Managing chronic physical pain during addiction recovery is a challenge many doctors are rue to accept in the age of the opioid crisis.
That’s why it’s so important for someone with chronic pain to know how to handle their pain outside of a hospital or rehab environment. Opioids aren’t always the antidote for pain!
Many of the people who abuse drugs were initially prescribed opioids by a doctor. A patient walks in searching for a resolution to his pain and walks out with addictive pharmaceuticals like Vicodin and Hydrocodone. According to the U.S. Department of Health and Human Services, over 80% of current heroin addicts report that they first started using opiates with prescription painkillers. Yes, the meds can take away the pain, but unless the patient is properly prepared for the physical and psychological effects of opioids – these fast-acting meds can cause long-term destruction.
Some patients take their medications as prescribed. Others burn for more. Both quickly notice that a few hours without a dose brings a return to both the original pain (amplified by a factor of ten) AND the painful ignition of opioid withdrawal. Time is no friend to these patients. The longer they take opioids, the less relief they will derive. The longer they take opioids, the more dependence develops until they became physically and mentally addicted.
The solution to reducing the physical pain? Take more pills. Digging the proverbial hole of physical dependence deeper and deeper. In order to get off the pain medication, many patients will turn to opiate detox centers for help. These programs can help patients overcome the physical and mental withdrawals associated with prescription opioid dependence. Once the patient is no longer physically hooked, one huge unresolved issue remains: how to function with chronic pain while dealing with physical and emotional toll of sobriety?
Pain management in recovery is vital to sobriety. When chronic pain again rears its tireless head, users are at high risk of relapsing. Learning how to safely and naturally manage pain and sobriety minus narcotic painkillers is essential to a healthier, happier life.
There are numerous non-narcotic medications out there to treat physical pain that don’t risk physical addiction. These non-opioid medications may assist with the management of acute and chronic pain: Gabapentin, Duloxetine, Tricyclic, Naproxen, Acetaminophen, Amitriptyline, Norpramin, DexPak and Prelone are some of the most commonly prescribed. Each medication has different and highly-specific label and off-label uses. Patients should only take these medications as prescribed by a physician who is informed of the substance abuse difficulties. (Note: If YOU are that patient, then it is YOUR responsibility to inform the physician BEFORE any prescriptions are written.)
Manage Physical Pain in Sobriety
A common myth in our society is that only drugs can cure pain. Some organizations including The American College of Physicians, the U.S. Department of Veterans Affairs and the Centers for Disease Control and Prevention recommend drug-free treatments as the first course of action for chronic pain.
Taking charge of yourself and doing activities like exercise, physical therapy, yoga, acupuncture, distraction therapy, biofeedback, deep breathing, meditation and mindfulness training can do wonders. Work with your doctor to develop a flare-up protocol to follow whenever you feel a flare up spark.
Alternatives to Prescription Opiates
Millions upon millions of Americans suffer from chronic pain and addiction troubles. Some suffer from chronic headaches, others back pain. Some are recovering from surgery or have been sidelined by fibromyalgia. Every year hundreds of millions of opioid medications are dispensed to patients to help them cope with physical pain. Too many of these people will find themselves physically addicted to these pills or harmful street drugs. If you or a loved one are struggling with physical pain, investigate natural options before turning to narcotic pain pills as a solution.
For more information and resources regarding substance abuse help, visit Opiates.net the Life Skills Village Resource Links Page.
If you suffer with chronic pain and live in southeast Michigan, Life Skills Village offers a Pain Self-Management Program that teaches people how to manage their own pain.
Our physical, spiritual and mental lives are all connected to the brain. Since the brain is the “CPU” of our bodies, it is through the brain we experience every aspect of life. At Life Skills Village, we promote a holistic approach to traumatic brain injury rehabilitation. We believe keeping your brain healthy is vital – especially during neuro rehab. That’s why the upcoming series of blog posts focus on diet, exercise and sleep.
Eating right is the best way to ensure your brain and body receive the crucial nutrients that will nourish them during rehab. Your brain is only a small portion of your body weight, but it greedily gobbles up 20% of your metabolic energy. People who eat a healthy diet tend to live longer lives, enjoying better-than-average cognition and memory. Conversely, a poor diet is associated with a lower quality of life and diseases like "heart disease, hypertension, diabetes, osteoporosis and cancer," as reported by U.S. Department of Health & Human Services.
How do we know what foods to eat and what foods to avoid? How do we make healthy changes to our diets? By categorizing the food we eat into nutrients that we know are good for the brain, it's easier to see how a healthy diet inspires a healthy, fulfilling life.
Magnesium is a dietary mineral with many psychological benefits and a deficiency is likely to result several side effects including increased general anxiety. There are a few reasons for this: magnesium activates Gamma-aminobutyric acid receptors in the brain whose purpose is to relax the brain and magnesium filters stress hormones like cortisol before they enter the brain. These stress hormones activate immune system messengers called cytokines that inflame the brain in an attempt to “heal” the stress. This autoimmune response doesn't work because there is no actual damage and can leave you with long-term memory problems. When these messengers are blocked, inflammation is reduced or prevented. Another physiological/chemical benefit of magnesium is that it binds with heavy metals in the body and carries them out. It is not known if this process is active in the brain, so it important to address the issue before the toxic elements collect. Studies have concluded that a magnesium supplement can help hypoglycemic individuals better maintain their blood sugar levels.
Magnesium could also bolster neuroplasticity, a process made mainstream by brain game apps such as Lumosity, which pairs well with cognitive rehabilitation because of its capacity to promote the creation of neural pathways and increase base-level serotonin. For this reason, magnesium may help alleviate depression without aggressive medication.
When these issues are addressed, it helps put the individual back in control; sleep is improved, stress is reduced, and focus and concentration are bolstered.
Magnesium should not be treated as a cure all, the research is not complete, and it should only taken in appropriate amounts. It has benefits but cannot solve your mental health issues on its own.
Sources of the best dietary sources of Magnesium.
These are the supplements to look for:
Protein is one of the 3 macronutrients essential to body and brain function. Protein is made up of many different amino acids, eight of which the body cannot produce on its own.
Diane Roberts Stoler, writer with Psychology Today, explains that if we don't get all eight in one meal, the proteins are broken down for energy rather than growth and repair and that "getting all eight together is most easily accomplished by eating animal products." However, it is possible to get complete proteins from non-animal products. Ask a registered dietician on how to best calculate your daily protein intake.
Protein can be acquired through powder supplements to be mixed into drinks. There are a lot of these out there and some are not good to use; be sure to research your protein shake before you buy and consume them regularly.
Dietary sources of Protein:
Folate (also known as vitamin B9 and folic acid depending on where it's found - folate is in food, folic acid is in supplements) is critical to healthy brain and body function. After being digested and absorbed it becomes methylfolate, which is essential for the brain's production of DNA and neurotransmitters.
Folate is also crucial for women attempting to get pregnant or who are already pregnant. During pregnancy: 400 micrograms per day are recommended. During lactation, 500 micrograms per day. This is especially important one month before trying to get pregnant and within 21 days of conception. Refer to our sources for more complete information. The National institute of Health has a list of recommended folate intake.
Good food sources of Folate:
Vitamin D is synthesized in our skin when it comes into contact with sunlight. However, because of our lack of contact with sunlight during winter, Americans are often Vitamin D deficient. Symptoms of this deficiency include bone pain, muscle weakness, seasonal depression and a study in the UK found evidence of impaired cognition. If a physician diagnoses a deficiency, it is important you take the active forms of Vitamin D: Calcitriol or Vitamin D3. While it is found in many foods, 10-20 minutes of direct sunlight will produce more Vitamin D in our bodies than a day’s worth of food. As we age your body is less efficient at producing the vitamin, so it is important to include in your diet and daily supplements.
Tips for supplementation: magnesium helps increase effectiveness of absorption. A safe amount of Vitamin D to include in your diet is 400 IUs for infants, 600 IUs for adults and 800 IUs for seniors.
Good sources of Vitamin D:
Antioxidants are in many fruits and vegetables, and can be made into supplements. They also have varying effects on brain and body function. Vitamin E has been shown to ward off depression; Vitamin C is linked to reduced incidents of stroke and enhances skin healing; and Vitamin A is good for eye health and cholesterol. All Antioxidants are used in the body's natural response to reactive compounds called free radicals (pollution, smoke, UV light). This process is useful because it helps preserve our cells in the presence of these irritants. They are also an anti-inflammatory, which is associated with reducing pain, preventing neuro degenerative disease and cardiovascular disease.
Flavonoids, carotenoids, and other phytonutrients are responsible for the bright coloring in fruits and vegetables. There are over 6,000 different types make up the largest group of phytonutrients, and are powerful antioxidants to seek out.
Antioxidants to look for in your food and supplements:
Various antioxidants can be found in these foods:
Healthy Fats (yes, they exist) are necessary for proper brain function, considering the brain runs on 60% fat. In utero and as we mature, our brains use fat to grow membranes, myelin sheaths and other structures. These are important to protect neurons and axons. The brain never stops needing fat to function and it will utilize available fats should the correct ones not be available. Omega 3 EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) fats are what the brain craves and allows it to function at peak performance. Heather Pratt, with Natural Grocers, postulates that these omega 3 fats are correlated with "neurotransmitter production and function, meaning... serotonin and dopamine (the chemicals in our brain that control happiness) absorption is improved [by omega 3 fats],” and that helps stabilize mood as well as stress response.
Healthy fats have a wide variety of positive body outcomes. Monounsaturated and polyunsaturated fats raise good cholesterol while lowering the bad. Omega-3 and omega-6 are good for the brain and skin.
Good fats to find in better food and supplements:
Good sources of healthy fats:
Vitamin K is known for its benefits to the circulatory system like improving bone health, reducing inflammation, and increasing blood flow. all of which helps improve cognitive function. The Vitamin comes in two varieties: K1 and K2. K1 is important to blood coagulation and is stored in the liver. K2 is more active around the body, and does everything mentioned above. Watch out for MK-4 and MK-7 on supplement labels, as those are the forms of Vitamin K2 that should ingest.
Good sources of Vitamin K:
Collagen production in our bodies declines as we age, making it important later in life to boost your collagen intake. It is usually known for its role in joints, cartilage and muscle, but it has also been shown to protect brain-cells from amyloid-beta proteins known to cause Alzheimer's disease. Watch out specifically for Collagen VI as it has been researched in these Alzheimer's findings.
Good sources of Collagen:
We wouldn't need good nutrition articles if we didn't have bad nutrition! Here are the bad things in food to avoid:
Trans fats are guaranteed to age your brain should they be consumed frequently. This quote by Psychology Today, describes it best: "Trans fats can lead to serious health complications including heart disease, cancer, diabetes, low birth rate, obesity and immune dysfunction. They also have serious consequences on brain health.” Look for partially hydrogenated vegetable oils in the ingredients list to know which items to avoid.
Avoid these foods, especially if packaged and store-bought:
Saturated Fats can be tolerated in amounts higher than trans fats but will still show the same raised levels of bad cholesterol and cognitive decline over time.
Saturated fats can be found in these food products:
Sugar, syrups and simple carbs cause obesity, metabolic syndrome and an assortment of other disorders and diseases that arise from those conditions. Studies have shown that high fructose corn syrup, a cheap sugar alternative, hampers cognitive ability, slowing down memory and learning. It is believed that this is because the test subjects (rats) developed insulin resistance which inhibited insulin's ability to regulate stored sugar for brain function.
Foods to avoid with High Sugars:
Mercury is a neurotoxin. It is found in seafood and can accumulate if eaten too regularly. After being ingested, or inhaled, mercury is stored in the kidneys, blood, liver, spleen, brain, fatty tissue, and bones. It is known to inhibit the development of babies’ brains, hearts, and circulatory systems in utero. It is a known cause for several types of cancer, can cause neurological and behavioral disorders, and can change neuromuscular activity.
Do not touch it with bare skin, avoid being in closed spaces with it, and do not eat it.
Foods to avoid with Mercury in them:
Brominated Vegetable Oil (Or Bromide) is a chemical used in citrus sodas to help keep flavor syrups from separating from the water. Bromide can also produce a sedative effect on the brain. It can replace the neurotransmitters that neurons use to communicate.This is a problem because the dosage for sedation is close to the dosage for toxicity, and the amount used in soda can be toxic to a person addicted to soda.
Drinks to avoid with Brominated Vegetable Oil:
There is a lot to consider when it comes to your brain health but the task of diet improvement doesn’t have to be daunting. With a few tweaks here and there over time your new habits will keep you healthy! Sign up for notifications from the blog to find out when we post the next part of our series “Brain Healthy!” What is your favorite super food? What would you like us to cover next?
This list is incomplete, and I am not a registered dietician. Research your nutrients before changing your lifestyle, and ask your doctor before changing your diet if you have digestive disorders or immune system deficiencies.
*General food sources: Draxe, EatThis
*Magnesium fact sources: BeBrainFit, Ancient-Minerals, Draxe
*Protein fact sources: PsychologyToday
*Folate fact sources: AuthorityDiet, PsychologyToday
*Vitamin D fact sources: Webmd, ScientificAmerican, PsychologyToday, ReadersDigest
*Vitamin E fact sources: Life-Enhancement
*Antioxidant Fact sources: Livescience, EveryDayHealth
*Healthy Fat Fact Sources: Greatist, NaturalGrocers, Draxe
*Vitamin K Fact Sources: EverydayHealth, Medlineplus
*Collagen Fact Sources: NewBeauty, ScienceDaily
*Trans Fat Fact Sources: IVLProducts, PsychologyToday
*Saturated Fat Fact Sources: IVLProducts
*Sugar Fact Sources: IVLProducts
*Mercury Fact Sources: GlobalHealingCenter, GreenFacts
*Brominated Vegetable Oil Fact Sources: ChemistryWorld
Brain Games are a recent upload to the modern digital milieu. Most are made for mobile formats. Some are surprisingly enjoyable. All of these apps endeavor to improve cognition, lower your mental age or improve focus by playing a variety of short games. Users are scored according to performance in each game and receive alerts intended to encourage consistency.
It's only natural that brain games have become a useful tool, perhaps nowhere more-so than in field of neuro rehabilitation. When a person experiences a brain injury, they inevitably suffer cognitive deficits. But they can still recapture some of their former attention, memory and focus through hard work on multiple fronts.
Neuroplasticity is the ability of the brain to adapt to change within the duration of a single lifetime. This process allows for damaged areas of the brain to pass along their responsibilities to other parts of the brain. Playing certain brain games on a very regular basis can "assist neurons during their hunt for a way around the obstructing injury." Repetition of both actions and games over time can help the survivor's brain facilitate and strengthen a neuroplastic response.
There are many useful applications designed for TBI survivors. These can be used as an extension of the mind; for example, reminder systems and note taking apps. Brainline.org compiled a large list of apps that can prove to be life changing for TBI Survivors including some of the apps on this list. You can read their list here. Our list focuses on just brain games that could prove useful during rehabilitation.
A very usable app with lots of variety, reminders, statistic tracking and pleasing, minimalist interface. When you first boot up the app you immediately notice that the interface is all about much options and self-motivation. The makers of Lumosity are very transparent about wanting you to upgrade to their paid "premium" version. This is one brain game that keeps some of your stats under wrap. Or, at least behind a pay wall. The interface displays your current cognition scores for speed, memory, attention, flexibility, problem solving and math ability.
On the other hand, the games themselves are quite easy to understand and usually fun. An article from Businessinsider.com takes an in-depth look at exactly how beneficial these games really are, noting that "specific populations [of people]... have shown some improvements in memory and executive function after Lumosity-like brain training." They are referring to differently abled individuals. This is in contrast to non-concussed people, who would improve in their ability to perform a specific task, yet not show improvement in their general cognition.
This one is subscription based. More available games than any other app on this list. Also, it is the most expensive.
Compatible with Android, and iOS.
Very similar to Lumosity in that it uses brain games, reminders and score features, but presented differently. Of the apps on this list, I find the games most stimulating visually and conceptually, and give the added bonus of being informational. These games practice skills that are relevant to daily activities like quickly calculating percentages, estimating price, and reinforcing correct spelling and grammar. Similarly the stats it collects are presented less as attributes of cognition and more of practical ability. This means it gives you writing, listening, speaking, reading and math scores and graphs them for you to see your progress.
This app guides you through the process of selecting and participating in activities. You will receive reminders that regularly track your progress. However, some of these games may prove frustrating or too difficult for some clients.
Paying their subscription fee allows you to play more games, and unlocks more performance statistics. Elevate is cheaper than Lumosity, and offers a more polished experience. The drawback is that Elevate doesn't have as many activities. Of this group I'd be most likely to pay for this one and you still get a lot for free.
Compatible with Android, and iOS.
Unique concept that takes its tenets and encourages users to internalize them and "practice" away from your phone. Happify's purpose (and mantra) revolve around positivity, happiness, and mindfulness. At Life Skills Village we use these same concepts in our TBI day program. Using Happify feels like meditation and helps to reframe your thinking; Happify is worth checking out. It's a refreshing mix of in-app mini-games, self-reflection techniques and real-life applications that makes for an interesting experience. This app helps you track your goals and progress - it even and asks you questions about your actions! Happify offers periodic checks-ins and a happiness assessment (so you know how happy you really are).
For all the positive vibes you get on this app, it can feel gimmicky at times. That said I am quite optimistic about positive outcomes and can't recommend this app enough. However, take note: the free version is restrictive and slow.
The subscription fee is the same as Lumosity's. and the app itself does not use any ads.
Download: iOS, Android
Fit Brains Trainer
Polished product with a decent variety of games available in the free version. Games can be somewhat derivative from other products (in some cases the only difference is color), but at least these are available in groups of five per day rather than the three that is standard from the big names. The product is no cheaper than others and the statistics offered aren't very in depth and are almost exactly the same as Lumosity's. I would have said that this one offers the most activities for free, but after five sessions the game locks up and you cannot continue training for free. Lumosity is probably a better option.
Download Here: iOS, Android
This is the first of the group that does not request you pay a subscription, instead it has one time charges for optional features, like removing ads, or their brain currency that makes the app easier. It is most likely entirely funded by ads, which are ubiquitous in the app. The lower your game score, the more ads you see. Skillz has a minimum viewing time as well. The upside is that you are not limited by how many games you want to play per day and can retry each game as much as you like. The games are somewhat low visual quality and unforgiving; however it's completely free and still offers the cognitive training desired. The app even tries to have a sense of humor and, for what it's worth, it helps you get through the games.
Downloads: iOS, Android
This app has both ads (a one time charge for removing ads) and add in-game currency (though at three dollars it's one of the cheapest on the list). The free version is not as restrictive as Elevate, Lumosity or Brain Fit. It's a happy medium that has many of the same games as other apps but doesn't lock them behind a pay wall, but rather a progression wall. So to play other games you have to play games! Smart offers no progress metrics and makes no specific claims about brain training. It just offers the same type of games as other well known brain training apps, and lets you play as much as you'd like. Its layout and transaction scheme is similar to the Skillz app, though a bit more polished.
Download Here: Android, iOS
Brain it on!:
The most unique entry in this list, Brain it on! is a series of puzzles that you solve by drawing shapes. It's a relatively simple concept and all of it sticks to the basic principles, but they extrapolate these ideas and keep adding and adding until the game becomes very difficult. Thankfully they offer hints (behind ad videos). The free version also has you unlock levels by playing other levels kind of like an early Mario game. The app does not offer progress metrics, but does award pleasing little stars and shows you how many you've earned. People with limited hand dexterity may find this outside their abilities, but it offers enough engaging content that I'd recommend it to people who wish to improve their hand-eye coordination.
The premium version is a one-time fee of $3, and removes all ads, unlocks all hints, and unlocks all levels.
Download Here: Android, iOS
The Ideal Brain Game for Brain Injury
This list was written to give a brief rundown of the most popular brain games currently on the market. Each app has its merits - be they functional or economical. My personal favorite has been Elevate, but I am biased because I had used it before, and opted in to the "pro" free trial.
The ideal brain game app would have vast scaling potential and variability. It would track a TBI survivor's cognition and offer a tracking system to show how the user has improved over time. Statistics like these are useful to the subject because they provide a sense of pride and accomplishment, but can be useful to a provider who might integrate this information into their treatment.
What do you think about brain games? What's your favorite?
With the NFL "Concussion" scandal beginning to fade from public consciousness, it's easy to forget that traumatic brain injuries are still a serious problem. A traumatic or acquired brain injury can change your life in an instant - whether you're playing pro football, fall off a ladder or get injured on the job. People with brain injuries know first-hand - life is different post-injury.
In the interest of raising awareness, we're using this blog to highlight celebrities who have survived traumatic brain injuries and what they've taken from the experience. If you have survived a TBI, we encourage you to share your story - and what you've taken from the experience - at the end of this post.
Gary Busey suffered a TBI in 1998. Best known for his roles in Lethal Weapon, Point Break and Predator 2, he crashed his motorcycle while not wearing a helmet. Busey fractured his skull and spent two months in the hospital. In an interview one year after the accident on The Tonight Show with David Lettermen he discusses how the accident changed his personal life, shifted his perspective on the world and informed his philanthropic endeavors. He has worked to raise $400,000 for muscular dystrophy and advocated for a skill tests that could result in required helmet use on motorcycles. Busey readily admits that his TBI caused him to act impulsively and has significantly lowered his "mental filters." Letterman even jokes "you're funnier now."
Busey has remained active professionally, maintained a populated filmography and capitalized on his well-known, unique demeanor. Despite his TBI, he was able to continue his acting career, raise a son and even become a major proponent for Brain Injury Awareness. He won $40,000 on the Celebrity Apprentice in 2011 and donated all of it to the Center of Head Injury Services in Missouri.
Steve Young was the San Francisco 49er's quarterback from 1987 to 1999. He suffered a minimum of 6 concussions over the course of his career. He retired early after a tackle by Aeneas Williams left him unconscious on the field for several minutes. Since then he's been an advocate for concussion awareness, prevention and protection. Young even created a collaborative infotainment page on YouTube discussing the prevalence of concussive risk for every player in every sport, the symptoms of a concussion, the risks of returning to the field while concussed, the effect age has on concussion recovery and severity, and what to do if you've been concussed. The mantra of the video is "When in doubt, sit it out."
On June 7th, 2014, A Wal-Mart semi-truck crashed into six cars, putting Tracy Morgan in a coma for eight days and killing his long-time friend James McNair. His recovery was long and arduous. Months later he still required a wheelchair for taking more than "some steps." In September 2015 he made a surprise appearance at the Emmy's, where he shared his first-hand TBI experiences. Using comedy and emotion, he told us that he was starting to feel like himself again. Backstage he shared that he "couldn't walk" and had to relearn "how to stand up and sit down again." Unfortunately, despite improving by leaps and bounds, "Tracy will never fully be himself again" and his therapy has no end date.
Tracy has since returned to showbiz. He's been welcomed back by Saturday Night Live, appeared in three films and has released a new standup special, "Tracy Morgan: Staying Alive." He is an active philanthropist supporting causes like Drug Abuse, HIV/AIDS and disaster relief.
Gabrielle Giffords, Arizona House Representative from 2007 to 2012, suffered a Traumatic Brain Injury from an attempt on her life at a public speaking event at a Safeway near Tucson. The gunman shot her in the head at point blank range and then opened fire on the crowd. Thirteen people were injured and six people were killed including Federal Judge John Roll, and nine-year-old girl Christina-Taylor Green. Here is the NBC report from the day of the incident.
A year into recovery, Giffords resigned from her seat in the house of representatives to dedicate herself to rehabilitation. Here is her resignation letter. In the years following, she championed gun control, founded "American's for Responsible Solutions," which is now known as Giffords. They campaign in congress and have worked to pass legislation that takes guns out of the hands of high-risk individuals.
Mark Kelly, Gabrielle's husband, put it best when he addressed the would-be assassin: "Mr. Loughner, you may have put a bullet through her head but you have not put a dent in her spirit and her ability to do good."
In 2017 she became the third living woman to see have a Navy Warship named in her honor. She fights the good fight and in spite of her injury she is an American hero.
A helmet saved Kevin Pearce's life, but the incident still left him with a Traumatic Brain Injury. He was a professional snowboarder and had his accident while practicing a maneuver called the "cab double cork" on a half pipe. He was preparing to compete against Shaun White for a spot on the US Olympic Snowboarding team. His injury was very severe and cost him his independence, his voice, career and ability to walk.
Pearce's rehabilitation was extensive and he had the support of his family and friends, but he attributes his successful and ongoing recovery to his competitive nature. He will never compete again, but has been able to safely return to recreational snowboarding. He also co-founded a non-profit called Love Your Brain dedicated to raising awareness and improving the quality of life for people with brain injuries and those with Down Syndrome people.
Kevin is very active in the world of brain injury and works very hard to educate and inspire people. Here he is leading a TED talk about TBIs, and this is his website if you'd like to know more about him and his causes.
Kevin Pearce said it best in his TEDx Talk, "a brain injury is like a fingerprint, no two are the same." Evidenced here through these wonderful stories is the fact that TBIs are the hardest thing a person can experience, but that also, to an extent, many of these injuries can be overcome. Their accomplishments are inspiring, and are proof that a new best self can be reached.
Do you have a personal story of surviving a brain injury? We welcome you to share those stories with us below.
Imagine that you wake up one morning to discover that you are in a foreign country. Everyone – including your friends and family – speaks a different language. Their language is as incomprehensible to you as yours is to them.
Now imagine that you just enjoyed a dinner with friends and had one too many drinks. You wake up in the morning and realize that not only did you fail to sober up – you never will. You will continue to be disoriented, dizzy and off-balance; impulsivity and dis-inhibition will define your behavior; your affect will alternate between inappropriately jovial and incongruously aggressive. Absent your normal inhibitions, you say and do things with no insight into your own behavior.
Take a moment to mentally fuse both scenarios. Now picture this state lasting for a minimum of two years. Or even for the rest of your life. Your loved ones may attempt to care for you, but it isn’t long before your behavior alienates both family and friends. Maybe even your children. You can no more hold a job than you could wish yourself better. You find yourself isolated, inconsolable and without immediate access to your usual emotions, memories and coping skills.
This may sound like a nightmare, but the reality is that there is a very real possibility of a head injury turning into a lifelong disability. How often have you heard the phrase, “I never thought it could happen to me?” I hear it dozens of times each week. As long as you drive a motor vehicle, you and your loved ones stand a chance of becoming victims.
You don’t have to suffer a catastrophic accident to acquire a brain injury. Experiencing rapid deceleration can cause your brain to slam into the front and back of your skull – this is called a contrecoup event and is one of the most common injuries resulting from an auto accident. Even minor injuries can damage billions of neurons and effect large parts of your brain. Unlike most physical injuries, a trauma to the brain is invisible – which makes it extremely unlikely that you will be afforded any sympathy for the behaviors we discussed earlier.
Instead, you will be held responsible for your behavior. You will become a victim of your brain’s inability to function properly. You may become a pariah, a social outcast unable to relate and unable to have other people relate to you. Soon, you enter into a world of pervasive loneliness. What’s more, the brain does not heal in a predictable fashion. Symptoms may vanish within six months or last a lifetime. The severity of a brain injury bears no correlation to the length of recovery time. Even a minor fender bender or fall with no visible physical injury can result in behavioral and cognitive deficits that have profound social and occupational consequences.
I was taught that the best moral compass for compassionate care was to treat patients as I would members of my own family. When we’re able to step into the shoes of a survivor, some things become very clear. People with brain injuries want:
· The basic respect afforded to anyone
· To be treated like an individual, not an injury or constellation of
· The dignity of being allowed input into a treatment plan
· Acknowledgement that they still have goals and ambitions
· To socialize with family, friends and to meet others
· A chance to be happy, fulfilled and find purpose
· A chance to realize true independence
We should all do our best to acknowledge their humanity, as well as their wants and needs.
The Pain Self-Management Program: Learn to Control Chronic Pain and Re-Discover Your Life by Drew Bufalini
I’ve had chronic pain for twelve years. I’ll spare you the grisly details. Suffice it to say that after years struggling to be “normal,” I lost everything, nearly everyone and wound up on disability living with my parents.
Today, despite the fact that my health conditions have gotten worse, I’ve moved out of my folk’s place, have a very fulfilling (and accommodating) job; a wonderful (and understanding) girlfriend; and even a smidgeon of a social life (yes, I’m counting visits to sick relatives and work functions).
I became an expert on pain. I devoured every book I could find on the subject. I scavenged the web. I interviewed doctors and fellow patients. I endeavored to exercise. I altered my diet numerous times. I learned to meditate. I volunteered to build up my endurance so I could return to work. I even launched a support group at my local hospital with the help of the American Chronic Pain Association.
To one degree or another, it took each of those efforts working in concert for me to overcome pain and live a purposeful, functional life again. Anyone who knows me will tell you, my pain is far from gone. But it no longer controls my life.
Today, I’m proud to announce that Life Skills Village - the company that first took a chance on me as a volunteer and then again to lead its marketing department – is launching a holistic, chronic pain self-management program. The goal is to turn patients into pain experts and provide the tools to self-manage their chronic pain (beyond simply taking medication).
The curriculum, developed by Dr. Bryan Weinstein (neuropsychiatrist) and Dr. David Cowan (neuropsychologist), is designed to augment any pain physician’s care.
Our psychologists and occupational therapists concentrate on skills pain patients can use every day – like developing a flare-up plan, adaptive exercise, mindfulness, meditation, using biofeedback, improving sleep, managing pain behaviors and improving relationships to name a few.
None of this is as easy as it sounds. Not with chronic pain. To control pain means understanding and accepting it as well as having the courage to tackle it head on. It means keeping an open mind to the therapies introduced. It means managing expectations. Because even though the program meets only once a week for twelve weeks, this will take time. Give yourself permission to try the pain self-management program because it beats the hell out of spending life stuck in a recliner.
The truth about chronic pain is that it will not go away on its own. Nobody wakes up one day magically cured, ambulatory and cheerful. Pain robs what little control we have in our lives and leaves us dangling over a terrifying abyss of uncertainty. Isolating yourself at home will not help you feel better. Self-medication only lengthens the road to recovery. The only way out of the pain labyrinth is to make a daily effort (no matter how small). We can help you take those first steps beyond chronic pain.
Chronic pain may force us to become victims, but we don’t have to stay that way. The Pain Self-Management Program starts in September. Contact me to get started.
Note: Life Skills Village happily accepts clients and other people of all religions and political persuasions. We encourage others to live well and to help each other - regardless or race, creed, color or sex - as Brother Williams suggests here:
I kneel to pray when the day was done and prayed ‘Oh, Lord bless everyone’
Lift from each heart the pain, and let the sick be well again
And then I woke one day, and carelessly I went on my way
But the whole day long, I did not try, to wipe a tear from anyone’s eye
I did not even try to share the load of my brothers or sisters there on the road
I did not even go to see, the sick man just next door to me
But yet once again, when the day was done I kneeled and prayed ‘Oh Lord bless everyone’
But as I prayed, to my ears it came, a voice whispering clear
The voice told me, precious hypocrite before you pray, whom have you tried to bless today?
God’s sweetest blessing it always go by hand we serve Jesus here below
And then I hid my face and cried, I said, “Forgive me, Lord, for I have lied.’
Let me but live another day and I will live the way that I pray.
“Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome.”
If this quote from Booker T. Washington is to be taken at face value (and I believe it should), then traumatic brain injury survivors are some of the most successful people on the planet. Think about it: there is literally no bigger potential obstacle than having to rebuild your life while your brain slowly reconstructs itself. From the agony of physical therapy to the agonizingly slow pace of neuro rehabilitation, people with brain injuries know they can either accept the challenge or settle into a new, lonely and depressing existence. Assuming that you’re either the former or a caregiver to the former, we have compiled this list of books and links with you in mind.
The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science by Norman Doidge, M.D.
The concept of "neuroplasticity" is quickly becoming gospel in brain injury rehabilitation circles. Basically, it means that the brain can rewire itself after a trauma. To borrow an analogy: neuroplasticity is “muscle memory” for your brain. In this fresh look at the brain, psychiatrist and psychoanalyst Norman Doidge, M.D., provides an introduction to both the brilliant scientists championing neuroplasticity and the people whose lives they've transformed. Click here to purchase
Falling Away from You: One Family's Journey Through Traumatic Brain Injury by Nicole Vinson Bingaman
This is the story of Taylor Bingaman and his journey through the world of traumatic brain injury. Authored by Taylor’s mother, Nicole, this book recounts the events following Taylor’s devastating fall down the stairs. She brings to life what happened in his accident and the rehab process that followed in a very personal and candid way. She reminds readers that each day is a precious and irreplaceable gift and that it can take a village to heal a brain injury survivor. Click here to purchase
Over My Head: A Doctor's Own Story of Head Injury from the Inside Looking Out by Claudia L. Osborn
This is an inspiring story of how one woman comes to terms with the loss of her identity and the courageous steps she takes while learning to rebuild her life. The author, a 45-year-old doctor and clinical professor of medicine, describes the aftermath of a brain injury that stripped her of her beloved profession. For years she was deprived of her intellectual companionship and the ability to handle the simplest undertakings like shopping for groceries or sorting the mail. Her progression from confusion, dysfunction and alienation to a full, happy life is told with great style, and considerable humor. Click here to purchase
Mindstorms: Living with Traumatic Brain Injury by John W. Cassidy
Navigating your way through the morass of doctors, medical jargon and the healthcare system can be daunting, especially when you only want what's best for the person you love. Dr. John Cassidy has devoted the past twenty-five years to helping families cope with traumatic brain injury. Mindstorms is his compassionate, comprehensive manual to demystifying this often frightening and life-changing condition. Click here to purchase
Traumatic Brain Injury: A Caregiver's Journey by Lydia Greear
Many family members are not prepared to deal with the drama of life after a traumatic brain injury. Greear provides a day-by-day account of her son’s journey from injury through rehabilitation. This book is written from the family member’s perspective and includes written accounts published by former patients, doctors and doctors who were patients. This book is a passionate account of the author’s journey as caregiver and guardian for her adult son following a traumatic brain injury. Click here to purchase
An Insider's Guide to the Injured Brain: A Workbook for Survivors and Those Who Support Them by Ruth Curran MS and Mary Lanzavechhia
Co-authored by two brain-injury survivors “The Insider’s Guide” provides insight and practical suggestions for survivors and their support systems. Generous in personal narrative and community sharing, “The Insider’s Guide” acknowledges the hidden world of brain injuries, validates the pain of the process and pushes you to work through it all. With an empathy that can only come from experience, “The Insider’s Guide to the Injured Brain” invites you to fumble, practice, work and ultimately grow your way into a new normal that feels sustainable, supported and full of life.
Click here to purchase
League of Denial: The NFL, Concussions, and the Battle for Truth by Mark Fainaru-Wada and Steve Fainaru
“PROFESSIONAL FOOTBALL PLAYERS DO NOT SUSTAIN FREQUENT REPETITIVE BLOWS TO THE BRAIN ON A REGULAR BASIS.” So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: a chronic brain disease that was driving an alarming number of players - including some of the all-time greats - to madness. Click here to purchase
Brain on Fire: My Month of Madness by Susannah Cahalan
An award-winning memoir and instant bestseller that goes far beyond its riveting medical mystery, Brain on Fire is the powerful account of one woman’s struggle to recapture her identity. While the author did not sustain a traumatic brain injury, her experience with encephalitis has much in common with that of a TBI survivor. In her breathtaking narrative, Susannah tells the true story of her descent into madness, her family’s inspiring faith in her and the lifesaving diagnosis that nearly didn’t happen. Brain on Fire is a profoundly compelling tale of survival and perseverance that is destined to become a classic. Click here to purchase
The Day My Brain Exploded: A True Story by Ashok Rajamani
Following a brain bleed at the age of twenty-five, Ashok Rajamani, a first-generation Indian American, had to relearn everything: how to eat, how to walk and to speak, even things as basic as his sexual orientation. With humor and insight, he describes the events of that day (his brain exploded just before his brother’s wedding!), as well as the long, difficult recovery period. Irreverent, angry, at times shocking, but always revelatory, his memoir takes the reader into new territory. That he lived to tell the story is miraculous; that he tells it with such aplomb is simply remarkable. Click here to purchase
After Brain Injury: Telling Your Story, A Journaling Workbook by Barbara Stahura and Susan B. Schuster
This workbook guides TBI and blast injury survivors through the cathartic experience of telling their own stories with simple journaling techniques. By writing short journal entries, survivors explore the challenges, losses, changes, emotions, adjustments, stresses and milestones as they rebuild their lives. Journaling after brain injury helps written and verbal communication skills as well as provides cognitive retraining for following instructions. It helps promote self-awareness as well as recognition of strengths and difficulties after brain injury. It is a tool for planning for the future and discussions with family members.
Click here to purchase
Beyond the books we compiled for this list, there are literally hundreds of texts written by and for brain injury survivors, their loved ones and caregivers….which ones would you recommend to the world?
My name is Dr. Bryan Weinstein. I am a board-certified psychiatrist specializing in the pharmacological and rehabilitative treatment of people with traumatic brain injuries. I see over 100 brain-injured patients every week and am privy to the tragic details and consequences of their injuries.
After an injury, my patients tell me that the world looks different to them – and sees them differently too. Allow me to employ a mental exercise to share their perspective with you:
Imagine that you wake up one morning to discover that you are in a foreign country. Everyone – including your friends and family – speaks a different language. Their language is as incomprehensible to you as yours is to them. Beyond learning the language, you now have to become culturally competent in your new home country.
Now imagine that you just enjoyed a dinner with friends and had one too many drinks. You stumble into an Uber and are chauffeured home. You wake up in the morning and realize that not only did you fail to sober up – you never will. You will continue to be disoriented, dizzy, off-balance; impulsivity and dis-inhibition will define your behavior; your affect will alternate between inappropriately jovial and incongruously aggressive. Absent your normal inhibitions, you say and do things with no insight into your own behavior (Let alone the ability to regulate that behavior!).
Take a moment to mentally fuse both scenarios. Now picture this state lasting for a minimum of two years. Or even the rest of your life. Your loved ones may attempt to care for you, but it isn’t long before your behavior alienates both family and friends. Maybe even your children. You can no more hold a job than you could wish yourself better. You find yourself isolated, inconsolable and without immediate access to your usual emotions, memories and coping skills.
This may sound like a nightmare, but the reality is that there is a very real possibility of a head injury turning into a lifelong disability.
Every day, we casually enter a nearly 5,000 pound vehicle and drive between 40 and 80 miles per hour while talking on the phone, texting, adjusting the radio or simply pondering the events of the day. We share the road with thousands of other drivers caught in these same moments of distraction. On some roads, oncoming traffic is separated by a single yellow line – when a vehicle strays across it, tragedy ensues.
You may think the potential for a crash is low, but how often have you heard the phrase, “I never thought it could happen to me?” I hear it dozens of times each week. As long as you drive a motor vehicle, you and your loved ones stand a chance of becoming victims.
You don’t have to suffer a catastrophic accident to acquire a brain injury. Experiencing rapid deceleration can cause your brain to slam into the front and back of your skull – this is called a contrecoup event and is one of the most common injuries resulting from an auto accident. Even minor injuries can damage billions of neurons and effect large parts of your brain.
A bruise to your brain can have devastating implications. Unlike most physical injuries, a trauma to the brain is invisible – which makes it extremely unlikely that you will be afforded any sympathy for the behaviors we discussed earlier. Instead, you will be held responsible for your behavior. You will become a victim of your brain’s inability to function properly. You may become a pariah, a social outcast unable to relate and unable to have other people relate to you. Soon, you enter into a world of pervasive loneliness.
That’s more, the brain does not heal in a predictable fashion. Symptoms may vanish within six months or last a lifetime. The severity of a brain injury bears no correlation to the length of recovery time. Even a minor fender bender with no visible physical injury can result in behavioral and cognitive deficits that have profound social and occupational consequences.
As a medical student, I was taught that the best moral compass for compassionate patient care was to treat patients as I would members of my own family. It’s no easy feat for any of us to understand what a person is feeling after a traumatic brain injury. However, it is incumbent upon all of us – whether a medical provider or loved one – to at least make the attempt. When we’re able to step into the shoes of a survivor, some things certainly do become clear. People with brain injuries want:
Note: This content was updated in February 2017. Some of the apps from the original post are still listed; however, we’ve found many more that can be extremely helpful…
We know what you’re thinking: don’t people with a traumatic brain injury have enough to relearn without training in new smart phone technology? Our answer: Yes and no. Yes, absolutely, which is why the apps we recommend are meant to complement existing therapies and programming. No, because the more frequently the mind is exercised, the greater the possibility of neuroplasticity rewiring the brain to be more functional in the future.
Technology today is working harder than ever to improve our lives. There are literally hundreds of apps for people with brain injuries and similar problems. We have selected these apps because they build on the day-to-day needs of an individual living with a TBI. We focused our research on these areas:
Specifically, these apps help clients work on the following: short-term memory loss, communication/socialization problems, anxiety, behavioral and organization issues.
Free with $1.99 Upgrade Available (iOS)
(Android Counterpart: Lists Alarmed!)
Alarmed augments short-term memory while the user is rebuilding his or her own. A productivity app for the masses, people with traumatic brain injuries can use Alarmed to create multiple reminders with unique, memorable tones for each task. Reminders can be customized with a “To Do” list and send multiple email reminders/updates. This app also comes with a timer to assist in programming.
Cozi Family Organizer
Free (iOS & Android)
Families can stay in sync on multiple platforms using this app that combines a shared calendar, shopping and “To Do” lists. With everyone on the same page, organizational skills are enhanced and frustration diminished.
Free (iOS & Android)
EverNote helps improve memory, organizational skills and even creativity by syncing ideas on multiple devices. The user can take notes, capture photos, create “To Do” lists and record voice reminders. The searchability function can be a tremendous boon for those with short-term memory loss.
Productive Habits and Daily Goals Tracker
Free with In-App Purchases (iOS)
(Android Counterpart: Habitizer)
This app helps users develop positive habits in their lives by keeping them organized, tracking their progress and maintaining motivation. It allows users to set the habits they want to develop and receive reminders when tasks are to be completed. Users can color code these based on the priority or category of the habit. This app can also allow a therapist or caregiver to set priority levels for each task.
Free with In-App Purchases (iOS)
(Android Counterpart: Luminosity)
Brain HQ tailors a training program for each persons’ unique mind. Therapeutic exercises are personalized based on performance and can help improve cognitive skills. Exercises are designed to improve attention, memory, people skills and navigation.
Brainscape - Smart Flashcards
Free to $9.99 with In-App Purchases (iOS & Android)
Pick a subject from geography to vocabulary-building and Brainscape has a set of smart digital flashcards. What makes these flashcards so smart? Besides being color-coded to aid recall, users are asked to indicate prior knowledge of the answers. Questions the user did not understand or answer correctly are repeated more frequently than those answered correctly.
Free for 30 Days (iOS & Android)
Constant Therapy is a speech therapy app for individuals who are looking to increase their cognitive abilities. This app is scientifically proven to improve speech, memory, cognition and comprehension skills. While this app can’t take the place of therapy, it is a great way to augment existing treatment by completing progressively challenging tasks right from your very own phone.
Spaced Retrieval TherAppy
(Android Counterpart: Spaced Retrieval)
Spaced Retrieval is a scientifically-proven way of improving recall of names, facts, the routines of several people and more. People with brain injuries can rehearse memory skills by recalling an answer over expanding intervals of time (1, 2, 4 or 8 minutes) that helps to cement the information in their memories. Please note: this app is not intended for use without therapy.
$1.99 (iOS & Android)
For non-verbal clients, this app utilizes two large, color-coded buttons, green for “Yes” and red for “No”. When either button is pressed, the app vocalizes the client’s decision. This is a wonderful tool to help those with a brain injury or speech problem communicate without a struggle.
Free (iOS &Android)
Audible is for individuals who love a good book but are having difficulty reading, retaining information or who simply enjoy closing their eyes and having a good book read to them. With Audible, users do not have to give up their literary passions, they just have to listen. This app is also compatible with Amazon, so books can be downloaded right from your account.
Clear Record Premium
Price ranges from $.99 to $1.99 (iOS) depending on upgrades
(Android Counterpart: AndRecord)
This audio recording app allows the user to record conversations in practically any environment and play it back at the speed and volume of their choosing. Unlike many other voice-recording apps, Clear Record Premium filters out ambient sound to ensure pitch and clear voices.
Free (iOS & Android)
Speak and this app will recognize the users voice and transcribe what they say into text messages, emails and even update social media. Dragon Dictation is a perfect mass media communication tool for anyone with a physical limitation.
Type ‘n Talk
(Android Counterpart: Type and Speak)
This app is incredibly useful for non-verbal individuals and other individuals who have difficulty with speech due to physical limitations. Type ‘n Talk allows the user to type what they need to say and their verbalized audio will play through whatever device is being used. This app also allows the user to copy text from websites and messages and provides a variety of languages.
Pocket Verbal Ability
Free (iOS & Android)
Users can increase their vocabulary with this user-friendly vocabulary app. Pocket Verbal Ability asks questions that will help prepare for job interviews, exams, and day-to-day life.
(Android Counterpart: Talkingtiles)
This app includes the most common topics in the functional social skills system for people with brain injuries to model for appropriateness. Topics include the following: meeting/greeting people, taking responsibility, being polite, joining others in groups, apologizing/excusing self, following directions and handling criticism. Users watch a brief video of a person performing the correct behavior for the social situation and can then pattern their own behavior accordingly.
Free (iOS & Android)
For anyone who could use a time out to relax, Breathe2Relax has been proven to help mood stabilization and control anger and anxiety. Users should simply indicate their level of stress and follow the audio instructions to breathe their way back to serenity. Essentially, this app provides on-site audio diaphragmatic breathing exercises.
Free (iOS & Android)
WeFeel is a mental health app that users can use to track their emotions and monitor how they change over time. This app can help manage emotions by allowing the user to visualize their anger, fear, stress, etc and then offer coping strategies. With a subscription, a counselor, therapist or caregiver will be able to monitor the users recorded emotions in real time from their own smart phone.
In Case of Emergency
$1.99 (iOS & Android)
This app allows people to store their medical information in a single location that is convenient for medical personnel in the event of any urgent situation. This app can also use to locate the nearest hospital.
All apps labeled iOS can be found at the Amazon.com: Apps & Games. Apps for Android can be found at either Google Play or the Amazon App Store for Android.
Since this is by no means an exhaustive list, we are always working to improve and add to it. We would love to hear from individuals with a traumatic brain injury and their physicians and caregivers about which apps they use.
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About the Doc
Dr. Bryan Weinstein is a practicing psychiatrist with certification from the American Board of Psychiatry and Neurology. He has practiced psychiatric pharmacology and psychotherapy since 1997. Dr. Weinstein is the CEO of Life Skills Village.