Tuesday, September 20, 2016

The Pressure Sore

The pressure sore (sometimes called bed sores if the person is in bed) is when the skin tissue starts to break down from pressure being put on it. You wouldn't think of it happening in bed, but to a person who doesn't move it can. Just do this one thing and you'll see...sit (laying will take longer and don't sit in an easy chair) in one position 30 minutes with no changes. Most will want to at least shift their weight after 15 minutes. You are not allowed to.

The person sitting in a wheel chair can't adjust every 15-20 minutes. If you can do 30 minutes without moving, then go the full hour. Your bottom may become uncomfortable. This is an area that develops pressure sores.

Sores start as redness and we don't think about them. When it reaches the further stages, medical intervention, maybe even hospitalization might be needed.

Caregivers should always check for redness, usually when undressing. Check when removing an AFO (ankle-foot orthotic) or brace. People laying in bed should be turned on a side every few hours.

The pressure sore can go deep and lead to blood poisoning. Home care can prevent this, though. Check for redness. Get off of or relieve what's causing the redness. If it's just a wrinkle in the sheets or clothes that caused it, re-position and don't get the person up into something rigid like a wheelchair or stander that day. A red mark usually goes away in a day and a lot of times faster. If it persists, seek medical attention.

If it's a child with an AFO or brace that is causing redness, don't put it on and let the teacher know. You might need to do a note. Experiment with thinner, well-fitted protective under-garments before making an adjustment appointment. If the redness is not in an area sat on, the person can get up.


Sunday, July 24, 2016

I Remember That Song!

That beginning quote is about savant syndrome. Savant syndrome can be caused by a brain injury, but cognitive skills can be magnified. All the other issues exist. Such is my case. I'm smart as a whip, but only use the one finger this is typed with. Music is seen as a "healer" in savant syndrome. That is only one type of brain injury. Music should be applied to all brain injury.

Music As a Healer

The music of the savant is delightful in its own right, and we are its beneficiaries. But it has a healing aspect to it also for the savant himself or herself. The 60 Minutes program title “Musically Speaking” is an apt one, for as that program demonstrates, and as Soundscape documents, music provides for the savant the “conduit toward normalization,” particularly language acquisition, that I address elsewhere on this site. Recent research documents that musical exposure can increase verbal memory, and with it, language acquisition. With that increased language skill comes increased social skills as well,   https://www.wisconsinmedicalsociety.org/professional/savant-syndrome/resources/articles/musical-genius-blindness-and-mental-handicap-an-intriguing-triad/

Music works for other areas.

Music therapy can do this part shown in the video, because the whole therapy is taking a long time to approve, http://braininjuryknow.blogspot.com/2016/03/using-that-hand-again.html
I recommend singing for speech problems. "Breath from the diaphragm." I didn't get that advice from speech therapy, but yrs ago from grade school music  (Hint: if you are not producing sound when trying to speak, it MIGHT be breathing. It's not always, but there is a good chance.) 

SOCIAL SKILLS come as well. "Recent research documents that musical exposure can increase verbal memory, and with it, language acquisition. With that increased language skill comes increased social skills as well" https://www.wisconsinmedicalsociety.org/professional/savant-syndrome/resources/articles/musical-genius-blindness-and-mental-handicap-an-intriguing-triad/

I find the following interesting. Music is used for cognition. It is used to bring back memory and function. This movie is based on a true story. In it, the main character does not speak or function without a certain music playing in the background.

"You know how you hear a song, and it places you back in that moment you fell in love with it?"

I quoted the trailer, but the music therapist takes it further.

I have an idea. Television played a big part in my life and most people I know. My idea is to use old television theme songs. They may bring up long forgotten memories. Here are some. You may add more in the comments.


Thursday, July 7, 2016

In My Face

Neuroplasticity, rewiring the brain, happens. When one part of the brain stops working, another takes over.

It can be seen in my face. It didn't happen over-night. You can see a smile line around my mouth. That wasn't there the year before.

The exercises I did do a lot was the "pucker-smile", exercises #3 and #4. All of these exercises will help- http://braininjuryknow.blogspot.com/2010/11/oral-motor-exercises.html

It has been told to me, and others, that rewiring happens the first year after injury. Mine didn't. It came years later. My injury was 2002. Rewiring did NOT happen in the first year. The pictures are 12/12/2014 and 12/12/2015.

I did exercises daily for that long. Whether or not my smile returned, I did the exercises. I knew they helped my speech.

Friday, July 1, 2016

Opening Hands

(An introductory post to go with this essay.)

Sometimes the hand is left in a fist. Not only do u have to start all over again, but u have to start with an adult body. Both my hands have been fisted. I type this with 1 finger on the hand that was lesser. I knew if I could get 1, I'd get the other. It's coming along, but it doesn't type. Although they both open n close n there is finger individuation, there is more to do. It's already been many yrs. What I describe here can span a few months or a few yrs, it depends on the condition n how fast your body wants to work. I wish mine was over night, but rly it's yrs.

Someone who has been thru it can explain it. We haven't ever had 1 have we? So yes, this is different. 

"Digits should move together. Don't worry about finger individuation yet. First get movement established" http://thoughtfulveg.blogspot.com/2014/11/neurons-that-fire-together-wire-together.html

If your hand is fisted, hold a rolled wash cloth. This will give your hand some separating space. The fingers won't be against the palm of the hand. It reduces and may even stop sweating of the hand. It gets the hand used to being open a bit.

A regular to thin wash cloth should do well for holding. The thicker luxury ones may roll too wide to hold.

Throughout the day, squeeze the cloth. You will make your fist tight. It will be in tightening your hand that you make it looser. Squeezing tighter will be isometric exercise.

Eventually you graduate and move up to stress balls, the kind you squeeze in your hand. I used a cheap foam one. Some companies will put their logo on them and give them away. You can find plain ones at stores. These are the cheap foam ones. They do go up in price as you find the gel ones used in hand therapy.

I actually found a picture of the one tied to my wheelchair. A nurse bought this with her other shopping at Wal-Mart. She thought of my fisted hand. She put a hole in it, and threaded gift-wrapping ribbon through it. She used the ribbon to tie it to my wheel chair.
When you squeeze your stress ball, your fingers stay together. You are not individuating them, yet. Finger individuation doesn't come right now. It is the next step.

From the squeeze ball, and even before you are done with it, you can start doing hand therapy exercises. Don't worry if you can't hold your hand wide open. That is what you are striving for. Just do as much as you can right now.

*I use the videos for their information, not their company.

Monday, May 16, 2016

You Are In Crisis And You Are In The Middle

There is little for the middle class in an emergency. You make too much to qualify for government assistance. You are not rich, either. What do you do when a medical emergency strikes? It happened to me. Luckily, I've worked in a program eligibility and I have economics background.

"Quality rehabilitation is in short supply at a few major centres, and in the US, those lucky enough to gain entry have their length of stay curtailed by reimbursement criteria that limit the amount and duration of care. Instead, patients are subjected to what is called ‘medical necessity’ or the improvement standard, where ongoing rehabilitative care ceases to be provided if improvement is not demonstrated in a timly fashion." https://aeon.co/essays/thousands-of-patients-diagnosed-as-vegetative-are-actually-aware?utm_source=Aeon+Newsletter&utm_campaign=f3c11e932f-Daily_Newsletter_10_May_20165_10_2016&utm_medium=email&utm_term=0_411a82e59d-f3c11e932f-68910097

I initially kept my work insurance under COBRA, and used the SSDI to pay the premium. COBRA is national. https://www.dol.gov/ebsa/faqs/faq-consumer-cobra.HTML For the monthly payment you will need the whole SSDI/SSI check. Insurance is pretty steep. Any extra money can pay bills, rent, or other needed cost. Most bills are headed for collections now as the last payment was missed due to the incident. Pick what you need first and pay on that. Don't worry about bad credit as you are now in crisis mode. "Crisis" will be your answer if questioned later. There is no argument.

The person in need may have to live with a friend, loved one, or family member, if he or she is not hospitalized. "Caregiving" may be reimbursable. This will be important, some mileage will be reimbursed by Social Security. Get that pre-approved and in writing. The person would have to have Social Security.

The work insurance will pay more on surgeries and will probably offer needed therapy longer than the government minimum that is given in government insurance. Keep this work insurance as long as possible. This therapy after surgery is needed and is crucial for "come back." I could only keep my insurance a few months after my surgery. New rules would make it longer now.

...In the middle
But me and Cinderella
We put it all together
We can drive it home
With one headlight

Sunday, May 1, 2016

Turn Off the Light

I have one way to start using that bad hand,  http://braininjuryknow.blogspot.com/2016/03/using-that-hand-again.html Piano wasn't for me, though. I wanted to turn my light off when I left my bedroom. My good arm is the left. The light switch is the right.

No need to restrain the good hand. Either retrain the bad, or turn around to use the good. I use a wheel chair. The light wasn't worth the trouble of turning the chair. So I put my bad arm up n let gravity take over. It wasn't pretty, but it got the job done. It looks better now. I have control over that bad arm. The point is that I was using it.

So what if it didn't look good? It felt good.


Choose an activity. This one chose me. You may have to restrain your good hand. Don't do anything fancy. Wear an oven mitt on your good hand.

Maybe you make your bed every day. Do the pillow with your bad hand. Either keep that mitt nearby, or concentrate on only using that hand. You can finish up the way you were doing, but you gave yourself some practical therapy. Formally, the therapy is called Occupational Therapy. Some figure it only to focus on the hands. It includes the use of equipment, also, in order to get a job done.

Friday, April 29, 2016

Stretches...from Baseball

After moving that arm again, I could really use some stretches! I thought back to when I was 15. I was in softball back then. We did stretches that were specifically for the arm.

I looked at this video. These stretches can also be arm exercises after a stroke or other brain injury. 

I'm already familiar with the first ones. That last one he called YTWL is new to me. I tried it and liked it.

Now it's time to stretch!