Injury Consequences Can't Wait, Drive Safe Now!

By Amy Price PhD

MTBI survivors and families want to know if and when it is safe to drive again. There is computer software and professional treatment that can help many with driving, processing and memory skills. It is important to know if the treatment is effective before going back on the road. Email for more information on what is available. The AMA has released guidelines for physicians on how to test for safe driving and in addition many universities with memory clinics have road testing clinics where driving skills can be practised and tested before heading back on the road.

Abilities like picking out an object against a contrasting background can diminish in TBI in addition to visual processing speed and acuity as well as balance. Attention is important as many accident are caused by Brain fog and this can often be rehabililitated.  The ability to find your way around or handle the stress of adverse driving conditions such as weather, traffic, headaches or bad drivers is critical for safe driving. Often fear can influence driving skills and it is common for those who have sustained a TBI as a driver or a passenger are justifiably concerned. The AMA and Highway Safety comission have partnered to creat a great guide for physicians to test driving ability. You may want to take this to your doctor. It is also a good barometer for you and your loved ones to assess when you are safe for the road!

Save Your neck and the Necks of others rehabilitate driving skills…see you at the Dashboard!

Dr and TBI

How you communicate with your doctor will often determine the quality of care you recieve and that your legal rights are protected. Here is a practical guide from Michael Kaplen a lawyer at BrainLaw. For other survival skills to help you through a doctor’s appointment this post is good reading

1. When you schedule your first appointment, tell your doctor that you will require extra time. Tell him that you need at least an additional 20 minutes (or more if you need it) for your appointment. The challenge here is to not feel rushed, as when you are stressed your cognition erodes.
2. If distractions bother you, arrange with the doctor’s office (when you make the appointment) for a quiet place to wait, such as a quiet exam room. If this is not possible, ask for somebody to come and get you in the foyer or your car.
3. Get to your appointment at least 15 minutes ahead of time, so you can collect your thoughts, become settled and unwind from the drive.
4. Write down everything you want to tell or ask your doctor. Cross each item off the list after you have covered it. Write down instructions that your doctor gives. Recap at the end of each issue, to make sure you understand.
5. Ask your doctor to write down your diagnosis. Ask for a written explanation in layman’s language. Ask for a written description of the preferred treatment and goals, with an estimate of the costs and the expected time frame.
6. Trust your instincts. If you don’t think that a diagnosis is valid, or if you think it minimizes your problems, remember this: YOU ARE PROBABLY RIGHT. Remember, you are the “expert” about you.
7. Always ask your doctor about the contraindications when he prescribes new medications. Additionally, have the doctor provide you with a written list. Take charge of knowing everything about the drugs you take.
8. Ask your doctor to make a notation in your file stating that you should receive a copy of all reports and tests as soon as they are received by the office.
9. Never sign a blank release form. Make sure all authorization forms are completely filled out. Read what you’re signing. Make sure the release has ONLY the names on it that YOU want. Get a copy of each and every release form/letter you sign.

With spinal injuries and head injuries it is often the secondary damage to the neurons that causes big problems especially when that swelling and inflammation is in the spinal cord or the brain. The worst damage shows up several hours to many days later. Now, scientists in Rochester, New York, have discovered a simple way to stop a lot of this secondary damage in its tracks…at least in mice by using that old familiar blue food dye that gives M&Ms, blue bubble gum and blue raspberry popsicles their color. Patients with spinal injuries could escape with vastly reduced loss of function if this works in people but they’ll turn bright blue in the process.

Much secondary damage is caused by adenosine triphosphate, or ATP. This chemical can go into overkill with trauma and cause neurons to fire until they burn out and die leaving inflammation and sludge to trip up the neurons behind them causing an unhealthy destructive cycle. With spinal trauma, the area around the injury is flooded with ATP, which causes otherwise healthy neurons to fire out of control until they die of exhaustion. It also increases the swelling around the wound. Swelling around an injury site is a positive healing factor in many parts of the body, but because the spinal cord is encased in a narrow column blood supply gets cut off and cells die. But a study published in July 28′s Proceedings of the National Academy of Sciences (PNAS) seems to show that it’s possible to block the actions of ATP and greatly reduce the severity and permanence of spinal injuries – using the same type of food dye that gives blue M&Ms their color, a food dye called Brilliant Blue G, or BBG.

BBG can be administered intravenously with no need to inject directly into the injury site. It has the ability to cross the blood-brain barrier, which then gives it access to the spinal cord. BBG binds to the same neuroreceptor (P2X7) as the ATP binds to but it has a stronger affinity for the receptor than ATP has and gets there first so it effectively blocks the action of the ATP at the injury site.
Only one problem….patients turn blue ! It is temporary and is sure better than having a serious injury. You wear the injury but the blue die wears off…..All I can say is color me blue for spinal injury.

See the full method of the experiments here (PDF). BBG has been a food dye approved by the FDA since the 1920s but would this be considered off label use like the cholesterol lowering of Cheerios cereal. While all the rats were severely injured, the BBG-injected rats showed a greatly improved ability to support their bodyweight on their hind legs, control their bladders, and even walk in some cases. The blue skin coloring eventually faded as well, and no side effects were noted.

Human testing would be required before BBG can be moved forward into clinical use. It would be a terrific tool for ambulance drivers and paramedics. They could begin treatment right at the site of the incident, It is cheap and easy, even hospitals can use the blue stuff as soon as they get the patient hooked up and ready to go.

The kids must have known best when they told me blue ice cream was good for me …As for me…I will stock up on blue Gatorade and drink it down just in case it could make a difference!

There have been multiple articles featuring brain and serious neck injury stating how people have overcome cognitive obstacles despite adversity. I celebrate these articles as I know from personal experience the tolls that this road takes and the cost to family members and supporters. One mother was explaining how one minute her brain injured son could do complex algebra and the next he could not tell a red diamond from a black spade in a deck of cards. I too remember those days.

The cognitive inconsistencies are joined by emotional areas. Sometimes the brain will forget what we want it to remember and play over and over like a broken tape those areas we only want to put behind us. The other day I found some practical help in the way of videos and research on how to navigate the initial trauma. These outline what to expect in the emergency room, how to protect yourself in the event of a crash and ways you can help yourself get the best medical care. I thought I would share them here. If you go to the web site you can download the material as MP3 or as PDF files. This is a brilliant solution as watching a video makes it tough to pick up the references which are the key to deeper study…Enjoy!

In the next few posts there will be strategies for overcoming brain fog and getting the sharp mental edge back

“The procedure is totally simple and cheap,” reports UNSW’s Dr Nick Di Girolamo (lead author of research study), “Unlike other techniques, it requires no foreign human or animal products, only the patient’s own serum, and is completely non-invasive. This preliminary trial was conducted on three people, two with extensive corneal damage resulting from multiple surgeries to remove ocular melanomas, and one with the genetic eye condition aniridia. The patient with aniridia had damage in both eyes so stem cells were taken from the conjunctiva area. Because stem cells have not yet differentiated into specific cells they could grow into the cells that were needed. Each patient’s sight improved significantly after only a couple of months

Here is how it works. Less than a millimeter of tissue is taken from the ocular surface of the patients own eye. It takes a couple of hours to prepare the eye and put the contact lens with the baby cells in place and the patient goes home. The stem cells are cultured on a post surgical contact lens which is then placed onto the damaged cornea for 10 days, during which time the cells are able to re-colonise and heal the damaged eye surface. Apparently it took some experimentation to find a lens that could be successfully used as a scaffold for the cells.

The scientists on this research project see this therapy as a simple way to restore sight for eyes damaged by scarring, chemotherapy and a range of other disorders. They suggest that all is needed is a simple lab and qualified medical personnel putting it within reach of even third world countries

Di Girolamo, Nick; Bosch, Martina; Zamora, Katherine; Coroneo, Minas T.; Wakefield, Denis; Watson, Stephanie L. A Contact Lens-Based Technique for Expansion and Transplantation of Autologous Epithelial Progenitors for Ocular Surface Reconstruction. Transplantation, 2009; 87 (10): 1571 DOI: 10.1097/TP.0b013e3181a4bbf2

There is equipment that can test your teen’s attention levels and improve their ability to resist distraction and stay on task. One of the programs used simulates road conditions to improve reaction time with practice before your teen gets on the road. Other programs help teens recognize their attention levels and teach them to self correct so they do not ‘space out’

They will not learn these skills in driver ed. This is a great way to equip the young driver in your household or restore skills to older drivers who see themselves as losing focus. Information about safe cars, saving your neck and how to adjust the headrest are available for free through the courtesy of the Save Your Neck Program sponsored by The Spinal Injury Foundation. Please click here for more info: http://spinalinjuryfoundation.org/neck.htm

For more information on programs to help driving skills an a free 39 point learning assessment you can take online click here

http://www.sparksofgenius.com/screens.html