suggest another path by which the drug could be improving cognition in aged animals, and could have implications for diseases from Alzheimer’s to diabetes that have been linked to heightened inflammation caused by an aging immune system.

    “This was very exciting to me because we know that aging has a profound and persistent effect on T cells and that these changes can affect brain function in the hippocampus,” said Rosi. “At the moment, this is just an interesting observation, but it gives us a very exciting set of biological puzzles to solve.”

    Success shows the ‘serendipity’ of basic research

    Rosi and Walter were introduced by neuroscientist Regis Kelly, PhD, executive director of the University of California’s QB3 biotech innovation hub, following Walter’s 2013 study showing that the drug seemed to instantly enhance cognitive abilities in healthy mice. To Rosi, the results from that study implied some walled-off cognitive potential in the brain that the molecule was somehow unlocking, and she wondered if this extra cognitive boost might benefit patients with neurological damage from traumatic brain injury.

    The labs joined forces to study the question in mice, and were astounded by what they found. ISRIB didn’t just make up for some of the cognitive deficits in mice with traumatic brain injury—it erased them. “This had never been seen before,” Rosi said. “The mantra in the field was that brain damage is permanent—irreversible. How could a single treatment with a small molecule make them disappear overnight?”

    Further studies demonstrated that neurons throughout the brains of animals with traumatic brain injury are thoroughly jammed up by the ISR. Using ISRIB to release those brakes lets brain cells immediately get back to their normal business. More recently, studies in animals with very mild repetitive brain injury—akin to pro athletes who experience many mild concussions over many years—showed that ISRIB could reverse increased risk-taking behavior associated with damage to self-control circuits in the frontal cortex.

    “It’s not often that you find a drug candidate that shows so much potential and promise,” Walter says, calling it “just amazing”.

    No side effects

    One might think that interfering with the ISR, a critical cellular safety mechanism, would be sure to have serious side effects, but so far in all their studies, the researchers have observed none. This is likely due to two factors. First, it takes just a few doses of ISRIB to reset unhealthy, chronic ISR activation back to a healthier state. Second, ISRIB has virtually no effect when applied to cells actively employing the ISR in its most powerful form—against an aggressive viral infection, for example.

    ISRIB has been licensed by Calico, a South San Francisco, Calif. company exploring the biology of aging, and the idea of targeting the ISR to treat disease has been picked up by many other pharmaceutical companies, Walter says.

    “It almost seems too good to be true, but with ISRIB we seem to have hit a sweet spot for manipulating the ISR with an ideal therapeutic window,” Walter said.

    Get more links to background studies from original article from UCSF News.
     

    CLICK HERE to read the original article
     

    Thankfulness: How Gratitude Can Help Your Health

    American Heart Association heart.org, November 10, 2020

     
    Gratitude is more than a buzzword. It’s a habit and practice that may actually change your perception of well-being.

    Are you feeling overwhelmed by the coronavirus pandemic, all the changes it has brought to your life and everything you need to worry about to stay safe?

    Or do you sometimes feel like you just can’t catch a break? You know — the truck that cut you off, the weird feedback you got from your boss, the grocery item you need but is never on the store shelf? Do you sometimes feel negative and cynical?

    Sure, we all do this a little, but doing it a lot can lead to depression1, which is linked to poor heart health, more inflammation and even a weaker immune system.2 Yikes!

    Some neuroscience experts think our brains focus on negative information as a way to remember pain so we can avoid it in the future. They call this the “negativity bias.”3

    To balance out this natural tendency, we can practice gratitude.

    “Gratitude is good medicine,” says Robert A. Emmons, Ph.D., a professor of psychology at the University of California, Davis and author of The Little Book of Gratitude.

    “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life. It can lower blood pressure and improve immune function. … Grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol and have higher rates of medication adherence.”4

    Dang, being grateful is the gift that seriously keeps on giving, right? Who couldn’t use all these benefits right now?

    Here’s a simple way to get started:

    Write these down before you go to bed or share them around the dinner table. In five minutes, you can practice gratitude from the heart.

    1. Health: What did your body do for you today?
    Did you know you take about 8 million breaths a year? Your feet can take you up a mountain; your arms can hold someone you love. Take a minute to marvel at the finely tuned machinery of your body, and thank yourself for the steps you take every day to keep it safe and healthy.
     
    2. Eat: What did you feed your body to nourish yourself today?
    Was it an old favorite, something you made or something new and different? If you eat three meals a day, you’ll eat about a thousand meals this year! Take a minute to savor an especially yummy meal. And check out some healthy options on the AHA’s recipe hub.
     
    3. Activity: What did you do that you really enjoyed today?
    Did you give it your all when exercising today, or find a quiet moment while sitting in traffic to reflect? Take a minute to think back on one particularly awesome moment.
     
    4. Relationship: Whom do you look forward to connecting with?
    Is it someone who sets your heart on fire, always has a smile for you, has your back or makes you laugh until you cry? Take a minute to smile as you think about this special person. Then make plans for a virtual meet-up.
     
    5. Time: What are you doing right now?
    Every single day you wake up with 24 brand new hours. The past is history, the future is a mystery and today is a gift. That’s why they call it the present! Take a minute to be thankful for the gift of time, including any extra time you have right now for your family or yourself.
    Let’s do this, and be Healthy for Good!
     

    SOURCES:
    1 Journal of Cognition and Emotion,Negative processing biases predict subsequent depressive symptoms. http://www.tandfonline.com/doi/abs/10.1080/02699930143000554
    2 National Institutes of Health, National Institute of Mental Health, Chronic Illness & Mental Health. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml
    3 National Institutes of Health, National Library of Medicine, Not all emotions are created equal: The negativity bias in social-emotional development https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652533/ and Agency Attribution in Infancy: Evidence for a Negativity Bias https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4011708/.
    4 American Heart Association News, Gratitude is a healthy attitude.

     

    CLICK HERE to read the original article
     

    Free & Low-Cost Activities to Think About During Lockdown

    Written by one of our own San Diego Brain Injury Survivors, November 20, 2020

     
    This year has been challenging for everyone. Especially as we close out the year with no sign of social distancing and lockdowns going away, it seems to be getting more and more difficult to think of new things to do to keep us busy…AND safe. So, a San Diego brain injury survivor put this list together to help you with new and fun things that can still be done for little or no cost! Enjoy!!

    1. Attend free Acquired Brain Injury (ABI) online classes through San Diego Community College District’s Continuing Education Center — sdce.edu
    2. Participate in UCSD Recreation’s free online classes (exercise, lectures, etc.) — recreation.ucsd.edu
    3. Participate in the YMCA’s free online exercise classes and lectures — ymcasd.org
    4. Visit Brainline website — brainline.org
    5. Watch “Brain on Nature” podcasts — brainonnature.com
    6. Do free brain training games on Lumosity — lumosity.com
    7. Watch free online UCSD-TV programs — ucsd.tv
    8. Watch the San Diego Brain Injury Foundation’s recorded meetings on their YouTube Channel at youtube.com/theSDBIF
    9. Check the calendar of virtual events on Live Well San Diego — livewellsd.org
    10. Enroll in free online classes offered through San Diego Public Libraries — education.gale.com
    11. Participate in the online classes through the Continuing Education Center at Rancho Bernardo — cecrb.com or call (858) 487-0464
    12. “Museums from Home” activities — sandiegomuseumcouncil.org
    13. Do mindfulness/adult coloring books (sometimes available at dollar stores)
    14. Borrow materials from the library (books, DVDs, e-books, etc.) — sdcl.org and sandiego.gov
    15. Call, email, write letters and send greeting cards to family, friends, former colleagues, etc.
    16. Try some new healthy recipes — eatfresh.org
    17. Here are a few brain injury yoga lessons that you can try out from the Love Your Brain yoga You Tube Channel — Gentle Floor practice and Gentle Chair practice

     

    Explaining Brain Injury to Your Child

    Chapter Four, The Caregiver’s Journey on tbi.cemmlibrary.org

     

    Having a parent with a TBI can be frightening for a child who looks to them to provide strength and safety.
    A parent with TBI may no longer act the same as they did before the injury. They may be angry, depressed, or uncertain. They may not be able to speak or walk, and they may not be able to do all the same things they did before they were injured (for example, go to work, pick up the kids from school, play on the playground). You can help your children by explaining TBI in a way that they can understand, or you can ask a healthcare provider to talk with your children.

    As a result of the changes caused by the injury, the special parent-child bond that existed previously has probably changed, at least to some degree.

    Children may be confused and upset about what is going on. This could be due to worry about a parent’s condition or concerns about changes in their parents’ relationship. It could also be due to financial strains, or simply adjusting to the new “normal” (in other words, the new way of life following the TBI). Be sure to communicate with your child that they are not to blame for the TBI – many children will assume they somehow contributed to the injury and will carry some sense of responsibility for it. If your child appears to be anxious or depressed for a long time, or they begin taking on risky behaviors, seek professional help.

    It is important to recognize that your children are grieving, just as you are – they are grieving the loss of the parent’s former “self” and the abrupt changes that have taken place. They may withdraw from social activities with peers, have mood swings, become withdrawn or disruptive, do poorly in school, and show other behavioral problems.

    Children also need time and space to be kids. Allow them time to think, play, talk, or just hang out – don’t smother them with too much information or attention over the injury – but be sensitive to their questions and concerns. Build new family routines, and keep an eye out for signs that your child is not coping well.

    Some children may need to take on some caregiving tasks for the parent or for younger children in the family. Children who care for parents or other relatives may experience conflict over the reversal of roles between parent and child. Others will find it helpful for them to play a supportive role.

    Make sure any tasks that your child takes on to help around the house or with caregiving activities – household chores or meal preparation, for example – are suitable for their age. Strive as much as possible to find other adults to help you, rather than relying on your children to play a major caregiving role.


     
    How Can I Tell My Child about TBI?
    
It is difficult to explain TBI to a child. Yet it is vital to tell your child what is going on. Some adults try to protect children from the truth because they think they are too young to understand. Children of almost any age are aware that something is wrong and they want to know what is happening.

    Communicate in an age-appropriate way what has happened to the service member or veteran with TBI. Protecting your children by withholding information may backfire. Children have active imaginations that may create a scenario worse than reality.

    How you tell your child about TBI depends on the age of the child. Here are some suggestions for how to explain TBI to a child:

  • Use Language a Child can Understand: The brain is similar to the command station of a spaceship. If a meteorite hit the command station, the crew would not be able to control what the spaceship does. If the brain is hurt, it may send out the wrong signals to the body or no signals at all. A person with TBI may have a hard time walking, talking, hearing, or seeing.
  • The brain is the body’s computer. When it gets injured, it doesn’t “boot up” properly, runs slower, has less memory, and may not perform all of its normal functions.
  • A cut may take a few days to heal, and a broken bone will usually heal and be as good as new in a few weeks or months. Getting better after a brain injury can take several months or even years, and sometimes the person may not get 100 percent better.
  • Even though the person with the injury may look the same, they may still be injured. These injuries might include having a hard time paying attention or remembering what you told them. They may get tired easily and need to sleep more than usual. They may say or do things that seem strange or embarrassing. They may get angry and shout for no apparent reason.
  • Explaining Anger Changes: Many people with a TBI develop anger as a direct effect of the damage to the brain. In other words, the parts of the brain that normally stop angry flare-ups and feelings have been damaged and don’t do their job as well. The parent with TBI may be mad because they can’t do the things they used to do. Their feelings may be hurt because others treat them differently than before the injury.
  •  
    Brain injury changes people. These changes can be confusing. Try to remember that the changes you see are caused by the brain injury. You can still love and care about the person regardless of the brain injury.
     

    CLICK HERE to read the original article
     

     

    The Benefits of Smiling

    By Jennifer, spindpals.com, July 16, 2020

     
    How many times have you smiled today?  If you’re an average adult, you’ll smile 20 times today.  If you’re a really happy adult, you’ll smile 40-50 times today.  That sounds decent, until you compare it to the number of smiles a child expresses each day: 400!
     
    Why do we smile and how does it affect our brain?  Here’s the sequence of events:

  • You feel happy
  • Your brain sends a signal to cranial nerve VII, which then triggers the face’s zygomaticus major muscle (the one responsible for lifting the corners of your mouth) and the obicularis occuli muscle (the one around your eyes)
  • You smile
  • A positive feedback loop is initiated and a signal is sent back to your brain, releasing dopamine and serotonin, and reinforcing positive emotions
  •  
    Other benefits of smiling:

  • It lowers the stress hormones of cortisol and adrenaline
  • It boosts the immune system by increasing gamma interferon (a protein that fights viruses), B-cells and T-cells (the white blood cells needed to create antibodies)
  • What about fake smiles?  It turns out that fake/”social” smiling enough can actually bias your brain to thinking you are genuinely happy due to the positive feedback loop.

    —>FUN FACT:  A single smile can stimulate neurotransmitters as much as 2000 bars of chocolate, but without the sugar crash and stomach ache!
     
    When you next pass someone on the street, flash your pearly whites.  You’ll make them feel good and cheer yourself up as well.

    “Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy” ~Thich Nhat Hanh

    CLICK HERE to read the original article
     

     

    My Tech Tools for TBI

     

    By Alexander Rostron, August 25, 2020

     
    After my traumatic brain injury (TBI), I suffered from a large drop in mental capacity.  I could not remain focused for even moderate lengths of time and forgot the majority of the content that I had just consumed.  

    Not only that, whenever I attempted focused work, I was so mentally and physically tired after doing something as simple as reading that I needed to take a nap.  The limited runs of mental stamina prompted me to explore different tools and systems for assistance.

    Below are three apps I find useful:

    Notability App (iOS, Mac)

    I use Notability to write notes (handwritten and typed), take photos and record audio from class and during medical appointments.  My favorite feature is the ability to capture audio while handwriting notes and highlighting key terms with the Apple Pencil.  

    While reviewing my class notes to study for a test, I realized that the audio recorded more information than I was able to put down during the lecture.  For example, a professor gives an example of the definition they had just explained.  I was only able to write out the definition, before the professor started on a different part of the lesson.  The audio recording left me more information than my writing speed could handle.

    Google Calendar

    I use Google Calendar to track the scheduled appointments I have.  My favorite part of that utility is the option of adding details to each event, such as the address, a notification to remind me an hour before, and a space for a custom description.  Here is where I list important details about what needs to be brought and prepared for the appointment.  I have used it to track things I need to bring and do before each appointment.

    Forest Pomodoro Timer (iOS, Mac)

    I use Forest to practice the Pomodoro technique for working on tasks that take intense focus, while giving scheduled breaks for a mental recovery.  It is a timer that stops if you use your phone.  This is to practice only studying for a set amount of time, with an alert after as a reminder to physically get up from where I’m studying and take a very short break.  Studies have shown that after 25 minutes of intense mental focus, human ability to retain information gets severely diminished.  This is a tool I consistently use when I am completing a task with a lot of paperwork and takes a lot of time and mental energy, such as writing essays or personal record-keeping.

    These 3 tools act as such a critical part of my life post-TBI.  The Notability app catches all of the information that I cannot record at the time of, and helps support my memories with the tools it gives to type, write, and emphasize certain information.  The Google Calendar system helps give me a clear layout of the events in the week ahead of me and contains a place for each small and important detail.  The Forest app helps me pace myself through large blocks of work with small checkpoint breaks to ensure that I don’t drain my mental battery and a chance to reflect about what info I had just absorbed.

    These are the systems that assist me with the mental stamina and memory recall struggles specific to my traumatic brain injury. If you have tools that you would like to add to this list, I would love to hear about what you have used to support your life post-TBI. If you would like to hear more about one of these tools please let me know.  If you have any comments, questions, or feedback please feel free to reach out to me at arroston@gmail.com.

    CLICK HERE to read the original article
     

     

    Alcohol and Brain Injury

    After a TBI or Stroke the brain can become more sensitive to the effects of alcohol. This can cause cognitive problems that impact memory, mobility, and speech. It can also cause someone to feel fatigued and unwell. What can be expected after your recovery?

     

    By Fred at Spindpals.com, July 18, 2020

     

    Whether we’re on holiday abroad or enjoying the Christmas festivities, an alcoholic drink tends to not be too far from reach for many of us.

    But after a brain injury, the body’s tolerance to alcohol is greatly reduced, and many survivors find that they are no longer able to enjoy alcohol in the same way as they did before their injury. The reduced tolerance to alcohol means that many effects of brain injury are exacerbated after drinking, such as memory problems, mobility issues, speech and fatigue.

    Remember you should always discuss with your medical practitioner your particular condition to understand what the impact would be on yourself. Never take alcohol without their approval and guidance.

    AUTHOR: “It is clear that there is an uneasy relationship between alcohol and brain injury. Survivors are often faced with the challenge of balancing a desire to enjoy the social life they had before they sustained their injury with the acceptance that alcohol now affects them in a different way.”

    We asked brain injury survivors to tell us about how their relationship with alcohol has changed.

    For some, the enjoyment of drinking is simply outweighed by the effects caused.

    “I don’t drink anymore,” said Louise Fry. “I couldn’t drink to start with because of meds, but now? It just hits me too hard.”

    Janet Creamer agreed: “Drinking is now a no-no. Just one alcoholic drink does awful things to my brain. It feels like I’ve drunk way too much and I get that spaced out feeling.”

    Others, like Giles Philip Hudson, have found that being advised by doctors to no longer drink has actually been a blessing in disguise.

    AUTHOR: “After sustaining my brain injury and spending over four months in hospital, doctors advised me not to drink alcohol. During this time I found I no longer needed to drink alcohol to make me feel good or enjoy myself. I certainly don’t need the headaches it causes.”
     

    Enjoy a drink at home with family and friends

    Naturally, many people want to continue to be able to enjoy a drink every now and then, particularly at social gatherings. But what if going to the bar is too daunting a prospect?

    Home drinking is increasingly popular For some, staying in allows them to enjoy a drink without some of the challenges of being in a busy, crowded and noisy pub or bar.

    “Since my disability I do not feel comfortable going into a bar as I may find it hard to use the restrooms,” said one member of the community, “so my drinking is done in my home.”

    Patricia Nugent on Facebook agreed: “We tend to drink at home so it is easier and less stressful to moderate intake,” she said.

    If you are choosing to drink at home, it’s important you monitor your intake carefully.
    Here’s some useful advice for home drinkers:

      1. Keep track of how many units you’re consuming
      2. Use smaller glasses
      3. Use proper spirit measures to avoid inadvertently pouring yourself a double or triple measure
      4. Eat as you drink
      5. Invest in a good bottle stop to make that bottle of wine last longer

    Out and about

    For others, however, a good night out is still a must! If that’s the case, then planning ahead can be the key to the success of the evening.

    “I don’t go out much, once every two months,” said Michelle Richardson. “But it’s lovely to have some drinks and let my hair down and forget how challenging recovery is for a while.

    AUTHOR: “I do have to prepare for a night out by having an afternoon snooze.”

    If you do want to enjoy a night out on the town with friends, here are some more top tips:

      ▪ Don’t drink on an empty stomach and check your medication allows you to drink
      ▪ Make sure your friends know about your brain injury, lowered alcohol tolerance levels, and any other issues such as an intolerance to noise
      ▪ Drink water between alcoholic drinks and avoid getting into rounds

    Alcohol-free alternatives

    Of course, not drinking alcohol doesn’t mean you can’t still go out to pubs and bars.

    “My husband has been told he can’t drink alcohol,” said Amanda Hopkins. “So, as he is a real ale drinker, we made a pact to still go to country location but to just check out ‘alcohol-free’ ales and to become connoisseurs of the growing ‘alcohol-free’ ranges that are now appearing from many microbreweries.

    “It won’t be quite the same but we hope it will be a bit of fun tasting them.”

    AUTHOR: Kathy M agreed: “I sometimes have a non-alcoholic beer shandy so I feel like I am having a pint and I’ve discovered things like elderflower cordial with soda. There’s nothing wrong with ordering a fancy coffee or mocktail either.”

    Drinking alcohol after Stroke

      ▪ Drinking too much alcohol contributes to a number of risk factors for stroke, including high blood pressure.
      ▪ Alcohol can interfere with the medicine you take to reduce stroke risk.
      ▪ Your doctor can advise when it is safe for you to start drinking alcohol again and how much alcohol it is safe for you to drink.
      ▪ Healthy men and women should have no more than two standard drinks a day, and no more than four standard drinks on any one occasion.

    Alcohol and stroke risk

    Drinking too much alcohol contributes to a number of risk factors for stroke. If you have already had a stroke or transient ischaemic attack (TIA), you can help reduce your risk by only drinking a safe amount.

    High blood pressure is the biggest risk factor for stroke, and drinking too much raises your blood pressure. Atrial fibrillation, which is a type of irregular heartbeat, can be triggered by too much alcohol.

    Diabetes and being overweight also increase your risk of having a stroke. Both of are linked to alcohol consumption.

    Alcoholic drinks are also high in calories with little nutritional value. Reducing the amount you drink will support you to maintain a healthy weight.

    Hemorrhagic stroke and alcohol

    A hemorrhagic stroke is caused by a break in the wall of a blood vessel in the brain. If you have had a hemorrhagic stroke, you must not drink alcohol for at least three weeks after your stroke. Ask your doctor when it is safe to start drinking alcohol again.

    Drinking alcohol and your medication

    Alcohol could interfere with the medicine you take particularly, blood-thinning medicine such as Warfarin. Discuss with your doctor about whether it is safe to drink alcohol while taking any medicines.

    Consuming alcohol safely if your doctor clears you to

    The Guidelines for Alcohol Consumption gives advice about safe amounts of alcohol.

    AUTHOR: Remember, the Guidelines are for healthy people. Talk to your doctor about whether it is safe for you to drink at all, and whether the amounts in the Guidelines are safe for you.

    The Guidelines state that healthy men and women should have no more than two standard drinks on any day and if you go out, no more than four standard drinks on any one occasion.

      ▪ For spirits with 40 % ABV, a standard drink is 30 mls (1.5 fl oz)
      ▪ A 285 ml (10 fl oz) glass of 3.5% ABV beer is about 1 standard drink.
      ▪ 100 ml (3.5 fl oz) of wine or champagne is approximately one standard drink, however this varies between types. Keep in mind most glasses of wine served in restaurants and bars are more than 100 ml (3.5 fl oz).
      ▪ Always check the label on the bottle to find out how many standard drinks you are having.
      If you find you are tempted to go over your safe limits learn strategies to help you keep to them.

    Strategies to reduce your drinking

    Write down how many drinks you have to see how much and how often you drink.
    If you find that you are drinking more than is safe, try these tips:

      ▪ Drink water when you are thirsty rather than alcohol.
      ▪ Sip your drink slowly. Put down the glass after each mouthful.
      ▪ At social occasions, make every second drink a non-alcoholic beverage. Choose something like a sparkling water rather than a sugary drink.
      ▪ Try low-alcohol alternatives such as light beer.
      ▪ Opt out of ‘shouts’. Drink at your own pace. If you cannot avoid buying a round, get yourself a non-alcoholic drink.
      ▪ Avoid salty snacks such as potato chips or peanuts. These make you thirsty and more inclined to drink quickly.
      ▪ Set goals such as not drinking alone and have at least two days without alcohol each week.
      ▪ Do not drink on an empty stomach. A full stomach slows the absorption of alcohol

    Brain Injury affects different people in different ways. There is no one size fits all. For some, their relationship with alcohol will be over. For others, a moderate consumption can be tolerated. Complete your recovery and then discuss with your medical practitioner your options. Do not make any decisions without consulting them first.

    This post is shared from the Stroke Association AU and Headway UK websites
     
    CLICK HERE to read the original article
     


    Ayn al Asad Air Base in western Iraq after an Iranian missile attack on Jan. 8. The number of service members experiencing symptoms associated with brain injuries has since topped 100. Photo Credit…Sergey Ponomarev for The New York Times

     

    Brain Injuries Are Common in Battle.
    The Military Has No Reliable Test for Them.

    Traumatic brain injury is a signature wound of the wars in Iraq and Afghanistan. But the military still has no objective way of diagnosing it in the field.

    By Dave Philipps and Thomas Gibbons-Neff for nytimes.com, February 15, 2020

     
    U.S. troops at Ayn al Asad Air Base in western Iraq hunkered down in concrete bunkers last month as Iranian missile strikes rocked the runway, destroying guard towers, hangars and buildings used to fly drones.
    When the dust settled, President Trump and military officials declared that no one had been killed or wounded during the attack. That would soon change.

    A week after the blast, Defense Department officials acknowledged that 11 service members had tested positive for traumatic brain injury, or TBI, and had been evacuated to Kuwait and Germany for more screening. Two weeks after the blast, the Pentagon announced that 34 service members were experiencing symptoms associated with brain injuries, and that an additional seven had been evacuated. By the end of January the number of potential brain injuries had climbed to 50. This week it grew to 109.

    The Defense Department says the numbers are driven by an abundance of caution. It noted that 70 percent of those who tested positive for a TBI had since returned to duty. But experts in the brain injury field said the delayed response and confusion were primarily caused by a problem both the military and civilian world have struggled with for more than a decade: There is no reliable way to determine who has a brain injury and who does not.

    Top military leaders have for years called traumatic brain injury one of the signature wounds of the wars in Iraq and Afghanistan; at the height of the Iraq war in 2008, they started pouring hundreds of millions of dollars into research on detection and treatment. But the military still has no objective tool for diagnosing brain injury in the field. Instead, medical personnel continue to use a paper questionnaire that relies on answers from patients — patients who may have reasons to hide or exaggerate symptoms, or who may be too shaken to answer questions accurately.

    The military has long struggled with how to address so-called invisible war wounds, including traumatic brain injury and post-traumatic stress disorder. Despite big investments in research that have yielded advances in the laboratory, troops on the ground are still being assessed with the same blunt tools that have been in use for generations.

    The problem is not unique to the military. Civilian doctors struggle to accurately assess brain injuries, and still rely on a process that grades the severity of a head injury in part by asking patients a series of questions: Did they black out? Do they have memory problems or dizziness? Are they experiencing irritability or difficulty concentrating?

    “It’s bad, bad, bad. You would never diagnose a heart attack or even a broken bone that way,” said Dr. Jeff Bazarian a professor of emergency medicine at the University of Rochester Medical Center. “And yet we are doing it for an injury to the most complex organ in the body. Here’s how crazy it gets: You are relying on people to report what happened. But the part of the brain most often affected by a traumatic brain injury is memory. We get a lot of false positives and false negatives.”

    Without a good diagnosis, he said, doctors often don’t know whether a patient has a minor concussion that might require a day’s rest, or a life-threatening brain bleed, let alone potential long-term effects like depression and personality disorder.

    At Ayn al Asad, personnel used the same paper questionnaires that field medics used in remote infantry platoons in 2010. Aaron Hepps, who was a Navy corpsman in a Marines infantry company in Afghanistan at that time, said it did not work well then for lesser cases, and the injuries of many Marines may have been missed. During and after his deployment, he counted brain injuries in roughly 350 Marines — about a third of the battalion.

    After the January missile attack, Maj. Robert Hales, one of the top medical providers at the air base, said that the initial tests were “a good start,” but that it took numerous screenings and awareness among the troops to realize that repeated exposure to blast waves during the hourlong missile strikes had affected dozens.

    Traumatic brain injuries are among the most common injuries of the wars in Iraq and Afghanistan, in part because armor to protect from bullet and shrapnel wounds has gotten better, but they offer little protection from the shock waves of explosions. More than 350,000 brain injuries have been reported in the military since 2001.

    The concrete bunkers scattered around bases like Ain al Assad protect from flying shrapnel and debris, but the small quarters can amplify shock waves and lead to head trauma.

    The blasts on Jan. 8, one military official said, were hundreds of times more powerful than the rocket and mortar attacks regularly aimed at U.S. bases, causing at least one concrete wall to collapse atop a bunker with people inside.

    Capt. Geoff Hansen was in a Humvee at Ayn al Asad when the first missile hit, blowing open a door. Then a second missile hit.

    “That kind of blew me back in,” he said. “Blew debris in my face so I went and sat back down a little confused.”

    A tangle of factors make diagnosing head injuries in the military particularly tricky, experts say. Some troops try to hide symptoms so they can stay on duty, or avoid being perceived as weak. Others may play up or even invent symptoms that can make them eligible for the Purple Heart medal or valuable veteran’s education and medical benefits.

    And sometimes commanders suspect troops with legitimate injuries of malingering and force them to return to duty. Pentagon officials said privately this week that some of the injuries from the Jan. 8 incident had probably been exaggerated. Mr. Trump seemed to dismiss the injuries at a news conference in Davos, Switzerland, last month. “I heard they had headaches,” he said. “I don’t consider them very serious injuries relative to other injuries I have seen.”

    In the early years of the war in Iraq, troops with concussions were often given little medical treatment and were not eligible for the Purple Heart. It was only after clearly wounded troops began complaining of poor treatment that Congress got involved and military leaders began pressing for better diagnostic technology.

    Damir Janigro, who directed cerebrovascular research at the Cleveland Clinic for more than a decade, said relying on the questionnaire makes accurate diagnosing extremely difficult.

    “You have the problem of the cheaters, and the problem of the ones who don’t want to be counted,” he said. “But you have a third problem, which is that even if people are being completely honest, you still don’t know who is really injured.”

    In civilian emergency rooms, the uncertainty leads doctors to approve unnecessary CT scans, which can detect bleeding and other damage to the brain, but are expensive and expose patients to radiation. At the same time doctors miss other patients who may need care. In a war zone, bad calls can endanger lives, as troops are either needlessly airlifted or kept in the field when they cannot think straight.

    Mr. Janigro is at work on a possible solution. He and his team have developed a test that uses proteins found in a patient’s saliva to diagnose brain injuries. Other groups are developing a blood test.

    Both tests work on a similar principle. When the brain is hit by a blast wave or a blow to the head, brain cells are stretched and damaged. Those cells then dispose of the damaged parts, which are composed of distinctive proteins. Abnormal levels of those proteins are dumped into the bloodstream, where for several hours they can be detected in both the blood and saliva. Both tests, and another test being developed that measures electrical activity in the brain, were funded in part by federal grants, and have shown strong results in clinical trials. Researchers say they could be approved for use by the F.D.A. in the next few years.

    The saliva test being developed by Mr. Janigro will look a bit like an over-the-counter pregnancy test. Patients with suspected brain injuries would put sensors in their mouths, and within minutes get a message that says that their brain protein levels are normal, or that they should see a doctor.

    But the new generation of testing tools may fall short, said Dr. Gerald Grant, a professor of neurosurgery at Stanford University and a former Air Force lieutenant colonel who frequently treated head injuries while deployed to Iraq in 2005.

    Even sophisticated devices had trouble picking up injuries from roadside bombs, he said.

    “You’d get kids coming in with blast injuries,” he said, “and they clearly had symptoms, but the CT scans would be negative.”

    He was part of an earlier effort to find a definitive blood test, which he said in an interview was “the holy grail.” But progress was slow. The grail was never found, he said, and the tests currently being developed are helpful for triaging cases, but too vague to be revolutionary.

    “Battlefield injuries are complex,” he said. “We still haven’t found the magic biomarker.”

    CLICK HERE to go to the original article
     

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