Carolina Reyes invites El Paso Military Spouse, Roxana Delgado, to attend State of the Union | U.S. Representative Silvestre Reyes

Carolina Reyes invites El Paso Military Spouse, Roxana Delgado, to attend State of the Union | U.S. Representative Silvestre Reyes Here is my wife. She will be attending the State of the Union Address tonight!!!

Traumatic Brain Injury (TBI) or Post Traumatic Stress Disorder (PTSD or PTS)

First and foremost, I will make the disclaimer that I am not a medical professional.  I am not trying to act like one.  I believe that my experiences and the fact that I survived a Moderate Traumatic Brain Injury gives me a voice to express thoughts in this subject.  The purpose of this article is to create a healthy and respectful discussion.

Many times, in the military, I hear the terms Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD or PTS) forced together in a phrase or a sentence.  It is implied that TBI and PTSD are "kind of" the same thing and that the treatment for one works on the other.  As many of you know I sustained a TBI in Iraq. It is expected for me to have PTSD.  Well... I am PTSD free.  My symptoms are 100% neurological that resulted from the TBI.  

I have heard that PTSD and TBI are comorbid.  I am sure that in many cases both conditions are present.  But according to the definition of comorbid, one does not exclude the other.  Not because they can coexist means that one will be treated and the other should be taken care by itself (which I have heard many times).  The American Heritage Medical Dictionary defines comorbid as coexisting or concomitant with an unrelated pathological or disease process. 

Rarely, I hear "amputee and PTSD" on the same line.  The amputee receives treatment and rehabilitation for the loss of a limb. If there is PTSD present they receive care for that as well.  Two separate injuries, two separate treatments.  But when it comes to TBIs, commonly I hear it side by side with PTSD.  Rarely I hear TBI by itself.  I believe talking about these two different conditions so attached to each other brings misconceptions, dismissal, downplay, and widens the room for error.  

The National Institute of Health defines Traumatic Brain Injury as: a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.  Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.   A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.  A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.

Also, the National Institute of Health defines Post Traumatic Stress Disorder as:  is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.

Clearly, TBI and PTSD are two separate and very different conditions that should require two separate and very different approaches. One is a physical injury to the brain whereas the other is not.  In my opinion, the care team should include different specialists for each of these conditions.  I am not a medical professional and I can see the difference.

I have heard that many of the behavioral issues after a TBI are due to a frontal lobe injury.  http://neuroskills.com defines the function of the frontal lobe as: The frontal lobes are considered our emotional control center and home to our personality.  

A question comes to mind: How many PTSD are frontal lobe injuries? Or, how many frontal lobe injuries are taken as PTSD?

Bottom line: TBI and PTSD are obviously two separate and very different conditions.  

I leave you all with the question:  Why are these two conditions are being forced to be "married"?

Traumatic Brain Injury: Feeling Useless or Unproductive?

Many times after a Traumatic Brain Injury we feel as if we are not good with anything.  In my experience this is a feeling that comes and goes.  From my personal stand point, at times I feel it becomes very difficult to engage on things.  Most importantly, it is those things that others expect us to do but we cannot find a motivation or a drive to get our hands on the given tasks.  I have to say that even utilizing the compensatory strategies it is hard to find that drive or motivation.  Everything seems to be a lot of work.  Even the things we used to enjoy before the injury.  I experience these feelings quite frequently.

I have learned to go around my impairments in a way that I do not focus on them.  There are some areas that are what makes us functional, those I do face with courage.  At the end we want to achieve complete independence, with or without impairments.

So, how to feel useful and productive?

The answer lies within our own selves.  What works for me is not going to work for everybody, but it can give you a general idea on how to to avoid such feelings.  I always try to focus on the things I can do well, and set a goal on a daily basis.  This set goal is one that can be achieved, is realistic and can be measured once completed.

For example:
I like to write and journal.  Let's say today my goal was to write this post.  Since I have been doing it for a while it has become something that does not take that much effort.  As soon as I finish writing it I will be able to see that I achieved what I had planned.  As for realistic, my goal was to write a blog post, I did not set myself the goal of writing a book or an essay today. In no way that can be a realistic goal, it is not likely that I will be able to complete that goal in one morning or one day.  It do not matter how many road blocks or struggles I find on my road today, at least I can say that I accomplish one task and one goal.

In my opinion feeling productive has a lot to do with what we accomplish in a day.  Accepting our limitations is a crucial part of overcoming feelings of uselessness.  We have to set those goals that we know we can achieve.  Setting goals that are too hard or close to impossible will bring those feelings we do not like and we want to avoid.

So, how do I succeed at accomplishing what others require me to do?  My life has become about setting goals and accomplishing them.  I have created a task list that goes by days and deadlines.  Every morning I look at the tasks for the day.  As I accomplish any given task I cross out the task as completed.  My goal every day is to clear the tasks that I have on my list.  At the end of the day I have a great feeling when I see my list being cleared.  When I am not able to clear it, I still feel good because when I look back I can say that I accomplish many things in the day.

Every Traumatic Brain Injury is different, I know that compensating is different for all. I hope that my experiences and strategies can be helpful in achieving success.

No matter how your day goes, always remember that "IT WILL GET BETTER".

Speech to the Miners at the University of Texas at El Paso

Hi all. This afternoon Roxana and I had the opportunity to address the women's basketball team at the University of Texas at El Paso. Needless to say it was a very gratifying experience. We shared the floor with a person that survived a car accident caused by a drunk driver. Him along with his wife and two children shared their survival experience with the team. The audience as well as Roxana and I were deeply moved by their story.
I spoke about my injury as well as coping skills, hope, and motivation. Also during the speech we addressed how life can change in the split of a second. The audience was you and energetic. I was humbled to see how my words had caught their attention.
As their season approaches we were ask to talk to them to help the come into focus and motivation for the upcoming games.
They could clearly understood that besides the blessing of being able to play their sport, there are opportunities that present in our lives that should not be taken for granted. I included in my speech my perspective of a team and leadership. I told them that the principles applied in the military for the execution of missions could be applied to the game of basketball. In order to be successful they needed to understand that they have to know each member of the team. They need to be able to know what the other is thinking when no words are spoken. I addressed that regardless of winning or loosing they always needed to play the best game possible. Life is not easy as the games are not going to be easy. But they had to play their best game every time.
At the end they seemed motivated and I think the goal of the event was met. Roxana mentioned something that stuck on them as well as on me. She said "The opportunities of today will define your future".
They named us honorary coaches of the team. I am honored and humbled by the opportunity.
Good luck to the Miners during this season. Go Miners!

September: Suicide Prevention Month

Hi everybody.  September is the Suicide Prevention Month. Many days in our lives are busy, rushed and at the end we wish we had more time to accomplish more.  At the same time we are going through our regular days, some people are going through an extremely irregular day because they might be contemplating the idea of suicide.  When was the last time you looked at all those around you and wonder if they are in need of help? The National statistics (http://www.cdc.gov/nchs/data/databriefs/db64_fig5.png) are alarming.  In 2009, there were approximately 11,838 suicides. That is a significant number.  In my opinion, 1 or 11,838, is significant when we are talking about suicides. 

How can we prevent suicide?  Regardless of our social status, job position, age, ethnicity, gender, political affiliation, etc, we should be taking care of those to our left and right.  We should be talking to them and be concerned if we see any sign of suicides.  As we see this signs we should become an instrument of hope, support and information. 

There is a very famous quote by Charles F. Browne "We can't all be Washingtons, but we can all be patriots".  In suicides, one cannot prevent all but we can all prevent one.  It is sad to see that a life is so hopeless that they contemplate suicide as an option.  It deeply saddens me when I learn through the media that somebody has committed suicide.  There is a lot that all of us can do to help prevent such deaths.

There are resources that by us knowing we can share with those in need.  Nationally we have the National Suicide Prevention Lifeline, the American Foundation for Suicide Prevention, the Veterans Crisis Lifeline, the Defense Centers of Excellence, Real Warriors, churches, chaplains, among many others.

Let's do our part!

Let's put our grain of sand!

Let's be people of action!

Let's help others!

Let's be instrument of change and support!

One life lost is too much!

             

                               

Sleep Problems After a Traumatic Brain Injury?

Yesterday a friend contacted me and mentioned that he couldn't sleep
well after his head injury, which is the reason why I am writing this
today.  The things I am about to mention are based on my personal
experience.  I am not a medical professional but I can tell you that I
know first hand what a brain injury is.
Immediately after I sustained a brain injury I had sleep issues.  The
issue that stood out the most was that I could not sleep enough.  I
went from being a person that could sleep a few hours, waking up full
of energy to a person that could not get enough sleep.  That was one
of the first signs that those around me noticed.  When it was time to
wake up, the alarm would be going off for hours and I could not hear
it.  I would sleep twelve plus hours.  This is an issue is an ongoing
today but I have disciplined myself to avoid any oversleeping.
I have heard from other TBI survivors that their problem is the
opposite.  They cannot sleep.  This has happened to me but the most
common for me is not being able to wake up in the morning.
Sleep is something that more than a need it is a process.  For this
process to happen optimally we have to understand that we have to
control and adjust our environment.  I know that many have TV sets in
the bedroom.  This is not recommended but at the same time it is
something that many of us are extremely used to.  The question now is:
what are you watching prior to sleeping? Are you watching Law and
Order? Are you watching a news channels? Watching programs as such
affect the amount of time I need to fall asleep. Many of us are
dependent of the TV, one thing that has worked for me is to watch
documentaries.  Not the type that show the gangs or people fighting in
prison.  I watch the type of documentaries that involve nature,
especially those that involve the ocean. This type of programs make me
feel some kind of relaxation. Last week I watched Oceans, a
documentary produced by Disney. I found this one very soothing.  It
got me so relaxed that I even fell asleep watching it.
Other things Roxana and I do is that we keep our bedroom very clean
and organized.  In order for me to have a pleasant sleep, I need the
environment to be peaceful.  I honestly don't believe that having a
mess can contribute or help for a good night sleep.
Once we are ready to go to sleep, we turn on a water fountain and the
recording of a thunderstorm.  I grew up in a place that thunderstorm
were almost a daily event. The recording I have sounds exactly like
the TStorms back at home.  We leave the fountain and the TStorm
recording run all night long.  With that I rarely wake up in the
middle of the night.
I have met other people that use things like guided imagery or
meditation before going to sleep.  According to them it works greatly.
If you are having sleep problems this can be another tool to
experiment with.
I have heard also, that avoiding looking at the clock while trying to
sleep is helpful.  So, I recommend to put the clock in a way you can't
see it. I use my phone as a clock at night.  When is time to sleep I
flip it upside down.
In my opinion, good sleep hygiene does not involve only the act of
sleeping but is a process that includes the person and the
environment. A neat environment can contribute to feeling at ease.
Only you know what bothers you and what might help.  Others can only
offer advice.
Remember, that after a brain injury we have to adjust the environment
to maintain our independence.  The same goes to sleep. We have to make
adjustments to succeed at having a good night sleep.  Keep trying and
you will see that you will succeed.

IT WILL GET BETTER

TBI Warrior Launches New Redesigned and Improved Webpage

http://www.tbiwarrior.com ~ During the past several months I gave some thought on how to improve the TBI Warrior webpage. On the new webpage you will find Forums. Users will be able to share, ask, answer, or just simply connect with others in the Traumatic Brain Injury community. I encourage survivors, caregivers and care providers to introduce themselves and network with others in the community.
You will also find a redesigned News tab. Here you will find the latest headlines Related to the care and treatment of TBIs.
Aside from the forums there is a "Share Your Story" area. Here, Survivors or Caregivers, Military or Civilians, can write and publish their own story.
The new page has a military look but is NOT limited to military and veterans. Bottom line, regardless of your mechanism of injury, a head injury is a head injury. We all have symptoms that manifest differently but they can be categorized within same categories. Military and civilians possess the power to support each other.
Feel free to stop by the webpage and submit any feedback to info@tbiwarrior.com.

"IT WILL GET BETTER"

Brain Injury (TBI) Rehab In The Military: A Firsthand Look to the National Intrepid Center of Excellence (NICoE)

After a long trip on the Washington DC Metro from King Street I arrived at the Medical Center station.  Arriving was a relief until I saw the never ending stairway to heaven.  The escalator was so steep I had to hang to the handrails with both hands.  As soon as I started moving up the escalator I felt my balance getting unstable.  I avoided looking up or down. I simply kept a steady stare at the few steps right in front of me. After a long trip I arrived to the light and the city once again unveiled in front of my eyes.  The first thing I saw was the National Health Institute building, a little farther pass the NIH was an intersection that will take me right to the gate of the Naval Hospital.  I proceeded to show my ID to gain access to the hospital grounds.

Once I was inside the Naval Hospital compound I saw to my right the marvelous structure that houses the National Intrepid Center of Excellence or NICoE as many know it.  I had heard about the NICoE program in the past, but nothing prepared me for what I was about to see.  I was blessed to tour the facility and see firsthand what the NICoE is about.

Walking through a set of glass double doors, I could feel the relaxing environment that is created for Service Members to feel at ease.  The structure is curved with no straight lines; I could not see any corners in the structure either.  It is pleasant just to look at and appreciate inside. Throughout my tour I had the opportunity to meet a committed group of providers.  Just by the way they talk and conduct themselves I could sense their level of knowledge, compassion, care, and understanding of what Traumatic Brain Injury is. 

As I was brought to each of the areas, I was amazed by the technology they use to give treatment to so many TBI survivors.  They have the most advanced technologies for assessment and therapy I have ever seen.  Almost everything I saw made me feel as if I was getting cared for in a video game.  Many Veterans that have sustained a brain injury overseas are young and of the video game generation.  I can see the benefit of such advancements in the care of TBIs. 

Just to mention a few things that I saw firsthand include:

·         A driving simulator with an actual car cabin that features interactive roads that appear on screens in front of the simulator.

·         A Fire Arms Training Simulator. Right now the NICoE’s mission is to return service members to active duty, so this is important step in getting Soldiers and Marines comfortable with their weapons again. All weapons are coded out weapons that have a Bluetooth system adapted to them (non firing weapons).  These weapons are fired to a big screen featuring many different ranges and scenarios.  Sort of a realistic video game.

·         Virtual Iraq and Afghanistan.  Here Service Members are given goggles that allow them to immerse themselves in a virtual battlefield.  As they move their heads the images within the goggles move.  They also have a device that produces the smell of the battlefield we operate on.  It may be used in the future in a virtual re-immersion therapy method, placing the Service Member back in the experience where he/she initially sustained the TBI, allowing doctors to more accurately assess the individual needs of each patient.

·         I could see from a distance a room that had a Computer Assisted Rehabilitation Environment (CAREN). It is one of the eight in the world and features a motion platform, embedded treadmill, and virtual environments for evaluating and rehabilitating a patient’s vision, reaction time, gait and multi-tasking ability. This amazing technology also is meant to treat the vestibular system that causes balance problems to so many of us.  One stands on this platform as it moves at the same time an IMAX type screen displays the virtual environment in front of them.  (Pretty cool!!!)

·         The gym where physical therapy takes place is a state of the art area with lots of space and advanced exercise equipment.  It has a harness that hangs from ceiling rails to help those with balance problems or injured (or missing) limbs.

·         The structure has an apartment built in it.  This area targets rehab in household task, i.e. preparing meals, doing laundry, etc.

·          There is an amazing conference room that is equipped with projectors to present images in 3D.

·         The NICoE also features a place called Central Park where there is an indoor labyrinth, a huge natural skylight, lots of plants and places to sit and relax.  It also has different terrains, from rocky to bumpy terrains, this can be useful for the retraining of visual and balance problems.

·         The NICoE also is practicing “Family Centered Care”. The entire care program is built around the patient and their family (could be Mom, Dad, brother or sister, Aunt, Uncle, boyfriend or girlfriend.  The “family members” are determined by the patient).

I have to conclude that I am amazed and thoroughly impressed by the advancement that has been accomplished in the care of Traumatic Brain Injuries.  I could clearly see that the military is viewing those invisible injuries with a sense of seriousness and commitment.   If centers like NICoE succeed in the care of these injuries, it should be replicated across the Nation, not only throughout the military but also throughout the civilian sector too.  The technology is useful, but not alone, it takes compassion and understanding from those providing the care.  And the NICoE has a strong blend of military providers who know what it’s like to be deployed, as well as some of the brightest civilian doctors in the country.  We are all part of a historical time that is revolutionizing the care TBIs.  We have come far, but definitely the road ahead holds endless possibilities and infinite successes.  Congratulations to Dr. James Kelly and the staff at the National Intrepid Center of Excellence for a job well done!  Your commitment sets the example for many to follow.  

Different Terrains in Doors

Balance Training

Driving Training

*****The above images were obtained through open source online. The were altered by me to protect the privacy of the individuals.*****

Do you see yourself as a VICTIM after a brain injury?

******This blog is part of http://www.tbiwarrior.com

 Dear friends, I hope you are all doing great and that you are having a wonderful week.  A few months back I met a fellow Veteran online and the first email he sent me was a one liner.  It was the question: Do you see yourself as a VICTIM?  Needless to say, many thoughts rushed through my head.  Among the thoughts was: "Who the hell this guy thinks he is?".  It only took me a few minutes to reflect on the question. Today I thank him for that question.  He really made me think and see my inner self.
Do I see myself as a victim?  The answer is NO.  Life is not easy and many time the card we are dealt is not the card we want for our next play.  It is my philosophy that regardless of the hand life plays me I am going to make the best game possible.  Victim for me is a moment in time.  A moment that comes and goes, or better to say it is a moment that comes and we have to let it go.  Life is about decisions.  For me is: either I choose to move forward and get the best out of my condition or I stand still and let the condition get all out of me.  I choose to move forward.  I cannot rewrite my past, but for sure I can write my future.  I was successful before the injury and I will be successful after the injury.
As a Soldier I learned to stand up and fight for what's just and for others.  I am going to do what the Soldier in me learned.  I am going to help as many people as I can.  I always tried to be the best example for those under me, and today I am going to be an example for many more.  Is TBI the end?  Hell no.  At least not for me.  This is a new beginning.  This is my second chance.  This is the new me.
Today I encourage you to see your present situation as your chance.  This is the chance, this is the moment, this is your time to write your story.  A story of how many lives were changed because of you.  This is your story, you are the star.

Ask yourself this question: Am I a VICTIM? What am I going to do about it?

God Bless you all!!!

*******This blog is part of http://www.tbiwarrior.com

TBI Rehabilitation: Hitting the Wall

Neurorehabilitation is the best treatment after a brain injury. This rehabilitation is a comprehensive and holistic approach to create new pathways in the brain and heal the aftermath of this type of injury. It includes speech therapy, physical therapy, occupational therapy, nurses, social workers and psychologists. Cognition problems are prevalent among TBI survivors. In rehab they'll teach new ways of thinking and how to compensate for the loss. Balance problems are addressed by physical therapy. Any behavioral issues, i.e. frustration, sadness, depression etc are addressed by the social worker or psychologist.
During the first few months of rehabilitation we experience big improvements in almost all areas. Then the improvement rate starts to slow down. In my experience here is where the lingering effects become noticeable. The process slows down but there is improvement happening. I'm at the stage that I don't see improvement. After 12 months of rehabilitation I think I'm probably reaching my optimum benefit from therapy. I still have many issues that are obvious but I don't see significant changes happening. I've been thinking: maybe this is it, I'm ready to go on my own. There is an underlying frustration that may be there forever, I don't know.
I am happy with my progress. If this is the card that life played me then I'll make the best game possible with it. Looking to my left and right I can say that I'm lucky. It all could've been worse, I could've died. Instead here I am writing to you. That alone is a blessing that some BI survivors don't have. I count my blessings and they outnumber my problems or issues by far.
May I be hitting the wall? Am I as recovered as I'll be? I don't know. There is only one way to find out and that is keep moving forward without looking back.
If you feel like leaving a comment, please do so and share you experience. Did you hit the wall?

Thanks.
"IT WILL GET BETTER"
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