You might have suffered a concussion playing football as a high school or college student, and because you felt nauseous and dizzy, you rested for a few days, just as your doctor advised. Those few days passed and you felt like your old self again, ready to return to the field.

Fifty years later, your family is concerned about your memory: you don’t know what month it is, and you can’t recall the conversation you had with your son two hours earlier. Your wife eventually takes you to a neurologist, who diagnosis you with Alzheimer’s disease. You’re surprised. After all, you have no family history of Alzheimer’s, and you’ve worked hard to keep your brain sharp: you’ve been an avid reader and crossword puzzle fanatic for years. The neurologist must be wrong, you think. Or maybe you haven’t considered the concussion you sustained half a century earlier.

A brain injury is a risk factor for Alzheimer’s. It’s possible that all it takes is one concussion. On autopsy, an Alzheimer’s brain reveals beta amyloid deposits – proteins that collect between nerve cells. Tau, tangled fibers of proteins, collects within the cells. As we age, it’s not unusual to expect protein build up within our brains, but in Alzheimer’s, they accrue in greater amounts, impeding communication between nerve cells, causing memory impairment and personality changes.

In autopsy studies of those who have died in the acute phase of a traumatic brain injury, researchers have found amyloid deposits in thirty percent of people, including children, and increased tau levels in the spinal fluid of those who died of a severe traumatic brain injury.

But studies have proven that amyloid is a mysterious protein as it relates to head trauma. Researchers have learned that individuals with mild cognitive deficits, who reported a history of brain trauma, showed brain changes consistent with Alzheimer’s. But those with no cognitive impairment, who also reported a history of brain trauma, did not show any changes.

So, at least there is hope – if you have suffered a brain injury, maybe you’ll be among the lucky and will escape the sticky plaques and fibrous tangles.

http://www.medscape.com/viewarticle/818376 http://depts.washington.edu/adrcweb/research-101/traumatic-brain-injury/

How do individuals who are unable to walk refer to themselves on the page? Why do some choose handicapped while others choose disabled, or even crippled?

At age nineteen, Joshua Prager suffered a broken neck when a truck driver rammed into the mini bus he was riding in while  traveling through Jerusalem. He spent four years in a wheelchair. Now, he walks with the aide of a cane. Prager has written a memoir, Half-Life, in which he tells of his tragic yet hopeful story of self-awareness, identity, and the loss of physical potency.

Throughout the book, Prager employs a varied lexicon when referring to himself post-crash:

1) “I took comfort … in the thought that my body spent fewer days disabled than not (106).

2) “I was a hemiplegic and wanted to be whole again (156).”

3) “Let the doctor glimpse what it is like to be nineteen and paralyzed (146).”

4) “I wished to sit there forever and never get up and never remind Sheri that I was disabled (172-173).”

5) “If I was finally at peace with my disability, I had fallen for a girl who wasn’t (183).”

6) “And then I became a quadriplegic (189).”

7) “I … allowed myself mention of … a divided body (280).”

Why does Prager not settle on a single descriptor for his changed body? Depending on the circumstance, his preferred label (labeling is really what this post is about) changes. For instance, in number 2 above, he chooses “hemiplegic” when he talks about his need to be “whole again.” The contrast of hemi- and whole in the same sentence is stark. When we see the prefix “hemi,” we might think of the word hemisphere: half of the brain, or half of the earth. We can visualize the fissure dividing the brain in half, or the equator separating the northern and southern hemispheres. When we see the word “whole,” we might envision something intact, like a circle.

In example 3, Prager says “paralyzed” in the context of the scene in which his doctor tells him he cannot leave the hospital to attend a baseball game. Understandably, Prager is angry. “Paralyzed” might evoke the image of an individual in a wheelchair, but it also evokes emotional and spiritual paralysis. Prager looked forward to the baseball game, but the doctor’s decision slashes any promise of “openness and freedom” for his patient (145).

In example 4, Prager employs the word “quadriplegic” when he’s wondering how his family will get him home from Jerusalem after the crash. Quadriplegia affects the entire body below the neck. In a sense, the entire body is weighted down, and the burden is on others to help care for the individual. Such is the case when Prager’s family must figure out how to get him home, physically and financially. The burden is on them.

But why does Prager choose “divided body” in the last example, rather than hemiplegia? Just prior to this sentence, Prager is listening to the solipsistic soliloquy of the truck driver who ran into the mini-bus: financial troubles, loss of land, loss of work, etc. When the driver finally asks Prager about his hospitalization, Prager refers to his body as “divided.” Though his intention is not to forgive the driver, but to hear him apologize, perhaps Prager is now wondering if it was a good idea after all to meet the man who nearly killed him. Is Prager “divided” about what he actually wants? Does he really want to be sitting, face-to-face, with this self-absorbed man?

I saved examples 1, 4, and 5 for last for a reason: acceptance. Even though the girl Prager fell for does not accept his “disability,” as he claims to, and he wants to hide that he is “disabled” from Sheri, the overall tone of the three sentences come across as softer than the others listed. The C, P, and G in hemiplegic, the Q, D, G, and C in quadriplegic, and the P, Z, and D in paralyzed are all abrupt, harsh consonants. And, though the L in these words creates a liquid-like, more flexible sound, because they end in harsh consonants, there’s lingering turbulence, as there are turbulent moments in Prager’s post-accident life. The D and B in “disabled” are abrupt sounds, the T in “disability” is an angry sound, and the S is a hissing sound. But the emphatic sound of the two D’s that bookend “disabled” give the impression of certainty – certainty that Prager has accepted his changed body. And the Y at the end of “disability” resonates with a long E, creating an airy quality to the word, which carries the liquid-like sound of the L a long way.

Or maybe Prager inserts “disabled” and “disability” throughout the narrative because eventually walks again, albeit with a cane – his wheelchair days are temporary. Perhaps if he called himself “crippled,” the caustic C, the in your face tone would sound more permanent. It’s worth noting that Prager refers to himself as “crippled” one time throughout the narrative. He becomes angry and says, “A cripple rebuffed at the Jewish equivalent of the Lourdes” while he’s praying at the Western Wall for his left hand to heal. He had reason to be angry – a bird had just shit on his head.

Prager, Joshua. Half-Life. Byliner. 2014. Amazon Digital Services.

Whenever I spent time with my three-year-old niece, she would bounce and clap to the Irish tunes I played for her on my fiddle (note: the fiddle and violin are the same instrument. The style of music differs: fiddlers typically play traditional music like old time, Celtic, and Klezmer, and violin players typically perform classical and jazz music. Since I play traditional music, I prefer the term fiddle). When I stopped playing, she’d yell, “Let me, let me play!” I certainly was not going to allow her, or any three-year-old, even touch my 1920’s one-of-a-kind fiddle. But she’d reach out for it, and try to yank on the neck of the instrument. I’d put it away, hide it in the closet, but she was developmentally on target and had a full understanding of object permanence. So she’d run to the closet, and attempt to pull the fiddle out of its case – but I knew enough to lock it. She’d follow me around the house, and do what a three-year-old does when she doesn’t get her way: jump up and down, cry, and scream, “Why not? Why not? “I want to play!”

I had never taught a child how to play the fiddle, but wanted my niece to learn. After all, learning an instrument improves academic skills in children, fosters their social skills, and helps them develop motor coordination. Learning an instrument, especially the fiddle, also teaches children how to be disciplined and patient. You don’t just pick up a fiddle and suddenly play a Bach concerto, unless you’re a Mozart musical prodigy.

So how do you teach a young child to play the fiddle? First, let’s start with when to begin teaching. Each child is unique in terms of her behavior and cognitive abilities. Some children are more cooperative than others, and can focus longer. A five-year-old might throw a tantrum when asked to sit for more than two minutes, whereas a three-year-old might be perfectly willing to sit for fifteen minutes as you hold the fiddle under her chin while she practices plucking the strings.

In The Strad, a magazine devoted to string instruments, Anne Bacon offers advice on how to approach a child’s first fiddle lesson. She reviews the proper fiddle hold, and how to teach children to handle the bow and pluck the strings. http://www.thestrad.com/latest/editorschoice/teaching-a-young-beginner-their-first-violin-lesson

On the website, Music in Practice, Sue Hunt, a teacher with 25 years of experience, offers tips on when to begin teaching your child the fiddle, and how to make the process fun and engaging. http://www.musicinpractice.com/2013/practicing-music-violin-lessons/

Other resources:

http://www.parents.com/kids/development/intellectual/benefits-of-music-lessons/

You reach for the bush, grab a cluster of summertime, then pop the handful of nature’s sugar into your mouth. A burst of warmth coats your tongue, meanders down your throat, and you think of homemade jam. You grab another cluster, then another, and eat them all, guilt-free, because you know they are good for you – blueberries.

They may be small, but wrapped inside the sheen of a blueberry skin lies a treasure of health benefits: vitamin C for immunity, manganese for strong bones and for converting fats, proteins and carbohydrates into energy. Blueberries are packed with fiber, which helps reduce cholesterol. Research shows that they even reduce the risk of obesity. Polyphenols – substances that give blueberries their blue-purple color – fight off unstable molecules that put us at risk for heart disease, cancer, and Alzheimer’s disease. Health magazines, Dr. Oz, and likely your own mother, have touted the benefits of eating blueberries. But did you know that these blue jewels, which have been around for more than 13,000 years, might help survivors of traumatic brain injuries recover?

The brain functions normally in the presence of glutamate – a neurotransmitter, or chemical that mediates excitatory signals through the nervous system. But, after a brain injury, glutamate rapidly increases, destroying cells. However, in animal studies, researchers have noted that when extracts from blueberries are added to the cells with glutamate they are actually protected. Though it is not necessarily a good idea to always heed “the more the better,” but “the more berries you eat, the better your brain will be protected if a stroke or traumatic brain injury occurs,” says Dr. John Weber, a researcher at Memorial University’s school of pharmacy. Dr. Weber, and others, is still trying to determine exactly how many blueberries are needed for a specific amount of antioxidants – molecules that combat free radicals, or unstable molecules – to reach the brain, and how long they will remain there.

But Dr. Weber is clear about one thing: those who have suffered a moderate to severe injury might not benefit from eating blueberries. Yet, the extracts in berries might be helpful in the later stages of healing.

Blueberries store well in the freezer –they don’t suffer damage to their fragile polyphenol skins. So, at only 80 calories per cup, stock up, and eat up!

http://www.naturalnews.com/032219_polyphenols_blueberries.html

http://www.blueberrycouncil.org

http://www.whfoods.com/genpage.php?tname=foodspice&dbid=8

http://www.thetelegram.com/News/Local/2014-08-05/article-3823293/Blueberries-could-help-heal-brain-injuries/1

You might think of war veterans when you hear, or see, the words post-traumatic stress disorder – an anxiety disorder recognized after the Vietnam War, when soldiers returned home with symptoms of mental illness. You might also think of victims of tragic accidents, rape victims, or those who have endured any kind of abuse. What about health care workers, such as nurses? We tend to think of nurses as in control, emotionally strong, even in the face of gore and death. Still, nurses often hear others ask them, “How do you do what you do? How do you manage watching people die all the time?” But nurses suffer from PTSD too, also referred to as compassion fatigue, vicarious trauma, or empathic strain. PTSD is an occupational hazard for nurses. Fourteen percent of nurses experience PTSD symptoms – compare that statistic to the 3.5 percent of the general adult population.

Critical care, emergency room, and labor and delivery nurses are particularly at risk for PTSD, as well as those who work on rescue transport teams. For long shifts – twelve, sixteen, hours they witness an unending stream of trauma: shooting and stabbing victims, an attempted suicide victim, the deaths of newborns – the list goes one. Nurses cannot simply walk away from patients who are bleeding or not breathing. Their duty is to be wholly present – physical and emotionally – at patients’ bedsides. And since nurses are perfectionists (I’m a nurse, so I know the feeling), they might view their own PTSD as a sign of weakness. It’s easier for them to see symptoms of PTSD in others, because that’s what nurses are supposed to do – assess patients, then intervene on their behalf. Nurses, unfortunately, don’t take care of themselves.

Treatment is simpler than you might think: stretches and meditation. Researchers at the National Institutes of Health followed 22 nurses with PTSD symptoms. Led by someone trained in exercise science and martial arts, the nurses participated in a twice a week mind-body class that involved stretching, deep breathing, meditation, and balancing techniques. After eight weeks, half of the nurses experienced a 41 percent decrease in symptoms; the other half experienced only a four percent decrease. The exercises were simplified so that the nurses could easily engage in them anywhere at anytime, even during a quick bathroom break.

For more information see The Endocrine Society’s Journal of Endocrinology and Metabolism, Volume 98 Issue 7 – July 1, 2013.

http://nursing.advanceweb.com/Features/Articles/PTSD-in-Nurses.aspx

http://www.uic.edu/orgs/convening/vicariou.htm

http://psychcentral.com/news/2013/05/30/mind-body-techniques-reduce-ptsd-in-nurses/55418.html

http://press.endocrine.org/doi/full/10.1210/jc.2012-3742