Category: Educational

A brain injury occurs in the United States every 9 seconds. We’ve all heard the stories about how untreated brain injuries can be tragic – like in the cases of actress Natasha Richardson and, most recently, actor/comedian Bob Saget. More than 3.5 million children and adults sustain a brain injury each year, but the total incidence is not known as many go unreported.

Brain Injury Awareness Month is an annual awareness campaign and a three decade-long tradition led by the Brain Injury Association of America (BIAA). Each March, the BIAA conducts a public awareness campaign designed to educate the general public about brain injuries and the needs of individuals who have sustained them. Some of the goals of the BIAA’s public awareness campaign include:

• De-stigmatizing brain injury through outreach within the brain injury community
• Empowering those who have survived brain injury and their caregivers
• Promoting the many types of support that are available to people living with brain injury

What is considered a Brain Injury?

There are basically two types of brain injury according to the Brain Injury Association of America. They are;

An acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma. Essentially, this type of brain injury is one that has occurred after birth. The injury results in a change to the brain’s neuronal activity, which affects the physical integrity, metabolic activity, or functional ability of nerve cells in the brain. These can include:

• Stroke
• Drowning
• Aneurysm
• Brain Tumor
• Infectious Disease

There are two types of acquired brain injury: traumatic and non-traumatic.

A traumatic brain injury (TBI) is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. Traumatic impact injuries can be defined as closed (or non-penetrating) or open (penetrating). These can include:

• Falls
• Assaults
• Motor Vehicle Accidents
• Sports Injuries
• Combat Injuries

According to the BIAA, no two brain injuries are the same (no matter how similar they may appear). Loved ones and caregivers should always keep in mind that:

• A person with a brain injury is a person first.
• No two brain injuries are exactly the same.
• The effects of a brain injury are complex and vary from person to person.
• The effects of a brain injury depend on factors such as cause, location, and severity.

Below are some of the common cognitive and communication functions that may be affected with a brain injury. Cognitive:                     

• Attention  
• Memory
• Problem Solving
• Time Management
• Thought Processing Speed
• Perception
• Comprehension
• Difficulty following conversations
• Inability to following directions
• Word Retrieval
• Inhibition Issues
• Slurred Speech and Aphasia
• Writing Issues

Common Sensory or Physical Repercussions may include changes in:                 

• Balance 
• Walking/Gait
• Fine Motor Control
• Sense of Smell
• Sense of Taste
• Hearing
• Vision

What to do when someone has a head injury?

Injury to the brain can occur from a blow to the head or by rapid movements of the head that force the brain to bounce around within the skull. Significant swelling or bleeding inside the skull can result in increased pressure that damages delicate brain tissue. If you suspect that a serious brain injury has occurred and results in a diminished level of responsiveness, the first thing you should do is call 911.

The repercussions of brain injury can have a lasting impact on the survivor’s ability to participate in daily activities, including school, work, socializing, and spending time with their family. The patient’s caregivers and friends are often directly impacted as well. Imagine having difficulty with any number of the repercussions listed above and how it would impact a person on a day-to-day basis.

When it comes to a brain injury, the severity is measured based upon loss of consciousness, the presence of an infarct on a scan of the brain and pre/post injury memory loss.

However, the severity of the injury itself does not indicate the severity of the lingering effects.

Treatment of Brain Injury

Mild brain injuries such as mild concussions may not require any treatment at all and can resolve with time and rest. Severe brain injuries may require extensive medical care and rehabilitation.  People with mild to moderate TBIs may only need minimal treatment. Your care may involve a short period of rest from sports, school, or work. Symptoms should improve within a few weeks.

For severe TBI, people often need hospital care and more intense treatments.

For all TBI grades, treatments may include:

• Counseling for emotional support. Many individuals experience stress and worries about their recovery. They may find that it is more difficult to get back to their work and hobbies than anticipated. Therefore, counseling is often very helpful in conjunction with other medical treatments.
• Surgery to treat a brain bleed (intracranial hemorrhage) or reduce pressure from brain swelling.
• Rehabilitation, including physical, occupational, and speech therapy.
• Rest. Depending on the type of TBI, some may need to rest for 1 to 2 days before going back to their typical activities. More severe head injuries may require longer periods of rest.

Brain injury is often referred to as the “invisible injury”. Many survivors exhibit minimal physically visible injuries yet struggle with everyday tasks. The “invisible injury” can lead to a lack of understanding and awareness of the population and all the more reason to recognize Brain Injury Awareness Month.

For additional resources on brain injuries, please contact The Brain Injury Association of America or locally, The Brain Injury Association of New York State

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Giving the Blood of Life

Blood supplies in the United States are dangerously low– so low that the American Red Cross is offering a chance to win Super Bowl tickets if you donate by the end of January. 

“This is the biggest challenge that I’ve seen in my 30 years in the business,” Chris Hrouda, president of biomedical services at the American Red Cross, told The New York Times in December. “We simply like to keep three days of inventory,” he said. “We’re struggling to keep one day.”

Demand and supply

Each year, 4.5 million Americans require blood transfusions. Daily, 45,000 pints of blood are used because someone in the United States needs blood every two seconds. Meeting such need requires a steady flow of blood donations–about 33,000 per day.

Why are blood supplies now at their lowest level in a decade?

According to Jim McIntyre, Red Cross of Northern Ohio, “During the first half of 2021, there was a surge in hospital demand for blood because of an increase of trauma patients, the number of transplant patients, and elective surgeries that had been put off during the first part of the pandemic.” He added that in the second half of 2021, donors were prevented from turning out in sufficient numbers by the Delta and Omicron variants and other issues caused by Covid-19.

Who needs donated blood?

“Most likely, your blood would be used for a medical patient who’s suffering a disease or it could be used for a patient that’s having surgery,” says Justin D. Kreuter, M.D., director of the Mayo Clinic Blood Donor Program.

Cancer treatments, transplants, open heart surgery, anemia, and sickle cell disease rely heavily on donated blood. People with sickle cell disease, for example, may receive up to four pints of blood every month to sustain their lives.  About a third of heart surgery patients will need a transfusion.

One pint of blood can save three lives

Blood is made up of several components, the major ones being red blood cells, platelets and plasma.

Sometimes, a pint of (whole) blood is used in its entirety for transfusion, but each component can be used separately for different patients.

• Red blood cells make up 40 percent of blood. They transport oxygen from the lungs to the body’s tissues, where it turns into energy. Red blood cells also carry the waste (carbon dioxide) from that process back to the lungs to be expelled.
• Platelets “are the cells that circulate within our blood and bind together when they recognize damaged blood vessels,” says Marlene Williams, M.D., director of the Coronary Care Unit at Johns Hopkins Bayview Medical Center. “When you get a cut, for example, the platelets bind to the site of the damaged vessel, causing a blood clot.”
• Plasma, about 55 percent of whole blood, is mostly composed of water. White blood cells and platelets are suspended within it. Plasma helps maintain blood pressure and volume, and ensures proper Ph balance in the body.

Each of these components can be used separately for different patient needs. Platelets are most often given to cancer patients, organ recipients, and those undergoing heart surgery, while plasma is used to treat bleeding disorders, liver failure, or major traumatic injuries. Red blood cells are used for anemia, and they improve levels of oxygen in the body.

Who can donate and where?

Anyone over 17 years old (or 16 with parental consent in some states) and in good health can make a simple blood donation. The fastest way to make an appointment is online at the American Red Cross website, where you can find blood drive locations in your community. You can also check for certain restrictions (medications you take, or health conditions) to donating blood.

Keeping America’s blood banks stocked depends on the altruism of everyday people. Most non-donors say they simply have never thought about it. January, a time for fresh resolutions, is also National Blood Donor Month.

If you care about helping others, but haven’t yet considered blood donation, this is your chance to make a critical difference.

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Live Well, With a Healthy Liver

Tucked under your right ribcage, on top of your stomach, is your largest internal organ–the liver. It’s one of your hardest-working, but least understood organs. According to Johns Hopkins Medicine, more than 500 body functions are identified with the liver. The most critical of those include regulating chemical levels in the blood; producing bile, to help carry away waste and breaks down fats in the small intestine; making immune factors; and removing bacteria from the bloodstream to resist infections.

Even when damaged, the liver continues to function, so people with liver disease are usually unaware of a problem. That’s noteworthy, because liver cancer rates have tripled in the United States over the last 30 years.  Bluntly speaking, “some 30,230 people are expected to die of primary adult liver cancer in 2021. The five-year survival rate is just 20.3 percent” (American Association for Cancer Research). While survival rates for most other common cancers have improved significantly during those decades, liver cancer deaths have doubled.

October is National Liver Awareness month; knowing what harms your liver could ultimately save your life.

The American Liver Foundation stresses that early detection of liver disease is critical, because     if you are treated successfully in early stages, your liver has a chance to recover. The liver is capable of repairing and even regenerating itself.

The Progression of Liver Disease

Liver disease progresses in stages:

Inflammation (hepatitis) (Stage 0 -1)

Inflammation of the liver occurs when the liver detects something dangerous in the body. Causes can be viral hepatitis (types A, B, or C), indulging in too much alcohol or fatty foods, or having an immune system that triggers a continual inflammatory response in the liver. About 4.5 million people in the United States are living with Hepatitis B or C, and most don’t even know. An estimated 20-30 percent of American adults live with excessive fat in the liver.

If the liver is inflamed, its repair mechanism is to deposit collagen that stiffens around inflamed liver tissue, allowing it to heal.

Fibrosis (stage 1 -3)

If the underlying cause of inflammation remains, the liver will repeatedly try to repair itself and continually release collagen. Excess collagen kills healthy liver cells, and becomes scar tissue. This is fibrosis of the liver; it progresses from mild, to moderate, to severe stages.

Even if your liver has some scar tissue, treatments may allow it to repair, or regenerate itself.

But at some point, fibrosis will lead to severe scarring, called cirrhosis.

Cirrhosis (stage 4)

Cirrhosis means the liver is permanently damaged. It shrinks and becomes hard, which makes it difficult for the liver to process the large amounts of blood it handles. This leads to problems with blood flow and fluid retention, and inability to clear impurities that affect the kidneys, brain, and other organs.

Although commonly associated with alcohol-induced liver disease, cirrhosis is caused by many forms of liver disease. There’s no treatment to cure it, although preventing further damage may help avoid liver failure.

As cirrhosis advances, the liver will begin to fail. Most people who develop liver cancer already have cirrhosis.

What Can You Do for Your Liver?

Learn what can harm your liver, even if you think your liver is healthy.

• Be proactive; even end-stage liver disease may not present symptoms.
• Ask your doctor if you should be tested for or vaccinated against Hepatitis A, B, or C.
• Inform your doctor about any hereditary liver diseases in your family.
• Discuss all the medications you take, or that may be prescribed, with your healthcare providers.
• Honestly assess your overall health and lifestyle. Do you have type-2 diabetes, high cholesterol, or obesity? The incidence of non-alcoholic fatty liver disease (NAFLD) is growing rapidly, even among children. Currently, six million American children suffer from it. NAFLD is the leading cause of chronic liver disease in children and adults in the United States.
• Appreciate this hardworking organ for all it does to keep you healthy.

 The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

June is National Aphasia Awareness Month, yet few Americans even know what aphasia is. According to the National Aphasia Association, 2 million people in the United States have aphasia, but 84.5% of Americans state that they’ve never heard the term aphasia.

What is Aphasia?

Aphasia is a language disorder that occurs when someone experiences brain damage, such as a stroke. The brain has two halves or hemispheres. Language skills are carried out in the left half of the brain. Damage on that side may lead to language problems. Damage on the right side of the brain may cause other problems, like poor attention or memory issues.

Aphasia may make it hard for someone to understand, speak, read, or write. It does not make them less intelligent or cause problems with the way they think. Brain damage can also cause other problems along with aphasia. People may have muscle weakness in and around the mouth, called dysarthria. They may have trouble getting the muscles of the mouth to move the right way to say words. This is called apraxia. They can also experience associated swallowing problems, which is called dysphagia.

Signs of Aphasia

Aphasia can lead to a number of different problems. Someone may have trouble speaking, reading, and writing. People with aphasia may experience the following:

• Cannot think of the words they want to say
• Say the wrong word without realizing it
• Change the order of compound words
• Use words that sound like gibberish
• Have a hard time creating sentences
• Use single words rather than sentences
• Create sentences that include non-words and real words

Comprehension

People with Aphasia may experience the following:

• Not understand what others are saying
• Have trouble understanding conversations in groups
• Be unable to understand humor or sarcasm

Reading and Writing

People with Aphasia may experience the following:

• Difficulty reading and comprehending magazines, books, and computer screens
• Unable to spell and put words together to write complete sentences
• Difficulty using numbers or doing math such as counting

Causes of Aphasia

Aphasia is most often caused by a stroke (brain bleed) but can occur as a result of any type of brain damage. This includes a traumatic brain injury, brain tumors, and certain types of dementia.

Testing for Aphasia

People should see a doctor if they have trouble speaking or understanding what people say. A doctor will determine if there is a medical cause for the problem. A speech-language pathologist, or SLP, will test their speech and language skills. The SLP will test how well someone:

• Understands words, questions, directions, and stories
• Says words and sentences
• Reads and writes

Treatments for Aphasia

Many people who suffer from aphasia following a brain injury will find it most beneficial to work with a speech/language pathologist. This can be done individually or in a small group. Some people with aphasia find it helpful to join a support group because it is a way of connecting to others who are experiencing the same type of communication challenge.

Tips for Communicating with a Person Who Has Aphasia

These tips may make it easier for you to understand and talk with those with aphasia:

1. Make and keep eye contact
2. Watch body language
3. Talk in a quiet place
4. Keep your voice at a normal level
5. Keep the words simple but do use not baby talk
6. Use shorter sentences
7. Give them time to speak
8. Try using drawings, gestures, writing, and facial expressions
9. Ask them to draw, write, or point when having trouble talking
10. Ask “yes” and “no” questions

Aphasia is a difficult and frustrating disorder for those who have it – it’s also caused by some other medical issue which adds to its complexity. If someone you care about has aphasia, please be patient and kind. It will go a long way in helping them recover.

Other Resources

• Aphasia Hope
• National Aphasia Association
• American Stroke Association

 The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

October is national Physical Therapy month. As a provider of both inpatient short-term rehabilitation and outpatient rehabilitation services, The Osborn knows the importance of physical therapy (PT) following an injury, accident, or surgery. Just as importantly, physical therapy can also help older adults retain their independence, whether they are managing a long-term illness or just want to improve their strength and mobility. Let’s take a look at how physical therapy helps older adults stay healthy and safe.

According to marketreach.com, physical therapy in the United States constitutes a $34.5 billion industry and the need for PT continues to grow each year. The goal of physical therapy is to help restore and improve functionality, reduce pain, and increase mobility for endurance, stamina, and balance. The last of these is very important as we age because falls are more prevalent in older adults and often can have negative long term and life changing effects. Some falls are even fatal.  According to the Centers for Disease Control and Prevention, one out of four older adults will fall each year in the United States, making falls a public health concern, particularly among the aging population. Thirty million older adults fall each year—resulting in about 30,000 deaths. Each year, 3 million older adults are treated for a fall injury and can benefit from physical therapy.

Osteoporosis, which is a progressive bone disease characterized by a decrease in bone mass and density, can lead to an increased risk for fractures. It can also be the cause of falls as we age. Physical therapy and regular exercise can help reduce the negative effects of this condition.

Some medications can also cause balance issues because they change the body’s equilibrium.  “Dizziness may be caused, or made worse, by taking a combination of drug products or by drinking alcohol with your medication,” says Barb Young, RPh, an editor at the American Society of Health-Systems Pharmacists during an interview with Consumer Reports. “Always tell your pharmacist all of the medications that you are taking or plan to take, including over the counter products or alcohol,” she notes. Certain classes of drugs are more likely to cause dizziness and they are antidepressants, anti-seizure, and certain high blood pressure medications. Always speak with your doctor or pharmacist about any drug that causes you to feel unsteady on your feet – chances are an effective substitute with less side effects will be available.”

Strength training and various exercises provided by a physical therapist can be tailored to the needs of each patient. Physical therapy for seniors has a variety of benefits which can include gaining strength and balance, as well as providing a renewed sense of confidence.  Physical therapy can give seniors back their independence and make daily tasks easier.

Working with a physical therapist for short-term or outpatient rehabilitation will not only reduce pain, but it will also help improve overall strength and ability and reduce the risk for injuries, helping you maintain a higher quality of life.

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

September marks World Alzheimer’s Month – a time to raise global awareness about Alzheimer’s’ related dementia, its devastating impact on families, and its societal cost.

Since March of this year, our attention has been directed toward the COVID-19 pandemic and its impact on so many facets of our lives. Although it has claimed many lives worldwide, we hope COVID will be preventable in the future when a vaccine becomes available.

Not so with a perennial disease that afflicts 50 million people worldwide–Alzheimer’s—which is expected to rise to 152 million by 2050. Since Alzheimer’s Disease was identified in 1930, the cause remains unknown, no vaccine can prevent it, and no treatment has yet been found to stop its progression or the dementia that is caused by it.

This year, the confluence of dementia and COVID-19 has proven especially deadly.  

“People with dementia are being disproportionately impacted by this pandemic and are in danger of being forgotten.Now more than ever we need to talk about dementia,” says Paola Barbarino, CEO of Alzheimer’s Disease International (ADI).

Kate Swaffer, Chair, Co-Founder and CEO of ADI’s partner Dementia Alliance International, adds that “in 2020, the rest of the world suddenly experienced what people with dementia and their families experience on a daily basis after diagnosis, such as isolation, distancing (from many family and friends), fear, anxiety and stigma.”

ADI, a federation of 100 Alzheimer’s associations around the world, sponsors international conferences and surveys, and each year publishes the World Alzheimer’s report. The newly-released World Report for 2019 is based on global surveys about Attitudes to Dementia.

Surprising Findings About Alzheimer’s and Dementia

According to the report, two out of three people believe there is little understanding of dementia in their countries because misinformation and stigma surround dementia globally.  

Despite ongoing efforts to educate the public about dementia, misinformation still exists. ADI’s survey of 70,000 people from 155 countries showed that one-third of people believe dementia is part of normal aging, rather than a disease. Many people think they will develop dementia in their lifetime.

Another staggering fact revealed in the study: 62% of healthcare practitioners believe dementia is a part of normal aging.

In reaction to that finding, Barbarino said, “Our message that dementia is NOT a part of normal aging, but a disease, is loud and clear, but it is clearly not getting through. We must work much harder on this.”

Stigma Still Abounds

Along with working harder to ensure that Alzheimer’s is understood as a disease, reducing the stigma also needs work.

People in the early stages of dementia are often reluctant to seek help because of the stereotypes and prejudice they fear.  A 60-year old interviewed in this year’s report summed it up: “People tend to run when they learn you have dementia.”

Do you have questions about memory care? Take our free memory care assessment.

Denial and not seeking help early may lead to more negative outcomes for the person. This self-stigma leads to avoiding social interactions, and not benefitting from dementia-appropriate services.

Public stigma still abounds. In the words of other interviewees:

• I used to be active in a club, but now I’m a non-person.
• Doctors talk to my spouse about me while I am sitting right there.
• Some work colleagues do not contact me anymore.
• I feel I cannot contribute at family gatherings because people get annoyed or feel uncomfortable.
• My neighbors avoid me.

Stigma also extends to caregivers and families of people living with dementia.

By default, stigma has a negative impact on research and research participation that could lead to a treatment breakthrough. Improving awareness, and debunking myths that dementia is a normal part of aging, is critical.

We can all play a role in fighting dementia and its stigma by increasing our own understanding of the disease during World Alzheimer’s Month.

Click to read the World Alzheimer Report.

For information about Alzheimer’s support and education programs, please visit  https://www.alz.org         

Learn more about memory care at The Osborn.                                         

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.