Before Seeing ANY Doctor…

January 27, 2009

Before Seeing ANY Doctor…

For the majority of individuals I’ve had contact with, it is very difficult to find professionals who really are knowledgeable and helpful in treating people with subtle brain injury. As a start, check with other brain injury survivors. Get to know people in your local brain injury support group who have a similar kind of injury as yours. For example, the doctor of your friend who was in a coma for 2 weeks, may not be as effective or knowledgeable with you if you were diagnosed with “Mild Traumatic Brain Injury” or “Post Concussive Syndrome.”

Despite the CDC’s (Center for Disease Control) attempts to educate doctors regarding brain injury, too many of them hold onto out-dated information. They believe one must hit his head or lose consciousness or have abnormal CT scans or MRIs in order to have a brain injury, even though the CDC clearly states in their booklet, Heads Up: Facts for Physicians About Mild Traumatic Brain Injury (MTBI):

“MTBI is caused by a blow or jolt to the head that disrupts the function of the brain. This disturbance of brain function is typically associated with normal structural neuroimaging findings (i.e., CT scan, MRI). MTBI results in a constellation of physical, cognitive, emotional and/or sleep-related symptoms and may or may not involve a loss of consciousness (LOC).”

Many doctors wrongly assume that individuals with Mild Traumatic Brain Injury recover within 2 years and that their symptoms could not possible result in long-term disability. While this is true for the majority, a small percent (about 15%) are not so lucky. As the CDC points out:

“MTBI symptoms may appear mild, but can lead to significant, life-long impairment affecting an individual’s ability to function physically, cognitively, and psychologically.”

Many doctors and psychologists are either unaware of the symptoms of Mild Traumatic Brain Injury, or too quickly conclude that patients are merely suffering from depression, conversion or somatoform disorder, or are simply malingering. Symptoms leading them to these conclusions are the very same symptoms of MTBI: nausea, vomiting, headaches, dizziness, numbness, fatigue, confusion, difficulty concentrating, sadness, irritability, and sleeping difficulties.

While you can’t administer a test of the doctor or psychologist which assesses their understanding and knowledge of brain injury, there is a simple step you can take. Check with the medical or psychology licensing board to at least make sure they don’t have any disciplinary actions taken against them. Even if it is a state agency referring you to a doctor or psychologist for testing.

Before you see any doctor or professional, I hope you will learn from my mistake by taking a few minutes to check the person’s professional license. To read about my experience, go to: Dr. Twittworth, Neuropsychologist.  Below are directions for how you can conduct a search on a physician’s or psychologist’s license.

Conducting a License Search

1. Google the following depending on the kind of professional:

Physician licensure, state or Psychologist licensure, state

2. Look for a selection to click on that says something like “License verification.”

3. You may be asked to choose what kind of licensing you want to verify.

4. At this point, you may be asked to type in the professional’s first and last name, and/or city and state.

5. The search will show the individual’s name and may indicate whether there has ever been any disciplinary action taken against the person. If this is not readily available, you may have to click on the person’s name for more information to appear.

6. Look for options titled something like “Administrative Actions” or “View Documents.”

7. If you can’t figure out how to do this through the web, or if your state doesn’t offer this feature, call the appropriate licensing board and ask how you, the consumer, can access this information as a first step in protecting yourself.

Sources

Heads Up: Brain Injury in Your Practice – A Tool Kit for Physicians. 14 June 2007. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 13 Oct 2008. <http://www.cdc.gov/ncipc/tbi/physicians_tool_kit.htm>

© Angela Cramer, 2008-2009

Clipart is the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com

Others Who Call Themselves “Doctors”-Chiropractors

January 19, 2009

Others Who Call Themselves “Doctors”-Chiropractors

A few weeks ago, I found out that part of Barack Obama’s plan to ‘fix’ our health care system is to allow chiropractors to have a larger role by serving as “Primary Care Physicians.” While I am an enthusiastic and hopeful supporter of Obama, this plan concerns me.

At one point in my life, I was concerned about “traditional medicine” which seemed to rely too much on pushing pills to solve all problems….at the cost of ignoring dangerous side effects and the long-term consequences, as well as ignoring the patient as a “whole” and not just individual systems independent of one another. In reaction to this, I gravitated to a primary care physician who utilized both traditional medicine and “complementary medicine” (used together with standard medical care). I was also interested in “alternative medicine” (used in place of standard medical care).

To me, complementary and alternative medicine for some reason seemed to carry a connotation of being a “safer” approach to healing. After the car accident when I was basically given a “clean bill of health” by an Urgent Care doctor and told that I only had soft tissue damage in his opinion, it made perfect sense to me to set up an appointment with a chiropractor since my primary care physician was on vacation. I figured my body was knocked out of alignment which must be the reason for the pain and other problems I was experiencing, and a chiropractor was the perfect answer to the problem. And I believed this was a “safe” alternative to taking pain medication. I am now living proof of the dangers of chiropractic care. (To read more, go to The Chiropractor)

I believe there are major and multiple problems with our medical system. Trying to “fix” our system with chiropractors serving as “primary care physicians,” however, is a mistake. Although they are called “doctor,” they are NOT medical doctors. And they have the potential to seriously harm people with some of their practices. I learned this the hard way. I hope I can spare someone else from a similar experience.

© Angela Cramer, 2008-2009

Clipart is the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com

And They Call Themselves Doctors!

January 16, 2009

And They Call Themselves Doctors!

A friend of mine from my brain injury support group called me earlier this week. She has been looking for a primary care doctor who “gets it about BI” on some level. She had a brain aneurysm burst in her brain and had a stroke during her surgery back in 2005.

Another group member recommended an internist who was married to a physiatrist/physical medicine and rehab doctor whom she had seen. Her rationale was that the physiatrist she had seen really seemed to understand brain injury, so it was likely that her husband would as well.

So my friend bundled up her medical records and gave them to this internist. She said he started out by saying, “So you think you have a brain injury?”

“Yes,” she replied.

He then asked her a couple of questions: “What’s my name?” “What year is it?” When she answered the questions correctly, he said to her, “Well, you’re memory is quite good and you’re doing very well considering what you went through!”

As I hear her share this, I think to myself: Is he serious? These are the questions he’s using to base his assessment of her cognitive functioning? Where did he get his medical degree…..the Columbia School of Idiots? And then I remember that most of my experiences with doctors has been much the same. As one friend reminds me, if doctors “don’t get it,” how can you possibly think that jury members will understand the devastation behind the invisible mask of brain injury disability? I like to refer to this phenomenon as a massive outbreak of “Cranial-Rectal Inversion” of epic proportions.

And doctors wonder why people turn to the internet to learn more about various conditions. Do they even bother to keep up on current medical knowledge or open a book after getting through medical school? While I understand how difficult it is to keep up with an ever-changing vast field of knowledge such as medicine, I resent the arrogant, demeaning attitude and treatment of many doctors. They are so full of their own importance and status that they cannot admit that they don’t know something. Instead of choosing the morally correct behavior of admitting they are not as knowledgeable and either need to research it more or refer the patient to another doctor, they puff out their chests, wrinkle their noses as if they are smelling a fresh pile of dog do-do, and announce in their all-knowing voice, “There is nothing wrong,” or my favorite, “It’s all psychological.”

Do you have stories of “stupid comments” made by doctors or other supposedly “intelligent” professionals? I would love to hear them.

© Angela Cramer, 2008-2009

Clipart is the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com

Living in Fear vs. Living in Faith and Love

January 15, 2009

Living in Fear vs. Living in Faith and Love

During my “down times” when I’ve overextended myself and am forced to rest to recover from the resulting migraines and fatigue, I spend time reflecting on this TBI journey. I think back to last year at this time. The lawsuit was over. Although the jury awarded me a settlement, it was so inadequate that there was nothing left for me after my lawyer’s percentage and his trial costs were deducted. The medical bills I owed were in excess of $130,000. My disability check was not enough to cover my monthly expenses.

I was overcome by my fears. When I first received the news, I checked myself into a psych ward because I knew what I would have done if I were left alone to deal with this. That only served to make sure I wasn’t alone and gave me a break from my life for a short period of time. Other than that, it was not a very helpful experience. The psychiatrist who was assigned to my case would come in every day for a week, shake his head solemnly and say, “You’re in a difficult situation. You’re disabled through no fault of your own, you owe a lot of money….I have no idea what you’re going to do,” and then would walk out. I could not attend their “group therapy” sessions since the stimulation from the noise and people was too overwhelming, and they did not bother to provide any accommodations for my disability.

Looking back, I acted as if all the worst case scenarios I could think of were reality and would likely happen in the next month or so. I would have to file bankruptcy. I would lose my home. I would have to move into some depressing apartment and lose my fur/feather family members. My car would be taken away and I would lose more of what little independence I had. I would lose the closeness of my neighbors, the familiarity of my home and community. I would be isolated even more and forgotten. Considering the losses I was already grieving with regards to my brain injury, I did not believe there was anything to look forward to.

Every time I received a call from a collection agency or some other stressor came along, I felt more hopeless. I slowly began to realize that I was still in my home, and none of my dreaded fears had become reality. I was spending so much time worrying about what my life would become, that I was not enjoying the time that I had.

Even though I knew that worrying was useless, wasted energy, I couldn’t stop worrying until I changed my attitude towards my situation. I began thinking about the Law of Attraction – the belief that people attract the very things they think about. And the lesson of the white buffalo in Native American teachings – as long as one remembers to give proper thanks, his needs will be provided. I thought about other difficult times in my life and how things always seemed to work out for the best. Why would this time be any different? Had I finally run out of luck? Or were things progressing as they should? Could what looked like a bad situation actually be some kind of blessing in disguise?

I began to appreciate and love my home, pets and neighbors even more. I would pretend that I had just moved there and revel in what a wonderful neighborhood I lived in where I could easily walk my dogs while riding around in my power chair. I marveled at how nice and friendly the people were in my neighborhood and told them so. Any positive thing about my life that I had taken for granted or worried about losing, I began to treat it as if I had never had it and feel the joy one would experience as if it happened for the first time.

Instead of waiting to see if the thing I was worried about was going to happen, I put more energy into writing for my website. In my post-TBI injury years, I spent a lot of time developing accommodations to help me function better. Knowing how difficult my own experience has been, I decided to share these things with others so that their journey would be a little less difficult, a little less lonely. Many people have contacted me, telling me how much the information has helped. I’m not sure they realize what a gift they gave me – the gift of telling me that I still have something important to contribute, something that matters.

Two days after I began writing this blog, I was watching the Ellen DeGeneres Show. She was interviewing Dr. Wayne Dyer who recently produced a movie called Ambition to Meaning, which viewers could download and watch for free that day. I took advantage of the offer and was glad I did.

Watching the movie was one of those “synchronistic moments” that gives me chills and makes me pay attention. Why? Because Dyer touched upon the exact themes I was reflecting upon and writing about: living in love vs. fear, and that our needs are taken care of when we live our lives through meaning and purpose.

In part of this movie, Dyer talks about when we were conceived, we came from the Divine and for 9 months in the womb, our every need was taken care of. He poses: Why should this be different during other phases of our life? This doesn’t mean that we sit back and do nothing. Opportunities open to us as we find ways to live our lives through meaning and purpose. (See Ambition to Meaning: Finding Your Life’s Purpose)

One of Oprah’s guests this week, Elizabeth Lesser, expanded on this theme. She explained that difficulties and challenges are part of human life; the spiritual part of our experience affirms that we will be okay, no matter what human difficulties we experience. She goes on to say that when we open to our brokenness, we are able to blossom into our lives. The important thing to remember is not to fight life, but rather relax into it. (See her book, Broken Open: How Difficult Times Can Help Us Grow).

The difficulty I experience is the part about having faith that everything will work out okay. During these times, I’m reminded of an amazing experience I had with a swan feather which has been an important lesson for me in all areas of my life. (See The Feather) Many times we pray for help or something we desire. Often, we get what we asked for, but it doesn’t come “packaged” the way in which we wanted it. Or we go through what seems to be very negative experiences, thinking that our prayers have not been answered. However, it may be these very experiences which lead us to the precise thing for which we asked.

A couple of years before the program I worked for was eliminated and before I suffered my brain injury from a car accident, I had been praying for work where I could touch more people’s lives than I was currently affecting. I worked in a program which served approximately 75 families with young children per school year. I was an excellent parent educator and I was also good at developing workshops and presenting at conferences to other professionals.

My vision was that I would find a job which would allow me to do more of the latter. My vision did NOT include a brain injury, disability and bankruptcy. Yet, I think about how many lives I may be touching through this website. Now I wonder, am I actually receiving that for which I prayed?

© Angela Cramer, 2008-2009

Clipart is the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com

New Year’s Wish

January 8, 2009

New Year’s Wish

I’ve been trying for a week or more to formulate some kind of intelligent or insightful wishes for the New Year. And the truth is, nothing has come to mind. The reason is because I’m still recovering from the holidays.

My goal was to have something tangible I could give to the people I love and care about. In my pre-brain injury days, I used to make gifts. I made plans to begin doing this again. While I accomplished my goal, I’ve had weeks of daily migraines and extreme fatigue.

Some might say, “Just don’t do that anymore.” But it is not as simple as that. Doing something I did before my brain injury provides many positive feelings of accomplishment and progress. Giving something other than “my presence” helps me feel more like an equal in relationships.

With that being said, I know that I still have some “work” to do. Proving to myself that I can do something I used to do, is a fine and admirable achievement…..as long as I respect my energy requirements for rest and balance. Tangible gifts are also fine, as long as I have the financial resources. The most important lesson I need to remind myself of is that the gift of a person’s love, friendship and simply “being” should always be more valuable than a “thing.”

My wish for you and myself is the following: May you be gentle and nurturing with yourself this year, and may you realize your true worth simply being who you are.

Angela

© Angela Cramer, 2000