I Can See!

UPDATE 9/7/2016

Some things have changed (the site) but I am keeping the linkl because they have something else you can click on. Posit Science is now known by BrainHQ. They don't offer that particular vision package anymore. Instead, those games have been incorporated in their on-line program. This is good because this program is more affordable. Just click the RED and then START NOW.

Exercises remain the same. Occupational Therapy (OT) already incorporates these. If you want vision as primary, let your therapist know.

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After a brain injury it is common to have vision problems (double vision for example, or maybe only one eye works). A common practice has been to ignore the bad eye and learn how to make do with the good eye. I propose something different-rehabilitate that bad eye. In so doing, you'll also increase vision in your other.

I say instead of ignoring the "bad" eye (I've seen it sewn up. Mine was covered with an eye patch.) use it. If you have the ability, purchase InSight from Posit Science, http://www.positscience.com/our-products/insight . This serves as the basis. Do the daily recommended schedule. If you can't and must save, then they do provide one demo game, http://www.positscience.com/our-products/insight/jewel-diver-demo . This is just one of the games in the program and can get you started.

Add reading to your program. If you have a "bad" eye, close your good one. Reading with both eyes open will work on coordination (good for double vision). Watch TV. (What?! This is good?) During commercials close the good eye, and watch with the bad eye. Use both to watch the program. Try to use both equally. It's common to want to use that stonger eye more, so you have to work at it.  Subscribe to an on-line joke-of-the-day or inspirational message. Every day read this with one eye closed. (Here's a trick: Combine this with Speech and read out loud.) Do the same with commercials when watching TV. (TV can be good for you!)

Do eye exercises. This comes from the Cawthorne-Cooksey exercises:

Eye Exercises

Looking up, then down. Slowly at first then quickly (20 times). Looking side to side. Slowly at first then quickly (20 times). Focus on a finger while at arms length. Move the finger one foot closer and back again (20 times).

Do the eye exercises every morning before you get up. You won't have to think of them the rest of the day.

Before starting any of this, wait at least one month after your brain bleed. It's possible any vision problems  will clear up. If it's been awhile since your incident, go ahead and start. It's never too late.

Therapy For Balance

I was looking for something to help my balance. I found Vestibular Therapy. For the original, go to http://www.goldbaum.net/balance/Vestibular_Therapy.html. Click the eye for exercises. I'm going to put all of it here though.

This has really helped my balance. Also, this has eye exercises. I encourage anyone with eye problems (like double vision) to do these.

Vestibular therapy works by having you perform motions that are
intended to make you dizzy while at the same time making you focus on your body position and coordination. This helps your brain compensate for lost balance more quickly. The therapy in the form of exercises, can be performed at home or at a vestibular therapy center. Exercises at the center are more elaborate than can usually be done at home (such as jumping on a trampoline) and are theoretically more effective.
The brain is remarkable for its ability to compensate for a balance loss and can compensate for the loss no matter how severe without therapy within a few weeks to a few months. Vestibular therapy accelerates the compensation process. Dizziness that does not substantially improve over time or even gets worse is an indication that damage is continuing to occur to the balance center. This cycle of continuous or periodic damage and compensation can last for years.
Each time damage (or balance loss) occurs to one balance organ, the brain compensates by "lowering" the sensitivity of the other organ. If you start off with a balance "level" of 100 and 10% is lost on average each time damage occurs, your level will change as shown: 100, 90, 81, 73, 66, 60... During the first balance loss, your brain has to compensate for a 10 point balance drop, which is the worst. The second time the loss occurs your brain has to compensate for a 9 point drop. Although this is terrible, it isn't as bad as the first occurrence. With each 10% loss in balance, your brain has less and less to compensate for, therefore each time a loss occurs it will be less severe. Of course this doesn't hold true if you loose 10% the first time and 15% the second. This may be why some people's balance problem appears to "burn itself out" after a few years. They just get to a point where the amont of damage that is periodically occurring is negligable and is quickly compensated for.

Vestibular Exercises

Cawthorne's Vestibular Exercises

Eye Exercises	Looking up, then down. Slowly at first then quickly (20 times). Looking side to side. Slowly at first then quickly (20 times). Focus on a finger while at arms length. Move the finger one foot closer and back again (20 times).
Head Exercises	Bend head slowly forward then backward with eyes open slowly, then quickly (20 times). Turn head from side to side slowly with eyes open slowly, then quickly (20 times). As dizziness decreases, do this exercise with eyes closed.
Sitting	While sitting, shrug shoulders (20 times). Turn shoulders right then left (20 times). Bend forward and pick up objects from the ground and sit up (20 times).
Standing	Change from sitting to standing and back again with eyes open (20 times). Repeat with eyes closed. Throw a small rubber ball from hand to hand above eye level. Throw ball from hand to hand under one knee.
Moving About	Walk across the room with eyes open, then closed (10 times). Walk up and down a slope with eyes open, then closed (10 times). Walk up and down steps with eyes open, then closed (10 times). Observe caution so you don't injure yourself.
	Any game involving stooping or turning is good.

Rehab At Home

Rehab is so little you will have to do more on your own, and when you need updates you will most likely have to research on your own and have to find exercises.  I know I have many therapies covered here so you can find them.  I'm writing this as if it's for the person receiving the services, but it may be 2 or more people, and may include, friends, family, significant others, or caregivers.  I used to do home early intervention programs for parents, so this comes natural.
 

1.  Know what you have.  Where was your bleed (this gives a clue on what you need)?  What are your limits?  What can you do?  Know your likes and dislikes.  Do you have any hobbies?  All this stuff has to be based on the here & now, not what you want or did.  The things you want to do can be goals you're working to.
 

2.  Get exercises from your therapist.  The easiest way is for them to provide a hand-out or write it down.  Next is you write it down.  Don't expect to remember it.  You might need these exercises 2 years from now and I doubt they will stay fresh in your memory.

3.  A good tip I learned was that commercials are just wasted time.  Do an exercise when they come on. 

4.  Take whatever you can get.  This may only be 30 days under disability.  You will need this to set up a home program, so get the report.  You will most likely need more, so setting up a home program makes sense.  Use your imagination.  The therapist probably used equipment you don't have, but you may be able to do something else to get the same results.  Modified.  This is a term used by therapists to describe an exercise that has been changed to accommodate the disability.  Don't be afraid to modify, or adapt, something.  Here's an example:  I did modified toe touches.  You'd think this not possible in a wheel chair.  What I did was bend over and touch the floor.  This created the same effect.

5.  If you want to address social skills, I suggest adding a game night (fun and who ever thought it was therapy?).

6.  Before your PT ends, ask the therapist for home exercises.  Preferably, these can be done on your own.  Some ideas are http://braininjuryknow.blogspot.com/2011/02/large-muscles.html

7.  For OT, occupational therapy, same thing, ask for exercises.  Here's some OT ideas, http://braininjuryknow.blogspot.com/2010/11/using-your-hands.html.  Also ask that person about any equipment (cost, ordering info, is it covered?  I once got a website address that's proved useful.)  This person can tell you all kinds of things about living independently, as that is their job.

8.  There are speech exercises at http://braininjuryknow.blogspot.com/2010/11/oral-motor-exercises.html. I copied a handout so all could use it.

9  When it comes time, go in and get re-assessed.  A lot don't know this, but although you use up your initial rehab, you can go in once a year to update that initial assessment (unless they change that too).  If it's the beginning of the year, and you are just bored with your exercises, look here and the internet first.  Don't use your only appointment.  You may need it later.

Using Your Hands

updated 3/26/2015 

1.  Invest in a stress ball.  These are usually made of gel or foam and fit in the hand.  Some health depts and banks give them away.  I've even seen them as promos for buisnesses and at fairs.  An idea of an exercise would be to squeeze it 20 times.

 

2.  Do Silly Putty or clay.   I once had an OT that used something that looked like Silly Putty.  She would have me press down with a finger to make an indent.  Then she would take and re-shape, and then have me press with another finger.

3.  Get a handwriting book. It's just easiest (and cheapest) to use what the kids use.

4.  Clapping

5. Snap your fingers

6.  Touch thumb to each finger (a lot of neuros will have this in their exam)

Some activities are good.  Try for 5 min with the bad hand before giving up and going about your usual way. Things like washing your hands, wiping a table, and tying your shoes.  In everything you do, just try with your bad hand (this may only mean to reach toward it).  (I started turning off a light with my bad hand.  This meant reaching to the switch.  I then let gravity do its job.  As my hand fell, it would brush the switch and turn it off.  Now I don't have to do that anymore.)

Oral-Motor Exercises

speech exercises

These are actual speech exercises.  I am copying this hand-out here.  It is the best I've seen.  I've kept mine over 5 years in a plastic protective sleeve. 

Highlight it.  Put your cursor on the highlighted area and right click.  Print.  It will most likely be 2 pages.  Just do a few exercises. Select new ones when you need a change.

ORAL EXERCISES

Please practice the  exercises checked

_____ times a day

_____ repetitions each.

MOUTH AND LIP EXERCISES

1.  Open and close your mouth slowly/quickly.  Be sure your lips are all the way closed.  Repeat.

2.  Pucker your lips, as for a kiss, then relax.  Repeat.

3.  Spread lips into a big smile, hold then relax.  Try to make both sides of your mouth even.  Repeat.

4.  Pucker, hold, smile, hold.  Try to make both sides of your mouth even.  Repeat this alternating movement without holding.

5.  Close your lips tightly and press together.  Hold for 3-5 seconds.  Relax and repeat.

6.  Move your jaw from side to side as slow as you can.  Relax  and repeat.

7.  Puff your cheeks up with air.  Hold the air in for 3-5 seconds.  Try not to let the air escape out of your lips or nose.  Rerlax and repeat.

8.  Same as exercise 15.  Tap your right cheek with your index finger while holding air in your cheeks Try not to let air escape through your lips or nose.  Relax and repeat.

TONGUE EXERCISES

9.  Stick out your tongue so that it is in the middle of your mouth and it does not go off to the side.  Hold that position for 3-5 seconds.  Relax and repeat.

10.  Stick out your tongue and move it slowly from corner to corner.  Relax and repeat.  Repeat moving your tongue quickly.

11.  Stick out your tongue and try to touch your chin with the tongue tip.  Relax and repeat.

12.  Stick out your tongue as far as you can and try to reach your nose with the tongue tip.  Don' t use your bottom lip or your fingers to help.   Hold that position for 3-5 seconds.  Relax and repeat.

13.  Hold a spoon  steady and upright (like a popsicle).  Push your tongue tip against the back of the spoon.  Relax and repeat.

14.  While holding your head steady, pretend to lick a sucker moving the tongue tip from down  to up.

15.   Move your tongue all around the inside of your lips in a circle as completely as you can touching the upper lip, corner, lower lip and corner.  Relax and repeat.  Do the same exercise moving your tongue around the outside of your lips.

Medicaid-The Govt Program

        

Medicaid - The Government Medical Program

   
http://www.cms.hhs.gov/MedicaidGenInfo/
This is the main site.

This is a big topic to cover.  It will take many times for me to add  to this, so check back to see if I added to it.  Sometimes I might refer to Medi-Cal.  California adds its money to the Medicaid money and therefore can call the program Medi-Cal (a combo of of the 2 names).  Some states will call the program something else, some call it Medicaid, and some don't offer it at all.  There is a wide variation and you will have to find out your state rules and names.

Medicaid is the government program for medical care    One would need this if they didn't have medical insurance.  Also, if the cost for medical care is too high for one to meet, then  use it.  I found a great description of Medicaid:

Medicaid is a medical assistance program jointly financed by state and federal governments for low income individuals and is embodied in 42 U.S.C. §1396 et seq (http://www.law.cornell.edu/uscode/42/ch7schXIX.html). It was first enacted in 1965 as an amendment to the Social Security Act of 1935. Today, Medicaid is a major social welfare program and is administered by the Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov/), formerly known as the Health Care Financing Administration.

Among the services that Medicaid covers are: in-patient hospital services, out-patient hospital services, laboratory and x-ray services, skilled nursing home services, physicians' services, physical therapy, hospice care, and rehabilitative services. Patients are restricted when selecting who will take care of their needs by selecting from pre-approved physicians and other providers of medical care. Because physicians are not fully reimbursed for services provided to Medicaid patients, many of them limit the number of Medicaid patients they see.    (http://www.law.cornell.edu/wex/index.php/Medicaid)

Because eligibility requirements vary from state to state, you should apply.  There's no telling if you qualify.  Basically, if you are low income and disabled, you should apply.  Low income is the key.  Sometimes you can qualify with a higher income but there is a share of cost, or co-pay.  This might be worth it if you have medical expenses that exceed this (i.e. the month you pay your insurance premium).  

If you have savings or an inheritance then you should first consult a lawyer before applying.  For example in my case, my father can't leave me anything because the state will take it (he consulted a lawyer).  It will be up to my sisters to make sure my children will get property that has been in the family.  The house I live in belongs to my father.  When he dies, a sister will get the deed and I can live in the house.