Why didn’t my bike helmet prevent my TBI?

BY: SOPHIA VOUMVAKIS

15 per cent of the approximately 18,000 traumatic brain injuries (TBIs) that occur in a year in Ontario are a result of a cycling accident. Every year in Canada, over 11,000 people die as a result of a traumatic brain injury (TBI) – using the same 15 per cent – that’s over 1600 people in Canada who die as a result of a TBI caused by a cycling accident. 85 per cent of all cyclists’ deaths in Canada involve a brain injury.

A little over five years ago, I sustained a TBI while riding my bike. It was a beautiful spring morning, and I was riding my bike to work, as I had hundreds of times before. I remember leaving my home that morning, and then waking up in the emergency room at St. Michael’s Hospital, several hours later. I was told by the doctors in the emergency department that I had been knocked off my bike, hit the ground, passed out, and taken to the ER by ambulance. Several hours later I was diagnosed with a brain injury. To this day, I have no memory of the incident.

I was wearing a bike helmet, which I always did, but my helmet did not protect me against acquiring a TBI. I’d always wondered why, and recently I got my answer. I came across a TED Talk by bioengineer (and former football player) David Camarillo, who, along with his team at Stanford University, has been able to demonstrate what really happens to our brain during a concussion, and why bike helmets, and other sports helmets, such as football helmets are not designed to protect against concussion, but rather, they are designed and tested to determine how well they protect against skull fracture.

What happens to your brain during a concussion?

The standard thinking of what happens to your brain during a concussion is that the head moves, the brain lags behind, catches up, smashes into the skull, rebounds off the skull and then proceeds to run into the other side of the skull. This dynamic is repeated many times. This understanding of what happens to the brain during concussion suggests that the brain is damaged on the outer edges.

In his Stanford University lab, Camarillo and his team, with the aid of new technology, have looked closely at what happens to the brain when it is experiencing a concussion. Their investigations suggest that the current thinking about what occurs to the brain during a concussion is not entirely accurate. Firstly, he does not believe that the brain moves around as much as current wisdom suggests. Camarillo argues that there is very little room in our cranial cavity for movement, perhaps a few millimetres, and our cranial cavity is filled with spinal fluid, which acts as a protective layer. Secondly, he suggests that the brain does not move as a whole.

Football player with ball about to fall to the ground

Our brain is one of the softest organs in our body – the consistency of Jell-O – and as the brain moves around in our skull during a concussion, it is probably twisting and turning and contorting – the tissue is getting stretched. Concussion does not appear to be something that is happening to the outer edges of the brain, but rather it is happening somewhere much deeper, in the centre of the brain.

The Laboratory – The Stanford Football Team

To help Camarillo and his team better understand what is happening to the brain during a concussion they utilized a mouth guard equipped with sensors and a gyroscope, which most experts believe can tell us what happens to the brain during a concussion. When someone is struck in the head, the mouth guard records how the skull moves at a thousand samples per second.

The study’s laboratory is the Stanford football team, young men who regularly go out and hit their heads.  This allows for rich information to be obtained when the researchers extract the data out of the mouth guard.

When the data from the mouth guard, was combined with a finite element model of the brain, developed by Svein Kleiven in Sweden, it showed that the brain of football players, who have suffered a concussion does not smash around in the skull, as current thinking would lead us to believe, but rather twists and contorts. The data shows that the greatest amount of stretching occurs very close to the centre of the brain.

What’s there? The corpus callosum, the wiring which connects the left and right hemispheres of your brain. Camarillo believes that this might be one of the most common mechanisms of concussion, the wiring is being disrupted, which causes a disassociation between your right and left brain and could explain a lot of the symptoms one sees in concussion. This is consistent with what researchers see with Chronic Traumatic Encephalopathy (CTE) – when the corpus callosum of a middle aged, former football player is viewed, and compared to an individual who does not have CTE, his corpus callosum is greatly atrophied.

Although there is a rapid transmission of forces down to the corpus callosum when the head is struck, it does take a certain amount of time. What Camarillo and his team believe is that if we can slow the head down just enough so that the brain does not lag behind the skull, but instead moves in synchrony with the skull, then we might be able to prevent this mechanism of concussion.

How can we slow the head down?

The most currently used bicycle helmet is constructed of expanded polystyrene (EPS) foam within a thin plastic shell. The EPS liner absorbs the force of an impact by deforming, while the outer shell increases the area over which the force is dissipates. The main considerations when designing a bike helmet is the size and stiffness of the helmet, which impacts how efficiently energy is absorbed. As a result of the materials used in constructing an EPS helmet, the size of the helmet has been limited to a few inches. This does not slow down the head enough to enable the brain to move in synchrony with the skull, rather than lag behind the skull. It turns out that air, in an expandable helmet would be the ideal mechanism for slowing the head down enough during impact, so that the brain moves in synchrony with the skull, rather than lagging behind.

woman wearing a skirt standing with her bike

It turns out that a company in Sweden called Hovding, is using the principle of air to give the wearer of their ‘helmet’ some extra space to prevent concussion. Hovding has created what is essentially the world’s first airbag for cyclists. The Hovding is a collar, worn around the cyclist’s neck, that uses advanced sensors, similar to the sensors used in the mouth guards described in Camarillo’s research above, that can sense the cyclist’s movement patterns and will react in case of an accident. The airbag will then inflate, fixate your neck and provide a shock absorption. In experiments conducted by Camarillo and his team they have found that the Hovding collar can greatly reduce the risk of concussion in some scenarios, compared to a standard EPS bike helmet. The Hovding is currently for sale in Europe and Japan, and is CE labelled, which means it complies with European Union safety standards, but not for sale in the United States, and alas, Canada.

In the US, bike helmets are federally regulated by The Consumer Product Safety Commission. The Commission has jurisdiction over the type of helmets they approve. The test they use in order to grant approval to a bike helmet is testing the helmets capacity to prevent skull fractures, not whether the helmet is likely to prevent concussion. In Canada, The Canadian Standards Association accredits organizations to certify that bicycle helmets meet certain standards, such as CPSC bicycle helmet standard, which uses the tests described above by Camarillo.

I contacted Hovding and asked about the availability of their helmet in Canada – alas, it is not available here. They replied that, at this time, they have not investigated helmet certification in Canada. So it might take some time to get my head into one!

Even so, any helmet is better than no helmet, so keep wearing whatever helmet you have, and wear it properly.

 Resources

Modelling and Optimization of Airbag Helmets for Preventing Head Injuries,  published in The Annals of Biomedical Engineering in September 2016.


Since her TBI in 2011, Sophia has educated herself about TBI. She is interested in making research into TBI accessible to other survivors.

Without action, awareness does little

BY: ALYSON ROGERS

Nine years ago, I walked into an emergency room with very obvious signs of a concussion. Despite glaring symptoms, no one would even utter the word ‘concussion’. Doctors told me I had whiplash, which didn’t even come close to describing the traumatic brain injury diagnosis I was given six months later.

Hospital emergency room entrance

This year, I walked into the same emergency room, with very obvious signs of a concussion. Despite nine years of brain injury awareness in the media, in hospitals, in schools and in sports, my experience was no different.

What good is brain injury awareness if we don’t put it into practice?

April 2017 marked nine years since I acquired my brain injury. I experience symptoms every day and it looks like they are here to stay.  Like many others, I navigated the health care and education systems before brain injury awareness hit the mainstream. My family and I had to research and advocate for every bit of care I received. Even with a CT scan in hand, it was difficult to get doctors to believe, let alone treat my symptoms. This was before Sidney Crosby, NFL lawsuits and head injury protocols; the dark ages of brain injury.

This year, I learned that we are still living in the dark ages. Last month, I was hit in the head with a locker by accident at work. When my symptoms continued to get worse instead of better, I went to the same emergency room I went to nine years ago. It didn’t even cross my mind that I would be treated exactly the same as I was back then, this was the new era of brain injury awareness, right? Wrong.

locker room

There were three of us in the emergency room with concussion symptoms; the doctor barely looked at any of us and sent us on our way.  I returned to my family doctor, who has seen me do this concussion dance with the health care system before, and was sent to another emergency room. The second ER doctor told me what I was experiencing was impossible and seemed shocked when I dared to ask for WSIB forms to be filled out. Despite the blurred vision, noise sensitivity, nausea and fatigue he put a question mark beside the concussion diagnosis on my papers.

June is Brain Injury Awareness month in Canada and it’s a month I’m excited for and take pride in every year. Considering how prevalent concussions / brain injuries are, I think awareness is important for everyone,  but awareness isn’t enough.

Being aware is the first step but it is by no means the only step in preventing and responding to brain injuries. The next step is to put that awareness into action; this action is going to require effort and change by professionals and individuals.

It’s easy to say we are aware and be done for the day but if we don’t put in this effort for people with brain injuries, awareness falls flat and nothing changes. The very people brain injury awareness is supposed to be helping are failed all over again- stuck in the dark ages of brain injury.

The other piece of brain injury awareness that requires action to be effective is prevention. Awareness that leads to policies such as concussion protocols are great (if they are put into action and enforced) but this doesn’t lead to a decrease in people sustaining brain injuries. Brain injury prevention is going to have to come from individual change; with the increase in brain injury awareness, we know that a hit to the head can have lifelong impacts. With that being said, there is no excuse for deliberately hitting someone in the head.

Many brain injuries, especially sports-related brain injuries, are entirely preventable and occur due to individuals decisions. My brain injury stems from a youth athlete’s decision to use physical force instead of skill to win a basketball game. This is similar to Sidney Crosby, during the NHL playoffs he sustained another concussion at the hands of a player on the opposing team. It is very well known that Crosby has a history of concussions and another hit to the head could, at the very least, end his career. With the increase in brain injury awareness, we should be seeing a decrease in these types of injuries simply by individuals changing their behaviour.

Woman playing basketball

My hope for this Brain Injury Awareness Month is to move beyond awareness and towards action.  This includes a decrease in the number of brain injuries and better outcomes for survivors.


Alyson is 25-years-old and acquired her brain injury nine years ago. She graduated from Ryerson University and is a Youth Worker at a homeless shelter. In her spare time, Alyson enjoys writing, rollerblading and reading. Follow her on Twitter @arnr33

 

 

 

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Talking it out: ABI survivor and caregiver stress

BY: MARK KONING

Whether you are a survivor or caregiver to someone with a brain injury, it is sometimes quite difficult to find a confidant that you can feel comfortable talking with when it comes to issues such as the stresses, emotional trauma or everyday hardships that can be inflicted upon one’s life. An individual can run the risk of losing friends, or in some cases, even family members.

two friends talking
photo credit: Two girls talking via photopin (license)

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Eat your GREENS this Brain Injury Awareness Month!

BY: JANET CRAIG

Brain Injury Awareness Month is here – and to celebrate ABI awareness and help us get our green veggies on , our columnist chef Janet Craig has written a super-green salad recipe for us to enjoy.

(Because green is the colour of brain injury awareness!)

asparagus, fiddle head and pea salada
PHOTO: JANET CRAIG

 

Ingredients:

1 bunch of asparagus cleaned & cut into diagonal pieces

2 cups frozen peas, thawed

1 to 2 cups fiddleheads, fresh or frozen

1 bunch of green onions cut into diagonal slices

  • If you want to add protein the a cup of Feta cubed is nice

Dressing:

1 lemon, zested & juiced

1/3-cup vegetable oil

1 tbsp Dijon mustard

salt & pepper to taste

1-tablespoon tarragon vinegar (or use 1 tsp dried tarragon & 1 tbsp white wine vinegar)

Instructions:

  1. Steam asparagus and fiddleheads (if peas are fresh add them) on high 2 minutes. Plunge into bowl of ice to blanch.
  2. Mix all vegetables into glass bowl.
  3. Mix up dressing and pour onto salad.

Chef Janet Craig recipes are simple, healthy, delicious and ABI friendly.  You can find out more about her HERE.

Satisfied Soul Personal Chef Service logo

 

Concussions: the missing piece of the puzzle

BY: KAROLINA URBAN

Its been over two years since my last concussion, which I got while playing hockey. I still have difficulty focusing and remembering small details. I have anxiety and, at times, I feel down.

Although I no longer have a concussion, I don’t feel exactly the same as I did before my brain injury, and that is exactly what has captivated me for over the past several years as a researcher.

hockey skates on ice
photo credit: Week One:Skate via photopin (license)

I continually ask myself, why is it that we can’t fully understand what is going on after a concussion? What is the piece of the puzzle we are missing and how do we get people recovered to a point where they can get back to doing what they love without any consequences? How can we find a way to assess concussions that don’t rely on subjective symptom reporting? More importantly, how do we educate people about brain injuries so they make an informed decision?

These are just some of questions that go through my head.

I think most athletes can say they have lied about aches or pains they have had occur in games or practices. Many have played through broken bones, torn or sprained muscles or joints.

This is part of the team-first culture, where blocking shots, taking a hit to make the play, or playing through an injury is idolized. However, there is a huge difference between injuries to the body and injuries and injuries to the brain.

Injured hockey player
photo credit: Learning the hard way via photopin (license)

The brain is truly extraordinary. It makes it possible for us to do the things we love, such as communicate, learn, share joy and many other things. How we achieve tasks such as skating, or how we understand situations and make decisions involves complex processes with many thousands of connections, millions of neurons firing, tens of millions support cells and all of this is completed at an incredible speed.

And yet sometimes we treat the brain as just another tool in our body, a sacrifice to the team.

When I think of it from another perspective I realize this is the wrong way to look at it!

The brain is what gives us the team-first attitude, what helps us make the correct decisions, and to achieve specific skills. Without it functioning properly we can not be the best we can be. And this is the perspective I know have taken on when I talk to young athletes who have sustained a mild traumatic brain injury. But is this enough to keep them from playing is yet to be seen.

Recently I became an assistant coach for a competitive female hockey team. One of the players was tripped up and hit her head on the end boards. She came off upset, emotional, in pain and clearly could have sustained a concussion. After the ice clean she came back out and wanted to play. Despite all my knowledge about brain injuries, I found it extremely difficult to tell her she needed to sit out the rest of the game.

It is hard to tell an athlete they can’t go back out there and that they need to rests especially when its all they have known their whole life.

16447977753_17dffab6b1
photo credit: Young Athletes via photopin (license)

“Get knocked down, get back up.”

“No pain, no gain.”

“Sacrifice your body to win the game.”

But how can we change this? How can we ensure our trainers, who are responsible for pulling the players out of the game, feel comfortable and believe that it is the right decision? Or can we make the athletes realize they need to be more accountable for their own health and long-term development? Maybe it’s the combination of both?

I can’t say I have the answer, but I can touch on some ways to change this problem.

Mentors

We need mentors, we need people such as Sidney Crosby or Jennifer Botterill speaking about their injuries and what they could have done or should have done to prevent those months of symptoms.

We all know that players are more likely to listen to those who have gone through similar situations, especially when their idols. I can  say I probably wouldn’t have thought about the injury any differently if a doctor, teacher came up and told me not to do something or to be honest about the injury. I mean they told me not to play through a torn tendon in my knee in playoffs, which I completely ignored.

21954264285_eabd80049b-2
photo credit: Jordan Reed via photopin (license)

Education

Despite the media constantly speaking about concussions, there is a lack of knowledge about the injury, symptoms, possible long term impact, what to do when you have a concussion, and what resources are available.

One example of a recent partnership is between the Greater Toronto Hockey League (GTHL) and Holland Bloorview Kids Rehab Hospital Concussion Centre. This partnership is an example of how leagues are hoping to educate their players, parents, referees and coaches.

The brain is one of the most complex systems in our body, yet there is little time allocated to teaching about the brain, diagnosis, and rehabilitation.

Many medical schools only spend about an hour or so covering concussions. Physiotherapists have limited education on the subject, which is concerning as they deal with many athletes.

We need to develop supports and education for all stakeholders – parents, coaches and trainers.

 Karolina Urban is a former University of Toronto and Canadian Women’s Hockey League player. Currently she is a PhD student at the Concussion Centre in Holland Bloorview Kids Rehab Hospital

TTC subway line numbers: what do you think?

At our October community meeting, BIST member Shireen Jeejeebhoy spoke to us about her concerns with the change of TTC subway line names to numbers.

picture of TTC subway signs
PHOTO VIA SHIREEN JEEJEEBHOY 

To summarize, Shireen thinks the subway line renaming, and TTC signage create cognitive and navigational challenges for people living with brain injury, and possibly people living with other kinds of disabilities as well.

Shireen also spoke about her experience at the TTC Public Forum on Accessible Transit this September, which she attended with BIST board member Kerry Foschia.

You can read more about  Shireen’s thoughts on the subway line name changes, and her recap of the TTC meeting on her blog, jeejeebhoy.ca.

Many members shared Shireen’s concerns about this issue, and expressed interest in contacting the TTC about their thoughts on TTC subway number lines and other accessibility issues.

Shireen has provided the following contact information for anyone to wants to share their concerns about the TTC:

TTC officials

Ian Dickson, Manager, Design and Wayfinding  https://twitter.com/ttcdesign or Ian.dickson@ttc.ca

Brad Ross, Head of Communications  https://twitter.com/bradttc or brad.ross@ttc.ca

PHOTO VIA SHIREEN JEEJEEBHOY
PHOTO VIA SHIREEN JEEJEEBHOY

TTC contact info for complaints, suggestions or compliments

For help with questions and concerns 7am-10pm 7 days/week: 416-393-3030; https://twitter.com/TTChelps

The TTC’s online form for complaints, suggestions or compliments

For service updates – When a service update gets tweeted, Shireen re-tweets it with the original line name and adds #accessibility in the post https://twitter.com/TTCnotices

For more information, you can contact Shireen via her Twitter or through her blog.

CHIRS / BIST member Rob Ashe gives UK brain injury organization, Headway Essex, t-shirt a tour of Toronto

BY: AMEE LE

Recently I’ve had a chance to visit England and walked through the doors of Headway Essex. Headway is a large organization which provides brain injury care and support throughout the U.K. I came in contact with Headway East London through discovering their art studio website. I discovered Headway Essex through Dr. Carolyn Lemsky, Clinical Director at CHIRS introduced me to Steve Shears, Trainer and Psychotherapist at Headway Essex. Steve kindly showed me the agency and I had a chance to visit and meet the people at Headway.

Headway Essex – 58b Head Street, Colchester, Essex
Headway Essex – 58b Head Street, Colchester, Essex

During my day visit, I had the opportunity to visit BounceAbility – Special Needs Trampoline Centre. Watching people of all physical abilities getting out of their wheelchairs and working on balance, coordination and stretching. There was also added “stealth benefits” (according to Andy Plowright, Service Manager) such as allowing another person to help you with your balance and relying on another person to support you on a moving surface can build trust and re-establish physical and emotional connections with another person. This supportive and trusting relationship is especially important for a person who have experienced physical trauma that have resulted in the head injury.

BounceAbility – Special Needs Trampoline Centre
BounceAbility – Special Needs Trampoline Centre

Visiting the day program and meeting people at Headway was heartwarming. One person showed me his ankle foot orthosis (AFO) brace that is very well made and seems to be protective of sensitive skin areas in the lower extremities. The brace was red and the owner of this brace is proud to be a Manchester United Fan; in Toronto, our AFO brace are uniformly white.

A Manchester United Ankle Foot Orthosis
A Manchester United Ankle Foot Orthosis

I had a chance to talk about my meditation and art program which hopefully generated some interest in developing meditation and art programming for people at Headway. When it was time to part, I was given several information guides, newsletter and a large Headway t-Shirt. Andy Plowright, Service Manager at Headway Essex was apologetic that the t-shirt would not fit me but generous in his giving spirit and gesture of appreciation.

When I came back to Toronto, I wanted to do something special and carry on the momentum of giving. I was speaking with my colleague Amanda Muise, Behavioural Therapist about my excitement and ideas. I thought it would be cool for CHIRS and Headway to connect and a T-shirt could be a good catalyst.  We talked about who could wear this T-shirt and she suggested Mr. Rob Ashe.

Rob ordering a burger
Rob ordering a burger

When I told Rob about my idea and showed him the picture, newsletter and T-shirt, he was very excited about the idea. He eagerly put the Tshirt safely away in his backpack. When I saw Rob two days later, he had taken pictures of himself around the city with the help of his friend, James.

Welcome to Toronto, Canada!
Welcome to Toronto, Canada!
Rob in front of Tim Hortons – a Canadian favourite for coffee lovers
Rob in front of Tim Hortons – a Canadian favourite for coffee lovers

Rob and I know each other through his participation in Mindful Art Workshop – Winter 2014. During the workshop, Rob learnt to meditate and try to do an art activity that was new to him. He made new friends whom he tries to keep in touch with. Rob was able to complete his art activity quickly and was ready to move on to the next task.

So sitting still and waiting and listening was new to him. He is very articulate and easily shares his stories, successes and difficulties but this ability to articulate could overshadow others who had a harder time sharing their voices. As the workshop progressed, Rob learnt to sit back and listen. To reflect quietly, then use his articulate voice to deeply appreciate other people’s talents and gifts. He talked more about others and less about his stories and came to appreciate this new way of being. Below is a sample of his art work. He called this piece – Anointed.

Anointed by Rob Ashe – art work from Mindful Art Workshop 2014
Anointed by Rob Ashe – art work from Mindful Art Workshop 2014
Rob Ashe infront of CHIRS
Rob in front of CHIRS – Community Head Injury Resource Services of Toronto

After taking a series of photographs, Rob and I sat down and I helped to upload the photographs from his phone. During the summer months in Toronto, there are several festivals and celebrations.

Below are the places that Rob visited with his friends from CHIRS:

Rob Ashe plays hockey at CHIRS
Rob at Hockey Night – a CHIRS program for persons of all abilities to have fun playing floor hockey in teams
Rob Ashe takes the subway in Toronto
Rob takes the subway Toronto
Rob with a street performer at Buskerfest in front of Yonge-Dundas Square
Rob with a street performer at BuskerFest in front of Yonge-Dundas Square
Rob poses with a street performer at BuskerFest
Rob with a street performer at BuskerFest
Rob in front of the HMV store on Yonge Street
Rob in front one of the HMV store on Yonge Street – one of his favourite places
Rob with Buskerfest volunteers
Rob with BuskerFest volunteers
Rob promoting epilepsy awareness at Yonge-Dundas square
Rob in front of Yonge-Dundas Square holding purple balloons to support epilepsy awareness – a cause that is close to his heart (BuskerFest is a fundraising for Epilepsy Toronto)
Rob and David Smith, mentor's coordinator at CHIRS in front of Pape subway station
Rob and David Slonim (mentors’ coordinator at CHIRS) in front of Pape Subway Station
Rob and his friend Jen sit in front of of Jen's childhood school
Rob and his friend Jen, sitting outside her childhood school, a private school for girls
Rob at Spadina Subway Station
Rob at Spadina Subway Station in Toronto. “This shows the humanistic side to us, ” Rob said. .”He was playing guitar and I waited for him to finish and I gave him some money and asked if he would like to take a picture together and he said, ‘sure’”
Rob in front the Old Mill in Toronto
Rob in front of the Old Mills. This is an important place as it is where he received his 25 years watch for working with the City of Toronto.
Rob in front of David's Tea.
Rob in front of David’s Tea.
Rob takes a picture of a UK flag for his wife who is from the UK
Rob taking a picture for his wife who is originally from the United Kingdom because she loves Union Jacks or anything to do with England

When I arrived at work on Monday morning, I found a treasure inside my mailbox. When Rob and I were sharing stories and photographs, he had tears in his eyes. Rob loves to connect with people and especially people of all abilities. He told me, “You couldn’t have asked for a more perfect person to do this task.”

Rob understands that people with a brain injury may not have the same physical abilities as they did prior to the injury. Through his travels he wanted to share with people the places and events that he has access to and hopefully through these images, all persons may have access to these places and events.

Rob's message to the author of this post
Rob’s message
Rob's message to the author of this post
Rob’s message

Hi!! My name is Rob Ashe and I am a client at CHIRS (Community Head Injury Resource Services) in Toronto. When I was asked to have pictures wearing your group shirt, I took on the task because I feel strongly that groups wherever and whoever need to make contact and then we have a better understanding of each other and That is Great!!!!

I want to thank you for this opportunity and let you know that I believe that having a brain injury should not hold us back as we have much to say, much to experience and above all, much TO GIVE

Rob with his wife of 19-years, Amanda
Rob and his wife Amanda. “We’ve been married 19 years and she helps me a lot.”

I can’t begin to tell you how much this has touched my heart. Sometimes the work that we do can feel like work and there are good days and challenging days.  Some days are full of beautiful moments and some days are problem solving days. My motivation for doing this work is to help others, whoever comes to my door. Knowing that we can touch each other’s lives and share in meaningful moments is a good reminder for me of the goodness inside each person that I’ve met. I am sure many therapists, helpers, teachers out there will share in my experience that the work that we do is relational and it takes two to form a relationship. The support and encouragement I give to the clients that have come into my life are reciprocated in so many ways that surprises me when I need it the most. It is these moments that helps me to remember what is important to me. To help others knowing that we all have an important part in each others lives.

NOTE TO HEADWAY ESSEX FROM BIST:

We’re sending you a t-shirt from our areyouaware.ca campaign – and can’t wait to see where it goes!

BIST areyouaware t-shirt and envelop to Headway


Amee Le is a Occupational Therapist (OT), meditation teacher, and art therapist practicing in the city of Toronto. She developed Mindful Art Workshop based on helping people with a brain injury through periods of high stress and anxiety.

You can find Amee on LinkedIn, Vimeo and YouTube.

This article was orginally posted on Amee’s blog:  Mindful Art Workshop