March – National TBI Awareness Month.
In recognition of National TBI Awareness Month, we are privileged to be able to publish an excerpt from Dr. Chrisanne Gordon’s soon to be published book, Turn the Lights On; a book describing the journey back from her “concussed” brain. In the book’s epilogue, below, she debunks the “Myths of TBI”
Epilogue- Myths of TBI
Throughout the book we’ve tackled these myths one-by-one and often looked at them through multiple lenses. I hope that these myths can be debunked and dispelled through spreading the truth about TBI and getting that word out to a wide audience; this is an issue that is increasing exponentially and affects nearly everyone – either as a patient, care giver, or acquaintance.
Myth 1 – You need to be knocked out to have a brain injury.
FALSE – Studies have revealed that even mild, jarring injuries such as a soccer header or hitting your head on the car door frame can result in TBI. Often, there is a dazed feeling that last for only a few seconds, but you do not have to be knocked out to suffer a TBI. Of course, the more severe the injury, the great the risk of blacking out. The longer you are unconscious, as a general rule, may mean the injury is more severe.
Myth 2 – If you are dazed or only mildly knocked out, you can return to normal activities immediately.
FALSE – Multiple studies have revealed the fact that resting the brain is imperative to healing. That includes limiting the stimuli from light, noise, or physical and mental activity. This is why high school athletes who suffer concussions may not return to school immediately due to the difficulties they can experience with studying which also impairs brain recovery. This impairment is an even greater concern for soldiers engaged in battle.
Myth 3 – A small concussion without noticeable effects is nothing to worry about.
FALSE – Every head injury needs to be evaluated, treated, and followed up on based on diagnosis. Studies have proven that the number one predictor for a head injury is having had a previous head injury; even a very mild one. We also know that the effects of repetitive injuries are more than additive. In fact, there is an entire syndrome called “second impact syndrome”, whereby the second concussion, in rapid succession from the first (i.e. within hours, days, or weeks) can lead to a more severe injury or even death.
Myth 4 – Everyone who fears or avoids crowds has PTSD.
FALSE – Avoidance of crowds, department stores, supermarkets, etc., as well as avoiding light or loud noise, is a trait of PTSD but it is also a hallmark trait of TBI. This results from the injured brain’s inability to filter information and stimuli. If a TBI sufferer places themselves in high activity areas the result is stimulus overload for the brain creating an adrenalin release, which may lead to panic attacks and further avoidance of these activities.
Myth 5 – I can self-medicate away the effects of my TBI with alcohol, drugs, etc.
FALSE – Studies have shown between 70 and 90-percent of TBI patients develop addiction problems related to self-medication. Self-medication, especially with alcohol, but also with a variety of drugs, is a hallmark of TBI. The initial use may help to reduce the brain overload typically related to the injury but over the long term can lead to significant social, financial, and legal problems. A combination of brain injury and addiction is a leading cause of the suicide and homelessness epidemic currently facing our injured heroes.
Myth 6 – I just have a headache, nothing serious, aspirin or Tylenol will help.
FALSE – The persistent headache resulting from TBI occurs as a warning and is often related to vascular instability in the brain. Migraine type headaches are common with TBI and should be treated differently than a normal headache, one which can be mitigated using aspirin or Tylenol for the symptoms. Aspirin can increase bleeding as it acts as an anti-coagulant, and Tylenol used in high dosages or used regularly over a long period of time can lead to liver problems. Both of these issues can be exacerbated by alcohol, which is the number on self-medicating drug for TBI. Any pain treatment following a TBI should be prescribed by a physician, even if it ends up being over-the-counter medicine.
Myth 7 – I can’t concentrate or remember things like I used to, I must be going crazy or be out of my mind.
FALSE – You may be out of your brain, but you are NOT “crazy” or “out of you mind”. Difficulty remembering things and concentrating are functions of the brain that may be affected by TBI. Recent advances using Diffusion Tensor MRI can show us the areas of the brain that are injured or deficient. In the brain, even a small area of injury can affect a significant function, as with a lesion in the speech center, for instance. It is imperative that these injuries be diagnosed so that proper treatment can be prescribed.
Myth 8 – My CT scan and MRI were normal, so I must not have an injury.
FALSE – Current standard imaging techniques such as the MRI and CT scan do not have the capability to show the lesions or damage in a majority (greater than 95%) of TBI cases. If you are experiencing some symptoms of TBI and an MRI or CT scan were done that didn’t detect an injury, you may still have suffered a TBI. Newer imaging techniques such as Diffusion Tensor MRI, SPECT, and PET scans can better determine the extent of injury in persons with TBI. Neuropsychological testing, similar to tests done with athletes, can also help to determine functional difficulties and therefore help to identify the location of the brain injury.
Myth 9 – I still feel out of sorts 6 months after my brain injury so I won’t ever get better.
FALSE – The brain may continue to recover for up to two years after the injury, possibly longer. Nerve injury healing processes require time and patience, and new research is proving that the brain can continue to repair itself for several years. Brain retraining through Speech Therapy and mind strategies, such as computer games or other applications, can assist with brain healing process by prompting the brain to lay down new pathways to perform the functions lost with the original injury. Physical exercise and balance training can also improve function and healing. Please consult your physician about the electronic devices and exercise program that are best for you.
Myth 10 – I cannot wait to be fully recovered and my old self again.
FALSE – Even mild traumatic brain injury can lead to a shift in brain function and personality. Usually, the period of loss of consciousness or decreased consciousness is often followed by a period of heightened awareness or hyperactivity, especially if you have been injured during a time in which you were adrenalin and cortisol charged, such as on the battlefield or the playing field. This may last for many months, and you and your family must be patient until the brain arrives at its new “steady state”. You may approximate your old self but there will likely be some differences. You and your family should not get discouraged, but understand the process and accept these changes as they occur. Many navigators in Iraq and Afghanistan, for instance, lose their ability to read maps and follow directions after IED blasts. Finding support and acceptance for these changes is the best strategy for overcoming any related frustration and depression or anger. As with any form of disability, our brain and our strategies for carrying on will compensate in other ways for what was lost as long as we’re willing to be open to these changes.
Resurrect a Hero – Strengthen a Nation
Let 2017 be the year that we make health care accessible for our Veterans – even those with complex neurological issues secondary to TBI/PTSD and enable them to have a productive, happy, successful career outside the military, as a valued member of the civilian world. Please feel free to to send us your comments, suggestions, and stories to:
We are here. We are listening. We are advocating for you – and our nation.
Chrisanne Gordon, MD
Founder and Chairwoman
Resurrecting Lives Foundation is proud to be a GuideStar Exchange Member