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).

November 16, 2014. 5 pm Pacific Time (8 pm Eastern Time): Tune into “Another Fork in the Road,” hosted by Donna O’Donnell Figurski, and listen to Melissa share the transformative impact of her traumatic brain injury. Feel free to call in with questions or comments at (424) 243-9540.

http://www.blogtalkradio.com/braininjuryradio/2014/11/17/another-fork-in-the-road-melissa-cronin-author-chicken-soup-for-the-soul

When it’s a cold, rainy day what better place is there to be than in a bookstore, slouching back in a cushy couch, nibbling on delicate pastries, and letting someone read to you? That’s how fifteen individuals, who were mutually interested in learning more about traumatic brain injuries, spent their Saturday afternoon this past weekend. As the hard rain tapped against the windows of Westwinds Bookshop in Duxbury, Massachusetts I spoke to them about TBIs, then read from my essay, “Invisible Bruise,” published in Chicken Soup for the Soul: Recovering from Traumatic Brain Injuries. Though I relayed a dump truck full of statistics, and read my story, my wish was to engage the audience in an honest discussion of the broader issues related to TBIs, inspiring them to pass on to others their new knowledge of this often misunderstood injury. And that’s exactly what evolved from my talk and reading: a couple, whose daughter sustained a TBI in a car accident last spring, shared their concerns about her suffering from depression. Another woman, with a granddaughter who is recovering from a TBI, asked about how one qualifies for disability insurance. The actor Chris Cooper, and his wife Marianne Leone, who has written a memoir about their disabled son Jesse who suffered a brain hemorrhage related to prematurity, spoke about the roadblocks they encountered when advocating for him to be included in classrooms with able-bodied students. The discussion continued for several more minutes, some vocalizing their thoughts about we view individuals with disabilities, even in the context of those who have not suffered a TBI, followed by others asking how TBI survivors cope with the loss of their careers.

And so my wish was granted: the event was not only to acknowledge my writing, and my TBI; it was for everyone in that room, and for those beyond the room who could not make it.

I came away from the reading with more than the sunny feeling that others benefited from it. Most of the people who attended I had never met before, but by the end of the event, I sensed each individual’s unique energy. As one after another thanked me, they reached out to shake my hand, but I refused. Instead, I reached out and hugged each one of them. They hugged me back.

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/

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