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Brain injury

‘I’m sorry for handling the steering wheel with buttered fingers’

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As he continues to come to terms with the loss of his ‘ex life’ and learns to celebrate the 21st birthday of his new self, The Brain Damaged Baron reflects on the comfort blanket of support from those close to him, while struggling with the loss of vanishing friends

 

Let’s get straight down to business.  The salient truth is that one day, the life I once knew came to an end. Yep, gone, cheerio, toodle pip.

It is an ex-life. It has ceased to be, I trotted off this mortal coil in order to push up some buttercups. Is it buttercups? I forget. 

It was so very difficult, sometimes impossible, to comprehend that all I knew had gone. That sentiment only increased over the years and there have been 21 of them. Twenty-one long years.  My new life has matured and is now old enough…

To vote – when it remembers to.

To drive – it can’t, partial blindness caused by the brain injury would make driving an absolute lottery.  That and the complete lack of spatial awareness. After all, I can’t walk down the street without colliding with lampposts. I wouldn’t be safe in a bubble wrapped bumper car. I’m not sure the roads of the UK are ready for me just yet.

To drink alcohol – it can’t, epilepsy denied that pleasure. Due to medication, I feel half-drunk most of the time anyway. Without alcohol, I have the memory of a goldfish with Alzheimer’s disease. I hardly need the odd libation to wipe what recall I do have. 

To have sex – if I can stay awake long enough. I’ll say no more. It was all I could do to prevent myself typing ‘stay up’ long enough. Ooh-er, Mrs!

And it’s now old enough to know what the hell happened to me.  And is still happening right up to this very day.

That’s the nature of a bang on the bonce; confusion.  

Massive disorder in my mind, incomprehension shadows me like the gloomiest raincloud preparing to unleash a deluge of perplexity. I know it’s there, it’s always there. The monkey on my back, the albatross overhead, the angry weasel with a chip on its shoulder.   learnt to live with it. 

That and the ability to invent nonsensical idioms. It’s a gift.

However.

Back in the day, long before I became 21 again, it began.  The curtains were closed, slammed shut. Well, to be fair, they were curtains, not so much ‘slammed’, but more ‘flopped’.  They needed opening, I had to let the day begin.  And commence it did, as the flaccid curtains were swept aside and the hard graft started.

While I was hurting, while I was struggling, while I was learning, there were other people around. There still are, every day. It’s just a question of tenses really.  

Watching, witnessing, feeling my pain. Either on the side-lines or directly involved, family, friends, all observing the effects. Mostly it was no spectator sport, it was grim viewing, if I am honest. And still they remained, standing by with a collective arm outstretched.  

Twenty-one years later and it’s still there. A comfort blanket, a safety net cushioning the unavoidable falls.

It’s a whole new world out there, and that world has a habit of biting back. Sometimes it is just a nip, although occasionally, it’s like a bite from a hungry shark. And those nibbles come thick and fast. Each bite eroded away my former self and ate away, no pun intended, at the life that had sadly departed.  All the while…

Watching, witnessing, feeling my pain…

There are so many bites that they all seem to merge into one. Remembering can be exhausting beyond belief. I had never thought it possible to get so drained, so shattered simply from attempting to recall what the day is.  

Another aspect of my life that my previous self had taken for granted. There was never any reason not to. I was a 25-year-old man and it didn’t seem a lot to ask to remember where I kept my keys. It was never a conundrum.  

However, after the injury, I could then forget where I kept my pants and socks, let alone my keys. Not when I was wearing them, obviously; my pants and socks that is, not my keys.  

And with the exertion of something as basic to a human being as ‘thought’ came the inevitable headaches. The first to strike shook me to my very core. It smarted, just a tad.  They continue to this day, bless ‘em. 

Almost a year after the old brain took its battering and continued to fight the good fight, epilepsy was thrust into my life. The unwanted gate crasher causing havoc with every appearance. A lightning bolt from the deepest blue. Body spasms, unconsciousness, confusion, memory lapses, post seizure headaches that make the usual head pains seem like old friends.  Well, it keeps me on my toes.  And still…

Watching, witnessing, still feeling my pain. The outstretched arm remained, absorbing the anger and feeling my frustration. 

Fatigue and apathy soon entered the fray. More undesirable visitors cluttering an already overloaded brain. They pushed aside my old friends ‘eagerness’ and ‘concentration’ as ‘alertness’ looked on with all the subtlety of a slightly annoyed bricklayer wielding a sledgehammer. Oh, he had anger issues too.

The passage of time was a cruel mistress. Particularly when my addled brain was struggling to establish some form of normality… whatever that may be.  

My life in its entirety had altered beyond recognition. Epilepsy could now strike without warning at any given moment, throwing the day into chaos. Fatigue that plagued almost every aspect of my life began to throw up barricades.  

It was hard to live with what I had become.  To live in the present and not rely on the past.

And still they watched, witnessed, felt my pain. And for some, it was too much, too difficult, too much like hard work. 

Relationships ended and friendships broke down. Ultimately, people vanished. They had their reasons, I was never told what they were, but I’m sure they had them. Occasionally I had the courtesy of an invented tissue of lies that possibly salved their own conscience, but only served to batter my own into submission.

Relationships with everyone in my life, friends, new acquaintances, and even the odd member of my family, seem to be based on the flip of a coin. 

Should a ‘Head’ land on terra firma and whatever my brain throws into the mix, they’ll hang around. Should a ‘Tail’ drop gracefully to the ground and they’ll turn that tail and run for the hills.  And that’s how it’s been since the day I landed on my cranium with one hell of a thud.  But wait a moment here…

I like to think I’m not a stupid man, I pride myself on it in fact. I’m 46-years-old now, time is marching on relentlessly like a runaway train with only one destination.  

I’m married to my best friend, a couple of children have their place in my life and I’m still learning more about my own limitations and abilities. Only one thing has remained constant throughout the journey that became my second shot at this rollercoaster we call ‘Life’. That damn scar on my brain still throws its weight around whenever it fancies a bit of a giggle. And thus…

I still forget things with frightening regularity.

I can’t control my emotions like I should.

Background noise irritates me to the point of exasperation.

I still invent idioms like a ferocious aardvark with a knuckleduster.

I may have a seizure with varying degrees of severity at any given moment.

Fatigue is a pest that simply won’t leave me be. And sleep is my panacea.

I can’t socialise like I once could.

I can’t drink, I can’t drive.

I am no longer the ‘me’ I once was. And do you know what? I no longer care. I wouldn’t change one God damned thing.

I throw out these statements with gay abandon, almost on a whim.  The fact remains that while I was coming to terms with the throwaway facts, those people close to me WERE watching, they WERE witnessing and they WERE feeling my pain.  

For instance, let’s start at the very beginning. I was in a coma in hospital. Essentially, I was asleep, just for a smidgeon longer than usual. I always was a lazy sod. While I slept, my family and friends sat at my hospital bedside wondering whether I would live or die. I had it easy, I really did. I still do.

The first epileptic seizure and every single one since sees my good self disappear into another world for however long, while whoever is there can only watch, wait, and worry.  Again, I repeat, I have it easy.

I have a wife I adore. The lady who came along and turned out to be the missing piece in my jigsaw. Who knew? The rock to my roll, the milk on my cornflakes. Much like my friends and family who were there long before that missing piece arrived, she tolerates the moods and the headaches.  She lives with the forgetfulness, the now thankfully muted anger, the annoyances, etc. They’re all part of just another day.

Twenty years of watching and worry. Good grief, I’m so sorry for putting you all through this journey, none of you asked to be passengers, you really didn’t. You still don’t, you never so much as complain. I certainly didn’t want to be the driver and I’m sorry for handling the steering wheel with buttered fingers…

Brain injury

New cycle helmet test discovers true level of protection for cyclists

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The effectiveness of bike helmets in protecting against brain injuries caused by collisions at speed has been tested for the first time. 

New helmet technologies have emerged in recent years to mitigate the instances and severity of traumatic brain injury (TBI) in collisions from cycling, but the way this is traditionally tested leaves room for doubt in their findings. 

The majority of real-world cycling-based TBIs are caused by rotational forces on the brain, which are generated by the head hitting the ground at an oblique angle, mostly seen when cyclists fall or collide while moving. 

However, current methods test whether heads are protected from falls at right-angles, which happen mostly when bikes are stationary, and do not account for the rotational forces at play when cyclists fall to the ground at speed.

Now, a new Imperial College London paper has demonstrated a new simulation-enabled helmet testing technique that tests how well helmets protect heads from rotational forces.

Testing 27 different helmets in a purpose-built rig at Research Institutes of Sweden, the project found that newer technologies reduced whole-brain strain compared with older helmets. 

However, they also found that the effectiveness of newer helmets depended on their technology and location of impact – some helmets which were designed specifically to reduce rotational forces didn’t appear to accomplish their aims.

Its findings could be significant in ensuring future safety innovations in cycling helmets, the research team said. 

“The amount of people cycling since the COVID-19 pandemic began has doubled on weekdays and trebled on weekends in parts of the UK,” says lead author Fady Abayazid, of Imperial’s Dyson School of Design Engineering.

“To keep themselves safe, it’s important cyclists know the best way to protect their heads should they have a fall or collision.

“Cyclists falling from motion will most often hit the ground at a non-right-angle. These angles produce rotational forces that subject the brain to twisting and shearing forces – factors contributing to severe TBIs, which can be life-altering. 

“However, current testing standards for bike helmets don’t account for this issue, so we designed a new analysis method to address this gap by combining experimental oblique impacts with a highly detailed computational model of the human brain.”

Senior author Dr Mazdak Ghajari, also of Imperial’s Dyson School of Design Engineering, adds: “With cycling’s popularity soaring, we are seeing more requests from the public and cycling communities for a thorough review of new helmet technologies to inform their purchases. 

“However, this is hard to do without testing that accounts for rotational forces.

“Our research could help to address this gap, inform customers, improve safety, and reduce the frequency and severity of TBIs from cycling.”

The authors are now looking into testing standards for motorbike and industrial helmets and the Dyson School of Design Engineering has also just built its own rig to carry out future experimental helmet impact tests.

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Brain injury

Calvert Reconnections strengthens senior team ahead of opening

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A groundbreaking neurorehabilitation centre is helping to plan for its future even before its opening through strengthening its management team. 

Calvert Reconnections is set to open on June 21 and is set to deliver new possibilities in brain injury rehabilitation through its UK-first residential programme which combines traditional clinical therapies with physical outdoor activities. 

The centre, based on the outskirts of Keswick in the Lake District, is now making new additions to its senior team as is prepares for its long-awaited opening, which has previously been delayed due to COVID-19. 

Claire Appleton has become head of service at Calvert Reconnections with Lorna Mulholland appointed as registered manager. 

Claire, an occupational therapist, has 23 years’ experience working in the NHS and has held various community roles including in acquired brain injury, long-term neurological conditions, neurological splinting and stroke rehab.  

Five years ago, Claire moved into a management post in the NHS leading the Eden Community Rehab Team, developing strategic specialist leadership and management skills, and gaining valuable experience delivering high quality health services.

Lorna has 12 years’ specialist experience within the social care sector, principally in acquired brain injury, learning disabilities, mental health and autism. 

She has an extensive knowledge base in delivering care within a residential and supported living setting with experience in complex challenging behaviour.

Sean Day, centre director at Calvert Reconnections, says: “As part of our senior management team, Claire and Lorna have a key role to play in the delivery of our service.  

“Everyone at Calvert Reconnections take great pride in what we do and the difference we can make to people’s lives.”

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Brain injury

UFC adopts concussion protocols for MMA fighters

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An official concussion protocol has been created for mixed martial arts (MMA) fighters competing in the UFC, in a first for the sport which builds further on global efforts to safeguard sportspeople from the effects of head injury. 

The UFC Performance Institute has published its protocol, aimed at both fighters and coaches, as part of a 484-page study based on data collected between 2017 and 2019.  

Hailed as the most comprehensive MMA study ever undertaken, it details the UFC’s five-step rules around returning to the sport following concussion or TBI. 

“The goal is we really want to support the ongoing development and performance behaviours and activities in the MMA gyms in the combat community globally,” says Duncan French, the UFC’s vice president of performance. 

“We are slowly aggregating our own insights and our information here in the Performance Institute, and we want to share that. We don’t want the PI to become an ivory tower where the information is only retained for a discrete 600 roster of fighters.”

Further investigation into any different needs for female fighters will be undertaken, the vice president adds. 

“Now, we need to do more work to understand how we can potentially support the ladies if they do have a concussion,” says Duncan. 

“Because that method, that approach to return to play following a concussion in females, might need to be different.”

In the new protocol, the details its return-to-sport approach as being similar to that of the NFL, beginning with up to two days of rest, followed by two stages of no-contact workouts. 

The UFC wants fighters to use its concussion assessment tool, the SCAT5, to monitor progress, and as they improve, fighters can go from no-contact workouts to moderate contact, although still with minimal risk of head contact. 

The final stage includes a return to sparring, and the UFC PI recommends starting with one session each week with no more than three rounds of five minutes, gradually adding more over a period of four weeks until they reach two full sparring sessions of five rounds per session. 

Returning to full contact will need medical clearance, the protocol states.

“For brain injuries like concussion, even if you are feeling symptom-free, a fighter should go through all stages of a return-to-sport protocol to ensure a full brain recovery,” the report says. 

“Further, resuming activity too quickly, especially in contact sports like MMA, not only increases the risk of subsequent musculoskeletal injuries and longer recovery times but also further concussions (e.g. second-impact syndrome) which can lead to chronic neurological conditions, permanent disability and death.”

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