May Community Meeting Recap: Chair Yoga with Kristina Borho

BY: JULIA RENAUD

During this sunny time of year, the days are long, the weather is warmer, and the flowers are wonderfully fragrant and in bloom. The true question is: do you take the time to smell the roses? Fortunately for us, Occupational Therapist, Yoga Tnstructor and the owner of Empowering Mind & BodyKristina Borho, brought her mindfulness and encouragement to lead May’s Community Meeting about chair yoga.

Kristina Borho

A whole lot of positive energy filled the room at this month’s meeting and Kristina’s passion and compassion kept the group intrigued and asking for more yoga therapy tips and techniques. She encouraged all of us to live in the moment and to engage with body, mind, and breath during the session, as well as in our daily lives.

Intention Setting

I was lucky enough to be one of the many participants at this very special community meeting and I am happy to share my experience with you!

One of the first things that Kristina told each person to do was to set an intention for the session. Intention setting, as I learned, is a very powerful way to gain perspective on how you’re feeling, and to recognize where you may need to focus your energy in order to feel better. Like Kristina, I decided that my intention for the following hour would be to find patience – something that I am slowly but surely learning – and definitely something that does not seem to come easily to me; allow me to digress.

I am known as a goal-setter and I have the ruthless determination to persevere to achieve any goal I set my sights upon, regardless of how much work it will take. Since my most recent concussion three years ago, I have had to face the fact that, while goal setting can be very helpful for some things, recovering from post-concussion syndrome (PCS) is not really one of them. PCS, like many brain injuries, is an unpredictable road that has its ups and downs and twists and turns much like a roller coaster. It also has the capacity to turn even the most realistic of goals on their head; hence my need to force goal-setting to take the back seat (as difficult as that is), and instead to persevere at being patient with the path that I’m on!

Chair Yoga Exercises

I believe I can speak for the group when I say we all need more yoga, chair or otherwise, in our lives! For this reason, I would like to share some of my favourite chair yoga poses that Kristina coached us through. I have given each of them a name so they’re easier to remember.

As you go through the poses, keep in mind our word of the night, elongated. What I mean by this is, for each pose, sit nice and tall, like there’s a string attached to the top of your head, pulling your head toward the sky and keeping your spine nice and long. Also, try to remember to think about the intention that you set earlier!

Down to Earth Neck Stretch:

  1. Sit tall in a chair with your feet flat on the ground, and your arms dangling at your side
  2. Breathe in while turning your head to look over your right shoulder
  3. Breathe out while tilting your head down to look at the floor while keeping your head turned to the right
  4. Switch sides

Shoulder Rolls:

  1. Sit tall in a chair, place your fingertips lightly on your shoulders
  2. Rotate your shoulders in backward circles
  3. Rotate your shoulders in forward circles
  4. Try to coordinate your breath if you can – breathe in when your shoulders rise, and out when they fall (this part can be tricky!)

Side-to-Side Slide:

  1. Sitting upright in your chair, place your right hand on your right hip, breath in
  2. As you breath out, side-bend your body to the left and toward the floor
  3. Inhale as you come back to centre
  4. Switch sides

 

Meditation

Kristina concluded the session with a brief body-scan meditation, thoughtfully conducted to take the mind away from all of the stressors of daily life, and instead to bring focus to various parts of the body, one by one. Doing a body scan is a great way to connect with how your body is feeling. I find it especially helpful in understanding the severity of my PCS symptoms and use it to check in with how my brain and body are handling the tasks that I am asking of them.

Generally, a simple way to compose a body-scan is to either go from head to toe, or the other way around. This helps to relax the mind while ensuring that you aren’t skipping over any important body parts that may require your attention. Your meditation can be as long or as short as you want, the key is to remember to remain relaxed and non-judgmental. If your mind drifts away to a thought unrelated to the task at hand, simply acknowledge that your attention has drifted, and regain focus on your body scan. At first this may seem really difficult, but try not to get discouraged!

With time and practice (in my case, a whole lot), you will begin to notice that your ability to keep your attention on the meditation will improve.

Collective Energy

I was able to feel how Kristina’s yoga therapy was able to change the energy in the room from buzzing and a bit chaotic, to happy and relaxed. By the end of the meeting, the group shared a true sense of togetherness, and isn’t that so important in brain injury recovery!

If you or someone you know is living with a brain injury, remember that these things can take time to heal, and you are never in this alone. So, take the days as they come and on your next walk or roll, don’t forget to take in that fresh air, and take the time to smell the roses!

Chair yoga - a group of 4 people sitting in a circle doing chair yoga, their arms stretched up

Next Community Meeting: Wednesday, June 27, 6 – 8 p.m.

TOPIC: Face Mapping with Occupational Therapist Amee Le

Everyone is welcome!


Julia Renaud is a very talkative ABI survivor with a passion for learning new things, trying new activities, and meeting new people – all of which have led her to writing this column. When not chatting someone’s ear off, Julia can be found outside walking her dog while occasionally talking to him, of course!   

 

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I’ve had 4 brain injuries in 10 years – and I’ve met so many doctors who still don’t understand how to treat ABI

BY: ALYSON ROGERS

June is here and that means Brain Injury Awareness Month is here once again. Last year, I wrote a post about how awareness isn’t enough and we need to see action, in particular in terms of how concussions are responded to and prevented.

I wrote this piece from a very interesting standpoint: I had my first brain injury nine years prior and had experienced a concussion again in April of 2017. What I learned was, not a thing has changed in terms of what happens when you go to an emergency room with a head injury.

Even after nine years of increased awareness, it could have been 2008 all over again. My  diagnosis was slow, multiple doctors were unfamiliar with symptoms and none took them seriously.  My analysis of our healthcare system failure ended at the emergency room doors when I exited and returned to work two weeks later.

Brain injury action

It is said that once you have had one head injury, you are likely to be susceptible to another, and surprise, I had another concussion in September 2017.  I bent over to get something I had dropped on the floor at work and hit my head on the edge of a desk.  Depth perception issues were apart of my original injury so this isn’t too shocking. Based on my last experience, I skipped the whole emergency room circus, I knew the drill at this point and wasn’t showing any signs of a serious head injury such as vomiting or loss of consciousness.

I thought I had recovered from my head injury until I started experiencing, by far, the oddest and unfamiliar brain injury symptoms I’ve ever had. Between the rapid blinking eyes, stiff arms and shaking, it looked like I was having seizures yet all of my tests for epilepsy were normal. Fortunately, I found a great neurologist who has been successfully treating these symptoms through medication but it was an uphill battle to get to him and to treatment.

Last year, all I wanted was for the medical profession to put brain injury awareness into action. After my latest brain injury, I’ve seen them in action and it isn’t pretty. This wasn’t the action I was hoping for and isn’t what I need as a person with a brain injury.

In the past six months, I have had doctors tell me the type of brain injury I had ten years ago was impossible with no proof otherwise, attempt to diagnose me with mental health issues and not consider my pretty significant brain injury as a factor related to my current health issues.

I want the medical profession to take a pause and really take the time to learn about traumatic brain injuries and educate themselves beyond the symptoms we commonly associate with these

I’ve sat through four hour long appointments where I was taken through every detail of all four head injuries I’ve had and questioned about every decision I have ever made. It felt like I was on trial as a victim of a crime being cross examined by a defence attorney.  If I couldn’t remember something, I was questioned why that was. Maybe it’s the brain injury? I hear those could cause memory issues but just a guess.

Last year, all I wanted was action. This year, I want a pause. I want the medical profession to take a pause and really take the time to learn about traumatic brain injuries and educate themselves beyond the symptoms we commonly associate with these injuries. Doctors need to have a more comprehensive understanding of symptoms that go further than what they read in a concussion pamphlet if they are going to treat them.

When I acquired my brain injuries, I had to open Google and crack open some books to get the information I needed. People with brain injuries don’t have time for the medical profession to take a pause so better crack open that textbook.

PHOTO: Annie Spratt via LifeofPix.com


Alyson is 26-years-old and acquired her first brain injury ten 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 or on The Mighty 

The Ultimate Guide to board games for brain training

Woman plays Jenga game

BY: ALISON

Without lights and sounds associating with gaming apps or consoles, board games are less stimulating than other activities and require very little physical exertion. They were among very few things that I was able to do during the acute phase of my injury.

Board games are great for brain training and reconditioning. In fact, I suggested board games as a mentally challenging activity in my previous article, Having a brain injury increases your chances of dementia: here are activities that can help and are great for encouraging and facilitating social interaction.

After my injury, I wanted to avoid my friends, because conversations were exhausting and difficult to follow. But playing board games with friends was perfect. I got the social connection that I needed without having to engage in deep conversation. Also, the pressure and focus was off of me, since everyone’s attention was directed towards the game.

Not to mention, board games are super fun (heck, they’ve withstood the test of time), provide hours of distraction, and can be played solo. I didn’t need assistance or company for entertainment.

The selection of board games is endless, so there’s always something new to try.

Scrabble board
Photo: Pixabay via  Pexels

 

How to challenge yourself using board games:

The following guidelines will teach you how to train your brain by gradually increasing the difficulty of your board games. The steps should be tackled one at a time, moving forward only when you are confident with the previous step. Be patient with yourself, as you may need weeks or months before advancing. Regular practice and repetition are the keys to success here.

Step 1:

In the beginning, focus only on learning and following the rules of the game. Don’t worry about speed or trying to win. Simply learn the basics of how to play. Play as many times as needed to become familiar with it. This will improve your learning and memory skills.

Step 2:

If you’re playing a game by yourself, then play with the goal of improving your result, speed, or efficiency. For example, depending on the game, you could try to collect more points, finish the game more quickly, or finish the game using fewer moves. Work through one objective at a time.

If you’re playing a game with others, figure out one strategy that will help you win the game. However, the focus should be on discovering and practicing the strategy, not on winning. This promotes problem-solving skills. If you’re stuck, ask the person you’re playing with to teach you their approach. Once you’re familiar with the first one, see if there are other strategies that could help you win the game. Determine which one(s) are the most effective. Eventually, the goal is to use a combination of strategies at the same time. This is great practice for multi-tasking skills. You might even start winning more games.

Step 3:

Now that you’ve figured out how you like to play the game, it’s time to pay attention to how your opponents are playing. See if they make decisions differently from you, figure out what their strategies are, and try to predict their next moves. Compare their approach to your own, see which one is more effective, and learn from them. Furthermore, think of new tactics that will prevent your opponents from winning. This will exercise your analytical and critical-thinking skills.

Finally, try to improve your chances of winning. You will likely need to change your plan multiple times throughout a game in order to adapt to new scenarios/problems and to circumvent your opponents. Once you become really good at the game, start these steps over again with a different game.

board games that can be adapted for single players

Board games that can be adapted for single players:

While it’s better to play board games with other people, one-player games allow you to practice at any time. Some of the board games listed were not originally designed for single players, but you will find solo variant instructions online. The following suggestions vary widely in difficulty and cost.

Word Games

Scattergories

Bananagrams

Scrabble

Boggle

Honourable mention: Code Names – Although this game cannot be played solo, it is, in my opinion, the best word-focused, brain training game. It allows you to practice communication, word associations, and different thought processes. The cards could even be used separately for reading and comprehension.

Pattern Games

  1. Set – This simple card game is really good for unique pattern-recognition, concentration, and different lines of thinking.
  2. Bingo –  even more fun if there are small prizes to be won.
  3. Puzzles
  4. Carcassonne – No language skills are required to play this tile-based puzzle / strategic game.
  5. Enigma – Includes fragment puzzles and 3-D puzzles among other challenges.

Honourable mention: Sudoku – This is not a board game, but it’s great for figuring out number patterns. The difficulty ranges from easy to very hard. Also, you can find free printable sudokus online.

 Fine Motor Skills Games

  1. Jenga – Try Giant Jenga if fine motor skills are an issue.)
  2. Perfection – There’s the original version with 25 pieces and a more affordable version with only 9 pieces. This game also has a pattern-matching/puzzle component to it.
Woman plays Jenga game
Photo: Pixabay 

Honourable mention: Building blocks and sets (e.g wooden blocks, jumbo cardboard blocks, Mega Bloks, Lego, K’Nex, etc.) – These aren’t board games, but they’re great for stimulating creativity.

Memory Games

  1. There are many different versions of matching card games that were designed to practice memory skills. See here for more information, you could also play this type of memory game using a regular deck of cards.

General Knowledge Games

  1. Cardline – Variations include: Globetrotter, Animals, Dinosaurs
  2. Timeline  – Variations include: Diversity, Historical Event, Inventions, Music and Cinema, Science and Discoveries

Problem Solving or Brain Teaser Games

  1. Mindtrap  – A game with many riddles, brain teasers, and picture puzzles.

  2. Enigma – This includes math-based and various puzzle-based challenges.

  3. Robot Turtles – This is a kids game that can be used to practice logical thinking, planning ahead, and improving efficiency. It was originally designed to introduce programming fundamentals to kids.)

Strategy Games

  1. Single-player card games, such as Solitaire (played with a regular deck of cards, Instructions on how to play can be found here) or Friday – a survival / battling card game.
  2. Catan Dice Game – a settlement-building game was designed for one or more players.
  3. Pandemic – The object of this game is to treat and eradicate diseases before they spread out of control.
  4. Imperial Settlers – This empire-building game was designed for 1 or more players.
  5. Blokus – This tile-placement game does not require language skills.

Adventure Games

  1. Mage Knight – This is the most complex and expensive board game I’ve listed in this article. It is a strategic game that is based in an adventure and story. The game includes instructions for solo play, but there are many pieces and rules, so I suggest watching YouTube videos, HERE and HERE that help explain them.

My Favourite Games Stores:

  1. Walmart

Walmart doesn’t have a large selection of unique games, but every now and then they have great sales on classic games. I purchased the following games for less than $20 each while they were on sale: Scattegories, Bingo, puzzles, Jenga, Perfection, Sudoku books, and decks of playing cards.

  1. 401 Games

This is my favourite board games store. They have an extensive selection, competitive prices, and incredibly knowledgeable staff. They have a storefront at 518 Yonge Street, Toronto, and an online store as well.

Although their store is wheelchair accessible, their games room for events is not. If you want to avoid a crowd, go before 3 pm or shop online. I suggest ordering your games online and then picking them up at the store to save on shipping. If transportation is an issue, shipping is a flat rate of $8.95 per order. Shipping is free for orders of $150 or more.


Mind Yourself with Alison’ is a collection of self-help tips, research, and personal experiences dedicated to helping people thrive after brain injury (or other trauma). Check out Alison’s other BIST Blog articles Women and Brain Injury: What you need to know and How to be a Good Friend to a Survivor.

Is the ketogenic diet the future for TBI treatment?

BY: MELINDA EVANS

Ask any dietitian, and they’ll probably tell you that their clients are asking them about the ketogenic diet more than any other recent ‘fad’ diet. Popular headlines have proclaimed it the miracle diet to shed weight, boost energy, reverse diabetes and send cancer into remission.

But does this diet live up to its hype? What could it possibly have to do with recovery from traumatic brain injury (TBI)? And more importantly, is it safe?

The Ketogenic Diet

The ketogenic diet started out as anything but a fad. It was developed almost 100 years ago to treat children with epilepsy that didn’t respond to anti-epileptic medications. By definition, it is a very low carbohydrate (less than five per cent of total energy per day), high fat (about 80 per cent of energy) and moderate protein (15 – 20 per cent) diet.

This is vastly different from Health Canada’s recommended macronutrient distribution, which is 45 – 65 per cent carbohydrate, 10 – 35 per cent protein and 20 – 35 per cent fat. Since glucose (a carbohydrate) is our body’s preferred source of fuel, this high fat / low carbohydrate diet essentially tricks the body into believing it is in a state of starvation. The liver begins to convert fat into ketones (hence the name), and the brain’s cells are forced to adapt. The result, for someone with intractable epilepsy, can be a 50 to 90 per cent decline in seizures.

Once medical practitioners observed the effectiveness of ketosis for the treatment of epileptic seizures, they started to wonder whether it might help other neurological injuries and neurodegenerative disorders, including hypoxia, ischemic stroke, ALS, Alzheimer’s disease, Parkinson’s disease, and of course, Traumatic Brain Injury.

Benefits of Ketosis for Traumatic Brain Injury

For a multitude of ethical and practical reasons, it is next to impossible to perform randomized clinical trials on humans with TBIs, so the research we have that looks at the role of the ketogenic diet has been done in animals. The findings are promising though, and suggest that following injury, when the brain’s need for energy is high but its ability to metabolize glucose is impaired, ketones might provide an alternative and efficient source of energy.

Following trauma, brain cells are at increased risk of oxidation, cell death and DNA damage, and the presence of ketones and absence of glucose may reduce oxygen available for oxidation and guard cells against free radicals and DNA damage, while increasing cerebral blood flow.

Knowledge Gaps

This is an exciting prospect, but we still need a lot of answers before we can incorporate it into practice. We don’t know which type or severity of brain injury might respond well to ketosis, or whether it is best achieved through fasting, the ketogenic diet or even intravenous provision of ketones. It is unclear whether ketosis is helpful only initially after injury, or if it will support brain recovery if used for a longer period of time. It’s possible that a modified and less restrictive form of the ketogenic diet would work just as well as the standard diet, and some studies suggest that it might be even more effective when supplemented with certain nutrients, including medium chain triglycerides and branched chain amino acids.

Challenges of the Ketogenic Diet

There are several challenges with the ketogenic diet, the first being compliance. Since it is extremely restrictive, it is difficult for most people to stick to the diet long-term. It excludes entire food groups (grains, fruits and many vegetables), increasing the risk of nutrient deficiencies including sodium, potassium, chloride, vitamin D, calcium, magnesium, selenium and zinc. Among other issues, these deficiencies can impair bone healing and increase the risk of osteopenia and bone fractures. For people with pre-existing kidney disease or renal failure associated with trauma, the high protein intake that usually accompanies a high fat diet may not be appropriate. And of course, with a high fat diet there is concern about elevated cholesterol levels. Studies evaluating the use of the ketogenic diet in children found elevated triglyceride, and total, HDL and LDL cholesterol levels at 6 months and 10 years, making this diet risky for people predisposed to coronary artery disease. Long-term use has also been associated with growth retardation in children, low-grade acidosis, constipation, dehydration,  vomiting and nausea.

A grilled cheese sandwich made with cauliflower
Photo of a Cauliflower Crusted Grill Cheese Sandwich via KirbieCravings.com

The Future of Ketosis in Brain Recovery

So, is the ketogenic diet the future for TBI treatment? Will it minimize brain injury and help to rehabilitate cognitive function, memory and recall? Maybe. We don’t have enough information yet to make it standard practice, and it certainly should never be implemented without careful monitoring from a physician and dietitian.

More research in humans is needed before we can give a final verdict, but what we know so far about ketosis and the brain is promising!


Melinda Edmonds is a Registered Dietitian with Aimee Hayes & Associates. She is a registered member in good standing with the College of Dietitians of Ontario and an active member of Dietitians of Canada. The focus of her practice is on the application of evidence-based nutrition therapies to optimize clients’ health, nutritional status and well-being in order to augment their quality of life and rehabilitation outcomes.

Aimee Hayes and Associates provides nutrition rehabilitation services to individuals with acquired and traumatic brain, spinal cord, and orthopedic injuries. Our diverse and dynamic team of Registered Dietitians works collaboratively with clients, families, caregivers and interdisciplinary rehabilitation teams to optimize nutrition in order to promote our clients’ wellness and recovery.

Super Simple, Decadent Salted Caramel Sauce

BY: CHEF JANET CRAIG

This simple, decadent sauce for either fresh fruit or ice cream is the current trend, ‘salt with sweet.’ Enjoy this weekend, or, heck, anytime!

2017-08-07 14.24.33

4 cups white sugar

¾ cup boiling water

3 sticks salted butter (1.5 cups)

¾ cup whipping cream

4 tsp salt – this is where you can use specialty salts such as Fleur de Sel (find out how to fake speciality salts, HERE)

  1. In a heavy saucepan, place sugar on medium heat and watch it caramelize. This is a lengthy process and you can’t leave it. Stir with a wooden spoon – not a metal one – as this will get too hot to hold.
  2. When the mixture is as golden as you wish (it turns brown quickly) remove from heat.
  3. Carefully pour in boiling water, stirring constantly.
  4. Add butter and whipping cream and keep stirring until texture becomes creamy.
  5. Add salt to taste.

This recipe can be halved. I store it in sterilized jars in the fridge for two weeks or freeze it for a gift.

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

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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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