With a family history of heart disease, I decided to err on the side of caution and started taking omega 3 supplements years ago. I had read that they are good for your heart, and help regulate cholesterol. But I did not know about the greater benefits packed within the glycerin coating.

The brain, consisting of more than sixty percent fat, is the fattiest organ in the body.  Twenty percent of that number is comprised of an omega 3 fatty acid called DHA, or docosahexanoic adic. DHA is found in the central nervous system and is believed to help maintain optimal brain function, reduce inflammation, and increase fluidity within cell membranes. Recent research shows that omega 3, primarily DHA and EPA (another fatty acid that helps reduce inflammation) are both beneficial in the treatment of traumatic brain injuries. Since the pathology of a TBI involves cellular destruction and death, researchers have concluded that omega 3 can help mitigate that process. But, as research tends to go, more studies are needed to look closely at the benefits and risks of treating TBIs with omega 3.

Of course, it’s always better to choose foods rich in omega 3 rather than taking supplements, because those foods contain other nutritional benefits such as protein. EPA and DHA are mostly found in fatty fishes like salmon. ALA, or alpha-linoleic acid, is another omega 3 found in plant sources such as nuts and seeds.

Here’s the disclaimer: Though the FDA has approved medications with omega 3 to treat high levels of triglycerides, they do not approve the use of nutritional supplements to treat TBIs. Because there are not enough scientific studies to prove the effectiveness and safety of omega 3, the FDA explicitly warns  consumers to avoid supplements that have been marketed to prevent, treat, or cure TBIs, including concussions. Of greatest concern is that athletes who have sustained a concussion will take omega 3, believing the supplement will hasten their recovery, then return to the field sooner than they should. Over the past few years, sports guidelines related to concussions have been updated, and clearly note that the first ten days after injury is the period of time posing the greatest risk for sustaining another concussion.

I am not a physician, nutritionist, or pharmacist, and don’t pretend to be an expert on nutritional supplements, so if you are considering taking omega 3 for a TBI, I encourage you to do your research, and, of course, speak with your doctor (please accept my apologies if I sound like a pharmaceutical commercial). But, if you are curious by nature and must know where to learn about omega 3 dosing for a TBI, click here.

 

Cheers to a healthy brain!

 

 

 

 

 

 

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With the warmer temperatures finally here, maybe you’ve unlocked your bicycle from sitting stiff in the garage all winter, and have been riding it, hopefully with a helmet, to work every day. Or maybe you ride for pleasure – to feel spring wash over your face while inhaling the lilac scented breeze.

It’s estimated that nearly 70 million Americans ride bicycles. It goes without saying that riding a bicycle is good for your health, but doing so does not come without risks, especially if you are not wearing a helmet. More than 600,000 people go to emergency rooms each year for bicycle-related injuries. Each year, head injures account for about seventy-five percent of bicyclists who die from crashes. Out of the estimated 33 million children who ride bicycles each year, nearly four hundred die from crashes and 153 million go to the ER for head trauma.

But there’s good news: wearing a helmet can prevent eighty-eighty percent of TBIs from bicycle accidents. This solution is a no-brainer (no pun intended). But how many adults, and children do you see riding a bicycle without a helmet? You may wonder why some people choose not to wear a helmet, why some parents do not insist that their children wear one too. Perhaps parents don’t think it will happen to them or their children – fall into the road and hit their head on the pavement, or get hit by a car in the process. Perhaps they forgot their helmets and didn’t feel like turning around to go home and get them. Or they think they’ll look silly wearing a helmet. Better to look silly than the alternative.

I’ll stop lecturing and offer you this video about how to properly fit a helmet. It will only take three minutes and forty-seven seconds of your time. And, if you’re concerned about appearances, check out this site here for some stylish helmets.

If you cannot afford the more costly helmets, click here or here for less expensive ones (disclaimer alert: some of the larger corporate stores I don’t necessarily endorse). You might contact your local bike shop, school, or fire department for places to purchase helmets. This past March, during Brain Injury Awareness Month, the Brain Injury Association of America partnered with Nutcase Helmets to raise awareness about TBIs. For every helmet purchased, two dollars went to the BIAA. Is there a similar fundraising effort happening in your area?

The government is working to prevent brain injures from bicycle accidents by enacting legislation that would require bicyclists to wear helmets. Twenty states have some form of a helmet law, but most only apply to riders under eighteen. To see which states currently have laws in place click here.

Happy, and safe riding!

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Do you enjoy memorizing poetry?

Do you recall your youth, when when your teachers assigned you poems to memorize? Shall I compare thee to a summer’s day? Sound familiar? Or maybe you have craftily blocked that time period from your memory bank. But, like our quads and gluts, the brain is a muscle too. If we don’t exercise our muscles they’ll turn to flab. Memorizing poetry, or a song or scene from a movie, is just one way to keep our brains fit. And the profits are worth the time invested (I know, you’re wondering what the profits could possibly be).

Memorizing poetry primes our brains for retaining other types of information like names of people or a list of groceries. Studies have shown that rote learning benefits the hippocampus, the part of the brain responsible for consolidating short-term memory into long-term memory (http://www.bestcollegesonline.com/in-praise-of-memorization).

Memorization helps us focus, and improves our working memory – the ability to hold multiple pieces of information in the brain at once – allowing us to comprehend what we read, see, and hear. According to Bloom’s Taxonomy, “the highest order of thinking occurs at the evaluating and creating levels which infer that the thinkers must have knowledge, facts, data, or information in their brains.” With the facts laid down in our brain, we are better prepared to evaluate information and think critically (http://www.edutopia.org/rote-learning-benefits.http://www.bestcollegesonline.com/in-praise-of-memorization).

A regular practice of memory training staves off cognitive decline. For those of you who are living with the sequelae of a brain injury, try memorizing a poem, even if it’s a short one, like The Red Wheelbarrow by William Carlos Williams (http://www.poetryfoundation.org/learning/guide/178804).

But how do you begin memorizing a poem? For me, I focus on two lines at a time, repeating them over and over. I close my eyes and visualize the words. For instance, a few years ago, I memorized my first poem, Once by the Pacific by Robert Frost. Here are the first two lines:

The shattered water made a misty din.

Great waves looked over others coming in

I started by envisioning myself walking along the beach, listening to the waves crashing to shore, washing over pebbles – the sound of “shattered” glass came to mind. “Shattered” became a signpost that carried me further into the poem. I immersed myself in the scene, watching the waves roll over one another. If you’ve been to the beach, you know how waves behave, so the key is to allow yourself to be there, in your head.

I tend to choose poems that resonate with me, the ones with which my body and psyche connect, like Once by the Pacific. Before I explain exactly how I connect with the poem, here are the remaining lines:

And thought of doing something to the shore

That water never did to land before.

The clouds were low and hairy in the skies,

Like locks blown forward in the gleam of eyes.

You could not tell, and yet it looked as if

The shore was lucky in being backed by cliff,

The cliff in being backed by continent;

It looked as if a night of dark intent

Was coming, and not only a night, an age.

Someone had better be prepared for rage.

There would be more than ocean-water broken

Before God’s last Put out the light was spoken.

For me, shattered, dark intent, rage, and more than ocean water broken conjure images of the Santa Monica Farmers’ Market, where an elderly driver hit me and dozens of other pedestrians. This poem catapults me back in time, just prior to the accident, a portent, if you will. You may wonder why I’d want to remember that moment, but the poem does much more than conjure tragedy ;it speaks to my love for the ocean. When I’m home in Vermont, hunkering down for another frigid winter, this poem transports me to the beach my husband and I visit a few times a year in Anna Maria island. Again, I close my eyes and see myself walking barefoot in the water, the waves massaging my feet, the salt marinating my wintered soles.

I’m currently memorizing T.S. Eliot’s Preludes – 54 lines. I’ve gotten part way through the third stanza. I’ll let you know how it goes.

What poems have you memorized, and what prompted you to choose them? What is your strategy for memorizing poems?

 

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For most of us, driving equates with independence and freedom. So when you are diagnosed with a traumatic brain injury and learn that you cannot drive at all, or need to limit your driving to daylight hours, you may feel the loss of independence you once enjoyed.

Even with a mild traumatic brain injury, changes in thinking, perception, vision, and motor skills can affect driving: the ability to stay in the correct lane, react quickly when another driver cuts in front of you, and seeing a green light change to red. With a TBI, individuals become easily fatigued and may have difficulty concentrating for long periods of time. They often have difficulty processing rapidly moving stimuli, such as passing cars and bicycles. http://www.biausa.org/brain-injury-community.htm

But the good news is that between thirty and sixty percent of individuals with a moderate to severe traumatic brain injury eventually return to driving. They do so with the help of driving rehabilitation professionals, who first evaluate cognitive functioning, judgment, and reasoning skills. They then conduct a road evaluation. Still, most TBI survivors are not adequately evaluated before getting behind the wheel again. http://www.biausa.org/brain-injury-community.htm

Family members can help too. If it’s your spouse, though, and you prefer to save your marriage, you may want to be evaluated by an objective party like a rehab professional. For me, though, my husband has been helpful (okay, so we’ve had a few spats). Since my TBI has presented with difficulty processing multiple stimuli and anticipating changes down the road, he has spent time with me driving – me behind the wheel and he the passenger – cueing me when to change lanes or to turn. He has also encouraged me not to engage in too much conversation while driving. Because I fatigue easily, I no longer drive long distances – either my husband drives or I take the bus. And he’s aware of what I call my “bad brain” days and initiates driving. More importantly, I’m aware of my “bad brain” days and either limit my driving, or do not drive at all.

Of course, making the change from limitless driving to limited driving has not been easy. I don’t see friends as much as I used to, and I spend more time indoors, especially during the winter. Thank goodness for social media!

How has your TBI limited your ability to drive? How have you learned to cope with the changes?

 

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Twenty-two-year-old Ohio State football player Kosta Karageorge had a history of concussions. Though we don’t know the inciting event that resulted in his suicide, research suggests that athletes who sustain concussions are more likely to develop depression, disorientation, and suicide. How so? You might ask. Chronic traumatic encephalopathy (CTE), a degenerative disease of the brain, originally called “punch-drunk” syndrome in boxers, is seen in any athlete who sustains repeated head trauma, especially football players. It’s not unreasonable to assume that Karageorge was a victim of this mysterious disease, which can only be diagnosed on autopsy. “I am sorry if I am an embarrassment but these concussions have my head all f***ed up,” Karageorge said three days before he shot himself (www.washingtonpost.com/football-player-kosta-karageorge).  According to his sister, Karageorge experienced confusion and mood swings, symptoms, which, in addition to aggression and gait disturbances, are not uncommon in those with CTE (www.marquettewire.org/karageorges-death-shows-concussion).

Though football players of any age may suffer from CTE, younger athletes are particularly vulnerable. Because their brains are not fully developed, they are at risk for second impact syndrome, a potentially fatal condition that occurs when a player sustains a concussion then returns to the game and suffers a subsequent concussion before the first one has had time to heal (www.usatoday.com/highschool football deaths). More sad news: the prevalence of depression among teenagers who sustain concussions is three times higher (http://www.ncbi.nlm.nih.gov/pubmed/24355628).

If you haven’t been following the news about brain trauma in football players, you might, or might not, be surprised to learn that, out of one hundred twenty-eight deceased players, as many as one hundred one had CTE (www.pbs.org/concussion). What steps are being taken to prevent football players from these unnecessary and brutal deaths? Both the National Football League and the National Collegiate Athletic Association settled class-action lawsuits in 2013 challenging concussion protocols. But, finally, this past November, a former football player, who sustained concussions playing the game, filed the first class action lawsuit against the Illinois State High Athletics Association.

Another young football player has also come out about his history of concussions, and subsequent plunge into depression. Though heartbreaking, his story will leave you more than informed; it will make you pause and think twice before you enroll your child in high-school football (www.huffingtonpost.com/football-concussions).

Let’s take a moment of silence for the others who chose to end their lives because of football (www.ajc.com/football-suicide):

Owen Thomas: The first, and youngest, collegiate player diagnosed with CTE.

Terry Long: An offensive lineman for the Steelers. Shot himself on June 7, 2005. Age forty-five.

Andre Waters: Played for the Steelers and the Cardinals. Shot himself on Nov. 20, 2006, at age forty-four.

Shane Dronett: A defensive lineman in the NFL. On Jan. 21, 2009, shot himself. Age forty-eight.

Dave Duerson: Played for the Bears, Giants and Cardinals. On Feb. 17, 2011, he shot himself in the chest. Age fifty.

Ray Easterling: Played for the Falcons. On April 19, 2012. Shot himself in his Richmond, Va., home. Age sixty-two.

Junior Seau: A linebacker for the Chargers, Dolphins and Patriots. On May 2, 2012, shot himself in the chest. Age forty-three.

Jovan Belcher: A linebacker for the Kansas City Chiefs. Shot and killed his girlfriend, then shot and killed himself. He was twenty-five.

Paul Oliver: Played for the University of Georgia, then the Chargers. Shot and killed himself on Sept. 24, 2013. Age twenty-nine.

If you’re looking for a holiday gift for a football fan, or a non-fan, check out Steve Almond’s Book, Against Football.  An entire chapter is devoted to football and traumatic brain injuries. The research is both startling, and disturbing.

 

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Many people experience moments when they can’t come up with the exact word, or words, they want to express, and resort to the hackneyed phrase: “It’s on the tip of my tongue.” But for those suffering from a traumatic brain injury, this phrase extends beyond its timeworn use. Word finding, or word retrieval, is one of the most common cognitive difficulties in TBI survivors. The language center of the brain is located in the left hemisphere – the frontal and temporal lobes. Difficulty with word retrieval usually means the damage has occurred in the frontal lobe, the location of most TBIs.

What does this mean for individuals who have suffered a frontal lobe injury? Called dysnomia, or anomia, they tend to have difficulty naming objects, people, and places. They may know what the object is that they are looking at, but cannot identify it.  Sometimes the process is selective, say, to colors. For instance, individuals might know the difference between blue and pink, but cannot name them. In other cases, individuals might be able to identity an object through sound – the ringing of a bell – or touch – a needle – but not sight. Others might use the wrong word. For example, instead of saying, “Can you please pass the salt,” they might say, “Can you please pass the tire?” http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

Circumlocution, a strategy where you “talk around” the name of the object, person, or place you are attempting to identify, often helps. If you’re looking for your cell phone, and you want to ask your husband if he has seen it, you might say, “It’s portable and it rings.” That way he will know what you are talking about. Also, this might prompt you to remember the object. Reciting the alphabet is a strategy that triggers words for me, especially if I can’t recall someone’s name, which happens all the time, even if I just met the person five seconds earlier. So, if I’m trying to recall the name Nancy, I say the alphabet in my head until I get to N. You can also visualize the word written out on a chalkboard, or whiteboard, or even a pad of paper. Similar to circumlocution, if someone cues me by sounding out the beginning of a word I’m struggling to express, my brain synapses suddenly come to life. http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

For writers with a TBI, difficulties with word retrieval interfere with crafting poetic sentences for our readers to chew on. I typically find myself staring at a sentence for several minutes, rubbing my forehead and biting on my pencil. It’s not unusual for me to spend hours working on one paragraph. I usually end up resorting to my pile of notebooks of quotes I’ve collected from some of my favorite authors. For instance, if I’ve used “walk” a hundred times in my manuscript to describe someone entering a room, I flip through the notebooks, scanning the pages for unique ways other authors describe this same action. Of course, I do not steal their phrases, but seeing alternative ways to express “walk” is similar to someone verbally cueing me: My brain lights up with all kinds of options to consider, and I feel as if I just won the lottery.

Give these exercises a try, and feel free to share what works for you.

(FYI: Including research, it took me five hours and twenty-eight minutes to write this bog post).

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