MINDMATTERS October, November, December 2012 UPCOMING MEETINGS AND EVENTS All meetings are held on the fourth Wednesday of each month from 6:00 – 8:00 p.m. at Easter Seal Rehabilitation Center 2203 Babcock Road, San Antonio, TX 78229 Unless otherwise noted “Improving the Quality of Life for Survivors of Brain Injury and their Families” Inside this issue: October 24 6:00 PM to 8:00 PM Easter Seal Rehabilitation Center Its Halloween Party Time! Join us for an evening of fall festival fun. Activities will include a costume contest and, everyone's favorite, the Cake Walk! A light meal of sandwiches and corndogs will be served. Family and friends are welcome. So conjure up a costume, bring a cake for the cake walk, and join us for a "ghostly" good time. Book Review 2 Stress & Depression 3 We want you to know... 4-5 An App for That! Brain HQ Brain Training 6 Veteran Care Givers November 28 6:00PM to 8:00 PM Easter Seal Rehabilitation Center 5 7 Organize Paper Clutter! 8-9 Family Members: Dr. Jonhenry "Jon" Grizzle, Clinical Psychologist from Brooke Army Medical Center will be facilitating a discussion for family members. Budget Holidays with Kids 9-10 Survivors: “Eat a Turkey, Don't Be One: a Survivor's Guide to Surviving the Holidays” December 2 2:00PM to 5:00 PM Easter Seal Rehabilitation Center Christmas Potluck Dinner It's time again for a visit from that jolly old fellow, St. Nicholas. Come out and join us for a potluck dinner and photos with Santa and Mrs. Claus. AHIA will be providing the ham and turkey, while guests can participate by bringing their favorite side dish or dessert. December 14 6:00PM to 7:30 PM Luby’s Diner Survivors’ Christmas Dinner Call Evelyn Tattini at to make your reservations today! See our website for more details: www.alamoheadinjury.org. Please note that the meetings and programs of the Alamo Head Injury Association (AHIA) are open to members, non members, guests, visitors and anyone desiring to provide or receive information and/or support. In our monthly meetings, we strive to provide speakers and programs that are informative and will benefit our members and survivors in some way. However, if you have come to our meeting seeking personal support or guidance and would prefer to speak with someone one on one, please let us know. There will always be someone available to talk with you. MINDMATTERS Looking for a Good Book to Read? WOULD YOU LIKE TO SHARE YOUR STORY? If any survivor or family member would like to share their own personal story about the life changing experience of living with brain injury, please send it to the AHIA at : 2203 Babcock, San Antonio, TX or email it to: Lost and Found: A survivor's guide for reconstructing life after brain injury by Barbara Webster Coping with life after brain injury is not easy. This practical and user friendly workbook and guide for survivors and their families is packed with everyday strategies, tips and accommodations to address the cognitive challenges of daily life. Based on the author's experience as a survivor and as a facilitator of hundreds of support groups, she presents a philosophy and approach for overcoming challenges, envisioning goals, and continuing their healing process. It is a collection of “brain injury survivor wisdom” that users will be able to apply each day, no matter where they are in their journey of recovery. The workbook comes with a CD to print all forms and worksheet tools. etattini@alamoheadyinjury.c om We would love to print it in a future newsletter, if space allows! A Special Thank You! AHIA wishes to send out a special thanks to Michelle Reyes for her generous donation to Alamo Head Injury Association. Michelle’s son, Matthew Shelton, sustained a severe brain injury while riding a motorcycle. Unfortunately, Matthew was riding without a helmet. Subsequently, Michelle formed Wear A Helmet for You Mom in her son’s name. The organization, founded just last Spring, has the following mission: “To decrease the incidence of traumatic brain injury [TBI] by getting people to wear their helmets on bicycles, skates, skateboards, & motorcycles ~ every single time. If not for yourself... then do it for your mom. or your dad. your wife. your child. Do it for someone you love because if you don't... their life changes forever too.” Wear a Helmet for Your Mom can be found on Facebook at www.facebook.com/ForYourMom. Michelle has organized and held two fundraising events, donating proceeds to AHIA for the purpose of purchasing bicycle helmets for children. Page 2 October, November, December Stress, Depression Reduce Brain Volume Thanks to Genetic ‘Switch’ By Rick Nauert PhD Senior News Editor, reprinted from PsychCentral.com Scientists have known that stress and depression can cause the brain to retract or lose volume, a condition associated with both emotional and cognitive impairment. Now, a new study discovers why this occurs. Yale scientists have found that the deactivation of a single genetic switch can instigate a cascading loss of brain connections in humans and depression in animal models. Researchers say the genetic switch, known as a transcription factor, represses the expression of several genes that are necessary for the formation of synaptic connections between brain cells. The loss of connections, in turn, can contribute to loss of brain mass in the prefrontal cortex, say the scientists. “We wanted to test the idea that stress causes a loss of brain synapses in humans,” said senior author Ronald Duman, Ph.D. “We show that circuits normally involved in emotion, as well as cognition, are disrupted when this single transcription factor is activated.” In the study, the research team analyzed tissue of depressed and non-depressed patients donated from a brain bank and looked for different patterns of gene activation. The brains of patients who had been depressed exhibited lower levels of expression in genes that are required for the function and structure of brain synapses. Lead author and postdoctoral researcher H.J. Kang, Ph.D., discovered that at least five of these genes could be regulated by a single transcription factor called GATA1. When the transcription factor was activated in animal models, rodents exhibited depressive-like symptoms, suggesting GATA1 plays a role not only in the loss of connections between neurons but also in symptoms of depression. This finding of genetic variations in GATA1 may help researchers identify people at high risk for major depression or sensitivity to stress. “We hope that by enhancing synaptic connections, either with novel medications or behavioral therapy, we can develop more effective antidepressant therapies,” Duman said. Psych Central depression screening http://psychcentral.com/depquiz.htm Page 3 Lost and Found: What Brain Injury Survivors Want You to Know Barbara J. Webster, Lash & Associates (Condensed exerpt from an article on BrainLine.org) I need a lot more rest than I used to. I’m not being lazy. I get physical fatigue as well as a “brain fatigue.” It is very difficult and tiring for my brain to think, process, and organize. Fatigue makes it even harder to think. My stamina fluctuates, even though I may look good or “all better” on the outside. Cognition is a fragile function for a brain injury survivor. Some days are better than others. Pushing too hard usually leads to setbacks, sometimes to illness. “Please don’t be condescending or talk to me like I am a child.” Brain injury rehabilitation takes a very long time; it is usually measured in years. It continues long after formal rehabilitation has ended. Please resist expecting me to be who I was, even though I look better. I am not being difficult if I resist social situations. Crowds, confusion, and loud sounds quickly overload my brain, it doesn’t filter sounds as well as it used to. If there is more than one person talking, I may seem uninterested in the conversation. That is because I have trouble following all the different “lines” of discussion. It is exhausting to keep trying to piece it all together. I’m not dumb or rude; my brain is getting overloaded! Page 4 Try to notice the circumstances if a behavior problem arises. “Behavior problems” are often an indication of my inability to cope with a specific situation and not a mental health issue. I may be frustrated, in pain, overtired or there may be too much confusion or noise for my brain to filter. Patience is the best gift you can give me. It allows me to work deliberately and at my own pace, allowing me to rebuild pathways in my brain. Rushing and multi-tasking inhibit cognition. Please listen to me with patience. Try not to interrupt. Allow me to find my words and follow my thoughts. It will help me rebuild my language skills. Please have patience with my memory. Know that not remembering does not mean that I don’t care. Please don’t be condescending or talk to me like I am a child. I’m not stupid, my brain is injured and it doesn’t work as well as it used to. Try to think of me as if my brain were in a cast. If I seem “rigid,” needing to do tasks the same way all the time; it is because I am retraining my brain. It’s like learning main roads before you can learn the shortcuts. Repeating tasks in the same sequence is a rehabilitation strategy. If I seem “stuck,” my brain may be stuck in the processing of information. Coaching me, suggesting other options or asking what you can do to help may help me figure it out. Taking over and doing it for me will not be constructive and it will make me feel inadequate. (It may also be an indication that I need to take a break.) You may not be able to help me do something if helping requires me to frequently interrupt what I am doing to give you directives. I work best on my own, one step at a time and at my own pace. October, November, December If I repeat actions, like checking to see if the doors are locked or the stove is turned off, it may seem like I have OCD — obsessive-compulsive disorder — but I may not. It may be that I am having trouble registering what I am doing in my brain. Repetitions enhance memory. (It can also be a cue that I need to stop and rest.) If I seem sensitive, it could be emotional lability as a result of the injury or it may be a reflection of the extraordinary effort it takes to do things now. Tasks that used to feel “automatic” and take minimal effort, now take much longer, require the implementation of numerous strategies and are huge accomplishments for me. We need cheerleaders now, as we start over, just like children do when they are growing up. Please help me and encourage all efforts. Please don’t be negative or critical. I am doing the best I can. Don’t confuse Hope for Denial. We are learning more and more about the amazing brain and there are remarkable stories about healing in the news every day. No one can know for certain what our potential is. We need Hope to be able to employ the many, many coping mechanisms, accommodations and strategies needed to navigate our new lives. Everything single thing in our lives is extraordinarily difficult for us now. It would be easy to give up without Hope. Created with the assistance of the "Amazing" Brain Injury Survivor Support Group of Framingham, MA. New Members Please Welcome: [Your Name Here] Don’t wait—become a member of AHIA TODAY! Donations AHIA would like to thank Christi Moorman for her generous and thoughtful donation. There’s an App for That! Stressed? Balance your life and experience a relaxed meditative state to relieve your daily stresses and tensions. Pranayama's simple and intuitive guide to deep breathing features a progressive course based on the principles of yoga, to help you find balance and stress relief. Combining the power of breath with technology, Pranayama is an easy way of improving your health and reducing stress, using music and animated visuals to guide you to slower deeper breathing. Even practicing slow breathing for only 15 minutes a day can reduce stress. Practicing slow breathing is not as easy as it seems. Pranayama guides you with the following features: - It does counting for you so that you can focus on awareness and technique. - Music cues that use distinct tones for each phase of breathing. -A structured course that gradually reduces your breathing rate as you progress through the sessions. -Customizable sessions Thanks also go out to Michelle Reyes for her generous donation to Alamo Head Injury Association. This is the second time that Michelle has chosen to honor the Association with donations. Page 5 MINDMATTERS What’s it Like to Use Brain HQ? 50 years ago, going to the gym wasn't something the average person did. Now, it seems, everyone has a gym membership, or finds another way to exercise regularly. That’s because a revolution took place in the 1980s and 1990s: we all learned how important physical exercise was for our overall health and well-being. Brain fitness is the next step in that revolution. Just as you can exercise your abs, delts, and quads, you can exercise your memory, attention, and more. As with physical exercise, brain exercise can help you improve your performance, feel your best, and even live longer. When it comes to brain fitness training, BrainHQ is best in class. Built by a team of top neuroscientists, with exercises proven in dozens of published studies to make real and lasting improvements in brain function, BrainHQ is your personal brain gym. To learn more about how it works, what makes it right for you, and how other people have benefitted from its exercises, visit the brainHQ website (www.positscience.com/brainHQ) explore the topics below. Memory Exercises Memories are made up of what you sense. When memory fails, it’s not because you forgot how to remember—it’s because your brain isn’t processing information very clearly. Our Memory exercises sharpen the brain’s ability to record what you see and hear so that you can create a crystal-clear memory that’s easy to recall. Examples include: Memory Grid To-Do List Training Syllable Stacks Brain Speed Exercises When it comes to brain speed, every millisecond counts. How quickly your brain can process events around you determines how effectively you can react to and remember those events. Find out how our Brain Speed exercises can have you operating at top speed. Click an exercise below to learn about it. Eye for Detail Fine Tuning Peripheral Challenge Sound Sweeps Visual Sweeps Attention Exercises Does it drive you crazy when you can’t remember where you put your keys? You probably weren’t paying much attention when you set them down. Each of our Attention exercises helps retrain the brain to focus its attention, so you feel more aware and less distracted. Click an exercise below to learn about it. Divided Attention Double Decision Mixed Signals Target Tracker Page 6 People Skills Exercises It can be hard to remember names and faces, to participate in conversations in loud places, to read people’s emotions effectively. But all these types of skills are real benefits when dealing with others—whether you’re at a party or meeting new clients. Try our People Skills exercises to increase your chances of success. Face to Face In the Know Recognition October, November, December A Message from: Despite the enormous effort to provide articles, webinars, PSA's, and more on the Invisible Injuries of PTSD and TBI, it seems that there are still too many families (and medical staff) that feel many of the symptoms are "in your head". There are two very good TBI blog posts by the Defense Centers of Excellence for Traumatic Brain Injury that may resonate with you and your warrior or veteran. The first addresses Neuroendocrine Dysfunction in TBI (http://www.dcoe.health.mil/blog/article.aspx? id=1&postid=402) and the second, older one discusses what the families may experience and how to best identify the problem and support your warrior (http://www.dcoe.health.mil/blog/article.aspx?id=1&postid=359). Undiagnosed TBI can lead to devastating outcomes for relationships. Many families talk about the "lack of verbal filters", the short-term memory loss, mood swings, paranoia, and the agitation that TBI may present. And, if you or your veteran is unfortunate enough to not receive care for your TBI because the doctors say "you look fine; just adapt", you may need to persist and document the symptoms to obtain care. Be alert to support those fighting to make sense of their lives when they suddenly can't keep it together, but don't understand what their list of symptoms may mean. The military is taking notice and working diligently to identify and treat TBI beginning in-country. A new blast exposure technical tool is in use for measuring blast exposure and potential injuries. Protocols exist for first, second, and subsequent concussive events. But, the families must be aware to bring specific behaviors to the attention of the warrior or veteran, as symptoms can manifest long after the last event. Consider the increased suicide risk without diagnosis and treatment of even mild TBI in this third article: (http:// www.traumaticbraininjury.net/diagnosis-of-traumatic-brain-injury-key-to-preventing-military-suicide/). Traumatic Brain Injury is serious, but there are options. Continually learn about new research and treatment alternatives -and do not give up the quest for diagnosis and management. Linda Kreter and the VeteranCaregiver Team Linda B. Kreter Chief Executive Officer WiseHealth, Inc. www.VeteranCaregiver.com Page 7 MINDMATTERS Get Organized : Tackle the Paper Clutter— A system that helps [not just] ADHD adults get organized and put an end Originally published on ADDitudeMag.com . by Judith Kolberg Like many of my clients with attention deficit hyperactivity disorder (ADHD), Sheila can't seem to get organizedand keep up with her clutter at home and at work. OK, that's putting it mildly; her apartment is one giant in-box, filled with letters, articles, bills, and receipts. "Here's the thing," says Sheila. "If I clip an interesting magazine article - and they're all interesting to me - or get a tempting credit card solicitation, it's here to stay. I can't act on it right away, so I put it aside, so that I'll have it when I figure out what to do with it." Barbara Hemphill, an ADDer and the author of Taming the Paper Tiger, sums up the problem this way: "The stacks represent unmade decisions. It's difficult to focus long enough to make a decision about each piece of paper. And if a document needs to be filed, an ADDer can think of 17 different ways to file it. Then there's the fact that managing paper is boring. Our minds wander off task." What's the solution to your paper problem? Stop treating each piece of paper in your home as something lifeless. Instead, see each as an action to take. Let's say you're digging out from under stacks of paper. Sort everything into three categories. "Toss" papers get discarded. "File" papers get filed. Papers that require more nuanced action go into your "Action" pile; I'm talking about anything that necessitates a phone call or an e-mail, that must be given to someone else, that requires faxing, that requires a signature, that pertains to an ongoing project, and so on. Sort quickly, and don't agonize over your decisions. Ask a friend or family member to be your "body double," working alongside you and mirroring your actions. Or, like Sheila, you can hire a professional organizer. Page 8 Recently, I spent four hours helping Sheila sort her papers. She had no trouble figuring out which papers were Toss, File, or Action. The only challenge was figuring out what to do with the papers that wound up in the Action pile. Well, as I told Sheila, I have a system for that, too. It's called PaperAction-Next Encounter, or PANEC. Tackling your "Action" pile The idea of PANEC is to take each piece of paper in the Action pile and write on it the very next action that is needed. Not the final action, mind you, or all of the actions to take. Just the next action, described with attention-getting words and phrases. Move each annotated Action document to a place you think will prompt you to actually complete the action. Like most of my clients, Sheila got PANEC right away. On a page ripped from a catalog, she wrote "Order by June 1." On a credit card offer, she wrote "Apply or Die." She put both papers on her desk, because that's where she takes care of financial activities. Grocery coupons? She taped them to the October, November, December refrigerator. She wrote "Give to Bobby." on an article about hybrid cars, and then stuck it in her son's sneaker (the only place he's sure to see it). And she taped an application she needs to complete to her bathroom mirror, so she'll see it each morning until it's done. Sheila takes about 20 Action papers at a time and distributes them around the house to their Next Encounter locations. She says that makes the process less monotonous, and helps her dissipate pent-up energy. You may prefer to do things a bit differently. That's OK, as long as you stick with the basic idea. PANEC works for ADDers because it reduces the uncertainty about what to do with each paper. Everything is either Toss, File, or Action. Just make sure not to cycle papers endlessly. If you move a document more than twice, your call-to-action phrase probably isn't specific enough - or maybe you need more information to decide what action to take. Depending on how many papers you have, digging out might take one morning or several days. Once your paper-handling system is in place, you can keep paper clutter to a minimum. What sweet relief! Sort papers as they come in: Toss it—have a trashcan or shredder nearby. File it—place it in a folder for future filing. Better yet, have your files nearby for quick and easy filing. Does it need ACTION? Fighting Pile-Ups Once you've discarded the papers you don't need, and filed the papers you may need in the future, you're left with a stack of papers that calls for some sort of action. How do you make sure these documents don't languish for months, mocking your inaction? Take each document in the stack and write on it the next action to take. Not the final outcome of taking action, and not all the actions required to reach that outcome. Just the next action. Then, place each Action paper in the place that is most likely to get you to follow through. Pay thi s by Friday! Ask Carolyn for help on this app p Lo o k u s fo r addres this PANEC 1. What is the very NEXT action required? Not the final action but the next—do you need to read it? Gather some info? Pay it, if it’s a bill? 2. Write the next action 3. Place it in it’s Next Encounter Location—a place you will be certain to see it and take action. Page 9 MINDMATTERS Happy Holidays with Kids— On a Budget! Enjoying the upcoming holiday season with your family doesn’t have to break the bank! Just check out the following items that San Antonio and the Internet have to offer! The first Sunday of each month, the San Antonio Museum of Art hosts a FREE event for children. Sunday, November 5th, 1:00—5:00 Celebrate Dia de los Muertos with live music, dance performances, poetry readings, and much more. Children and familes are invited to make sugar skulls, calavera masks, nichos and papel picado in this special family day honoring the long tradition of Dia de los Muertos. ZOO BOO Tuesday, October 30 and Wednesday, October 31, 2012 6:30 p.m. to 9:30 p.m. Join the Zoo for some “spook”tacularly scary fun at the 26th Annual Halloween event, ZOO BOO at YOUR San Antonio Zoo. Zoo Boo is an exciting, safe, and non-scary Halloween event for families with children 12 years of age or younger held on the grounds of the San Antonio Zoo. Guests are encouraged to wear non-scary costumes. Activities include trick-or-treating, face painting, entertainment, and games. Children can participate in the costume contest. . Admission Tickets purchased October 30-31, 2012 Members - $6.00 Non-members - $7.00 Page 10 Celebrating Día de los Muertos, SAY Sí’s 6th Annual Muertitos Fest will feature local artists, folk art exhibits, altars to honor the deceased, family workshops, food booths, artisan stalls, and live music and dance performances on November 1-3, 2012. Muertitos Fest First Friday | November 2, 2012, 6-10 pm FREE and open to the public. The festivities continue with Día de los Muertos First Friday celebration. Enjoy the exhibits, altars, live musical and dance performances, festive food and artisan booths. Muertitos Fest Family Day | Saturday, November 3, 2012, 12-3 pm FREE and open to the public. All events take place at: SAY Si Central 1518 South Alamo San Antonio, TX 78204 For more information please call 210.212.8666 “Join SACM as we countdown to the New Year at the kid-friendly hour of 12:00, noon. Get ready to rock to the beat of our funky DJ, toast with sparkling juice, and watch the ball drop as you flick your flutter-fetti stick, sending colored confetti everywhere. You won't want to miss this unique year end event!” October, November, December Everyone knows that Lowe's is a great place to go to for home improvement, building supplies, etc. But did you know they also offer a FREE kids craft every other Saturday at 10:00. Check out your local Lowe’s, but October features fun crafts such as this “Ghoul Bus” and the “Creepy Keeper”. Magik Theater JUNIE B. JONES IN JINGLE BELLS, Windcrest Lights up the Night BATMAN SMELLS (Nov 14 - Dec 22) Tuesday – Friday 9:45am & 11:30am, Friday at 7pm & Saturdays at 2pm Junie B. returns to San Antonio and The Magik Theatre in this hilarious holiday tale! Between taking part in the holiday pageant and picking a Secret Santa gift for her big rival, Tattletale May, there’s never a dull moment in the life of the world's funniest first grader. With Santa watching her like a hawk, will Junie B. make the right choice and give May something other A tradition since the 1950s, San Antonio residents and visitors enjoy viewing the dazzling Christmas lights in the City of Windcrest annual Light Up. Thousands drive through the Windcrest streets in awe of the amazing Christmas light displays. A contest is held by the city to select the most beautifully decorated homes in various categories prior to their opening ceremony in mid-December. To find all the best locations, you can print a map from the city's official website. It's not just the homes in Windcrest that participate; churches, schools and businesses also get involved. The streets of Windcrest get very crowded with spectators as Christmas approaches, so visit on a weeknight for less traffic. Windcrest is adjacent to the Interstate 35/Loop 410 interchange, just 15 minutes from downtown San Antonio. than a lump of coal? Junie B. will steal your heart—and brighten your spirits— with her last-minute choice. General Admission is $10 per person WWW.CRAFT FUN! These website offer up a whole host of fun family activities, crafts, printable coloring pages, and more. Every Saturday from 11:00 to 3:00, Lakeshore learning offers a FREE, detailed craft activity for children. Usually, the Saturday before a holiday, they will provide a holidaythemed craft as well as other activities, such as face painting. www.enchantedlearning.com www.familyfun.com www.dltk-kids.com – crafts for kids Page 11 October, November, December 2012 AHIA BOARD OF DIRECTORS Ann Cameron, President Lupe Armendariz, Vice-President Kay Dabney, Recording Secretary All board meetings will be held Diana Najara, Treasurer at: Dr. Douglas Cooper, Board Member at-large RIOSA Robin Hinson & Sam Velazquez: 9119 Cinnamon Hill, Survivor Representatives San Antonio, TX 78229 Brain Injury Association of America: Federal Policy Update Improving Access to Mental Health Services for Veterans, Service Members, and Military Families On August 31, 2012, the President released an Executive Order to improve access to mental health services for veterans, service members and their families. BIAA applauds the President for taking action on this very important issue so that all returning service members, veterans and their families receive the access to mental health services they deserve. In Section 5 of the Executive Order, the President requests the establishment of a National Research Action Plan to better understand the underlying mechanisms of Post Traumatic Stress Disorder (PTSD), other mental health conditions, and Traumatic Brain Injury (TBI). The National Research Action Plan will research prevention, diagnosis, and treatment of PTSD, TBI and other mental health conditions. In order to improve the coordination of agency research into these conditions and reduce the number of affected men and women through better prevention, diagnosis, and treatment, the Departments of Defense, Veterans Affairs, Health and Human Services, and Education, in coordination with the Office of Science and Technology Policy, shall establish the National Research Action Plan within 8 months of the date of this order. This order shall be implemented consistent with applicable law and subject to the availability of appropriations. Page 12