College Basketball Sees An Increase in Concussions

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Posted on 6th March 2010 by Gordon Johnson in Brain Injury

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Football isn’t the only sport that is causing concussions in players: There has been a rise in head injuries for college basketball players.

In a detailed story, the Associated Press suggests that college hoops has gotten more physical and fast-paced with more massive players, and this is leading to more concussions. http://sportsillustrated.cnn.com/2010/basketball/ncaa/wires/03/05/2060.ap.bkc.concussions.on.rise.adv07.1263/

The issue has become so serious that the National Collegiate Athletic Association will hold a summit on concussions this spring.

Head and face injuries in all NCAA divisions have risen 6.2 percent from 1984 to 2004, a study by the National Athletic Trainers Association found, with concussions making up 3.6 percent of all injuries reported. Strangely enough, female hoops players were three times more likely to sustain a concussion than male players.

Several marquee players – such as Michigan State’s Delvon Roe and UCLA’s Malcolm Lee – have been forced to sit out games and practices after they exhibited the symptoms of concussions. And the Air Force basketball team has suffered at least six concussions this season.

College players are no longer “pipe-cleaner thin,” according to AP, and “the game has adapted to the size and strength of its players, becoming more about power than finesse.”

Let’s see if the college basketball moves faster to address the concussion problem than other pro and collegiate sports.

The obvious counter to the thesis of this research is not that concussions have gotten more frequent, but that the diagnosis of concussions has changed. It is unlikely that concussion itself is increasing. The game has changed very much. But now, trainers, coaches and fans understand the symptoms, and players injuries are given more attention. That is a good thing.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Followup to Injuries in Jamaica Air Crash

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Posted on 25th December 2009 by Gordon Johnson in Brain Injury

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I was once a news reporter and I understand the process of gathering news, but it is amusing in retrospect what the first reports of a major event look like. Take for example this story in the New York Times about the American Airlines Flight 311 crash in Jamaica on December 23: http://www.nytimes.com/2009/12/23/world/americas/23briefs-Jamaicabrf.html?scp=1&sq;=american%20airlines%20flight&st;=cse

The story said:
An American Airlines flight from Miami overshot the runway in Kingston on Tuesday but came to a safe stop, an airline spokesman said. The spokesman, Charley Wilson, said that there were no reports of injuries or fatalities, and that all the passengers were off the plane.
How does American Airlines release a story like that? All one has to do is look at the wreckage of the aircraft to know that people had to be hurt. See the photo from the Jamaica Observer at http://www.jamaicaobserver.com/news/Observer-first-in-the-world-to-report-AA-crash Miracles notwithstanding, there is no way an airplane is torn apart like that without injuring virtually everyone who was near the fracture points. The Jamaica Observer reported further on the status of injuries:
One hundred passengers were reported injured when the plane crashed and broke in three after landing at the airport shortly after 10:00 Tuesday night.

Most of the injuries were classified as lacerations and blood trauma. A few fractures of long bones and ribs were also reported. On Thursday, a statement from the Ministry of Health said that 13 of the 14 passengers who were admitted to hospital have since been released.
It is great news that all but one of the passengers was released from the hospital for Christmas. But as I said in my last blog, being released from the hospital does not give any of that group of injured people a clean bill of health as far as brain injury is concerned. There is no question that there were concussions on that plane. There was simply too much force involved in tearing up that jet to not have injured some brains. To tear apart an airplane like that severe twisting forces must have been involved. Those forces could have been just as severe to any passenger on board, but especially to those sitting in the seats adjacent to where the plane broke up.

The important thing now is that anyone on board who is having any head injury symptoms go back to the doctor or emergency room and get the kind of follow-up evaluation that an NFL quarterback would get. Most important in that follow-up is a determination as to whether there has been any amnesia, or loss of memory for events, between the time of the accident and the time of the evaluation. Post-traumatic amnesia is the single most important predictor of a negative outcome from a concussion. Other obvious symptoms that should be taken seriously are balance or visions problems, confusion and headache.

Concussions can disable. The concussions that disable are the ones that are symptomatic 24 to 72 hours after the injury. Now is the time to identify those symptoms.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Iraq Long Haul PART VII: Homecoming, struggles and new beginnings

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Posted on 11th August 2008 by Gordon Johnson in Brain Injury

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Date: 8/9/2008 12:01 AM

BC-The Long Haul VII,1st Ld-Writethru/1869
Eds: Minor edits, adds detailed Multimedia note. MULTIMEDIA: An interactive, including video, battle recreation and audio slideshows, exploring personal stories from a unit of the Minnesota National Guard during their 22 months tour of duty in Iraq will be available in the _national/long_haul folder by noon Saturday, Aug. 2.
PART VII: Homecoming, struggles and new beginnings
By SHARON COHEN

EDITOR’S NOTE — Homecoming at last, with troops and families reunited, though struggles remain. Conclusion of a seven-part series on the longest deployment of the Iraq war.
By SHARON COHEN
AP National Writer

The chartered plane loaded with soldiers descended slowly in the summer sky as Sgt. John Kriesel watched eagerly on the tarmac, clutching a walking cane. He had been waiting for this reunion for more than seven months.

Kriesel hadn’t seen his “guys” since he lost his legs in a roadside bombing in Iraq. Now, finally, on this bright July day at Volk Field in Wisconsin, the soldiers who served with him — several of whom he had known since high school — were home after a 22-month tour of duty, including 16 months in Iraq.

And he was there to welcome them.

Wearing shorts, sunglasses and bright yellow running shoes and standing firmly with his prosthetic legs, Kriesel beamed as a long line of soldiers formed, snaking from the plane’s steps across the tarmac.

One by one, Kriesel greeted them with hugs, hand shakes, smiles and jokes.

One soldier carried his battered M-4 weapon that survived the IED attack. “Is that my rifle?” Kriesel exclaimed, touching it again.

“You look good!” another friend said. “You look better than me.”

“No, I don’t,” Kriesel replied. “YOU look good. You got legs, bro.”

Staff Sgt. Tim Nelson, who was Kriesel’s roommate in Iraq and squad leader, jumped ahead in line and the two men embraced, holding each other tightly. Nelson was in the Humvee seat behind him when it ran over an IED.

Nelson flew with Kriesel to the military hospital in Balad, Iraq, and held his hand when Kriesel’s survival was in doubt.

“Good to see you, dude,” Kriesel said to Nelson. “I heard you yelling and I wasn’t going to let go.”

Staff Sgt. Todd Everson was also there. He was one of Kriesel’s rescuers, binding his left leg in a tourniquet.

“I’d be dead without you,” Kriesel said.

The next day, as Kriesel watched the soldiers’ formation at Fort McCoy, they surprised him by shouting, whistling, waving — and pointing to the place he had always stood.

Kriesel walked over and took his regular spot at the formation, and his battalion commander pinned the Combat Infantryman Badge and the Bronze Star on his chest.

For Kriesel and others who were part of the 1st Brigade Combat Team/34th Infantry Division, the summer of 2007 was a time of reunions and readjustment. Most had been gone nearly two years; their children had grown, their parents had aged, the world they left behind was different — and so were they.

When Janelle Johnson ran off the bus at Camp Ripley in Little Falls, Minn., she was amazed to see how big her two daughters looked. Emily, who’d been just 6 months old when she left, didn’t want to come to her mother or pose for a family photo and when the little girl relented, she clung to her father.

A general watching the scene put a comforting hand on Janelle’s shoulder.

“It’ll get better,” he whispered. “It’s going to be a long haul.”

And it has gotten better. Over the last year, while continuing to work for the Guard, Janelle has settled back into motherhood, reading bedtime stories to her girls and celebrating birthdays with them, not missing them anymore.

Seth and Alicia Goehring, who got married by proxy, are expanding their family. They’re expecting their second child in August, a girl they’ll name Audrey Florence.

Others have picked up where they left off.

Dr. Joe Burns went back to the emergency room of a Fargo, N.D., hospital, though he probably will return to Iraq next year.

Cassandra Houston entered a nursing program in college — something she postponed when she went to Iraq. Seeing so many needy people in Iraq inspired her. She wants to work for a humanitarian organization.

She had to adjust, too, to changes at home. During her 22-month absence, her son, Josh, turned 16, got his driver’s license and his first car. He proudly picked her up in the dented 1997 Sunfire to take her home.

Chad Malmberg came home to glory.

On Sept. 22, 2007, hundreds of friends, family and dignitaries gathered to watch him receive the Silver Star for his bravery during a January firefight.

Malmberg “deliberately and courageously exposed himself to enemy fire in order to prevent the enemy from assaulting through the kill zone and overwhelming his convoy,” the citation read. “His selfless actions prevented the enemy from turning the tide of the battle and undoubtedly saved the lives of his soldiers.”

The medal now hangs on the wall. And the hero has gone on with life. He finished Minnesota State University at Mankato with a 3.4 average and will enter the St. Paul, Minn., police academy in September. For now, he works for the department, issuing parking tickets.

In his first few days this spring, he was cussed out a half-dozen times.

It didn’t upset him. He has been in tighter spots.

___

For Dathan Gazelka, it wasn’t easy to put aside military rigor when he returned home and went to rejoin his wife, Mandy, in the real estate business.

He hated wearing a coat and tie, wasn’t sure what to say, and didn’t like Mandy being the boss.

He likes clear rules. Yes or no. Not maybe — or, I’ll think about it overnight.

He had an unorthodox sales pitch to prospective home buyers: “Listen, we’re going to look at three houses today and you’re going to buy one of them.”

Made perfect sense to him. Mandy, of course, found herself doing damage control.

And so, when the National Guard invited him to return to his job as a recruiter, Dathan (and Mandy) quickly accepted.

And he has a second job now: being a father. Mandy gave birth to Nyah last July.

J.R. Salzman was relieved to be back in Wisconsin after nine months at Walter Reed Army Medical Center.

His wife, Josie, was happy to be back in her own bed, sitting on her own couch, watching her own TV. But she worried, too. When they traveled to a Minnesota veterans hospital, she noticed that her husband — who had lost his lower right arm — was the youngest patient by far. She wondered whether the government would be there helping them for the next 50 years.

Both Salzmans enrolled quickly at the University of Wisconsin-Stout.

But college life wasn’t easy for J.R., who had stopped taking medicine that made him groggy. He couldn’t sleep more than three or four hours a night.

His memory failed him often. He missed classes because he couldn’t remember his schedule. He had trouble focusing. Then one day, while researching a paper he read a report about traumatic brain injury.

He reviewed the symptoms — confusion, anxiety, memory problems — and realized he had every one of them. Then he discovered from his Walter Reed records there was something he had been unaware of: He had minor traumatic brain injury. Bingo. It all made sense.

As the months passed, Salzman improved. His memory got better. And he took a big step toward returning to his old life.

It happened last summer when he and Josie visited Lumberjack Days in Stillwater, Minn. — trailed by an ESPN crew chronicling his recovery.

“You’re going to log roll,” Josie told him. “You’re done putting it off.”

She tied his tennis shoes and watched.

Wearing his prosthetic arm, he stepped onto the log. First tentatively, then more confidently, he took a few steps. He rolled for a few seconds, stopped, then rolled some more, getting into the rhythm.

He smiled broadly.

J.R. Salzman had to relearn how to tie his shoes, to write his name. But log rolling? It came back naturally.

Just like he never was away.

___

In the year since he arrived home, Col. David Elicerio has traveled to several states, advising Guard units, telling them what to expect when they are deployed to Iraq.

In May, the colonel was on hand for the unveiling of a “Fallen Heroes” memorial to Minnesota soldiers who died. A sculpture of a helmet, a rifle and combat boots stands atop a granite slab inscribed with their names.

Elicerio also carries his own personal memorial: a chain with replicas of 21 dog tags, each bearing the name of a 1st Brigade soldier who died in Iraq.

Every time a soldier in his command was lost, Elicerio wrote the family a letter, vowing to remember their sacrifice. In a small way, he feels those tags are holding up his end of the bargain.

One bears the name of Staff Sgt. Joshua Hanson.

Nearly two years have passed since his death but for his parents, Robert and Kathy, there still are days when they feel he might call or walk into the room.

Their home is filled with memories of Josh. Outside, there’s a bench a friend made, with “Remember Sanchez,” his nickname, carved in it. His old room remains the way it was when he left it. The stuffed bass he caught as a boy, the Minnesota Twins 1987 World Champion baseball pennant, the taekwondo belts.

His military medals rest on a corner table in the dining room, illuminated with a prayer candle.

On Aug. 30, the second anniversary of Josh’s death, a picnic shelter at Maplewood State Park, where Robert Hanson is a ranger, will be dedicated in Josh’s honor. Much of the work on the shelter was done by Josh’s Guard friends.

It will have a polished black granite marker inscribed with the words: “YOU WILL NOT BE FORGOTTEN.”

___

John Kriesel knows how close he came to death. He’s determined to savor every minute of life.

In December, he, Katie and the boys moved into a wheelchair-accessible house — built by a construction company for cost and paid for with two fundraisers.

Kriesel is taking broadcasting classes at a local college. He interns at a sports radio station, where he’s on the air one morning a week.

This fall, he’ll start a marketing job with the Guard, working with sports teams, the media and businesses.

In the mirror, he can still see the faint scars of war etched on his 26-year-old face. And sometimes, he has tingly phantom sensations as if his feet were still there. He realizes, of course, he’ll never have the feel of walking on freshly cut grass or a plush carpet. He does not dwell on the past or his injuries

He is a grateful man. Every night, he kisses his two sons as they go to sleep. Every morning, he hops in his wheelchair, showers and puts on his prosthetic legs.

There’s no time to waste. He’s got lots of plans. Even for next summer. That’s when he hopes to start running again.

___

NOTE: The story of 1st Brigade Combat Team/34th Infantry Division of the Minnesota National Guard and its tour in Iraq was reconstructed from scores of interviews with more than 20 soldiers and members of their families. Most quotations are as remembered by the speakers. In addition, the series draws upon numerous official documents, including after-action reports; videos of news conferences; correspondence provided by the families (including e-mails and letters); television coverage of the unit’s return; personal journals and blog postings.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Iraq Long Haul – PART VI: An ambush produces a hero

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Posted on 9th August 2008 by Gordon Johnson in Brain Injury

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Date: 8/8/2008 12:00 AM

BC-The Long Haul VI,2nd Ld-Writethru/2166

PART VI: An ambush produces a hero
By SHARON COHEN

EDITOR’S NOTE — An insurgent ambush yields a hero, and a wounded soldier recovers back home. Sixth of a seven-part series on the longest deployment of the Iraq war.
By SHARON COHEN
AP National Writer

It all looked as if a video game had come to life.

Through his night vision goggles, Staff Sgt. Chad Malmberg saw the insurgents scurrying from berms to canals. Some popped up, ran a few yards, then fell to the Americans’ gunfire. But others kept advancing toward his convoy.

Malmberg’s rocket counterattack hadn’t stopped the enemy. And Truck 4, at the back of the convoy, had just radioed two urgent pleas for help.

It was running out of ammunition. And the enemy was within shouting distance.

Once again, Malmberg ordered his truck to race to the back — this time with two other Humvees, one of which supplied .50-caliber machine gun bullets.

The insurgents, once five or six football-field lengths away, were now within 50 feet, hunkered in a ditch. When their muzzles flashed, Malmberg saw their faces and their turbans.

When his truck stopped, he flung open his door and hopped out, quickly lobbing a grenade into the ditch.

“Frag out!” he shouted so others could take cover, then repeated the alert on the radio. Then his truck stopped again and Malmberg’s driver threw a second grenade.

Finally, that threat was eliminated.

Still, the fight wasn’t over. Insurgents near the front of the convoy, where Malmberg now returned, were launching rocket-propelled grenades as all five Humvees sprayed the area with gunfire.

In the midst of this, Malmberg’s gunner alerted him that smoke was billowing from both sides of the cab of a civilian truck. Malmberg looked through his rearview mirror. Surely, he thought, the driver was dead. He radioed an order to a Humvee crew: Remove the body.

But when the sergeant opened the door, the driver popped out and hugged him. Miraculously, the man had survived, so frightened that he then crawled under his truck for safety.

The sergeant pulled him out. They had to go. Now! They had to get out of the kill zone.

And they did.

When the Humvees returned to base, Malmberg and the others set up a board to reconstruct what had happened in the 55-minute firefight. It was almost impossible. There had been so much chaos. The gunners had shot so many targets. No one knew for sure how many of perhaps 30 to 40 insurgents were killed.

They did know this: No one in the convoy — soldiers or civilian drivers — was dead. No one was even injured.

And Malmberg, whose greatest worry was that he might somehow fail his men, would be decorated as a hero.

___

U.S. troops were not the only targets of the violence that flared across parts of Iraq in early 2007. Ordinary Iraqis, too, found themselves in the middle of a firestorm.

Sgt. 1st Class Cassandra Houston was in her second day as a nurse in the intensive care unit at the sprawling Balad Hospital when an Iraqi family was wheeled in for “comfort care” — the father, mother and son were about to die. All she could do was help them go peacefully.

They’d all been shot in the head, apparent victims of sectarian hatred, and the parents succumbed quickly.

Their son, around 14, was unconscious but still breathing. Houston suctioned blood from the boy’s mouth, changed the gauze bandage on his head and tenderly held his hand.

She wanted to make sure he did not die alone.

She thought of her son, Josh, who was about the same age.

Afternoon gave way to evening as Houston stayed by the boy’s side. She watched the monitors as his labored breathing subsided, his blood pressure dropped and his heartbeat dwindled.

When the boy died, a chaplain returned, and Houston, along with other nurses, gathered around his bed for a prayer.

That night, back in her room, she cried. She called Josh and told him she missed him.

And she was back in intensive care the next morning.

As she stood by others — including wounded, frightened troops — in the months that followed, her eyes might tear up but she learned not to cry every time she saw something terrible.

At times, she wondered if she had a heart anymore.

___

At the end of February, a dump truck loaded with gravel and explosives veered into a crowd of worshippers leaving a Sunni mosque in Habbaniyah where the imam had spoken out against extremists.

Dr. Joe Burns heard the sirens wailing. Within minutes, dozens of injured Iraqis arrived at the gates of Al Taqaddum Air Base.

One was a little boy, around 8. He was unconscious. The top of his head was wrapped in a blood-soaked bandage, a bone jutted through his left leg. His breathing was shallow, his pulse rapid.

Burns called for breathing tubes and when he removed the bandage from the boy’s matted hair, he saw a hole the size of a quarter in the back of his skull. The gray matter of the brain was visible.

He gingerly felt for shrapnel or any foreign material, but found none. That was good news.

Suddenly, the boy regained consciousness, sat up, started crying and reached for his head.

He told the interpreter his name was Youssef — Joseph, like the doctor — but little else before lapsing back into unconsciousness.

Burns and others lifted Youssef’s stretcher from the floor, weaving through a crowded hallway toward an open bed. As Burns prepared to give Youssef medicine so he could insert a breathing tube down his throat, an emergency room doctor arrived.

“What have you got?” he asked.

“Open fracture. Open head wound,” Burns replied.

The doctor shook his head.

“No,” he said, “make him expectant.” Put him aside to die, because others could be saved.

Burns protested gently.

No, he talked, he regained consciousness, Burns said. He’s young, this isn’t beyond hope.

Eying the boy again, the doctor reconsidered.

“OK,” he said, “do you want me to fix the head wound?”

The doctor sutured the scalp as Burns trained a flashlight on it and held a temporary breathing tube in the other hand. He and five other doctors worked shoulder to shoulder, their arms, legs and heads tangled around a nest of tubes, cables and medical equipment. Dozens of other doctors and nurses struggled to save other patients, wading through ankle-high piles of torn-off bandages.

Some died, but others survived.

And Youssef? Once the boy was stabilized, he was flown to Baghdad for treatment.

Later, Burns would try to check on the boy whose life he helped save, using a computer that tracks patients. For six weeks, Youssef’s name appeared. Then suddenly one day, it was gone. Burns heard rumors the boy had gone home; he would never know for sure.

But on that February day when he fought for Youssef’s life, the North Dakota doctor had a final duty.

He walked a mile to a base morgue to establish the cause of death for two Iraqi civilians killed in the blast and two U.S. soldiers.

He signed the paperwork, then ended his 19-hour day with an e-mail to his wife, Becky. He feared she’d hear news of the bombing and worry. “I am fine,” he wrote. “Disregard news reports.”

As it turned out, she hadn’t seen the news at all.

___

At Walter Reed, a new reality was setting in for Sgt. J.R. Salzman, recovering after the loss of his lower right arm.

He’d thought he would get a prosthetic arm, rebound quickly and be just fine. But after several surgeries — including the amputation of his left ring finger — it was becoming clear: This wasn’t a two-week recovery. It would be months, even years.

Salzman, who had been the go-to guy when a Humvee needed fixing in Iraq, now had to learn how to do the most rudimentary things: Zip a jacket. Brush his teeth. Write with his left hand.

He was haunted by nightmares. Sometimes he dreamed he saw the flash of an IED explosion. Other times, he woke screaming that his arm was gone, begging for a tourniquet.

The methadone and Lyrica he took for nerve pain left him dizzy, confused, drowsy. He had trouble remembering appointments.

Even proud moments turned into ordeals.

When Salzman was invited to the president’s State of the Union address, it took 20 minutes and help from his wife, Josie, just to put on his dress uniform. It was his first trip outside Walter Reed; he didn’t like leaving his safe haven.

As they listened to the speech, which was interrupted several times by applause, J.R. couldn’t clap. Josie felt like crying, and applauded loudly on his behalf.

Josie was insistent that J.R. talk with a therapist. She didn’t want to put it off. Her husband, an athlete, a champion log roller, had lost his right hand. He needed to talk with someone about it.

When they finally arranged to meet together with a therapist, it did not go well.

Josie thought J.R. wasn’t being honest, that he said he was eating and sleeping well, when he was having nightmares and living on pudding snacks.

Tensions mounted. He threatened to send her home. He thought she expected him to be the same person with whom she had fallen in love, and he wasn’t.

But as the months passed, Josie stayed and J.R. improved. He learned to write left-handed, to dress himself, even to fly fish with a prosthetic arm.

His sadness, though, lingered. He found himself remembering small details about the hand he lost, down to the scars he had from carpentry work. He’d think about that day when his wedding ring was snipped off by bolt cutters at the Green Zone Hospital in Baghdad.

Salzman knew others had worse injuries. He wanted to be positive, but sometimes it was hard.

“I think having given two years of my life and my right arm is more than enough for my country,” he wrote in his blog. “Now I want to get back to my private life, and learn how to live again all over.”

___

As spring approached, Sgt. John Kriesel prepared to take his first steps on prosthetic legs.

He wanted to walk earlier, but he had to heal from back surgery needed so he could bear weight on his legs. His spine, sacrum and pelvis had to be fused.

Kriesel had prepared for months, watching other amputees being fitted with prosthetic legs. His left leg — which was amputated above the knee — was replaced with an aluminum limb that bends like a real leg; a computer chip inside senses if he’s going to fall and lock ups to prevent it.

His artificial right leg — shorter because his leg was amputated six inches below the knee — has a carbon-fiber foot with a high-tech shock absorber.

On March 12, 2007, Kriesel donned a stars-and-stripes T-shirt and red shorts, wheeled into the therapy room, grabbed the parallel bars and stood.

At first, he felt as if he was on stilts.

But he was thrilled to look at people at eye level and kiss his wife, Katie, standing up. He walked back and forth, heel to toe, heel to toe, to perfect his form.

A doctor had warned Katie that because John’s spine was fused, he’d lose mobility in his lower back and would waddle. His gait, though, was smooth.

Kriesel worked up a sweat but was reluctant to quit. Only when therapists started switching off the lights at the other side of the room did he stop. They locked up his prosthetic legs so he didn’t try to practice when no one else was around.

Five days later, Kriesel graduated to a walker.

Two weeks later, he had two canes.

___

At the end of April, Dr. Joe Burns headed home.

When the plane refueled in New Jersey, some soldiers kissed the American soil. For Burns, the smell of humidity and the sight of greenery almost made him giddy.

After a debriefing in Texas, he flew to North Dakota on April 25, his 26th wedding anniversary. When the plane pulled up to the gate at Fargo, Burns’ daughters, Anna and Sarah, waited, along with his wife, Becky.

His gift to Becky, purchased in Kuwait, was a brass Aladdin’s lamp, the kind you rub to make a wish.

His own wish had already come true.

Shortly before midnight, Burns arrived home. Within minutes, Becky was asleep. A teacher, she had to be at school the next day.

But Burns was wired.

He wanted to savor the comfort of his own bed, the closeness of his family, the quiet he had desperately missed. And the peace.

Finally, he fell asleep.

___

TO BE CONTINUED …

___

NOTE: The story of 1st Brigade Combat Team/34th Infantry Division of the Minnesota National Guard and its tour in Iraq was reconstructed from scores of interviews with more than 20 soldiers and members of their families. Most quotations are as remembered by the speakers. In addition, the series draws upon numerous official documents, including after-action reports; videos of news conferences; correspondence provided by the families (including e-mails and letters); television coverage of the unit’s return; personal journals and blog postings.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Vietnam Remains Our Biggest Military Health Issue

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Posted on 18th June 2008 by Gordon Johnson in Brain Injury

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As we shift our focus of this blog to the emotional side of the synergistic neuropsychiatric disability that faces combat vets, I want to put the context of current soldier suicides and PTSD into perspective. This series of blogs began with my reaction to this news:
“The Associated Press announced that active duty military suicides hit its highest level on record in 2007, 119 soldiers dead. See the AP story at: http://hosted.ap.org/dynamic/stories/M/MILITARY_SUICIDES?SITE=CADIU&SECTION;=HOME&TEMPLATE;=DEFAULT “

My first reaction to that number when I read it was that there was something wrong with the record books, because I had remembered reading a number of references over the years about suicide in Vietnam veterans with numbers as high as 250,000 people. Well, the reason 119 is a “record” is the Pentagon didn’t start recording soldier suicides until around 1980 and that number is for active duty soldiers and doesn’t include vets.

Still, the overwhelming question that seems to being missed in the political debate and news coverage of 2008 is what about the Vietnam vets? As tragic as the Iraq and Afghanistan Wars have been, their footprint of death, disability and psychosis has yet to reach 10% of the magnitude of that of Vietnam. While Vietnam is now more than 30 years in our rear view mirrors, the primary group of soldiers it affected are from 55 to 70 years old. That is a serious public and military health issue for at least another generation.

$500 million dollars for TBI research for blast injuries in the so-called War on Terror is great – but what about Vietnam? The discovery of brain injury and brain damage in Iraq by the politicos and news media is truly wonderful. But Iraq is not the first war with blast injuries, not the first war where our soldiers suffered brain injury, not the first war where the soldier who returned home is a brittle, vulnerable shadow of the vibrant young man who left.

John McCain makes great political hay out of his Vietnam heroism as a prisoner of war. But how can McCain make those claims without looking back and recognizing that the United States mental health obligations to its Vets reaches back to Vietnam, Korea and even World War II survivors?

The issue of the brain injury disability and mental health of older Vets has countless sub-issues, but the most important for this blog is that brain injury and brain damage were not even considered in what we today call mild to moderate brain injury during Vietnam. Prior to 1990, there was little belief in the medical community that a brain injury that involved less than a five minute loss of consciousness was significant. Now we recognize, and have highly sophisticated neuroimaging and neuropsychological methodologies to confirm, that brain damage can occur without a loss of consciousness.

We often hear that our modern medical interventions result in more people surviving brain injury, because soldiers who would have died in Iraq or Afghanistan are now saved because of the rapid evac and treatment. That is true, but what is implicitly missing in such a statement is the clear fact that almost no one with a mild to moderate brain injury would die from it, regardless of whether they got prompt treatment. The realities of combat in Vietnam, and all wars that preceded it, is that a soldier on the front lines who gets knocked out, dazed or confused – is not likely to die from such injuries, unless he is killed by his inability to respond to the immediacy of the combat demands at the time.

Thus, there are probably far more vets with mild brain injuries in the Vietnam era than in the current generation of soldier and vets, but there are no medical records to document that they suffered such injuries. A soldier with a short-term confusion in that combat was likely expected to shrug it off and go back to fighting. Making matters worse, the complete catastrophe that is the Vietnam military health records makes it almost a certainty that documentation of brain injury is just not there. Further, the brain damage suffered in Vietnam is considerably broader than just brain injury because of the prevalence of Cerebral Malaria, which may have caused brain damage to hundreds of thousands of U.S. soldiers in Vietnam. See http://www.va.gov/OCA/testimony/hvac/16JY98NV.asp

Without the documentation of brain damage, what came out of Vietnam were hundreds of thousands of soldiers with clear cut neuropsychiatric symptoms in search of a diagnosis. The result: PTSD. PTSD is a Vietnam era syndrome of severe emotional problems, that are tied to some type of extreme emotional stressor, such as combat. But as with most “syndromes” the purity of its diagnostic criteria is lacking. The resulting over inclusive use of it in differential diagnosis of any emotional or neuropsychiatric symptom is staggering. At its threshold criteria, it requires life-threatening terror.

See http://en.wikipedia.org/wiki/PTSD which states the threshold requirement that “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.” The second (A2) requires that “the person’s response involved intense fear, helplessness, or horror.”

This sounds like combat, it does not sound like a rear end automobile collision. While some automobile or other accidents involve prolonged moments of terror, most do not. They are over within a few moments of beginning. I have experienced both kinds but my memory of the truly terrorizing accidents (and yes, I did have that realization that my life was about to end both times) ended abruptly at the moment of collision. Relatively few people who suffer concussions have clear enough memory of the event to be exposed to a pure PTSD terror. What most relate is a moment of surprise that an accident is about to happen and then a gap in memory.

In contrast – combat, rape, fires – involve prolonged exposure to truly terrorizing events. This is the type stressor that can actually make a hard wire change to the way the brain processes information. This is the type of stressor that can create haunting memories. This is the type of stressor that can create nightmares. Yet PTSD should never become a catchall for all emotional reactions to life changing events. The category for stressor has as its blue print combat. When there is no elongated exposure to terror, the focus should be on normal human emotional responses, not a psychiatric catchall.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Understanding Combat Related Suicide Requires a Comprehensive Evaluation of all that is Wrong Inside the Head

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Posted on 7th June 2008 by Gordon Johnson in Brain Injury

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The cause of suicide: “it’s all in the head.” 

That cliché is said typically about psychological problems. But the brain injury community likes to twist this cliché, with a tone of irony, pointing out that a brain injury, is also “in the head.” While our psyche is in our head – our brain’s structures, our neurons, the center of our neurological systems, are there, too.

In 1980, the American Psychiatric Association formally recognized the diagnosis, Post Traumatic Stress Disorder, (PTSD) largely because of the increasing recognition of the clustering of emotional problems from Vietnam veterans.  See the DSM-IV.  Since then, PTSD has been the easy catch-all for emotional problems that someone who has been in combat, is suffering.  Other generations had other labels – shell shock the most enduring. The problem with the historic combat stress diagnosis is that the organic component of the emotional symptoms experienced after combat has never been properly addressed.

I believe that to properly treat a neurological malfunction, it is necessary to fully understand the cause of the problem. If the emotional problems relate strictly to the emotional shock and stress of combat, then that would indicate a certain strategy to address those issues.  If on the other hand, the emotional problems are secondary to organic injury to the brain, then different strategies may be necessary.

The May 19, 2008 New Yorker contains a fascinating article about the use of virtual reality therapies that are designed for the treatment of PTSD in Iraq War veterans. Click here for this article. What is ironic though is that while the story of soldier Lance Boyd’s combat stress is quite harrowing, the article and in all likelihood the military, have ignored one very important aspect of his neurological health: at the time he was wounded, he also suffered a concussion.

Depression comes in many forms, but for someone who has suffered a brain injury, that depression has multiple elements. As with anyone who is injured and/or disabled, there is a depression that relates to the loss of previous abilities, a reactive depression. With someone who has a brain injury, there also is the risk of an organic depression, specifically related to an injury to the mood centers of the brain. The brain’s mood is controlled by multiple areas of the brain, working together. If there is an injury to one or more of these centers, or the communication fibers that connect them, a very specific type of depression may exist. However, the emotional changes that can come from injury to other parts of the brain, can be even more pronounced.

Another major element in the depression mix is fatigue. I had once believed that depression causes fatigue. While it can, research indicates that the cause and effect is often reversed: fatigue causes depression. Perhaps one of the two or three most common symptoms of brain injury is fatigue. There are multiple reasons for this fatigue, but the two easiest to illustrate relate to:
  • 1) Sleep problems, and 
  • 2) Over-attending fatigue.
1. Sleep. Organic injury to the brain can disrupt sleep, because it can interfere with the neurological triggers and mechanisms for sleep. Further, as will be discussed below, pain interferes with sleep.

2. Over-attending Fatigue. Virtually everyone with a persisting brain injury disability, has problems concentrating and multi-tasking. I have often illustrated this with analogizing it to a computer that is just about to crash. Picture how all of a computer’s functions slow down as the computer’s processor spinning out of control. Likewise, for a brain injured person, when every mental task requires activating more of the brain’s power than it did pre-injury, the brain’s mental energy is rapidly consumed. Another example: the difference between an easy two hour drive on an uncrowded expressway, versus the mental fatigue of driving in traffic, or in a storm. The easy drive may actually refresh, the traffic or storm situation will quickly exhaust. For the brain injured, mental processing of even simple tasks may involve a virtual traffic jam of thought inside the injured brain. The result, fatigue.
Another common denominator for depression and brain injury is pain. I once thought of brain injury as a cognitive disorder, with associated personality and fatigue-related symptoms. But each time I asked a group of brain injured survivors the question for the most common symptom, I got the same answer back: headache. Headache after brain injury can come in many forms, but migraine is present in at least half of my clients. Vertigo and neck pain also contribute significantly to headache in this population. The causes of headache are as multi-factorial and synergistic as depression, but the they all increase depression. Pain = depression. Pain = lack of sleep. Pain = disability.

Again from the New Yorker article of soldier Lance Boyd, who not only suffered a concussion, but other physical injuries:
“We had to crawl out of there,” said Boyd, who was hit with shrapnel and suffered a concussion, earning a Purple Heart. “That was my worst day.”
If all that the virtual reality does is address the emotional stress of being under fire and having a buddy killed, it is not likely to make a major dent in depression.  If all of the factors at work aren’t treated, the cure may work in a virtual world, but not in this one.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

NFL, War and Brain Injury

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Posted on 15th May 2008 by Gordon Johnson in Brain Injury

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My internet news today had an intersecting of two recurring themes in the brain injury world, with that of an unexpected death of a former NFL player. The first theme is the difficulties retired NFL players have with disability. The second theme the degree of depression found in post Iraq war veterans. What does the death of Curtis Whitley have to do with the other two themes? Perhaps nothing, but even if this case doesn’t, other similar cases could. For the full story on the death of Curtis Whitely, click here.

Anyone who works in the field of brain injury, has often turned the old cliché about mental illness “Its all in the head” on itself, because of course, anything to do with the brain, is in the head. But, the extent of the interplay between emotional problems and brain injury is never, and I repeat never, fully appreciated. As I sit here and write this, I can’t fully appreciate this interplay, because it involves the area of human emotions and function, that we are only scratching the surface in our capacity to understand and have no clue as to how to measure.

Brain injury deficits and emotional deficits are synergistic, meaning the whole of the problems when you combine these two, is greater than the sum of the parts. From a recent deposition I took of a defense neuropsychologist:
Q If I were going to use the term “synergistic” to apply to the cumulative effect of all of these multifactorial aspects of an outcome, is that a reasonable word to use to describe it.
A Can you define how you’re using synergistic?
Q Well, if synergistic means the total exceeds the sum of the parts, do you believe that post concussional deficits can be synergistic?
Q I’ll add to that. Do you believe that the cumulative disability from post-concussional deficits can be synergistic?
A I believe — I hope I’m answering this consistent with what you’re asking — but I believe that these factors can feed off of each other and result in a very complex, poor outcome.
With respect to Whitley, the 39 year old was found face down in a bathroom in Fort Stockton, Texas. The local sheriff said there was no indication of foul play, but the case is under investigation. That investigation will likely look at Whitley’s history of drug and/or alcohol abuse. What won’t be examined is how many concussions he had, how his dependencies on substances might have interplayed with those concussions and how his emotional vulnerabilities from the combination of the two contributed to the end of his NFL career and his premature death.

But perhaps, Iraq war veterans will have a better fate. A recent article in the Science Daily, promises more for them, and we will discuss such issues in our next blog. Click here for that story.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

TBI Survivor Uses Internet to Assist with Brain Injury Disability

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Posted on 5th May 2008 by Gordon Johnson in Brain Injury

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From a former client Cindy, a consistent source of ideas and content for my blogs. Cindy has found a novel way to use the internet to deal with day to day obstacles, brain injury survivors encounter.

Hi Everyone,

I am a TBI survivor, going on almost 4 years now. Two of the hardest things for me to deal with have been: 1) asking others for help and 2) social isolation, particularly since I’ve lived alone during most of this time. I thought I’d share with you something I started doing which has helped with both of these issues.

First, it is so hard asking other people for help, especially when I used to be a person to whom others would turn when they needed help. Even though many of my friends told me I should see it as a way of allowing them the joy of helping me, it is still hard. I worried about what if I was asking particularly people too much of the time? And what if I asked them and it really wasn’t convenient for them, but they said they would help me?

This is a situation in which I am so thankful for the internet. I asked my friends and neighbors if they had internet access and if I could include them on my “Help Needed” email requests. I explained to them my dilemma of not wanting to bother them by asking them for them for help when it may not be convenient, not knowing who I should call first to ask for help, my concern that my friends and neighbors would burn out on my requests for help, etc. My “Help Requests” include: what I need help with and a goal date I’d like to accomplish the task.

Examples: Need help transporting my birds to get their nails and wings clipped; grooming is done every Thurs. from 1 – 7 p.m. Need help cleaning and organizing my family room; goal date—March 1. Need help taking items to Goodwill; goal date—April 1. Would like companionship to see a movie during “off hours” (i.e., weekdays before 4 p.m.); goal date—anytime.

So that no one feels pressured, I tell my friends: “If you can help me with something, call me and we’ll set up a time.” If people can’t or don’t want to help with certain things, they just don’t respond to my email. When I send out my next email request, I always make a point of thanking various people in my email. I do this so that everyone knows that my requests are spread out over many different people and no one person needs to feel pressured, like they are the only person who can help me.

My next dilemma was: What do I do so that my friends and neighbors don’t begin to dread getting emails from me? What can I do to make them fun, interesting and maybe even enjoyable? .
\

Cindy will address her strategy for not wearing out her helpers in tomorrow’s blog.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

The Emotional Adjustment to Brain Injury

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Posted on 29th April 2008 by Gordon Johnson in Brain Injury

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EDITORS NOTE: Continuing with this week’s theme of the emotional impact of brain injury, I have another post from a TBI advocate/survivor I want to share. Kimberly was referenced on our blogs a few weeks ago with respect to seizure dogs and she started following our blogs at that time.

Hello, Mr. Johnson:

My name is Kimberly Carnevale, founder of Canine and Abled, Inc. You wrote about me and my program in a recent blog. I’ve since followed your blog, and was happy to learn that you are educating about the “invisible” nature of brain injury; something that I struggle with everyday.

When I first was injured, I would try to “hide” my impairments from others. I was confused at how to React to other’s reactions to my injury. To be honest, I think I was very surprised and disheartened at people’s lack of support/understanding of my deficits. I fed off of other’s discomfort at my differences. I felt guilty at the behavior I had trouble controlling, was embarrassed when I couldn’t remember things I knew that I knew, and was self-conscience living in a body that “looked” fine, but as it’s captain, I knew was anything but fine.

Everyone used to say, “you look wonderful!”…but that’s only because on the days that my cognition was impaired, I would retreat into my shell, not emerging again until I felt fairly “normal” again. I felt as though people only accepted me when I didn’t show signs of my disability, and were uncomfortable dealing with my cognitive issues; and so I locked them (and myself) away until they subsided. It was a very solitary and depressing way to live.

If you have a broken bone, folks are prone to be more compassionate because they can see the cast, or limp or other physical sign. If you are brain injured, no one but you experiences the overwhelming anxiety of trying to manually process the environment and deal with the wide spectrum of emotions that overtake you at any given moment.

It wasn’t until I gained much-needed support through TBI groups, that I started to feel differently about my disability. I found that I wasn’t alone, and didn’t need to be embarrassed by my deficits any longer. While I once was apologetic about my service dog (the ONLY thing that made my confusing and overwhelming life bearable), I now hold my head high and am proud to be accompanied by the noble friend who offers assistance, safety, and never-ending emotional support.

I would like to personally thank you for educating people about hidden disabilities, and thank you for telling my story in your posts. If I can ever be of assistance to you in any way, please do not hesitate to ask.

All my best,

Kimberly Carnevale
Author/Motivational Speaker/Disability Advocate
President, Canine and Abled, Inc.
“Taking The Dis Out Of Disabled”
www.canineandabled.com
www.KimberlyCarnevale.com
canineandabled@aol.com
Kimberly’s is a success story, but only because she was able to move past the emotional and adjustment issues that plagued her.  And my take is that her dog helped her make an emotional connection that greatly assisted in that process.  There is something special about the connection between the canine and the human.  Maybe it should be at the cornerstone of all brain injury rehab.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney

Emotional Issues After TBI

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Posted on 28th April 2008 by Gordon Johnson in Brain Injury

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This week, we will focus on emotional issues after TBI.

I will begin with a contribution from an old TBI from entitled Hope For Anger by Stephanie St. Claire:

There is help and hope for out of control anger. I no longer put holes in doors trying to get through them to the person I am angry at, or kill animals in a rage. Rages used to flood me even when I was relaxed, comfortable, and walking down the hallway. Is this the type of out of control emotion you are talking about? (I hope your anger is MUCH less violent.)

What helped me was:

1. Tegretol. It took away the violence of the mood swings and gave me enough control to be able to get away and alone in a quiet place until the flood of anger passed, sometimes four or more hours later. When I made changes in my environment, lifestyle, and was able to become more conscious of my emotions as they began, I no longer needed to have Tegretol for emotional control. Some rages/anger are caused by temporal lobe seizures, which need a Doctor’s (as much as I despise them, present company excepted) care.

2. Stopped pushing myself so hard to be “normal.” I grieved deeply for the “self” I had lost and then could better accept where I was at. The result was when I was tired I rested and it was easier to do, and when I was overloaded I took time out and relaxed. My pace of life slowed down enough to accommodate my difficulties, which helped lessen the high stress I carried around inside, and helped my brain function better.

3. My senses are overwhelmed very easily so I now live in a rural area that is quiet. Overstimulation would (still does) overload me and increase the likelyhood that I would be enraged at little things. (Or cry at the drop of a hat, or laugh and not be able to stop.)

4. By paying attention to how tired, stressed, anxious, overactive, or overloaded I am I am better able to catch flashes of emotion before they flash and burn everyone in sight. Being aware of physical sensations that tell me when my brain isn’t functioning as well (such as headaches or nausea) helps too.

5. Feedback from others helped me know what I was feeling. If someone I could trust saw a strong emotion, or one quickly building, she or he would ask me if I was feeling “angry” or whatever emotion they saw. I could then check myself and began to understand that when my chest felt tight and I was energized that I was agitated. In time I began to be able to recognize it for myself, as it sounds like you are starting to.

6. When I was able to get out and interact with people it helped to limit my social contact to people who were generally positive and upbeat (no phony optimists) and who accepted me as a human being, not as a brain injury.

7. My underlying mental and emotional outlook is critical. After the TBI I no longer have the ability to keep on functioning, come what may. I look for things to laugh about, I look for and find love, and I live as relaxed and comfortable a life as I can. I haven’t been able to change the TBI, but I have found that it is in my power to chose how I am going to cope. Though there is very little I am able to do about what goes on in my external environment I have found that there IS something I can do about what goes on with my internal life. It has taken me years to learn that. Staying relaxed and laughing has helped a lot to enable me to regain control. It took me years of fighting, denying, angry at, and bargaining with this TBI for me to get to the place where I could accept it, even though it wasn’t in my game plan or something I ever wanted. When I got to where I could accept it then I was where I could better do something about it.

Some of these things don’t seem to be related to not having belches of anger and they aren’t directly related, but they do have a behind the scenes effect of calming the brain down.

After time, and these things I’ve listed, I am able to be aware when my irritability makes its appearance. I then check myself, usually I am tired and I need time out. I no longer put off taking that time out and resting my brain. Feedback from others is still helpful, but it is rare these days that I don’t see it for myself and can take action. There are occassional flare-ups of irritability that tell me I still need to take precautions but I have regained emotional control and I haven’t had a flash of rage in many years. If your anger doesn’t become rage, like I was being flooded with, you might find that your emotions become better settled down and predictable more quickly than mine.

It may take time, and more patience than you knew you had, but it is possible, I believe, that your anger will be under your control again. It might take working through your emotions about having a head injury to help you regain mastery of those emotions that your brain creates against your will. If you can deal with the normal emotions then the TBI ones are easier because then there is less emotional baggage to cope with. At least I have found that to be the case. Staying away from angry, agressive people, or people that trigger emotion is a good idea too, at least until you can get a good handle on your own.

I related very strongly to what you wrote. I hope my experience with working through this and coming out on the other side helps you. Yes, it is possible to get through this and make it better. And yes, there ARE people who relate to what you are experiencing!

Better days ahead,
Stephanie, TBI Survivor


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney