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Jack Sisson's TBI Blog

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A new book out entitled After the Crash indicates that motor vehicle accidents are the leading cause of Post Traumatic Stress (PTSD) in the general U.S. population. Car crashes are the most frequent directly experienced trauma for men and the second most frequent for women. TBI survivors are well acquainted with motor vehicle accidents, as they are the second leading cause of TBI in the U.S. (CDC 2004 statistics), but may not be informed on what PTSD is.

What is PTSD ?

PTSD is a response to or a set of symptoms experienced following exposure to a life-threatening event. PTSD can occur even if you are a witness to an event that involves death or serious injury to a person other than yourself. This response involves intense fear or helplessness that lasts more than a month after the event occurred.

People suffering from PTSD persistently reexperience the traumatic event, by replaying the event in their mind, having nightmares about it or by feeling as if it were still happening. Many times a person suffering from PTSD may begin to avoid places that remind them of the traumatic event. An example would be avoiding the interstate highway if one had experienced a crash there.

Some people with PTSD go numb. They become detached, less involved with others lives, isolated. They loose interest in activities they used to like. Some experience a sense of foreshortened future, which means they may not expect to have a normal life span, have a family or have a career.

PTSD is also associated with heightened arousal. It may be hard to fall asleep or stay asleep. Hypervigalence and irritability are common symptoms. It may also be difficult to concentrate.

*Please note that children respond to traumatic events in different ways. The above symptoms are only indicated in the adult population.
** If you suspect that you may be experiencing PTSD discuss it with your doctor and someone you trust - the good news is the above symptoms can be effectively treated.

How is PTSD treated?

The studies reviewed in this book indicated that multiple sessions of Cognitive Behavioral Therapy (CBT), early on, is most effective means of treating PTSD.

CBT is a short-term therapy that focuses on the thoughts that perpetuate stress. CBT also trains individuals on how to cope with stress through the use of relaxation techniques and cognitive restructuring (changing negative thoughts to more positive self affirming beliefs). CBT is very problem specific. In terms of PTSD, CBT aims at neutralizing the thoughts that maintain fear and the persistent reexperience of the trauma. Unlike other therapies, it does not encourage clients to recount a long list of woes or explore past experiences.

The author found that a single session of CBT in the first few weeks following an accident is not an effective approach to dealing with traumatic stress, and may in fact be detrimental.

Interestingly supportive counseling and education had a negative effect on persons in the study that fared better without these interventions.

Participating in some form of treatment is an important part of recovering from PTSD. It is important to note that valuable time, energy and resources can be wasted on receiving ineffective treatment. Be sure to interview therapists prior to treatment to ensure they are skilled and familiar with specific CBT treatments that relieve PTSD. Current research often dates the training of both the medical and psychological field. Practitioners who are not privy to current research findings (as is always the case with TBI) may be of limited assistance.

Many of the people this blog intends to reach suffered TBI as a result of a car crash. It’s likely that some of you are experiencing PTSD. Stress is a normal and expected result to trauma. Naturally a person would avoid an intersection where they nearly died. Yet, after some time, if the recollection of that accident started to control daily life sleeping habits, the ability to work or attend school, the ability to sustain relationships – then treatment may be indicated.

Learning about PTSD caused by an accident is the first step in treating it. To find out more the following links are a good start:

The National Center for PTSD.

American Family Physician.

PTSD Support Services.

As always we value your comments and experiences. Please share if you or a loved one experienced traumatic stress after an accident and how they are coping with that stress.

"They train soldiers to do this and that, but they don't train us, the wives, what to do - what to expect. They don't train you how to pick up the pieces.” says Cindy Tuschel on her husbands return from Baghdad. Cindy’s husband returned to the states with TBI. Read the October 12, 2005 Milwaukee Journal Sentinel article entitled Bomb blows away soldiers old life, for more on an extremely telling story on life after a TBI.

What is complementary medicine and how does it help someone with TBI?

Complementary medicine is also known as Integrative medicine and Alternative medicine. It is defined by the National Center for Complementary and Alternative Medicine, a division of the National Institute of Health, as unconventional treatment used in addition to treatment recommended by a physician.

Complementary medicine is healing-oriented medicine that takes into account the whole person (body, mind and spirit), as well as all aspects of lifestyle. It emphasizes therapeutic relationships and makes use of all available therapies, both conventional and alternative.

Basically, you get more than a 6-minute visit.

Where can you get alternative treatments?

Complementary medicine has come out of the fringes and into the mainstream. If you Google "University Complementary Medical Centers," you get 18,700,000 results. Nearly every University Medical Center has a division of and center for Complementary Medicine. That means they are teaching it to medical students and nursing students, they are researching the efficacy of complementary therapies and they are using it for patient care.

So what types of therapies are involved?

Chiropractic is the most common complementary therapy. Massage, acupuncture, meditation and yoga are all very common treatments as well. Support Groups have emerged as a key component because they have been shown to prolong life and prevent (re)occurrence of disease. Diet and exercise are also critical components of any plan of care. All complementary medicine is specialized to meet the unique needs of each patient.

What's more, complementary medicine also shows that human experiences such as love, touch, relationships and connectedness are powerful determinants for prognosis and healing. For example, the University of Texas medical School did a study (Thomas Oxman, principle researcher) where people about to undergo open heart surgery were asked two questions:

1. Are you a member of a social group that meets regularly (bridge club, civic group, sports group)?
2. Do you draw strength from a religious faith?

Those who answered "no" to both questions had a seven times greater incidence of death six months after surgery than those who answered "yes" to both questions.

World-renowned heart physician and founder of Preventive Medicine Research Institute, Dean Ornish M.D., has written a New York Times bestseller (Love and Survival) on the power of love and intimacy to actually heal and reverse heart disease.

Is there actual evidence that complementary medicine works?

Yes. In fact, there is a scientific basis for the healing power of alternative therapies. Dr. Ornish has done extensive review of the literature on the healing power of love and intimacy - see Chapter 2, Love and Survival.

David Spiegel, M.D., at the Stanford University Medical Center, found that woman with breast cancer lived twice as long if they participated in a support group than woman with breast cancer who did not.

Each University Integrative Healing Center's Web site provides links to studies and current research on the efficacy of integrative medicine as well.

Whatever the symptoms, or condition, complementary medicine considers all aspects of a person's health in the treatment plan. Does that mean you'll be sipping on green tea and vegetable soup between your a.m. massage and afternoon support group? Yeah, something like that.

September 22, 2005 the Center for Disease Control and Prevention published a new fact sheet on TBI. It includes the most updated information on the incidence, causes, risk factors and costs associated with TBI. This fact sheet includes a list of resources on page two.

For an excellent definition of TBI and how your entire brain is effected in a car crash see University of Illinois Center for Cognitive Medicine.

If TBI patients were told this much it would empower them, their caretakers and loved ones to make better medical and lifestyle choices from the beginning.

A report by the National Highway Traffic Administration entitled Evaluation of the repeal of the all-rider motorcycle helmet law in Florida.
reviews the crash reports after the repeal of the mandatory motorcycle helmet law . The report indicates that motorcycle fatalities have increased 81% when comparing 2001-2003 fatalities (after the repeal) than in years previous (1997-1999).

The report also showed that head injury admissions to the hospital increased by 82% in Florida due to motorcycle crashes. Before the repeal of the helmet law, the average annual cost of head injury treatment in hospitals has increased anywhere between $10,000.00 to $45,600.00 per person.

There is not much to think about here. Strapping on a helmet can save your life, $45,000. 00 in hospital fees and a life forever changed by a head injury.

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