Suicide Awareness Week and Month

September is suicide prevention awareness month.

Monday, September 10, 2018 is suicide prevention awareness day.

September 9th-15th, 2018 is suicide prevention awareness week.

If someone talks to you about suicide or harming themselves or if they open up to you about how they feel, listen. Listening to and acknowledging someone can save a life.

Let’s work towards ending the stigma of mental health and suicide. Instead if saying someoneone committed suicide say they died of suicide or they died of depression.

People commit crimes, suicide isnt a crime, it’s the last symptom of depression.

Never Say These To A Caregiver

How to Survive as a Primary Caregiver Word Cloud Concept Text Background

Cindy Laverty, caregiver coach, radio talk show host, and author of, “Caregiving: Eldercare Made Clear and Simple,” offers examples of phrases that can leave caregivers thinking, “Did she really just say that?”

11 Things to not say:

1. “Why are you having such a hard time being a caregiver?” Usually voiced by someone who has never been a caregiver for a loved one, this question can be very difficult for a caregiver to hear. As Laverty points out, it effectively takes their role of providing care for a loved one, and diminishes it.

2. “Gosh…we haven’t seen you in such a long time. Why don’t you get out more?” Though it probably comes from a place of love, Laverty points out that this can be an unproductive way to express concern for a friend or family member who is a caregiver. “The truth is that most caregivers do need to get out more, but this is an insensitive way of saying it,” she says.

3. “You look really tired. Are you making sure to take care of yourself?”Caregivers generally have a good reason for looking tired and haggard—because they are. “The biggest issue for caregivers is that they tend to sacrifice personal care—it’s the first thing that goes,” Laverty says. Caregivers look tired because they are not getting enough sleep, they spend their nights worrying and making sure their loved one doesn’t wander. But, that doesn’t mean that they appreciate having that fact pointed out to them.

4. “Caregiving seems like a burden. You shouldn’t have to sacrifice your life for your mother’s.” Caregiving is hard. That’s why so many people, both caregivers and non-caregivers alike, refer to it as a ‘burden.’ But, according to Laverty, when a friend or family member likens caregiving to a burden, what they’re really telling the caregiver is that they aren’t handling the situation properly and that this isn’t what they should be doing with their life. “Caregivers get into their role because they started out as loving, caring people trying to do the right thing,” she says.

5. “You need to get a ‘real’ life.” As the old saying goes, ‘you’re preaching to the choir.’ “Every caregiver understands that they need to get a life, have a plan, start making time for themselves,” Laverty says. But, telling a caregiver to ‘get a life’ is like telling them that what they’re doing now (caring for a loved one) doesn’t matter.

6. “Why don’t you just put you mother in a nursing home? It would be better for everyone.” Laverty says that comments like this can make a caregiver feel like they’re not doing a good job taking care of their loved one. The reality is, a nursing home might not be financially feasible, or a caregiver may be trying to keep their loved one at home for as long as possible. Outsiders think they’re offering good advice, when they might really just (unintentionally) be making a caregiver feel guilty.

7. “Why do you visit your dad so much? He doesn’t even know you.” If a caregiver is taking care of someone who has Alzheimer’s or another form of dementia (or brain injury) and they live in a nursing home, people may ask why they bother to visit someone who doesn’t even remember who they are. “People need human contact and love, or they will just shrivel up and die,” Laverty says, “Caregivers shouldn’t feel stupid for going to visit someone who doesn’t recognize them outwardly. As long as they know who their loved one is, that’s all that should matter.”

8. “Don’t feel guilty about…” When you’re a caregiver, “guilt just comes with the territory,” according to Laverty. Caregivers want to fix everything, to solve every problem, to ease every hurt, when the reality is that no one can do it all. When people tell a caregiver not to feel guilty about something, it can make things worse by bringing that guilt to the forefront of their mind.

9. “Let’s not talk about that. Let’s talk about something happy and fun.” When it comes to your average small talk scenario, caregivers generally don’t have a lot of “fun” things to contribute. Laverty says that people need to understand that people taking care of an elderly loved one need to talk about what’s going on. Friends and family members of caregivers should take the time to listen to what a caregiver has to say, no matter how ‘unpleasant,’ or ‘unhappy’ it is.

10. “You must be so relieved that it’s over.” When their loved one dies a caregiver is likely to be facing a bunch of mixed up emotions. Relief may be one of those feelings, but Laverty feels that it’s probably not productive to point this out to a person who has just lost a parent, spouse, or sibling. “If you diminish the event, you diminish the life and effort of the caregiver,” she says.

11. “When are you going to get over it (a death) and move on?” Grief is an individual process. For some people, processing the death of a loved one will take some time. This is particularly true of caregivers, who’ve poured a significant amount of time and energy into taking care of the person who has just passed.

Journey Into the Dark Side

I have been reflecting.  Reviewing old notes, writings, posts from the first 3 years after the wreck.  This was the epicenter of the hardest of my recovery.  Also the hardest was not feeling listened to by certain providers, especially during that first year; these providers who dismissed my pain, and who I was supposed to be trusting with my care.

I have decided to share some of those thoughts here….in my Blog.  This one was from 2014 just after the first of several surgeries to come:

The Journey Into the Dark Side

I remember.   I remember going to Spectrum Health Butterworth for surgery. I remember the surgeon calling me the night before after weeks of trying to get a hold of him to quash my fears and answer the questions, which to him were probably nonsense….but to me – were the words that drove my every waking breath and desire to understand what I was about to endure.

I needed his reassurance.  His candidness.  His time. His empathy.  His patience and his understanding.  I needed his apology, which I doubt I will ever hear. I remember feeling frustrated and angry that he told me to call any time with questions and then never responded to those questions, leaving me hanging perilously from day to day as if I were waiting for my death sentence.

Each moment, perhaps my last with each click of the clock which hung on the wall and taunted me so consistently with each passing hour, day, and night.  To him he was probably busy, and thought I should just TRUST him because he was one of the best if not the best surgeon in his specialty/field…..but how could I trust when that trust had been shattered like the pieces that lay inside my body still broken, painful, and damaged?

That trust was broken by him when he didn’t believe me and my complaints of pain, and yet I craved his answers and solace to help me get through the coming days and weeks before that daunting day when I would go beneath his knife.  I craved his humanity and his ownership for his role in my current state.  Yet that never came.

I felt trapped.  I knew I needed the procedure….this surgery.  How could I trust once the betrayal had been sown?  How could I believe that this was the right thing to do by this same man who cast me aside like a scrap piece of paper not worthy of his time until I got beneath the glaring lights of the cold and clinical Operating Room…..where I saw him momentarily.

How could I in the face of adversity and enormously high risk of dying on the operating table….TRUST?

I took a break, several in fact, and pretended like everything was okay, for my family’s sake.  I don’t know how I made it through other than by faith, the driving and enormous desire for relief of the growing pain in my right side (where the ribs never healed) that never went away; and the increased loss of strength and use in my right arm (most likely from forcing myself through therapy for 12 weeks and putting forth my BEST EFFORT with tears flowing like endless waterfalls as I forced myself to continue each exercise…..not knowing that my shoulder/scapula was still fractured and had not healed at all either as well).

How could I push aside the rage and anger that made several professionals miss such an important detail that I was very vocal about?  How could I give in to the experience when I had so much left to say, learn, live, and experience?

I just kept breathing…..deeply, slowly, studying each item, each line in the ceiling as I was wheeled along in the stretcher.  I focused on the names of those pushing me, and their conversations and attempts to bring calm to me.  I embraced each quirk on the face of my husband, mother, and Medical Case Manager as this may be the last things I see.  I was acutely aware of every single detail and overwhelmed by the voices, noises, and conversations around me.  The lights were bright, my headache grew, and I had to take myself to another place while still being exactly where I was.  I know that sounds silly but I have no other way to explain it..

This fileting of my body with a magnificent dance of his scalpel tools and his skillful artistry beneath the clinical shroud of the operating room;  a handful of specially trained staff who would bring me to the other side of waking up once more…..or so I secretly begged for  – and perhaps begged for aloud as well.

I remember putting on my bravest face and not knowing if this was the day that I kissed my children goodbye for the last time before I saw them walk out the door to go to school;  not knowing if this was the last time that I would see my mother’s face, feel my husband’s touch, and I was so afraid.  I wasn’t afraid to die.  I just wasn’t ready.  I thought on this intensely.  Should I have written good bye letters the night before.  I had decided not to because to me that was the same as giving up.  How do I find the words to say the things that I feel? HowI do I make the words in my head come out on paper in the way I wanted them to and to have enough of an impact to make everything up to that point feel “worth it” when since the wreck I struggle just to get my words to get from my head out my mouth in the way I desire.

How do I trust God and the Universe and all my spiritual beliefs and experiences?  How do I know at this point that God is even real any more?  Then I had to remind myself of all the miracles surrounding the wreck and force myself to believe that miracles would happen that day.

As it so happened…..the 3.5 hour surgery we were told it would take turned into about 8 including the 2 hours in recovery, per my husband and mom.  The stakes were high.  The man I decided at the last minute to trust with my life in its entirety took me on a journey and he and his team brought me out the other side.

This was my first post surgical feeling of gratefulness!!! When my eyes opened and I noticed people rushing around me in recovery, and seeing my O2 sats in the 80’s but just feeling such calm, feeling peaceful, acutely becoming aware again, and just blinking ever so slowly…….grateful in that very moment.  Grateful that I had been allowed to once again survive that Journey…..

The Journey into the Dark Side.

~ Caren, 2014

carenpostsurgery

Brain Injury Poem

Brain Injury Poem 2: Don’t Take Away My Hope

Things may be bad sometimes and to some may seem hopeless, please just let me accept my life in reality and love my life anyway.
But I am pleading with you not to steal what keeps me going…Hope.

There are those times that I am quite aware of how bad things are,
those temporary moments when I can not see through my streaming tears.
But I am begging you to let me hold on to what I know I need…Hope.

Please do not ever say you could not stand to live the life that I have,
you could not possibly know unless my life were the life you were living.
I am asking you to let me have what I need most for the moment…Hope.

Do not make false promises or paint false dreams, let me have my own dreams.
Please do not as a professional, ever say there are no more answers or help.
I am pleading with you to allow me the life luxury I need most…Hope.

Always there are more answers, it may be just you without those answers.
When you say discouraging things,it makes it hard to hold on to my hope.
I am telling you that all patients need that one joint component…Hope.

If you have not walked in someone else’s shoes, do not be too quick to judge.
All of us at times face adversity, just some have to live with it all of the time.
We are somehow able to find strength and endurance through our…Hope.

No matter how grave the situation or how serious the medical problem,
remember that miracles and things not quite understood by man do happen.
Do not ever be so cruel and heartless as to take away someone’s…Hope.

Do not ever say we will amount to nothing or get no where in this life.
As long as we are alive, we can share with someone else what we have.
In giving to others the survival tips we have learned we give…Hope.

by: Debbie Wilson, 7-24-96

– See more at: http://tbilaw.com/brain-injury-poems.html#sthash.ZtsM34Hb.dpuf

Silent Epidemic: Domestic Violence

When we hear traumatic brain injury, we often think of a trauma from say….a vehicle accident, or sports, or falls.

It’s time to continue bringing awareness to this silent epidemic…Domestic Violence.

*Polytrauma and Traumatic Brain Injuries are common with Domestic Violence

* Women experience about 4.8 million intimate partner-related physical assaults and rapes every year.

*Less than 20 percent of battered women sought medical treatment following an injury. A significant number of crimes are never even reported for reasons that include the victim’s feeling that nothing can/will be done and the personal nature of the incident.

*The cost of experiencing Domestic Violence includes medical care, mental health services, and lost productivity

*Domestic Violence affecting LGBT individuals continues to be grossly underreported; it is as much as a problem within LGBT communities as it is among heterosexual ones.

Domestic violence, also known as intimate partner violence, is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person[1]

Research on abused women shows that between 40 to 92 percent of victims of domestic violence suffer physical injuries to the head; nearly half of these women report that they have experienced strangulation, according to research published in October 2017 in the Journal of Women’s Health.

DID YOU KNOW?

More than 40 per cent of victims of domestic violence are male.

40% of those reporting serious assaults by current or former partners in the past year were men, and most of their attackers were women.

80 per cent increase in reports from male victims between 2012 and 2016.

Women are as likely as men to be agressors.

Men also make up about 30% of intimate homicide victims, not counting confirmed cases of female self-defense.

Female-on-male violence is often assumed to be harmless, given sex differences in size and strength. Yet women may use weapons — including knives, glass, boiling water and various household objects — while men may be held back from defending themselves by cultural taboos against harming woman

Domestic violence against men can take many forms, including emotional, sexual and physical abuse and threats of abuse. It can happen in heterosexual or same-sex relationships.

Abusive relationships always involve an imbalance of power and control. An abuser uses intimidating, hurtful words and behaviors to control his or her partner.

Men who find themselves as victims of domestic violence are often viewed by and made to feel emasculated and weak. We are told to fight back and ridiculed for “accepting” or “allowing” the abuse. Many people don’t know how to approach the conversation for fear of adding insult to literal injury, or because they simply don’t believe a man can be a victim of domestic violence.

Men are expected to be violent and in control, particularly in control of women, while supressing their emotions and sucking it up whenever life doesn’t go their way. When a man steps outside of this box, he is often ridiculed as weak or as not being a “real” man.
This toxic view of masculinity often leads men to become perpetrators of domestic violence, but when they’re victims, it can prevent them from coming forward. The stigma, and the fear of not being believed, can be so strong that men simply don’t report the abuse.

Abused men have faced widespread biases from police, judges and social workers. Equality should include recognizing women’s potential for abusive behavior.

Claims on both sides should be fairly investigated — without political bias, sexist bias, or cultural bias.

Domestic violence service providers. Screen everyone who seeks DV services for TBI. A brief screening tool that was designed to be used by professionals who are not TBI experts is the HELPS.2
HELPS is an acronym for the most important questions to ask:
H = Were you hit in the head?
E = Did you seek emergency room treatment?
L = Did you lose consciousness? (Not everyone who suffers a TBI loses consciousness.)
P = Are you having problems with concentration and memory?
S = Did you experience sickness or other physical problems following the injury?
If you suspect a victim has a brain injury, or she answers “yes” to any of these questions, help her get an evaluation by a medical or neuropsychological professional – especially if she has suffered repeated brain injuries, which may decrease her ability to recover and increase her/his risk of death.

https://www.biav.net/traumatic-brain-injury-domestic-violence/

http://www.opdv.ny.gov/professionals/tbi/dvandtbi_infoguide.html

Printable version of Traumatic Brain Injury and Domestic Violence Quick Guide

http://www.biav.net/wp-content/uploads/2018/05/Domestic-Violence-Fact-Sheet-lb.pdf

https://ncadv.org/statistics

https://now.org/resource/violence-against-women-in-the-united-states-statistic

https://www.everydayhealth.com/neurology/shining-light-on-traumatic-brain-injury-domestic-violence/

https://www.npr.org/sections/health-shots/2018/05/30/613779769/domestic-violence-s-untold-damage-concussion-and-brain-injury

https://www.helpguide.org/articles/abuse/help-for-men-who-are-being-abused.htm

https://melmagazine.com/what-domestic-violence-against-men-looks-like-74ce9500ab8d

https://www.independent.co.uk/voices/domestic-violence-male-victims-shelters-government-funding-stigma-a7626741.html

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence-against-men/art-20045149

http://www.latimes.com/opinion/op-ed/la-oe-young-sorenson-male-domestic-abuse-20180222-story.html

https://pro.psychcentral.com/exhausted-woman/2018/01/males-can-be-the-victims-of-domestic-violence-too/

Newer Brain Imaging Technology

Medical imaging is an important part of assessing the severity of head injuries, but a new device could help medical providers in emergency situations detect structural damage to the brain even before you reach a CT scanner.
The FDA approved BrainScope’s Ahead 100, in 2014, a device that patients wear on their heads – like a hat – that can produce an electroencephalogram of the brain’s structure.
May 18, 2015 BrainScope Company,
Inc. announced that the United States Food and Drug Administration (FDA) has cleared the company’s “Ahead 200” device. Using commercial smartphone hardware that leverages Google’s Android operating system, the Ahead 200 records and analyzes a patient’s electroencephalograph (EEG) using a custom sensor attached to the handheld to provide an interpretation of the structural condition of the patient’s brain after head injury.
It is indicated for use as an adjunct to standard clinical practice to aid in the evaluation of patients who are being considered for a head Computerized Tomography (CT) scan, but should not be used as a substitute for a CT scan. It is to be used on patients who sustained a closed head injury within 24 hours, clinically present as a mild traumatic brain injury (TBI), and are between the ages of 18-80 years.
In September 2016 Brainscope announced clearance by FDA for its latest device, the Ahead 300. This the first of the company’s products that will actually be distributed commercially and it was touted as their most advanced version. It utilizes disposable electrodes and a connected smartphone to process the information. It relies on the firm’s proprietary algorithms and machine learning to spot certain patterns and correlations within the recorded brainwaves.
http://brainscope.com/
(compiled from various sources)

Biomarkers – Blood Work for TBI

biomarkers-can-reveal-tramautic-brain-injury-293810

Scientists are looking to biomarkers, or biological indicators, in the blood to help them differentiate between brain injuries of different severities. For example, there may be an increase of a specific biomarker in the blood of a patient with a severe injury that wouldn’t be present in a patient with a mild injury. When doctors are better able to determine the severity of an injury, they can make sure patients get the right care at the right time, and that could make a big improvement in their prognoses.

Some of the biomarkers used are the following:

•Known as Banyan BTI (Brain Trauma Indicator), the new test measures levels of two protein biomarkers — ubiquitin carboxy-terminal hydrolase-L1 and glial fibrillary acidic protein — that are released from the brain into blood within 12 hours of head injury.

The Brain Trauma Indicator blood test the levels of two proteins, UCH-L1 and GFAP. Upon brain injury, these proteins are released from the brain into the blood. If found at elevated levels, brain damage, with intracranial lesions, normally otherwise only visible on a CT scan, is suggested. Levels of these blood proteins after mTBI can help predict which patients may have intracranial lesions visible by CT scan and which won’t.

To give approval, FDA used data from a clinical study of 1,947 individual blood samples from adults with suspected TBI and compared blood test results with CT scan results. How did the blood test perform? It was able to predict the presence of intracranial lesions on a CT scan 97.5 percent of the time and those who did not have intracranial lesions on a CT scan 99.6 percent of the time.

•Levels of one protein, called brain-derived neurotrophic factor (BDNF), taken within 24 hours of someone’s head injury, could predict the severity of a TBI and how a patient would fare, they found.

While healthy people averaged 60 nanograms per milliliter of BDNF in their bloodstreams, patients with brain injuries had less than one-third of that amount, averaging less than 20 nanograms per milliliter, and those with the most severe TBIs had even lower levels, around 4 nanograms per milliliter. Moreover, patients with high levels of BDNF had mostly recovered from their injuries six months later. But in patients with the lowest levels of BDNF, symptoms still lingered at follow-up. The results suggest that a test for BDNF levels, administered in the emergency room, could help stratify patients.

•Tau protein (MAPT) possible biomarker for traumatic brain injury . The formation and accumulation of misfolded protein aggregates composed of amyloid-beta (Aβ) and tau. APT is a neuronal protein that plays an important role in axonal stabilization, neuronal development, and neuronal polarity. MAPT release into the CSF and blood has been interpreted as indicative of axonal injury.

It is believed that this biomarker may prove helpful in identifying high-risk patients with mTBI. However, additional studies are needed to establish the diagnostic value of serum tau in detecting traumatic brain injury in patients with mTBI.

(all information compiled from various sources)

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