Archive for October 2010

Driving and Brain Injury by Nancy Bartuska

October 28, 2010

Please read the following Fact Sheet from the Association for Driver Rehab. Specialists.   Please contact your local DMV for specific rules and regulations, regarding return to driving after a medical event.   You can locate a Certified Rehab. Driver Specialist Program in your area by logging onto the following Web-site and entering the tab for CDRS Directory Search:


The Association for Driver Rehabilitation Specialists


 Driving and Traumatic Brain Injury

Traumatic Brain Injury and Acquired Brain Injury commonly occurs due to motor vehicle collisions or neurological impairments. Injuries may cause a loss of consciousness of less than five minutes to several weeks. Any level of injury can result in symptoms that may impact safe driving. Driving problems may be caused by problems with vision, accuracy and speed of eye movements, speed of response, Visual or Auditory attention, memory, problem solving, judgment and/or loss of physical skills. New learning and insight into difficulties may be affected which may result in difficulty with compensation. Without a comprehensive driver evaluation unsafe driving encounters, unpredictable driving actions or repeat collisions may occur.

Warning signs to look for:

    Inappropriate driving speeds

    Is slow to identify and avoid potentially hazardous situations

    Needs help or instruction from passengers

    Doesn’t observe signs or signals or speed limits

    Does not respond to important road, traffic or warning information

    Easily frustrated or confused

    Pattern of getting lost, even in familiar areas

    Collisions or near misses

    Blames their driving mistakes on the behavior of other drivers

A driver rehabilitation specialist, with knowledge of the medical conditions, can provide a comprehensive evaluation and assist you with determination of safe driving potential.

This assessment should include:

    Vision Perception

    Functional Ability

    Reaction Time

    Behind-the-wheel evaluation


To locate the driver rehabilitation specialist in your area contact:

The Association for Driver Rehabilitation Specialists

2425 N. Center ST   #369

Hickory, North Carolina 28601


The Need for Brain Injury Case Management by Esther J Curtis

October 28, 2010

Imagine yourself in this situation. You’re 29 years old, and a survivor of brain injury. Your recovery has not been easy. Among other things, your emotions have been really unpredictable. Your family is becoming less tolerant of your outbursts, and they frequently remind you that you’ve essentially bankrupted your parents. Their emotions are equally unpredictable. You’re embarrassed to ask for more than they’ve already sacrificed. Challenges abound. You can’t focus long enough to make a series of phone calls to extend your prescriptions. You haven’t been to physical therapy in weeks because you don’t want to call the transit service… their staff can’t understand your slurred speech. Although you have a power wheelchair, which is great, you have a tough time getting in and out of it. You’ve fallen several times. The last time really scared you. You knocked your already hurt head on the headboard and saw black. There aren’t many self-help books in brain injury. There are a few, but you have to be able to find the books in the first place. The computer screen makes your eyes swim, and reading is impossible, anyway. The letters bounce around on the page as you try to focus. Watching TV is really the only thing you can do – and only for a few minutes at a time – because you have migraines. Worst of all, you don’t even realize what you don’t know. There are good solutions out there. But solutions remain hidden from those who need them. Finding help requires a certain level of cognitive ability, determination, and physical ability. If you don’t already get my drift, many brain injury survivors are unable to help themselves because their injury has depleted pertinent skills. Recently, ran an article on a particularly good brain injury case manager, Chris Swenson. Swenson works for Brain Injury Services in Burke, Virginia, below Washington D.C. He has about 30 local clients who depend on him to help them find and collect benefits. “We have roughly 30 active clients with active goals, such as following up with therapies, finding a job, and finding housing. We also have 10 to 20 consultative cases,” Swenson said. Here’s the link to the article: In Delaware, we lack a formally structured brain injury case management group. Case management is handled within different state departments, i.e. DSAAPD or DDDS, but to my knowledge, no organization handles just brain injury case management. Brain injury case management would not be an easy task. Brain injury issues are innumerable and diverse. A case manager might be tasked one day with finding appropriate housing and the next with helping someone get a wheelchair ramp installed. A case manager may deal with Medicaid, Medicare, or insurance issues. This same person may be responsible for finding a food bank or arranging for transportation to and from a medical center. There could be no definitive list of responsibilities. In fact, any case manager would be familiar with the five most hated words ever: All other duties as assigned. But think about it. What if all you had to do was make one phone call to get what you needed to get done? What if the person on the other end was someone who was familiar with your case, knew your needs, had a list of resources, and could place calls with you, or on your behalf? We have a few Delaware survivors who remember our phone number and call BIAD first. They are the lucky ones. Many survivors don’t even know we exist. Still, BIAD cannot provide case management. The demands of BIAD’s part-time staff are already overwhelming. We just do what we can to help them find the right phone number or the correct contact person and put them on the right path. If we cannot find a resource that addresses their need, we do research and get back to them. Sometimes, the answer is difficult to find. Moreover, we don’t have a Chris Swenson. If we do, I certainly haven’t found him yet. I want to know what you think about this issue. Send me your thoughts. I’m at

H.R 1347: Concussion Treatment and Care Tools Act of 2010 (ConTACT) By Christopher Rowe

October 22, 2010

The bill was recently passed in the House and will now be voted on by the
Follow ConTACT’s progress by clicking on the link below

Army Research

October 15, 2010

Article in USA TODAY

Blood Test can prove Mild Head Trauma in People

Tim Walker


What? Another football player is sitting out because of a concussion? By Brenna Meixner

October 12, 2010

You do realize that is a brain injury right? And we hear that all to often, as it is football season and is happening all too often on TV in the NFL, at the local colleges and high schools.  At least these days the players are forced to sit out the rest of the game, well the ones they catch it with.

I recently watched an online training course from the CDC about concussions.  For more information go to: They are also having an online training for coaches:

Brenna Meixner

Re-Construction of Self Following Traumatic Brain Injury by Tracey Landmann

October 12, 2010

I write this after a quarter-century of intense TBI experience. At sixteen I lay in a hospital bed thinking “My life is over.  Everything is dark in this room and that’s the way my entire life will be from now on.” In fact, at that time, there was no life, there was no time, consequently no future to think of.  Not to be Biblical about it, but at that point I didn’t visualize any state other than formlessness and chaos.  Then there was light, and it was called FRUSTRATION.  At sixteen an age where identity is just beginning to solidify, losing the bits of it that had formed was pretty scary.  I am sure if your Self disappears when it has fully ripened, it is much more frightening.  For example, a 25-year-old has just reached the intermediate level in Self development.  As a newly minted TB Survivor, this person awakens one day to find aspects of his or her identity either upside-down sideways, incredibly well-hidden or just plain gone.

So there you are one day, living a normal life, participating in a mundane activity, secure in your place on this earth.  Or perhaps you are doing something a little risky but not really: why would you do anything if you’re realistically worried about a negative outcome?  You, after all, feel pretty invincible. You may be under-confident and depressed but when you look past the drama of everyday “who am I” questions, you must admit: you are familiar with your core being. Then suddenly, something traumatic happens to your head.  It might be a car accident, a fall off a horse, maybe you just trip over something on the sidewalk, but   in all these cases your cranium makes contact with a surface and the brain inside is damaged.  For most who experience this, the world goes black following impact.  For all, some shade on the gray scale ensues.  Suddenly, you’re no one.  You don’t have a world; instead you’re an endlessly repeating event in the worlds of others, and if you make it out of Nobody Land, you become… someone else.  Who that might be is not quite as certain:  you study your own reflection and are appalled to find that you can’t focus on it.

Survivors of Traumatic Brain Injury often wake to find life a shattered mirror.  The glass’s fragments are of various sizes, ranging from razor-sided splinters to blunt-edged slabs.  Some are covered with a sludge that distorts, or in some cases, completely obscures the image the mirror is trying to reflect.  The environment surrounding a survivor can be made more navigable by therapists, informed and caring family members and helpful friends. Journals, photographs, remembrances as related by others burn off the outer layers of mist. Organizations such as BIAD are invaluable in that they make tangible beacons more visible to those who seek services.  Although these people (and groups) are essential parts of the physical and cognitive restoration processes, the reclamation of Self is up to the survivor.  The rule is the same for everyone: if you don’t find your own Self, the one you end up with is merely an ill-fitting suit.  People often complain of insecurity, take innumerable classes, try “new” things until they find one that works for them. Sometimes, in the most lonely and tragic situations, they choose to end their lives.   The painful solitude of having no one at all is beyond this writer’s conception.  The misery of having no one within the emotional walls of your own body is not.  I would never claim to speak for all TBI Survivors but I’ll bet that here, when I write about searching for a Self, a whole lot of people can identify with the words.

Long-term TBI Survival is all about rehabilitative multi-tasking.    The life voyage is a series of circles that ripple outward in verrrry slow motion.  Every one of our experiences is a single step in a journey of concentric therapies.  Some everyday people choose to devote their lives to developing their existences; we have to.  Spending your time inching along, suspecting the point you’ll ever see is the one where you began is a frustrating thing.  It takes courage, determination and a high tolerance for emotional pain to keep up your crawl.  Where are you going?  Why waste the energy and time if nowhere is your final destination? I’ll tell you why: because TBI Survivors have the ability to embrace the despair of hope.  We can ignore improbability’s sodden heaviness because we can hardly feel weight at all.  Our attention is on our personal lightness of being; that is, trying to find what fills the emptiness rendering us so buoyant.   As we creep along, our footsteps fall in a rhythm: “Who am I? Who am I? Who am I? We start our reconstruction from the ground up while learning all that visible stuff: the walk, the talk, the ability to communicate needs.  The ability to exist as the world sees us – and all the while, with every rhythmic footfall that might or might not repair the tangible.  We painstakingly polish the pieces of our internal mirrors; wiping the sludge away with tattered shirt sleeves in time with our stumbling steps.  When we’ve finally got those slightly shinier shards laid out in a chaotic jumble we wonder “How can I put these together?  How can I be what I was?”  Forget it.  Bid adieu to what you glorify as the ideal : the former self.  The ideal has lost its appeal.

I have read so many articles on how separating one’s life into Before/After Brain Injury phases is a BAD thing – you are still the same person!  No you’re not.  You’ll never be.  AND if you think being the exact individual you were pre-injury is a realistic goal, then you’ve bought the glue for mirror re-assembly from the Dollar Store – in other words those pieces will never form a whole;  at least, not one the slightest bump won’t destroy once more.  And they shouldn’t, because a TBI Survivor has just had a boatload of wisdom-through-experience rudely shoved down his or her throat.  My advice?  Digest it and concentrate on absorbing the nutrients therein.  Not only is your gag reflex turned off in this case, sticking your finger down your throat is always incredibly harmful to your innards.

The fear, discomfort, emotional pain and sometimes downright anger of those who believe TBI survivors cannot and/or should not “find” themselves without instruction on who  they ought to be is almost as sad to watch (and I’m sure to feel – ask my mom)as  is the struggle for identity.  We make so many mistakes.  I cringe as I think of the innumerable missteps of my life; all that could have been if I’d just, if only…  in fact, there’s so much “if only” in my life post-injury I don’t even have room to keep the “if only” of Accident Day in my soul anymore!  But I digress.  Back to the horror and misery people feel while watching us screw up over and over again; their own tears as they have to observe our humiliation, frustration, our bitterness at the condescension and smirks of the outside world.  I feel sympathy for those who can’t bear to see our grief and self-loathing; but no one is to blame for allowing or preventing their loved one from walking a frayed tightrope…so you see?  It has to be the Survivor’s decision to rebuild a new mirror out of the old, using an adhesive he/she create; and filling gaps with fragments of mirrors encountered on life’s journey. It’ an adventure that reaches far beyond the beginning; achieving new thresholds is worth much more than the cost of getting to them .  It’s both the survivor’s and the caregiver’s responsibility to stand  to accurately gauge the credibility of judgment used in the making of that decision, and standing back, allowing embarrassment and setbacks to happen if they’re not going to endanger anyone.

I assure you: it’s not easy.  It’s not fun.  But I repeat: when you get to the apex (or at least, a ledge_ and can safely survey the magnificent vista spread before you….well, there’s no feeling quite like it.  And you never forget it.

Tracey Landmann