JUNE 2015 • VOLUME 22 • ISSUE 2 Brain Injury Awareness Month EDUCATION: AWARENESS: SUPPORT: How Brain Injuries Affect Men and Women Differently pg 41 Provincial Acquired Brain Injury System Navigators pg 23 I am the Face of Brain Injury - Two Perspectives pg 11 OBIA REVIEW 2 JUNE 2015 BOARD OF DIRECTORS President Barbara Claiman Treasurer Brad Borkwood Corporate Secretary Dr. Debby Vigoda Directors Alice Bellavance Dr. Sheila Bennett Sabrina Chagani Maria Hundeck Nancy Nicholson Veronica Pepper Hazel Wood OBIA Advisory Council Representatives Wendy Charbonneau Mary Lou Dalaire Tim Slykhuis Dr. Mary-Ellen Thompson INSIDE THIS ISSUE Awareness: The Provincial Acquired Brain Injury System Navigators 23 Education: How Brain Injuries Affect Men and Women Differently 41 Support: I am the Face of Brain Injury - Two Perspectives 11 OBIA STAFF 905-641-8877 1-855-642-8877 Toll-Free Support Line: 1-800-263-5404 Executive Director Ruth Wilcock ...#238 Associate Director Tammy Dumas ...#240 Financial Controller Ad Lewis ...#230 Advocacy Specialist Katie Muirhead ...#229 North Eastern Ontario Advocacy Specialist Tanya Jewell (705) 471-7610 Support Services Specialist Carla Thoms ...#227 Admin. Services Coordinator Terry (Wilcox) Bartol ...#234 Training & Admin. Assistant Diane Dakiv ...#231 Communications & Program Assistant Kimberly Butcher ...#224 I.T. Consultant Steve Noyes ...#232 Special Projects Assistant/ OBIA Review Editor Jennifer Norquay ...#242 Also Inside Ruth’s Desk .............................................................................4 Gail’s Retirement ......................................................................7 In the News: Community Transportation Pilot Grant Program ......................... 10 Survivor Stories: Brain Injury Survival - In the Beginning ....................................16 OBIA’s Provincial Peer Support Program....................................19 Expanding Support Services ....................................................21 Across the Province ................................................................27 New at the Bookstore ..............................................................31 Survivor Stories: Lori White - Riding Away Stigma ..............................................33 Coping - Getting Back in the Saddle Again ................................38 Events Calendar .....................................................................44 Community Associations ..........................................................46 Provincial Associations ............................................................50 OBIA Training: Children and Youth with Acquired Brain Injury...........................52 VISIT www.obia.ca Connect with us! EMAIL obia@obia.on.ca Copyright 2015, PUBLICATIONS MAIL AGREEMENT NO. 40005485 RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: Ontario Brain Injury Association, PO Box 2338 St. Catharines, ON L2R 7R9 Ph: 1-800-263-5404 (support) 1-855-642-8877 or 905-641-8877 Fax: 905-641-0323, E-mail: obia@obia.on.ca Registered as a Canadian Charitable Organization Reg. #10779 7904RR0001 3 OBIA REVIEW AWARENESS During Brain Injury Awareness Month, I would encourage you to contact your MPP’s to educate them about the needs of those who sustain brain injuries. These needs include timely access to expert trauma care, specialized rehabilitation and individualized services and supports. By Ruth Wilcock Executive Director, OBIA 4 RUTH S DESK Why the Need for Brain Injury Awareness Month According to Health Canada, there are dozens of health-related awareness days, weeks and months. This includes: mental health, breast cancer, Alzheimer’s, lupus, arthritis, autism, Huntington disease, heart and liver disease and the list goes on and on. Although these are extremely important, we must ask ourselves is there place and need for Brain Injury Awareness Month? The short answer is a resounding yes! Some of the more obvious and imperative reasons include: educating the general public about the incidence of brain injury, the needs of people with brain injuries and their families and reducing the stigma of brain injury while at the same time empowering those who have survived. Also, we know that we can be at risk for sustaining brain injuries by participating in everyday activities such as driving our cars, riding our bikes or using a ladder that can lead to a fall. This is where awareness and prevention come together. OBIA’s Provincial D.O.N.T. (Drive Only Never Text) campaign is a prime and powerful example of why there is such a compelling need for Brain Injury Awareness Month. Another very important reason why we need to bring awareness and education about brain injury to the forefront is the recently proposed changes to the Standard Auto Insurance Benefits (SABS). These changes are very troubling as they will greatly impact 65,000 Ontarians who may be injured in a motor vehicle collision this year*. Some of the proposed changes include: • Rehab and Attendant Care for Serious Injuries, $65,000 combined (a $21,000 or 25% cut) * • Rehab and Attendant Care for Catastrophic Injuries, $1,000,000 combined (a $1,000,000 or 50% cut) * • The budget also suggests changing the criteria for “catastrophic” The Ministry of Finance states that “working with the auto insurance industry, the government will ensure that consumers are aware of the changes to the standard auto insurance policy and can make an informed decision should they choose to take advantage of enhanced optional coverages to suit their needs”. In 2010, the government introduced Politics: runoff election likely a JUNE 2015 “optional benefits” to allow consumers to buy better coverage. Less than 2% of policy holders bought optional coverage (according to the Financial Commission Services of Ontario-FSCO). This indicates that a great deal of work will have to be done with insurance agents and brokers to ensure that consumers are well informed. (see chart below for changes to accident benefits since 1996) This brings us back to the issue of why there is a need for brain injury awareness. In my experience, most of those who represent us in government are well intentioned. However, they may not be as well informed about specific issues including brain injury and the devastating impact that it has upon those living with brain injury and their families. During Brain Injury Awareness Month, I would encourage you to contact your MPP’s to educate them about the needs of those who sustain brain injuries. These needs include timely access to expert trauma care, specialized rehabilitation and individualized services and supports. With the proposed changes to auto insurance there is no question that access to services will be reduced. This will lead to a further burden on our health care system. Our vision is that all persons living with brain injury are able to live healthy, independent and satisfying lives. We must make our friends, families, coworkers and our elected officials aware of how these changes to insurance will lead to further devastation for those who have survived trauma and are now living with brain injuries. ◊◊◊ *Source – The Ontario Rehab Alliance Summary of Changes to Accident Benefits Since 1996 MEDICAL-REHABILITATION & ATTENDANT CARE – SUMMARY OF CUTS TO ACCIDENT BENEFITS • Rehabilitation (“rehab”) benefits cover a range of medically necessary goods and services that aren’t funded in the public system such as physiotherapy, speech therapy, psychology, medications, accessibility renovations, nursing, wheelchairs, artificial limbs, etc. • Attendant care (“AC”) benefits cover the services of personal support workers to assist with bathing, dressing, toileting, etc. • All goods and services are always subject to the insurer’s determination of what is “reasonable and necessary”, so insurers can deny any request for rehab or AC services even if funds are available. • There are approximately 65,000 people injured in motor vehicle accidents in Ontario each year: minor injuries account for about 80% of all injuries, serious injuries account for about 19% and catastrophic injuries account for just 1%; insurers have strong controls over which individuals get classified into which severity category. 5 OBIA REVIEW Providing direct therapy, transitional support and community integration to children, youth, adults and seniors recovering from an acquired brain injury and/or serious trauma. www.bartimaeusrehab.com 1-877-542-9990 Setting the standard of excellence in Rehabilitation Support Workers since 1988 Memory Loss When you need support to EHZKR\RXDUH3DWKZD\V can help you to LIVE with an $FTXLUHG%UDLQ,QMXU\ “ I love being a part of this club. I love the shopping, theatre, and all the activities. I’ve met some of my very best friends here ” —“K. B.” Supported Client in Pathways Family Home program “ to Independence Acquired Brain Injury Services Accredited by the Commission for the Accreditation of Rehabilitation Facilities (CARF), Pathways to Independence specializes in providing community based living services and programs to people living with an ABI. Pathways ABI programs and services are tailored to accommodate client needs and provide a continuum of care. Pathways works closely with every client to develop a Depending upon the nature of the brain injury, these supports may include: I like that I have a place to go where I feel safe and comfortable ” — “B. B.” Supported Client at Pathways Club ABI 24 hour Supported Homes Family Homes Respite Services ABI day programs Employment Supports Behaviour Management 5HDFKRXWWRXVWRÀQGRXWPRUHDERXW3DWKZD\V$%,6HUYLFHV : 289 Pinnacle St., Belleville, ON K8N 3B3 T 613.962.2541 F 613.962.6357 356 D Woodroffe Ave., Ottawa, ON K2A 3V6 T 613.233.3322 6 service plan that supports a person’s rehabilitation and reintegration to the community following a brain injury. In addition to assisting with activities of daily living, Pathways employees actively work with the client to access social networks and community partners to develop and support the implementation of a person’s individualized service plan. Psychological & Psychiatric Services Legal Services Medical and Wellness Support such as Physiotherapy, Speech Therapy, Occupational Therapy, Nursing, Dietician www.pathwaysind.com JUNE 2015 Happy Retirement Gail! By Ruth Wilcock, Executive Director, OBIA After over 21 years of dedicated service to OBIA and those living with brain injury, Gail Coupland is entering into a new and exciting phase in her life. As we know, the Financial Controller is paramount to any charity. Gail’s wisdom and guidance through the years has assisted OBIA in being the organization it is today. Her presence, loyalty, devotion and her wonderful sense of humour will be missed by all. OBIA’s Online Bookstore A great selection of Books, DVDs, and Manuals for professionals, survivors and family members. Share your expertise... On behalf of the Board of Directors and the staff at OBIA it is my honour to wish Gail much happiness and deserved relaxation in her retirement. ◊◊◊ #SaveYourBrain Visit www.obia.ca OBIA’s Concussion Booklets Information includes: Be an OBIA Review Guest Author Upcoming themes: • • • • • • • What is a Concussion? Anatomy of a Concussion. Symptoms. What Should I do? How Long Will it Take to Feel Better? When Can I Go Back to Work, School, Play, Activity? What is Second Impact Syndrome? Where Can I Get Help? Resources. September 2015 Education December 2015 Relationships March 2016 Innovation To receive a copy of this brochure, or if you need further information on concussion, contact: Contact the Editor: editor@obia.on.ca 1.800.263.5404 support@obia.on.ca • • 7 OBIA REVIEW 8 OBIA REVIEW AWARENESS IN THE NEWS Community Transportation Pilot Grant Program By Katie Muirhead, OBIA Support Services Consistently, one of the most often identified barriers to accessing services across the province is transportation. Whether you live in the Northern parts of Ontario where there is a vast geography to navigate or in smaller communities sprinkled throughout Ontario where there are limited services, transportation services have often been the missing link. The Ministry of Transportation established the Community Transportation Pilot Grant Program in November 2014 to attempt to bridge that gap. This is a $1 million pilot program aimed at providing financial assistance to municipalities across the province to improve community transportation services for seniors, persons living with disabilities, youth and other members of the community who need transportation. Applications for the program were accepted until January 30, 2015 and the Ministry has now announced the successful applicants. Eleven municipalities have been selected to receive up to $100,000 to provide better transportation services through the sharing and coordination of community transportation resources. The Community Transportation Pilot Grant Program provides funds to municipalities to partner with community organizations, such as health and community agencies, transit agencies, school-bus operators and private transit operators, to co-ordinate local transportation services, Region Municipality 10 so more rides can be provided to more people and to more destinations. This program is part of the Ontario government’s commitment to provide support to help seniors stay healthy and stay at home longer. It will also improve transportation services, options and resources for everyone in the community, such as students and youth who need to get to school, persons living with disabilities, or those in rural areas where amenities and services are too far to reach without a car. Quick Facts • The Community Transportation Pilot Grant Program launched on Nov. 25, 2014, and closed on Jan. 30, 2015, with a total of 54 applications submitted across Ontario. • Up to $1 million in funding will be provided from April 1, 2015, to March 31, 2017, with a maximum grant amount per eligible project of $100,000. • After March 31, 2017, the funded community transportation services will be evaluated to determine the effectiveness of coordinated community transportation as a service delivery model. Below are the 11 selected municipalities who have been successful in their application and a short description of their project. For more information on how these services might assist you, contact your local municipality. ◊◊◊ Project Grant Funding Northwest Atikokan New coordinated service to share vehicles and drivers, and centralize trip booking and dispatch for nine organizations. $91,586 Northwest Terrace Bay New service to connect five communities to Thunder Bay for medical appointments. $95,847 Northeast Papineau-Cameron New service to connect eight municipalities and 23 organizations with maximized taxi service with centralized intake, booking and scheduling. Northeast Haliburton Enhanced service through one contact, integrated website and mobility manager to refer trip requests to nine organizations and multi-modal options, including ride-share. $77,540 Northeast Black River-Matheson New service using school buses to transport seniors to medical appointments, shop and/or visit friends within community and to Timmins and Iroquois Falls. $30,500 Southwest Grey New coordination of existing service using software for centralized access, scheduling and dispatch. $100,000 Southwest Tillsonburg New coordination of existing service through a phased approach: hiring of coordinator, acquiring software/ technologies and purchasing new accessible van. $100,000 Central Georgina New coordination of existing services to phase-in a centrally coordinated service: taking an inventory of local transportation services/resources, assessing mobility needs and integrating available services. $99,866 Central Simcoe New coordination of existing service to implement a transportation service/resource web portal to enable online intake, booking and referral. $97,000 Central Pelham New coordinated service to provide inter-municipal and volunteer service to surrounding municipalities, Niagara College, Niagara Regional Transit and GO Transit. $100,000 East Prescott & Russell Enhanced coordination of existing service to increase capacity (i.e., patients with high needs) by purchasing van and GPS technology and hiring a driver. $100,000 $100,000 JUNE 2015 SUPPORT I am the Face of Brain Injury Two Perspectives ABI and knowledge of what it takes to help you get your life back is priceless. I have now adopted a much slower pace of life to cope with my injury—switching between tough cognitive tasks and rest. Early in the process, the fog lifted just enough to make it clear that life would never be the same for me. Don’t get me wrong, I am grateful for my life. It is just that at times the list of things I can’t do or will never be able to do again piles high like a threatening Jenga stack. It’s tough to imagine a future where you can’t fully depend on your brain. One of the most therapeutic benefits was meeting others with ABI, seeing people suffering with the same things I am. It was these relationships that first started to form what action was possible. I watched how much some struggle with letting go of their old lives and how much anger can be built up because of the injury. Stephanie’s Story One of my favorite quotes has always been “Life is 10% what happens to me and 90% of how I react to it.” For my first 29 years, I faced life challenges with hard work and a positive attitude. However, when acquired brain injury (ABI) put the brakes on my life four years ago, I faced a situation where my usual hard work reaction was the least helpful and sometimes not even possible. It was July 2011. I was working in Ottawa launching a radio station when a bicycle accident left me with a broken rib and finger, a black eye and an mTBI, also known as a concussion. The emergency room doctor told me about a website I could look at to learn about concussion but provided no clue that this could be a life changing moment. I went home convinced I could figure out how to recover and be back to normal as quickly as possible. As the days went by it became less and less clear what my reaction should be. Not understanding the implications of a concussion, I floundered for 1-1/2 years, trying to work. I thought I was losing my mind—I didn’t connect my headaches, brain fog and dizziness to the accident—so in March of 2012 I moved back to London, where I was from originally. On the very day I was to start receiving concussion care at Parkwood Institute’s Acquired Brain Injury (ABI) program, a sign fell on my head resulting in a second concussion. My ABI therapists are helping me as I learn to cope with my mTBI. When the rest of the world feels cold and harsh, the ABI team is like a cocoon. Their thorough understanding of When I heard about the OBIA Peer Support Program, I knew the healing part of my therapy could finally begin. The program matches persons with lived experience with an individual who is living with the effects of acquired brain injury and is looking for support. The matches are based on similar experiences, needs and personal interests. As a Peer Mentor, I provided weekly phone support for a woman recently diagnosed with ABI. She was so confused and fed up with not feeling like herself. She felt that some of her family and friends didn’t even believe that anything was wrong with her. I could hear myself in her words. Being a Mentor was like therapy for myself, as I was able to bring some comfort to another person in this very confusing time. That was the root of what is now my personal mission—to raise awareness about brain injury. Even if ABI can’t be seen, it is very real. Without visible symptoms, sometimes it’s difficult for people to understand. It’s so frustrating when people say “But you look great!” after I tell them I have a brain injury. I will admit, before my bike crash, I assumed persons with brain injuries were too ill to be out. I assumed they would be in a wheelchair. I’m ashamed of my lack of empathy now. I drew on my pre-ABI life to help me raise awareness about the “face” of brain injury. Having worked in radio and TV for 10 years, I approached colleagues at Rogers TV who helped me create a public service announcement in the form of a 30 second video. The purpose of the video is to create a broader understanding of brain injury and to let people know that not all brain injuries are visible. Through Parkwood Hospital and the Brain Injury Association of London and Region, I recruited other people living with ABI to bravely represent the face of brain injury in the video. 11 OBIA REVIEW “I am the face of brain injury.” As my peers announced this tag line, I felt a shift. It was so inspiring to experience my peers owning their injury. I was on the verge of tears during the entire taping. Deep inside it was clear that just saying the words gave them, us, a sense of control in this uncontrollable time. Powerful. “I can only dream that this video will help at least one other person on this confusing brain healing journey.” To view the video “I am the face of brain injury” go to http://youtu.be/SPlxSEFFblw Nancy and Shawn’s Story It has been almost 7 years to the date since Shawn’s motor vehicle collision and it has been a challenging journey, but the struggles have been worth it. After 5 years of intense rehab therapy, we decided to make the move from Cambridge back to Shawn’s hometown of Kingston. It seemed like the most natural progression to return to the city he loves and where most of his family and friends still live. One of the biggest components of his recovery that was missing was the social element and just being around people that know and love him and see past the deficits from his brain injury. We both couldn’t be happier since we moved because we felt so isolated and alone in Cambridge and it took a toll on both of us. The lack of social life in Cambridge was the missing piece in our lives so we knew it was time to take the plunge and give up the fantastic professional support we had. We needed to look to the future and decide how we wanted to live our lives in the real world. We built a beautiful fully accessible home and moved our family to Kingston in the summer of 2013. We have had many ups and downs trying to put together a new rehab and support team in a smaller city with fewer resources, but we have never regretted the decision. We couldn’t be happier with our new home and how things have worked out and seeing our friends on a regular basis and just having fun. As Shawn would tell anyone, there is more to life than just doing rehab all the time. Life needs to be lived. Nancy’s Blog - The New Us...Life After a Brain Injury (http://lifeafterabraininjury.blogspot.ca/) A coma is nothing like you would imagine or how they play it out on TV. There’s no sudden arousal, there’s no talking to you and completely comprehending everything going on. I think the coma was the worst part, even though early on the doctors said that Shawn would wake up from his coma, they had no idea when. The initial Neurosurgeon was the one that had told us on the 2nd day that due to the locations of the brain bleeds, in his opinion, Shawn would wake up. However, he would have deficits in motor function and memory. Sounded pretty simple but that was really before they knew the full extent that the Diffuse Axonal injury and the Hypoxia (lack of oxygen to the brain) would affect Shawn long term. That particular doctor I was very impressed with, probably because his news was leaning more on the positive side. The next Neurosurgeon that came on the rotation reviewed Shawn’s CAT scan and believed that his deficits would be extremely severe and placed him on the low level of outcome— hated that guy! It seemed every time you started to feel good about how things were going, someone would come along and just pull the blanket right out from underneath you. Living with a constant knot in your stomach definitely takes such a huge toll on you both emotionally and physically. I am amazed that our baby survived and my pregnancy continued because the amount of stress was overwhelming. My doctor had told me that the body has an incredible way of protecting babies from outside stresses and she was right. It was right after my first prenatal visit with her, just 6 days after Shawn’s accident that I learned of my first real life coma story. It’s kind of amazing the way it happened, but after that appointment I asked Shawn’s sisters to take me to Chapters book store so that I could find a book on brain injury. We walked in and there was a poster advertising a new author that had just written a book about his experience recovering from a brain injury!! What were the odds that this book would have this author coming to this book store in 2 days to sign copies of his new book?? I bought a copy and started reading and couldn’t believe it because this man had been in a car accident about 10 years earlier and had been in a coma and here he was writing a book. It gave me such hope and the more I read I learned that he was in a very serious car accident and his coma lasted about 3 weeks and he had to learn how to walk and talk again. Meeting that man in person and hearing his story gave me such inspiration when I needed it the most. That was not the last time I heard about a coma story from someone I met; it seemed like they started popping up out of nowhere. The priest that came to give Shawn a blessing was also in a coma when he was child for about 3 weeks from a bicycle accident. The clerk at a retail store told us about her relative being in a coma and they all seemed to be around the 3 week mark when things turned around. Well, it was a little over 3 weeks before Shawn officially was considered “out of the coma.” There was no “hey, how’s it going” or “what happened” from him like you see in the movies, it was a simple eye opening that lasted just a split second and 12 JUNE 2015 that was him coming out of the coma. It started off so slow with his eyes opening for a second until weeks later he had them open for 45 minutes straight and that was very exciting. His eyes may have been open but there was no recognition and he was never tracking or following anything, he just looked straight ahead. He never opened his eyes when you would ask but just spontaneously for a short time, sometimes only once a day and sometimes more. Regardless, I sat by his side and talked to him and told him about what was happening and who had visited or I would read him a book or put his iPod on for him. Whenever his eyes would open, I would get right in his line of sight and even though he didn’t seem to see me, I knew he did and I knew he knew I was there. Once in awhile he would squeeze my hand and even though I was told it was not “purposeful” I felt like it was and that he was letting me know that he was there and just to give him time. Most people don’t remember their coma so it’s hard to say what exactly they hear but in Shawn’s case we knew he was listening and trying to show us that he was. In one situation, a doctor ignorantly spoke to us in Shawn’s presence about his lack of any real recovery and to expect the worse, his heart rate raced as he was listening to everything that man was saying. Other than the times he would squeeze my hand, he actually showed some movement when an old friend that he knew from childhood visited. It was within that first week and his good friend Roy was speaking to him and Shawn actually lifted his right hand up in response to Roy’s voice. Roy was ecstatic and he came back in the waiting room saying, “He’s in there, my boy is in there!!” None of this was ever given any regard by the medical staff, as they felt it was all reflex, they just didn’t know who they were dealing with. Shawn is/was a fighter and it was him trying to let us know he was coming back to us. I had read so many brain injury stories trying to get an idea of what to expect but none of them ever really addressed the coma. I think that was largely due to the survivors writing those stories so that wasn’t a time they remembered and could only recount what they were told. I remember so that is why I want to share this with everyone and also share with Shawn, who follows this closely because he too wants to gain more insight into what happened back in 2008. So as I mentioned, he came out of the coma after 3 weeks and it was a long long process before he was able to look at me, I mean really look at me and see me and show he knew who I was. The first time he actually watched me walk across his hospital room, we had long left the trauma hospital and he was repatriated back to our local community hospital, which was 6 weeks after his accident. Some of the great ideas we had been told or read about back during the coma were to not only talk to him but also heighten his other senses with smell and touch. I would find things that I knew had stronger smells, like cinnamon, and also smells that were familiar to him, my body lotion for example. To this day the smell of Bath and Body Works White Tea and Ginger body lotion reminds me of the ICU and that hospital, whereas before that it was my favourite smell. ◊◊◊ 13 The 2015 Awards of Excellence in Brain Injury Rehabilitation The Ontario Brain Injury Association, along with the lawyers from The Personal Injury Alliance, are pleased to announce the 2015 Awards of Excellence in Brain Injury Rehabilitation. These awards are meant to recognize exceptional service to the brain injury community in the following categories: Hospital Social Worker Case Management Health Care Provider Community Brain Injury Association Rehabilitation Company Insurance Company Nominations for the Awards of Excellence can be made online between June 1st and July 17th, 2015. Voting for the selected nominees will take place online between August 4th and August 28th, 2015. The 2015 Awards of Excellence will be presented by the Ontario Brain Injury Association at the Back to School Conference on September 10th, 2015 at the Four Seasons Hotel in Toronto. To nominate, vote or for more information about the Awards of Excellence, visit: F EXCELL DS O E AR E NC R NI N IN B AI N J U RY E H A BIL R MCLEISH ORLANDO OATLEY VIGMOND 2015 TA TIO AW OBIA.ca I PRESENTED BY ONTARIO BRAIN INJURY ASSOCIATION THOMSON ROGERS PERSONAL INJURY LAWYERS JUNE 2015 15 OBIA REVIEW SUPPORT SURVIVOR STORIES Brain Injury Survival - In the Beginning By Mary Lou Dalaire Mary Lou and her dad on BIAN’s canvas, used at community diplays. I, like many others, live my life with some of the many challenges of brain injury and have so for the past 21 years. It all began around Christmas 1993 with what I thought was a cold that accelerated to pneumonia, meningitis and encephalitis and, lucky for me and thanks to my ex-husband who had come to visit, ended with me being rushed to hospital unconscious and in critical condition on January 14, 1994. I was not expected to survive but I did, thanks to the excellent medical care (the head neurologist was just coming out of an operation and was called to see me shortly after I arrived) and encouraging, determination-driven rehabilitation staff (both at the old Royal Victoria Hospital in Barrie and at Shaver Rehabilitation Hospital in St. Catharines). My wonderful supportive family (my parents moved into my apartment in Barrie instead of their condo in Florida for the coldest winter on record) made a big difference in my recovery by encouraging me every step of the way. My sister and her family were there every weekend. My ex-husband was there every day. My special friends were pulling together for me, visiting me often, talking to me, bringing pictures and sharing special memories hoping to help me to regain some of my memory. All these special things helped me to survive and thrive. 16 I am so thankful! It’s not often one gets a second chance at life, even if I did have to struggle to get it and even if I have a lot of daily struggles to face. I definitely think it was/is worth it. I was in intensive care for about a month in fairly rough, sometimes critical shape, then moved to the rehab floor, where I was encouraged to try to stand and walk a few steps and eventually got well enough to be moved to Shaver Hospital in St. Catharines for further rehab, where my family were close by and able to keep a watchful eye on me. Following my 3-month residential rehab, I was invited to stay with my parents and was bussed to Shaver on a daily basis. Rehab was not easy, but the staff was very patient and understanding and encouraged and helped me. I tired very easily and found I was always very frustrated at not being able to do some of the simple, daily activities. I had a special challenge and that was to learn how to do everything that I had been doing as a right handed person as a left-handed person. I learned how to walk again, but needed to wear a brace for my foot and had difficulty bending my knee and keeping my JUNE 2015 balance. I felt so very awkward. I learned how to write with my left hand and type with my left hand only (slowly, but I could do it!). I had to learn how to talk again too, which presented some difficulty (I thought I talked funny). One of the ways I practiced talking was to read out loud. This helped my speech but also helped me concentrate on what I was reading and not lose my spot. It works! I learned how to do things in the kitchen: use an electric can opener, cut vegetables (making sure to miss my fingers), mash potatoes, use a timer so that I wouldn’t forget and burn something, take something out of the fridge, use it and then put it back (so it would stay fresh). I was soon able to make a meal by/for myself because my goal for rehab was to be able to survive on my own. The whole rehab process took a lot of work. My brain was often tired and would turn off and not allow me to do things. I would need afternoon naps. I would need times of solitude to rejuvenate. There were a lot of failures but soon there was a growing list of successes and it was worth it! When I finished my term in rehab, I knew it was time to start my life. I was able to find my own apartment in Welland (with the help of my sister) and soon I was living in the upstairs of a house close to her. My dad was very afraid that I would fall down the stairs, but I promised him I wouldn’t. Two days after moving day we visited the Humane Society and Oliver came home with me. He was a lovely orange tabby cat, who was fairly wild at first, but when he calmed down he became my buddy, always there with me/for me. Having a cat was very important to my recovery. He would wrap himself around my head to soothe me, cuddle to comfort me and never gave up on me. Living on my own presented many challenges. I had to do my own cooking, my own cleaning, make my own bed, wash, dry and put away my own dishes (without breaking them) and I was determined to do it right. My personal goal was to keep my place, my home neat and clean—a place of comfort. Having to walk up a full flight of stairs presented a challenge, as my right side was not fully active and my landlord helped by putting a railing on both sides of the steps. I lived there for 4 years and never fell down the stairs. Living with brain injury doesn’t mean you can give up on resuming your life. There are always going to be “special” challenges but there are ways to help yourself. With me it was becoming involved with Brain Injury Association of Niagara (BIAN). I began attending peer support (Friends Helping Friends) meetings and BIAN family support meetings with my family where we got to know other families and how having a survivor as part of the family affects everyone’s lives. My family and I made many good friends at these meetings— everyone sharing special experiences and challenges, making life easier to understand. We attended family picnics, family Christmas parties; I even acted in plays at the Valentine Day survivor party. I was encouraged to write for the newsletter (and still do) and was a contributor to BIAN’s book “Winds “Sister” Mary Lou performing at one of BIAN’s Valentine’s Day plays. of Change”, a book of 32 BIAN survivor stories. I helped with painting what would be the trademark for the two BIAN conferences. I was invited to attend BIAN’s Moving Ahead with Brain Injury Group, a group of dynamic, energetic and caring survivors. Our group members helped BIAN with fundraising—with 2 garage sales, volunteered at conferences, Food for Thought celebrations, brain injury prevention events, concussion prevention and recognition events. I became a client at BICR (Brain Injury Community Re-Entry) in 1998. The programs at BICR opened a lot of doors for me, giving me an opportunity to participate and attend different group programs, writing, reading, oil painting, gardening, a special women’s group that covered many topics. As a volunteer, I was able to assist the Social Worker and together we developed a staff and family training program “Walk in My Shoes” , that was presented in-house and to other agencies. A few years ago my volunteering got a boost with the addition of my husband, Pierre. Now we both volunteer regularly at BIAN and at OBIA Conferences together. Meetings with other survivors through BIAN and BICR enabled me to learn from others and share with them in discovering ways to ACCEPT, to CHALLENGE, to CHANGE life. ◊◊◊ 17 OBIA REVIEW Funding for the Peer Support Program is provided by: 18 JUNE 2015 SUPPORT OBIA’s Provincial Peer Support Program Making Peer Connections from Niagara Falls to Thunder Bay By Carla Thoms, OBIA Peer Support Services and Tammy Dumas, OBIA Associate Director One of the most important benefits of peer-to-peer support is the sense of hope that comes from talking to other people with similar lived experiences. In talking and listening to others like us, there is a belief in a better future that comes from being with or talking to people who have worked through their difficulties. (Davidson et al, 2006). Recognizing the inherent value and effectiveness of peer to peer support, in 2006 OBIA established the Peer Support Mentoring Program for people living with the effects of acquired brain injury. In 2012, for simplicity, the name officially changed to Peer Support Program. • • • • • • • • • OBIA’s program was developed based on the TBI Mentorship Program, a joint venture of the Research and Training Center (RTC) and the Brain Injury Association of New York State (BIANYS). It was launched in Ontario nine years ago and has been rapidly evolving since its inception. In 2011, an independent three year evaluation of the program concluded and the following key messages for OBIA emerged: there is a life-long need for support following brain injury (for individuals and family members) and OBIA’s Peer Support Program is meeting that need. How Can I Get Involved? Is This For Me? Through our Peer Support Program, Ontarians living with brain injury are matched with one another in a supportive peer mentoring relationship. An individual with lived experience (the Mentor) is connected to an individual who is seeking peer support (the Partner) to assist them in understanding their experience with ABI. Through weekly telephone or video calls they engage in a mutually supportive peer relationship for up to one year. The value of this type of support is that individuals can schedule the calls at a time that is convenient to both of them and they can participate in the call from the comfort and privacy of their own home. Mentors and Partners are matched based on similarities in background, injury, life experience, personal interests and hobbies. The program is available to people living with a brain injury and to their family members and unpaid caregivers. Where Do I Go? Our program is delivered in communities across Ontario through our affiliated community Brain Injury Associations. In each location, a Peer Support Coordinator is responsible for promoting the program and for the recruitment of new Mentors and Partners. Coordinators work collaboratively to thoughtfully ‘match’ Mentors and Partners around the province. The following 14 Associations are currently coordinating the program in their local area: • • • • • Brain Brain Brain Brain Brain Injury Injury Injury Injury Injury Association Association Association Association Association of of of of of London and Region Niagara North Bay & Area Ottawa Valley Peel Halton Brain Injury Brain Injury Brain Injury Brain Injury Brain Injury Brain Injury Seizure and Brain Injury Brain Injury Association Peterborough Region Association of Quinte District Association of Sarnia & Lambton Association Sault Ste. Marie and District Association of Sudbury and District Association of Thunder Bay and Area Brain Injury Centre (Timmins) Society of Toronto Association of Windsor and Essex County To Be a Partner: For those who are currently looking for support through the Peer Support Program (to be a Partner) you can contact your local brain injury association. If your local association does not offer the program please contact OBIA and we will assist you directly. Once an initial intake interview is complete, you will receive information about the program and the process of finding you a Peer Mentor will begin, taking into account your background, experiences, interests and goals for the program. “Wonderful service. I live in remote northwestern Ontario and was blessed to have a very understanding and caring person to support me. I hope to become a Mentor as well. She has inspired me…” OBIA Peer Support Partner To Be a Mentor: There is a mandatory screening and training process for individuals who are interested in becoming Mentors. This includes, but is not limited to, one full day of Mentor training and a completed criminal background check. Please contact your local brain injury association for more information, or OBIA directly if not offered in your community. “I find it extremely rewarding giving my time and sharing my personal experiences with others who are now going through the same thing.” OBIA Peer Support Mentor For more information about the Peer Support Program please contact peersupport@obia.on.ca Resources: Davidson, L., Chinman, M., Sells, D, & Rowe, M. (2006) Peer Support Among Adults With Serious Mental Illness: A Report From the Field. Schizophrenia Bulletin. Vol 32, 3, 443–45 ◊◊◊ Funding for the Peer Support Program is provided by: 19 OBIA REVIEW 20 JUNE 2015 SUPPORT Expanding Support Services North Eastern Ontario Advocacy Specialist By Tammy Dumas, OBIA Associate Director OBIA is pleased to announce the expansion of our Support Services program into North Eastern Ontario and the launch of a new two year pilot project. Through this project, OBIA will bring enhanced advocacy and support services to people living with the effects of acquired brain injury in North Eastern Ontario. We are delighted to welcome Tanya Jewell of North Bay to our team and to the role of North Eastern Ontario Advocacy Specialist. to people living with acquired brain injury. If you would like to make a referral or would like more information about the NEO Advocacy Specialist Project please contact Tanya Jewell: Self-referrals to the program can also be made through contacting the OBIA Support Line at 1.800.263.5404. ◊◊◊ This project was developed by OBIA in collaboration with community agencies in North Bay to address the increasing need for individual advocacy and holistic transitional support for people with brain injury. Program services are available to both children and adults living with brain injury and also extend to their family and caregivers. Accordingly, Tanya brings a wealth of knowledge to this role and is well suited to provide this much needed direct and ongoing support. In addition to a very well developed background in advocacy and community engagement, Tanya also brings a very important perspective to the role: lived experience. Notice of OBIA’s Annual General Meeting 1p.m. - 3p.m., Saturday June 20, 2015 Room 318, Miles Nadal Jewish Community Centre 750 Spadina Avenue, Toronto Tanya is currently orienting herself to the role and reaching out to community agencies to raise awareness about her role and to ensure that individuals and families know how to gain access to this program. The program, while located in North Bay, does extend services to people living in the entire North Eastern Ontario Region. We are very pleased to be partnered with the Brain Injury Association of North Bay on this project and we are grateful for the support of the North Bay Regional Health Centre (NBRHC) and the many agencies in the NEO area who provide assistance Please R.S.V.P. to Diane Dakiv: ddakiv@obia.on.ca by June 15, 2015 21 OBIA REVIEW podemos ayudarle. pwede kaming ~ giúp. tumulong. chúng tôi se As Toronto’s largest ethnic personal injury law firm, speaking 24 languages, we are dedicated to ensuring our clients receive the rehabilitation and fair compensation they deserve, in a language they understand. At Carranza, many of us are first or second generation Canadians who are able to provide expert legal representation in multiple languages. Not only can we help overcome the language barrier, but we can also assist with many of the cultural issues that may arise throughout treatment and recovery. No matter how you say it, “we can help.” Toronto: 416-633-1065 London: 519-266-6715 Toll Free: 1-877-633-1065 www.carranza.on.ca 22 JUNE 2015 AWARENESS The Provincial Acquired Brain Injury System Navigators By Veronica Pepper, HNHB ABI Network & System Navigator In 2010 the Ministry of Health and Long Term Care provided each of Ontario’s 14 Local Health Integration Networks (LHINs) with funding to obtain an Acquired Brain Injury System Navigator. This was in response to the Ministry’s recognition that the ABI system in Ontario was fragmented, uncoordinated and inconsistent throughout the province and it was not meeting the needs of many individuals who sustained an ABI in an effective and efficient way. As a result, many ABI individuals were ‘falling through the cracks’, being misdiagnosed or undiagnosed and consequently they were not receiving appropriate supports or services in a timely manner. These problems were often leading to blocked hospital beds and/or mental health beds, specialized rehabilitation beds, repeated visits to Emergency Departments and many ABI individuals and/or their families and caregivers were going into crisis, some to the point of conflicts with the law or incarceration and homelessness. A first step for the ABI System Navigator, therefore, was to complete an ABI clinical pathway analysis in their LHIN area that would identify the gaps, barriers and challenges experienced by their ABI system. Then the ABI System Navigator identified potential solutions that would address the issues relating to the problems. The overarching goal of the ABI System Navigator’s role is to develop a well-coordinated and consistent service pathway that will provide increased service capacity of and efficient access to, services for adults living in Ontario who have sustained an ABI. This also includes individuals who not only have suffered an ABI but who can also have other diagnoses such as a mental illness, addictions problems and an intellectual/ developmental delay. However, this goal needs to be achieved with no additional funding from the LHINs and/or the Ministry of Health. It must be achieved by using and coordinating already existing resources, both ABI and non-ABI resources. Addressing barriers in the system required first identifying what was causing the barrier and then breaking down the barrier by changing current protocols or practices and improving communication. To address gaps in the ABI service pathway it often meant facilitating relationships between and among ABI and non-ABI service providers including mental health, addictions, developmental services, geriatrics, corrections and social services such as housing, meals on wheels, public transportation, financial supports (i.e., ODSP and OW), etc. These new partnerships often included co-consultations, crosstraining and education and shared support. It is also important for the ABI System Navigator to maintain the relationships and keep them in place for any future ABI cases. For very complicated or complex cases which usually involve individuals with an ABI, significant behavioural problems, mental illness, addictions, homelessness and conflict with the law the ABI System Navigator often facilitates ‘complex case resolution meetings’. These special meetings include every service provider or professional that has had involvement 23 OBIA REVIEW Online Concussion/mTBI Support Group Do you have a Concussion or Mild Traumatic Brain Injury (mTBI)? OBIA is pleased to announce the launch of our ONLINE SUPPORT GROUP FOR ADULTS (18 and over) living with Concussion or mTBI: • • • Providing support and sharing information about brain injury and concussion Delivered online and available throughout Ontario Free and confidential For more information or to register for the group, contact: 1.800.263.5404 or support@obia.on.ca. 24 JUNE 2015 A very important role of the ABI System Navigators is to raise awareness with their respective LHINs regarding the incidence and prevalence of ABI and the difficulties the healthcare system experiences when providing support to them, the professionals who support them and their families and caregivers. with the individual in the past or are currently involved with them as well as those who have not had involvement but likely should be involved. These meetings provide the forum for much needed problem solving, creative thinking and more importantly, the opportunity to develop an effective plan that will ultimately resolve the case and avert further crisis. The Navigator then follows the case to monitor the progress and organize additional complex case resolution meetings if required. Another role of the ABI System Navigator is to be a resource to any professionals who are working with individuals with a diagnosed ABI. This can include Social Workers, Personal Support Workers, Nurses, Physiotherapists, Occupational Therapists, Speech-Language Pathologists, Doctors, Psychiatrists, Psychologists, Case Managers, etc. The job of the Navigator is to link these professionals to the appropriate ABI resources available to them in their LHIN area. However, it is also the Navigator’s job to know all of the other 13 ABI Navigators in the event that they receive contact from a professional in a LHIN area other than their own. A very important role of the ABI System Navigators is to raise awareness with their respective LHINs regarding the incidence and prevalence of ABI and the difficulties the healthcare system experiences when providing support to them, the professionals who support them and their families and caregivers. The Navigators, along with their ABI service providers, identify the pressures on the system and provide potential solutions to the LHINs for consideration and possible funds to address the problems. Although all 14 ABI System Navigators have some common goals and roles, they also have differences amongst their responsibilities and duties. Some of the Navigators’ main focus is on the ‘higher systems level’ where they look at the bigger ABI system as a whole. They address the problems within the larger system and therefore they have no direct clinical involvement with the person with the ABI and their family/caregivers. That is they do not have a role in direct case management. They are involved in cases at more of a distance by getting information about the cases from the service providers or professionals who are involved with them. That information is then used by the Navigator as a way to identify where the problems are within the system. However, other Navigators do have a more active role in case management where they are directly involved in the assessment and clinical aspect of every case that is brought to their attention. Therefore they will assess the individual with the ABI to identify their needs and then coordinate the care, rehabilitation and supports they require. They will monitor the progress of the individual and provide further support when required. They also provide support directly to any professional, service provider or family and caregiver who is involved in the case. Another area of the Navigator job that varies from Navigatorto-Navigator is the role of referrals, admissions and wait list management. That is, some Navigators are the ‘gate keepers’ to the ABI services in their LHIN area. All referrals go through them. Then the Navigator assesses the referred ABI individual to determine appropriateness and suitability for admission to their ABI services and if they are approved for service, their names are placed on a wait list. For some Navigators, it is also their role to monitor the wait list, provide support where necessary and determine who receives services next when a vacancy becomes available. For other Navigators their role is simply to facilitate a referral directly to the appropriate ABI services in their LHIN area. The admission assessment and wait list management is provided by the ABI service provider, not the Navigator. Education and training for non-ABI service providers also differs between Navigators. As written earlier, the role of the ABI System Navigator is to ‘link’ service providers who are working with ABI individuals to the appropriate ABI supports in their LHIN area. This often includes linking the non-ABI service providers with the ABI resources in that area that will provide staff education and training on ABI. For some Navigators it is their job to provide direct education to professionals on acquired brain injury and the problems that can occur as a result of an ABI. They may also provide training to various front line staff that are supporting persons with an ABI on how to better manage their cognitive, behavioural and communication problems. Since the roles and responsibilities of the ABI System Navigators varies across the 14 LHIN areas it is best to contact your local Navigator directly and clarify what their role is specifically and how they can best support the service provider, the individual with the ABI and their families and caregivers. The Acquired Brain Injury System Navigator has proven to be a very useful and effective role. Currently the Navigators are collecting common and individual data that will allow them to monitor the effectiveness of their role in helping individuals with an ABI specifically and also their impact on the ABI systems within their respective LHIN areas. ◊◊◊ 25 OBIA REVIEW Tax-free, guaranteed structured settlements are all we do, and we pledge to do it right. OUR PLEDGE Henderson Structured Settlements is licensed with all major federallylicensed life insurance companies underwriting structured settlements in Canada. A structured settlement produced by Henderson Structured Settlements will always be brokered without regard to the commissions payable to Henderson for its brokerage services and with the intent of producing the best structured settlement income/cost attainable in the marketplace at the time of final brokerage. Ceteris paribus (other things being equal), Henderson Structured Settlements will always be able to match or better any structured settlement income/cost attainable in the structured settlement marketplace at the time of final brokerage. Henderson Structured Settlements will, with every structured settlement annuity contract, produce a written guarantee of tax law compliance and ongoing service and responsibility. HENDERSON STRUCTURED SETTLEMENTS LP Your Partners In Service® Since 1981 www.henderson.ca 1.800.263.8537 26 JUNE 2015 AWARENESS Across the Province The View from the OAC The OBIA Advisory Council met in Toronto on March 14, 2015 and was treated to a wonderful presentation by Linda Marshall of Marshall Connects Inc., entitled “25 Fundraising Habits of Successful Boards.” Throughout her talk, Linda stressed the importance of the saying “It’s all about how you make people feel.” (Maya Angelou). Linda encouraged our organizations to practice excellence and integrity at all levels; the office level, the Board level and in our encounters with the public. She challenged Board members to be passionate about their Mission statements and to advocate for their associations. Linda encouraged us by stating that “Giving leads to giving if donors are treated respectfully and believe in the organization’s mission.” Hopefully, members will be able to use Linda’s advice as we continue to strive to raise funds for the work of our Associations. The afternoon was a lively sharing of information and ideas from across the province. The OAC provides the opportunity for a unified provincial approach to the challenges of ABI with professionals, caregivers and survivors working towards a common goal. Community Programs & Events As always, we are delighted to be able to showcase many of the wonderful programs and events happening around Ontario. BIA Ottawa Valley The Brain Injury Association of the Ottawa Valley partnered with OBIA to provide Brain Basics and Peer Mentor Training. Hélène Richardson will be the new Peer Support Co-ordinator for the association. Congratulations to all the graduates from both trainings. Members of our volunteer team were Linda’s presentation can be viewed at: celebrated at a breakfast in their honour https://vimeo.com/123359171. OBIA is pleased to support the Brain Injury Association of London and Region, along with Brain Tumour Foundation of Canada and Dale Brain Injury Services, in launching the Year of the Brain 2015 in London & surrounding area. The focus of Year of the Brain is to provide a platform for all neurological and mental health based organizations in the area to come together to support people living with brain-related conditions. With a monthly webinar series, Brain Fair and other events‒it s bound to be an exciting and busy year ahead! Visit www.YearOfTheBrain2015.com to find out more. held on April 23rd at the Bay Bistro. (pictured above) The members of the Step Up Work Centre have once again partnered with the City of Ottawa and Tim Hortons to participate in the “Cleaning the Capital Campaign.” This is the 4th year that the membership has been involved in this project. Hats off to the members who participate. June is Brain Injury Awareness month and plans are well underway. We have partnered with the law firm of Burn, Tucker Lachaîne LLP in the Helmets on Kids Program. Approximately 800 helmets will be given out in three schools in the City of Ottawa. Thank you to the members of OTLA that will be participating in this program. Members will be conducting a bicycle survey along the bicycle pathways to see if there has been an increase in the use of helmets by both children and adults. The survey will also include the use of helmets with respect to inline skating and skateboarding. Some of the members of the Running Group will be taking part in the “Spring Spring” sponsored by the Brain Tumour Foundation on June 7th, 2015 at Andrew Haydon Park. Don’t forget to stop by our booth at Brain Injury Awareness Day sponsored by Vista Centre Brain Injury Services being held at the Hampton Inn on June 12th. The 2 nd Annual Fleming Fitness golf tournament will be held on June 18th at Loch March. For more information please contact Pat Fleming, R.Kin, CSCS at patrick@flemingfitness.ca. (see ad on page 29) 27 OBIA REVIEW Our Annual General Meeting will be held at the Bronson Centre on June 16th at 6:00 pm. For information about any of the programs offered by the association please telephone Wendy Charbonneau at (613) 233-8303 or email braininjuryottawavalley@bellnet.ca BIA Windsor-Essex County The Brain Injury Association of Windsor & Essex County hosted its 2nd annual Sports & Sparkle: The Main Event gala on April 11th, 2015. Over 250 people attended to raise funds for BIAWE. It was a wonderful evening with great food, music, entertainment and celebrities who came out to support BIAWE and brain injury survivors and their caregivers. Brain Fast Facts DID YOU KNOW? • 86% of those employed for pay at the time of injury are currently not employed Athletes and event speaker from left to right, Tarrence Crawford of the Windsor Lancers, Daryl Townsend of the Montreal Alouettes, Ernie Soulliere and Tyrone Crawford of the Dallas Cowboys attend the second annual Sports and Sparkle gala, Saturday, April 11, 2015, at the Caboto Club. (Photo: Rick Dawes: The Windsor Star) Brain injury survivors from left to right, Cathy Polidori, Kathy Worotny, Bev Fortier and Caterina Pintus attend the second annual Sports and Sparkle gala, Saturday, April 11, 2015, at the Caboto Club. (Photo: Rick Dawes The Windsor Star) HIA Fort Erie Annual family picnic will be held at the HIAFE Centre Thursday June 25. This will be an excellent opportunity for the community to engage with clients who participate at the Centre. Throughout the month of June, HIAFE will display information about brain injury and articles about who we are and what programs we deliver. HIAFE participants will conduct a pledge survey within the Community pledging to Drive Only...Never Text. • 69% state there has been a change in relationship with other members of the family • 52% of caregivers admit they have concerns about the behaviour of their friend/relative since sustaining an ABI which may put her/him at risk. - 2012 OBIA Impact Report 28 Members of HIAFE made a one-of-a-kind mural that adorns the hall of the HIAFE Centre. Pictures (left to right) are a few of the mural’s creators: Roger, Elizabeth, Heather, Michael, Fred and Mike. JUNE 2015 BIA Niagara We have some exciting news to share! Brain Injury Association of Niagara is pleased to share that our association has received a three-year grant from The Ontario Trillium Foundation to commence a member-driven Clubhouse for people living with the effects of brain injury in the Niagara region. Our annual Kerry’s Head for the Hills Race/Corporate challenge event and 1k survivor walk was held on April 25, 2015 in St. Catharines, with special thanks to our sponsors, corporate challenge teams and participants. This event is held in association with the St. Catharines Roadrunners and Walkers. As part of our Brain Injury Awareness Month activities, we are gearing up for our Annual Summer Prevention/Awareness Campaign, “We Caught You Using Your Head,” together with our community Policing partners, individuals “caught” JUNE 18 wearing their helmets while engaged in muscle powered, sportsrelated activities will be awarded a “Surf’s Up Day Pass” for the indoor Wave Park, courtesy of Americana Conference Resort & Spa. Our 3rd Annual Fundraising “Meet Me in Niagara” Food for Thought Gala will be held at Club Roma on June 4, 2015. The Gala committee is once again working to develop an exciting and enjoyable evening with excellent food and entertainment. The goal with this event continues to be to raise funds in support of the operations of BIAN. Just over $30,000 was raised at the 2014 Food For Thought Gala, thanks to all who participated! with eight successful Mentors including parents, survivors and a spouse. Since the training, three of the eight mentors have been matched with a Partner. Two more matches are presently in the works. The program has one Partner matched and is presently looking at recruiting new Mentors and Partners to the program. Contact has also been made with local support groups and Brain Injury Community Re-entry, which highlighted this invaluable program in its “learning and Leisure Guide. BIAN participants continue to enjoy themed-based horticultural craft activities in association with Karin Vermeer. (Shown right is Andrea.) The Peer Support Program for BIAN held its first Mentor Training in February, SAVE THE DATE… For the 2nd annual… Golf Tournament All proceeds benefiting the Brain Injury Association of the Ottawa Valley …at Loch March Golf & Country Club FEATURING DR. DONALD CHOW AS HONORARY GUEST & SPEAKER, AND DERICK FAGE, DAYTIME HOST OF ROGERS TV, AS THE M.C. CONTACT PAT FLEMING FOR SPONSORSHIP OPPORTUNITIES (2 PLATINUM, 1 GOLD, 1 SILVER, 1 BRONZE) Patrick Fleming, R.Kin, CSCS Fleming Fitness 613-882-8434 patrick@flemingfitness.ca 29 OBIA REVIEW BIA Sudbury & District The Brain Injury Association Sudbury & District in partnership with the March of Dimes Canada hosted its first St. Patrick’s Day themed Porketta Bingo on March 13th from 1-3 pm at 2750 Bancroft Drive for their survivors and caregivers. The event was a great success due to the awesome turnout and support. There were lots of porketta bingo winners who either chose to eat a yummy porketta sandwich or could replace the sandwich by placing their name in a draw for one of five prizes! Prizes included Tim Horton’s and MacDonald’s gift cards, as well as a grand prize for two to view a movie at Silver City Cinemas! Everybody went home a winner that afternoon with either a full belly or a smile on their face. A special thanks to Jan Oystrick and her team at Subway for donating the delicious deli buns and for all who volunteered their time to put on this great event. Due to the success of this Porketta Bingo more events shall be planned in the near future! ◊◊◊ 30 JUNE 2015 New at the OBIA Bookstore BRAINLASH: Maximize your recovery from Mild Brain Injury $56 TIP Cards (various) $3 Slow Dance: A Story of Stroke, Love and Disability. $20 Author (various) Author: Gail L. Denton, PhD Author, Bonnie Klein Book on concussion helps families, individuals and caregivers understand the consequences of mild traumatic brain injury. Written by a psychotherapist who coped over many years with the effects of several mild brain injuries, it provides clear and practical information with many tools and strategies that can be applied to daily life. Brain injury affects children and adults differently, so we offer over 50 different cards on different topics related to acquired brain injury. They are called “Tip Cards” because of the emphasis on checklists and suggestions for what to do. All are written in clear language for families, educators and advocates, as well as clinicians. In 1987, filmmaker Bonnie Klein suffered two catastrophic strokes. “Slow Dance” presents her candid, moving account of adapting to life with a disability. An inspirational book with the pace of a thriller that brings disability to centre stage. For a list of available resources, visit OBIA’s Online Bookstore: www.obia.ca/bookstore/ 31 OBIA REVIEW 32 JUNE 2015 SUPPORT Survivor Stories Riding Away Stigma By Lori White walked around dealing with shame, hopelessness, loss, fear, abandonment and feeling as though there was quite literally a piece of me missing. I attended summer school every year after repeatedly failing so many classes. I finally graduated high school after six long years, when I turned twenty! Although I struggled and felt insanely lost, I never lost sight of what I wanted to do. I wanted to be a teacher. I believed teaching would bring me great joy. Little did I know that the road to becoming a teacher would prove to be even more difficult than the struggles I had faced in high school! The summer of 2015 marks a new journey for me. I will be riding my bike 1,340km from Montreal, Quebec, to Halifax, Nova Scotia, solo! A challenging commitment for anyone; being a brain injury survivor makes this personal journey even more arduous and rewarding. My intention is to help enhance awareness for all people impacted from brain injury, and/or, mental health issues and raise donations for their respective agencies. Infused with personal stories, this campaign’s focus is to emphasize educating those who silently suffer and those who stand alongside them. Only with perseverance, inner strength and your support, will this task reach fruition. By working together, we will be Riding Away Stigma! I have come to understand the magnitude of courage and vulnerability required to complete this endeavor and I wish to share my experience with as many people as possible. My ride is inspired by two things; brain injury awareness and mental health awareness. This is my story: At the young age of fourteen, my life changed and I no longer saw it through the same eyes. I sustained a moderate traumatic brain injury after a very severe car crash. High school was an incredible struggle and I felt very alone throughout the entire experience. I didn’t want to get out of bed in the morning and I couldn’t sit still in class. In grade nine I failed Math, Science, Geography and English! My struggles were academic, emotional and social. I did not have the confidence to even get a job or my driver’s licence. At 18, I applied for my first job with the help of my both my basketball coach and friend Karen. Their support and assistance ensured that I would have the patience and skill set to fill out a simple job application. I got the job, but I remember feeling so stupid since the process was so incredibly difficult and I felt like no one understood that. During this time my brain injury was undiagnosed and I After graduation and having only 3 of the 6 mandatory OAC’s and an academic average of 53% I enrolled in part-time studies at Wilfred Laurier University (WLU). Having been successful in the two classes, I then applied for full-time studies in Physical Education at Brock University for the fall of 1999. I was accepted and also played Varsity Soccer my freshman year! That year was an enormous learning experience. Since I had one full credit from WLU, I was only required to take four full credits my first year. The second year, I enrolled in five classes and it felt like I was drowning. I was studying my heart out and only getting 70-75%. I strongly believed I was capable of better. Some may feel like that would have been a success, which in many respects it was, but I cannot stress enough that my effort exerted and the 70-75% grades were not cohesive. I watched my peers study habits and couldn’t comprehend how they would seemingly apply only half of the effort I was, yet achieve higher grades. It left me dumbfounded. I went to a Doctor at Brock’s Medical Centre and for the first time the history of my accident was taken into account. She referred me for a neuropsychological assessment which, once completed, determined that I suffer from a moderate traumatic brain injury. This assessment came ten years after my accident. I lived not knowing that I sustained a brain injury for those ten years but I also knew that something within my being was gravely wrong and I had NO idea what it was or, what to do about it. The details of my injury are irrelevant, but what is paramount is from that moment on I began receiving the necessary support and education in order to be successful in life. It also validated that I am not crazy, there is legitimate reason for my overwhelming difficult feelings of loss throughout high school. I cannot get the ten years back without a diagnosis, nor do I want to, as those lost years are a part of my journey. What I do want, is to bring education and awareness surrounding the issues of brain injury in order to decrease the possibility of someone suffering as long as I did. 33 OBIA REVIEW Restoring Hope. Building Futures. Comprehensive rehabilitation services from providers you can trust. physiotherapy | case management | discharge planning | occupational therapy speech-language pathology | rehabilitation therapy | home assessments vocational counselling | personal counselling | life care planning/future costs medical & psychological assessments | employer services | insurer services 34 www.rehabfirst.ca 1-888-REHAB-90 | info@rehabfirst.ca JUNE 2015 In May of 2004, I graduated from Teacher’s College with a Bachelor of Education degree and have been employed with the District School Board of Niagara as an occasional teacher for the past 10 years. My struggles with my brain injury did not end once I obtained a career. My consistent perseverance and dedication to developing my self-awareness is my greatest strength and that is shaping the person and educator I have become. Further to Brain Injury Awareness, another cause I am passionate about is Mental Health Awareness. I believe that frequently these two issues overlap and symptoms mirror one another in persons afflicted. There is much evidence to support that persons with brain injuries are also suffering from some form of mental illness. Mental health on its own affects a large percentage of the population. In particular, as a dedicated teacher for 10 years now, I see first-hand how the impact of mental health issues can weigh upon the youth, their struggles and the stigma surrounding it. They wrestle with similar overwhelming feelings that I encountered as a brain injury survivor: hopelessness, loneliness, sense of abandonment, shame and depression—the list can go on. The importance of early educational awareness and a proper diagnosis is crucial. This summer’s ride will test my perseverance, dedication, courage and ability to be vulnerable and overcome adversity in order to accomplish my goal. I want to draw more awareness to brain injury and mental health issues, to the educators, healthcare personnel, brain injury survivors and their families. I can’t stress enough the significance of early diagnosis of brain injury and proper diagnosis of mental health issues, as it provides the effected person and their family with the knowledge and tools needed to aid them in life. Education is vital and I hope this journey helps shed some light on the importance of increased awareness in our communities, homes and schools. The cause of my ride is to strengthen awareness for brain injury and mental health sufferers and their families and to raise money for the Ontario Brain Injury Association and Pathstone Mental Health. This 1,340 km adventure can be tracked via social media every kilometre of the way and I have enlisted the support of many to help organize this trip. I am extremely excited to share this experience with those who follow, for what this ride means personally and the potential it has to empower everyone to make positive changes in one another’s lives. ◊◊◊ Follow Lori’s ride: www.ridingawaystigma.com @LoriRide 35 CANA D I LAWYER M A INE AZ G AN JUNE 2015 Canada-wide serious injury care with a local “touch” Bayshore HealthCare delivers a wide range of nursing and attendant care to people with serious injuries, helping them regain their daily lives and maintain quality living within their community. Our nurses are specially trained to care for clients who need advanced clinical care, while our personal support workers perform many delegated tasks for individuals with catastrophic and non-catastrophic injures. They are supported by internal clinical experts and our Managed Care Team – a convenient, central contact point for workers’ compensation boards, insurers and government care programs, providing individualized care plans, standardized client reporting and timely service. With 60-plus offices across Canada, we also offer a local “touch” when it comes to professional care for people with serious wounds, fractures, amputations and spinal cord/acquired brain injuries. To learn more, please call 1.877.289.3997 www.bayshore.ca ISO 9001 HealthCare Quality Management System Registered Company 37 OBIA REVIEW SUPPORT Survivor Stories Coping: Getting Back in the Saddle Again By Barrie Faulkner etc. To an ABI survivor this can be overwhelming and fatiguing. Although brain injury supposedly does not affect an individual’s I.Q., it definitely slows the decision making process which can result in bad decision making. Best allaround to trust in a guide. Most modern multi speed bikes have two gear levers. There are good and bad combinations of gears. Bad combinations are inefficient and can have safety issues, for example, it is possible to drop the chain resulting in the loss of all power in the bike. The chain drop problem became much more acute as weather conditions deteriorate or as the driver becomes fatigued. I really love riding a bicycle. Two years ago my son and I rode our bicycles from our home in Bracebridge to Istanbul, Turkey and back. OK, we cheated by putting our bikes on the Queen Mary to cross the Atlantic Ocean each way but that was all part of the fun. As an ABI survivor I’m aware that I have problems in addition to those faced by most bike riders and these problems get more acute as I get tired. Logically it might seem that I should “give up” bike riding, however, for all ABI survivors it is essential that we do not “give up.” Instead, taking steps to make it easier for us to cope and make life safer is of the utmost importance. 38 (carbon-fibre reinforcement) and temple protection. It is not the lightest, best ventilated, most pony-tail friendly or most fashionable helmet on the market. My research shows it to be the SAFEST. I wear a helmet for safety…period. I no longer ride in groups. Riding with others is distracting and with brain injury I have trouble multi-tasking. Watching traffic, road surfaces, conversing with others, maneuvering around other bikers is multi-tasking. The consequence can be dangerous. Best I avoid this. Here are some of the steps I’ve taken to cope with bike riding: This seems a total contradiction to #2, but when I ride somewhere new I’ve learned to never ride alone. The person riding with me must be very knowledgeable about brain injury. Riding with me means either being quite a bit ahead, leading me or quite a bit behind, watching for possible problems. I try to stay current with the latest helmet safety technology. My present helmet has MIPS (Multi-directional Impact Protection System), Aramid bridging In addition to the normal challenges facing a rider, really new situations present problems with navigation, sights, customs, maybe even language Gear changing is a constant task and for most riders it becomes largely automatic. For ABI survivors the constant decision making can be quite fatiguing and can become extreme if inattention and/ or lack of ability to learn automatic response is a factor. Also with combination gearing systems, gear changing must occur while the rider is pedalling the bike. If a rider forgets to gear down while braking (gearing down and braking at the same time is multitasking), the bike is in too high a gear and starting up is quite difficult and can be dangerous as it is easy for the bike to wobble when starting in the wrong gear. My bike is equipped with a fourteen speed internal gear hub. Only one shifter, no bad combinations. The chain is always in a straight line and tensioned, making it almost impossible to “drop the chain.” Any gear change can occur either in motion or at a stop. Way less for me to worry about, way fewer problems, way safer! Almost all serious cyclists use pedals that the shoes clip into and these have a JUNE 2015 number of advantages. To disengage the shoe from the pedal simply requires the rider to flick his/her heel away from the bike. Fine while the bike is in motion, physics keeps the bike upright. When the bike is stopped, the outward flick of the heel causes the bike and rider to unceremoniously fall sideways onto the road. The rider is unable to break the fall, quite dangerous when in traffic. Again most riders quickly learn to automatically clip out when slowing down. For an ABI survivor, slowing down at a traffic light, gearing down, signally a turn, watching the light, watching where the curb is, watching what the car beside you is doing and clipping out all at the same time is multi-tasking. Dangerous if you get it wrong and suddenly tumble over sideways onto the road. The simplest solution is to use platform type pedals but those eliminate some safety features of clip-ins such as your foot cannot accidently slip off the clip in pedal. toes. When disengaging the foot moves backwards out of the cage, an action which does not cause the bike to topple over (care must be taken to ensure the shoe treads do not catch in the pedals). My bike’s taillight has a sensor mode which automatically turns on if it gets dark and the bicycle is in motion. The light stays on for four minutes after the bike has stopped, keeping me visible at a traffic light or stop sign. I no longer have to remember to turn my light on at dusk or when entering a long bridge or tunnel, or turn off to save the batteries. A safety feature that I do not have to waste my energy worrying about. We all have different problems. These are some of the ways I cope in claiming back an activity that I love. They at least help me to feel safer as I ride along. We’re all in this together and need to share what we have learned. Please write and share something that has helped you cope in your ABI recovery. ◊◊◊ My solution is to use the old rat trap type pedal where there is a cage over the We want to hear from you. Do you have a story of survival? Do you have coping strategies to share? Are you a caregiver to someone with ABI? Have you dedicated your life to helping those with brain injuries? To help spread the awareness of how brain injury impacts our lives, OBIA is pleased to share stories from our readership. The goal is simple: Share • Inspire • Support To share your stories with our readers, email us at stories@obia.on.ca 39 OBIA REVIEW Support Services for Brain Injury Helping individuals living with the effects of brain injury achieve a better quality of life Serving East Central Ontario MindWorks Group 312 Rubidge Street Peterborough, Ontario K9J 3P4 Phone: 705-741-3412 Fax: 705-741-4098 Toll Free: 1-800-559-8323 www.mindworksgroup.ca 40 OUR SERVICES s s s s s Rehabilitation Assistants Community Support Staff School Support Staff Recreational Programming Vocational Planning, Programming and Coaching JUNE 2015 EDUCATION How Brain Injuries Affect Men and Women Differently By Alison, BIST Blog Contributor Traumatic brain injuries (TBIs), concussions in particular, have been getting some much-needed attention from the media. Despite recent evidence that females are more susceptible to concussions and have greater difficulties with recovery than men, the media reports mainly on male athletes. For example, hockey fan or not, most people heard about NHL player, Sidney Crosby’s struggle with concussions from 2011 to 2012. However, around that time, far fewer people heard about award-winning, female hockey Olympian, Meghan Duggan’s struggle with her concussion. Even fewer learned of Katie Weatherston’s lost chance at the 2010 Olympics due to concussion symptoms. This disparity concerns the unreported statistics of female athletes that have retired from professional sports due to TBI. Focus of attention should be shared between men and women equally, so that female athletes may be better protected and female survivors better supported. This article discusses some of the ways that brain injuries are known to affect men and women differently. The brain is the most complex organ in the human body. It controls our bodily functions, movements, thoughts, and feelings. Although no two brains are alike, men’s and women’s brains are remarkably different, so trauma to the brain can affect the sexes differently. Given that TBI has a multi-factorial pathophysiology and a symptom profile that is unique to each person, it is very difficult to develop treatments that are effective in most TBI survivors. Factoring gender into the standard of care is a much-needed approach to the management of acquired brain injuries. Further research is required to understand how men and women respond to and recover from TBIs differently. neuronal densities, connections, and activity. Male brains have a higher proportion of gray matter whereas female brains have a higher proportion of white matter. Gray matter is made up of more active neurons that process information where white matter networks information between different areas of the brain. White matter allows people to integrate thoughts from gray matter, which helps with complex skills such as language (Jung and Haier, 2007). This suggests that women’s brains are more complex, even though men and women are equally intelligent. Evidence also suggests that the percentage of gray and white matter regions involved in cognition that are located in the frontal lobes is drastically larger in women than that in men. Taking into account the specific location of trauma to the brain, these differences could explain some of the genderspecific variations of TBI symptoms. For instance, injury to the frontal lobes could be more devastating to females than males. Concussion Rates for Men and Women Although the majority of people that sustain a TBI are male, recent studies indicate that females are actually more susceptible to concussions and poorer outcomes. Despite the fact that more males play contact sports than females, females suffer significantly higher rates of concussions than males playing the same sports. Where males have a higher percentage of concussions resulting from player-player contact, females have a higher percentage of concussions resulting from playersurface contact and player-equipment contact (Dick, 2009). A higher incidence rate of sports-related concussions (SRCs) has been documented in females in high school sports (soccer and basketball) (Powell JW and Barber-Foss KD, 1999) and How Male and Female Brains Differ The anatomy of the male and female brains differ in many ways. In general, men’s brains are larger than women’s brains, and women’s brains have thicker, more convoluted cortexes with more tightly packed neurons (brain cells). The following parts of the brain are, on average, larger in male brains than female brains: the hippocampus, which is involved in memory formation; the amygdala, which is involved in emotion and memories; and the third interstitial nucleus of the anterior hypothalamus, which is believed to play a role in sexual orientation and gender identity. Functionally, male and female brains rely more heavily on different sides of their brains when performing various tasks. Most interestingly, there is a substantial difference in ratios of gray to white brain tissue matter between the two sexes. This translates to different 41 OBIA REVIEW college-level sports (soccer, basketball, and ice hockey) (Hootman et al., 2007; Covassin et al., 2013). Furthermore, high school girls are more likely to have recurrent concussions than boys (Castile et al., 2012). The gender-specific rates of SRCs have been explained by the fact that women have less neck strength than men. Neck strength is crucial for protecting the brain from sudden acceleration-deceleration forces. In fact, it is already welldocumented that women are more susceptible to whiplash injuries, which are cervical spine injuries due to sudden acceleration-deceleration. TBI and whiplash are often experienced concurrently and can cause similar symptoms. Besides having stronger neck and back muscles, men also have more cartilage in the facet joints of the spine, resulting in better protection from injury. Another theory behind the discrepant SRC rates between men and women is that a person’s body mass index (BMI) may play a role in transmitting force and, hence, contribute to the severity of an injury. Young girls tend to have higher BMIs than boys their age. Also, the women that were analyzed in a study that showed worse outcomes in females after TBI had a slightly higher average BMI than the men in that study (Covassin et al., 2013). Concussion Morbidity in Men and Women Besides being a factor in the rate of concussions, gender is also a risk factor for morbidity. An analysis of 8 different studies demonstrated that TBI outcomes were worse, in general, for women than men in 85% of the physical symptoms, including memory, concentration, dizziness, fatigue, sensitivity to light and/or noise, headache, anxiety and depression (Farace and Alves, 2000). One study looked at 1425 subjects with mild TBI to compare the acute symptoms of post-concussion syndrome (PCS) between men and women. The subjects were assessed at the initial emergency department visit and then 3 months later. The results showed a significant correlation between female gender and worse symptoms that was especially strong for females in their childbearing years (Bazarian et al., 2010). A different study focused on the long-term consequences of mild TBIs and found that 3 years after their injuries, women had worse outcomes than men in terms of symptoms and disability. Of 163 patients, approximately 50% of the women had PCS, whereas only 30% of the men had PCS after 3 years (Styrke, 2012). Additional variances can be seen when comparing the ability of concussed men and women to demonstrate specific skills. For example, studies have shown that post-concussion female soccer athletes have significantly slower reaction times than their male equivalents (Colvin et al., 2009). Concussed female soccer players have also been shown to perform more poorly than concussed male soccer players on visual image memory tests (Covassin et al., 2007). In contrast, female TBI survivors tend to outperform male survivors on tests of verbal memory (Bengston et al., 2000) and executive functions, including 42 planning, initiating, and problem solving (Barr, 2003; Bounds et al., 2003, Putukian et al., 2000; Schopp et al, 2001). The psychosocial consequences of TBI appear to be harder for women than they are for men. One study reported that women are less likely to have a caregiver and are particularly vulnerable to isolation, disempowerment, and abuse (Alston et al., 2012). For some reason, males with TBI are more likely to be successfully employed, more likely to receive vocational rehabilitation services, and less likely to have vocational services prematurely terminated than woman (Jensen and Thulstrup, 2001; McCauley et al., 2001; Bounds et al., 2003). Hormonal Changes After TBI Although the mechanism is not yet fully understood, it is clear that sex and stress hormones play a major role in protecting the brain and/or damaging it further after trauma. The sex hormones include estradiol, progesterone, and testosterone, and the main stress hormone of interest is cortisol. The pituitary hormones, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), stimulate the production of the sex hormones. Brain injuries have been shown to disrupt hormone production. Immediately after severe TBI, the following hormones become acutely elevated: estradiol and progesterone in men; testosterone, FSH, and LH in women; and cortisol in both men and women. These hormone levels then plummet below normal within the first six days following the injury, resulting in hypogonadism (a reduction in sex hormone secretion) (Wagner et al., 2011). Another study documented hypogonadism between 7 and 20 days after moderate to severe TBI in up to 80% of males and 90% of females (Agha et al., 2004). Severe and/or chronic disruptions to sex hormones have been correlated with worse outcomes. There is ongoing research on understanding how these hormones repair and/ or damage male and female brains differently in hopes of developing new hormone therapies for TBI. Hormones fluctuate more drastically in women, making women particularly susceptible to migraines and reproductive changes after a TBI. Fluctuations in estradiol are a cause of migraines in women of childbearing ages. Concussed female JUNE 2015 Barr, W.B. (2003). Neuropsychological testing of high school athletes. Preliminary norms soccer players report double the rate of migraines compared to the males (Covassin et al., 2013). One study followed 104 women with moderate to severe TBI and observed that 46% of those women had amenorrhea lasting up to 60 months and 68% of them developed irregular menstrual cycles including more skipped menses. The women also reported worsened premenstrual syndrome (PMS) and menopausal symptoms after TBI. Although the study did not see an effect of TBI on fertility, it noted that fewer female TBI survivors gave birth to children than the controls and that those that did had more difficulties in the postpartum period. (Colantonio et al., 2010). and test-rested indices. Achieves of Clinical Neuropsychology, 18, 91-101. Bazarian, J.J., Blyth, B., Mookerjee, S., He, H., McDermott, M.P. (2010). Sex Differences in Outcome after Mild Traumatic Brain Injury. Journal of Neurotrauma, 27(3): 527-539. Bengtson, M., Martin, R., Sawrie, S., Gilliam, F., Faught, E., Morawetz, R., Kuzniecky, R. (2000). Gender, memory, and hippocampal volumes: Relationships in temporal lobe epilepsy. Epilepsy Behavior, 1, 112-119. Bounds, T.A., Schopp, L., Johnstone, B., Unger, C., Goldman, H. (2003). Gender differences in a sample of vocational rehabilitation clients with TBI. NeuroRehabilitation, 18, 189-196. Castile, L., Collins, C.L., McIlvain, N.M., et al. (2012). The epidemiology of new versus recurrent concussions among high school athletes, 2005-2010. British Journal of Sports Medicine, 46:603-610. Colantonio, A., Mar, W., Yoshida, K., Escobar, M., Velikonja, D., Rizoli, S., Cusimano, Conclusions M., & Cullen, N. (2010). Women’s health outcomes after traumatic brain injury. Journal of Women’s Health, 19(6), 1109-1116. This review of the scientific literature concludes that gender has a significant effect on TBI outcomes. The conditions that determine when and how women or men might fare better or worse are multi-factorial and include age, severity of injury, timing of the assessments, and affected area(s) of the brain. In general, females, particularly young girls and women of childbearing potential, are more susceptible to sustaining new and recurrent TBIs. Women deal with increased incidences of migraines and reproductive changes after TBI. Trend analyses indicate that post-TBI, women fare worse with visual memory whereas men fare worse with verbal memory and executive functions. Moreover, evidence suggests that psychosocial effects of TBI are more detrimental to women than men. Colvin, A.C., Mullen, J., Lovell, M.R., Vereeke West, R., Collins, M.W., Groh, M. (2009). The Role of Concussion History and Gender in Recovery From Soccer-Related Concussion. American Journal of Sports Medicine, 37:1699. Covassin, T., Schatz, P., Buz Swanik, C. (2007). Sex Differences in Neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery, 61:345-351. Covassin, T., Elbin, R.J., Harris, W., Parker, T., Kontos, A. (2012). The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion. American Journal of Sports Medicine, 40(6):1303-12. Covassin, T., Elbin, R.J., Bleecker, A., Lipchik, A., Kontos, A.P. (2013). Are there differences in neurocognitive function and symptoms between male and female soccer players after concussions? American Journal of Sports Medicine, 41(12):2890-2895. Dick, R.W. (2009). Is there a gender difference in concussion incidence and outcomes? British Journal of Sports Medicine, 43:i46-i50. Other studies have published findings that are controversial to the ones presented in this article. The discrepant results can likely be explained by variations in the sample populations. In other words, the contradicting studies did not use the same criteria for selecting participants and/or performing analyses as the studies discussed in this article. Given the inherent difficulties surrounding the study of brain injuries, it is very difficult for researchers to design trials that control for all of the factors that could potentially affect the results. Some of those factors include, but are not limited to, equal number of male and female subjects, baseline test scores, timing of post-injury testing, BMI, age, severity of injury, cause of injury/specific sport, education level, concussion history, and medical history, etc. Farace, E. and Alves, W.M. (2000). Do women fare worse: a metaanalysis of gender differences in traumatic brain injury outcome. Journal of Neurosurgery, 93:539–545. Hootman, J.M., Dick, R., Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training, 42:311–319. Jensen, O.K. and Thulstrup, A.M. (2001). Gender differences of post-traumatic headache and other post-commotio symptoms. A follow-up study after a period of 9-12 months. Ugeskr Laeger, 164, 5029-5033. Johan Styrke. Traumatic brain injuries and whiplash injuries: epidemiology and longterm consequences. Doctoral thesis, 2012. Jung, R.E. and Haier, R.J. (2007). The Parieto-Frontal Integartion Theory (P-FIT) of intelligence: Converging neuroimaging evidence. Behavioural and Brain Sciences, 30, 135-187. McCauley, S.R., Boake, C., Levin, H.S., Contant, C.F., Song, J.X. (2001). Postconcussional disorder following mild to moderate traumatic brain injury: Anxiety, depression, and Given the anatomical, hormonal, and psychosocial differences between men and women, it would be beneficial to consider gender a factor when planning treatment, support, and return to school/sports/work for TBI survivors. However, further research is needed before gender-specific treatments can be developed and new medical management guidelines established. social support as risk factors and comorbidities. Journal of Clinical Experimental Neuropsychology, 23, 792-808. Powell, J.W. and Barber-Foss, K.D. (1999). Traumatic brain injury in high school athletes. JAMA, 282:958–963. Putukian, M., Echemendia, R.J., Mackin, S. (2000). The acute neuropsychological effects of heading in soccer: A pilot study. Clinical Journal of Sport Medicine, 10, 104-109. Schopp, L., Shigaki, C., Johnstone, B., Kirkpatrick, H. (2001). Gender differences in cognitive and emotional adjustment to traumatic brain injury. Journal of Clinical References Psychology in Medical Settings, 8, 181-188. Wagner, A.K., McCullough, E.H., Niyonkuru, C., Ozawa, H., Loucks, T.L., Dobos, Agha, A., Rogers, B., Mylotte, D., Taleb, F., Tommy, W., Phillips, J., Thompson, C.J. J.A., Brett, C.A., Santarsieri, M., Dixon, C.E., Berga, S.L., Fabio, A. (2011). Acute (2004). Neuroendocrine dysfunction in the acute phase of traumatic brain injury. Clinical serum hormone levels: characterization and prognosis after severe traumatic brain injury. Endocrinology (Oxford), 60(5), 584-591. Journal of Neurotrauma, 28(6):871-88. ◊◊◊ Alston, M., Jones, J., Curtin, M. (2012). Women and Traumatic Brain Injury: “It’s not visible damage”. Australian Social Work, 65(1):39-53. 43 OBIA REVIEW EDUCATION Events Calendar For more listings, check: www.obia.ca/events Location: Four Seasons Hotel, Toronto, ON Contact: Elisa O’Neill, Client Services Coordinator Phone: 416-868-3195 Fax: 416-868-3134 Email: eoneill@thomsonrogers.com September 28, 2015 BIA Quinte District presents: Empowering Your Rehabilitation: Today, Tomorrow and Yesterday (originally scheduled for May 14, 2015) Location: Core Centre, 2nd Floor, 223 Pinnacle Street, Belleville, ON Contact: BIAQD office Phone: 613-967-2756 Email: info@biaqd.ca October 6, 2015 June 10, 2015 BIST/OBIA presents: 11th Annual Mix and Mingle Location: Steamwhistle Brewery, Toronto, ON Contact: Terry Bartol Phone: 905-641-8877 ext. 234 Fax: 905-641-0323 Email: events@obia.on.ca June 20, 2015 Dale Brain Injury Services presents: 7th Annual HEADS UP Walk-a-thon for Brain Injury Awareness Location: Springbank Gardens, London, ON Contact: Lisa McIntyre Phone: 519-668-0023 ext. 102 Email: contact@daleservices.on.ca Website: www.daleservices.on.ca June 20, 2015 OBIA presents: Annual General Meeting Location: Room 318, Miles Nadal JCC, 750 Spadina Avenue, Toronto, ON Contact: Diane Dakiv Phone: 905-641-8877 ext. 231 Fax: 905-641-0323 Email: ddakiv@obia.on.ca September 10, 2015 The Personal Injury Alliance (PIA) presents: Back to School Conference/2015 Awards of Excellence in Brain Injury Rehabilitation 44 MRI Appointments presents: Brain Injury Disagnostics Half Day Conference - What’s New and What You Need to Know Location: Windsor, ON Contact: Deborah Crowe Phone: 519-878-5839 Email: deb@mriappointments.com October 14-15, 2015 OBIA and Headwaters ABI Group (HABI) present: Brain Basics Location: Dufferin Child and Family Services, 655 Riddell Road, Orangeville, ON Contact: Diane Dakiv Phone: 905-641-8877 ext. 231 Email: training@obia.on.ca Website: www.obia.ca/brain-basics/ October 23-24, 2015 OBIA and Brock University present: Children and Youth with Acquired Brain Injury Location: Holiday Inn & Suites Conference Centre, St. Catharines, ON Contact: Diane Dakiv Phone: 905-641-8877 ext. 231 Email: training@obia.on.ca Website: www.obia.ca/brock-university-certificate-courses November 11-13 2015 OBIA and participating Community Associations present: 2015 ABI Provincial Conference - Innovate Integrate Motivate Location: Sheraton on the Falls Hotel, Niagara Falls, ON Contact: Terry Bartol Phone: 905-641-8877 ext. 234 Fax: 905-641-0323 Email: conference@obia.on.ca Website: www.ontarioabiconference.ca ◊◊◊ JUNE 2015 2015 Acquired Brain Injury Provincial Conference PRESENTED BY INNOVATE INTEGRATE MOTIVATE and PARTICIPATING COMMUNITY ASSOCIATIONS Register Now! For more information www.ontarioabiconference.ca November 11 -13, 2015 Sheraton on the Falls Hotel Niagara Falls, Ontario Brain Injury Diagnostics Half Day Conference “What’s New and What You Need to Know” Tuesday, October 6, 2015 • 8 a.m. - 12 noon Holiday Inn Hotel & Suites, 1855 Huron Church Road, Windsor, ON Speakers DR. YIN-HUI SIOW DR. WILLIAM PAVLOSKY Radiologist and Director of Nuclear Medicine, Southlake Regional Health Center Associate Professor, Schulich School of Medicine & Dentistry, University of Western Ontario, Department of Medical Imaging DR. DONALD LEE DR. SAADIA AHMAD Neuroradiologist, London Health Sciences Centre Clinical Neuropsychologist, Faculty, Hotel Dieu Grace Healthcare Program approved for 4 Substantive CEU’s through the Law Society of Upper Canada All proceeds to be donated to: Contact: Deborah Crowe • Telephone: 1-519-878-5839 • Email: deb@mriappointments.com 45 OBIA REVIEW SUPPORT Community Associations All recent changes to information marked in orange. Call OBIA 1-855-642-8877 Toll Free Support Line 1-800-263-5404 (HELPLINE) Ontario Brain Injury Association Dufferin County (Mail) PO Box 2338, St. Catharines, ON L2R 7R9 (Courier) 3550 Schmon Parkway, 2nd Floor, Thorold, ON L2V 4Y6 Phone: 905-641-8877 or 1-855-642-8877 Toll-free support 1-800-263-5404 Fax: 905-641-0323 Email: obia@obia.on.ca Web Site: www.obia.ca Headwaters ABI Group (HABI) Belleville BIA of Quinte District 223 Pinnacle Street, Core Centre Belleville, ON K8N 3A7 Phone: 613-967-2756 or toll free: 1-866-894-8884 Fax: 613-967-1108 Email: info@biaqd.ca Website: www.biaqd.ca Chatham-Kent New Beginnings ABI & Stroke Recovery Association (2 Locations - Chatham and Sarnia) 9 Maple Leaf Drive Chatham, ON N7M 6H2 Phone: 519-351-0297 Fax: 519-351-7600 Email: info@newbeginnings-cksl.com Website: www.newbeginnings-cksl.com Contact: Bob Rawlinson 46 Orangeville, ON Phone: 519-215-1519 Contact: Volunteer Intake Coordinator Durham BIA of Durham #24 - 850 King Street West Oshawa, ON L1J 8N5 Phone: 905-723-2732 or toll free: 1-866-354-4464 Fax: 905-723-4936 Email: information@biad.ca Website: www.biad.ca Contact: Frank Murphy, Exec. Director Fort Erie HIA of Fort Erie and District 649 Niagara Boulevard Fort Erie, ON L2A 3H7 Phone: 905-871-7789 Fax: 905-871-7832 Email: hiafeadmin@bellnet.ca Contact: Donna Summerville Hamilton-Wentworth Hamilton BIA 822 Main Street E. Hamilton, ON L8M 1L6 Phone: 905-538-5251 Fax: 905-390-3649 Email: info@hbia.ca Website: www.hbia.ca Contact: Adria Repp JUNE 2015 London and Region Peterborough Area BIA of London and Region Brain Injury Association Peterborough Region 560 Wellington St., Lower Level London, ON N6A 3R4 Phone: 519-642-4539 Fax: 519-642-4124 Email: info@braininjurylondon.on.ca Website: www.braininjurylondon.on.ca Contact: Donna Thomson 158 Charlotte St. Peterborough, ON K9J 2T8 Phone: 705-741-1172 or 1-800-854-9738 Fax: 705-741-5129 Email: biapr@nexicom.net Website: www.biapr.ca Contact: Cheryl Ann Hassan Niagara Area BIA of Niagara Office: #10 - 261 Martindale Road, St. Catharines, ON Mail: PO Box 20019 Thorold, ON L2V 5B3 Phone: 905-984-5058 Fax: 905-984-5354 Email: pat@bianiagara.org Website: www.bianiagara.org Contact: Pat Dracup North Bay Area BIA of North Bay and Area c/o PHARA 280 Oakwood Ave. North Bay, ON P1B 9G2 Phone: 705-840-8882 Fax: n/a Email: contact@bianba.ca Website: www.bianba.ca Sarnia-Lambton BIA of Sarnia-Lambton #1032 - 1705 London Line, Sarnia, ON N7W 1B2 Phone: 519-337-5657 Fax: 519-337-1024 Email: info@sarniabiasl.ca Website: www.sarniabiasl.ca New Beginnings ABI & Stroke Recovery Association Lochiel Centre 180 College Avenue North, 2nd Floor Sarnia, ON N7T 7X2 Phone: 519-491-2668 Fax: 519-491-2632 Email: info@newbeginnings-cksl.com Website: www.newbeginnings-cksl.com Contact: Bob Rawlinson Sault Ste. Marie BIA of Sault Ste. Marie & District Ottawa Area BIA of Ottawa Valley 211 Bronson Avenue, 3rd Floor Ottawa, ON K1R 6H5 Phone: 613-233-8303 Fax: 613-233-8422 Email: BrainInjuryOttawaValley@bellnet.ca Website: www.biaov.org Contact: Wendy Charbonneau PO Box 272 Richards Landing, ON P0R 1J0 Phone: 705-943-0424 Fax: n/a Email: braininjuryssmd@gmail.com Website: www.braininjuryssm.ca Contact: Elizabeth Eddy Sudbury and District BIA of Sudbury & District Branch Peel-Halton BIA of Peel & Halton PO Box 47038 Sheridan Mall PO Mississauga, ON L5K 2R2 Phone: 905-823-2221 or 1-800-565-8594 Fax: 905-823-9960 Email: biaph@biaph.com Website: www.biaph.com Contact: Jorun Rucels 2750 Bancroft Drive Sudbury, ON P3B 1T9 Phone: 705-670-0200 Fax: 705-222-2427 Email: info@biasd.ca Website: www.biasd.ca Contact: Sean Parsons 47 OBIA REVIEW Thunder Bay Waterloo-Wellington BIA Thunder Bay & Area BIA of Waterloo-Wellington #217 - 1100 Memorial Ave. Thunder Bay, ON P7B 4A3 Phone: 807-621-4164 Email: biatba@yahoo.ca Website: www.bisno.org/brain-injury-association-of-thunder-bay #1-31 McBrine Drive Kitchener, ON N2R 1J1 Phone: 519-579-5300 Fax: 519-579-0118 Email: patti@biaww.com Website: www.biaww.com Contact: Patti Lehman, Exec. Director Timmins 48 Seizure & Brain Injury Centre Windsor-Essex 733 Ross Ave. E. Timmins, ON P4N 8S8 Phone: 705-264-2933 Fax: 705-264-0350 Email: sabicrl@eastlink.ca Website: www.seizurebraininjurycentre.com Contact: Rhonda Latendresse BIA of Windsor and Essex County Toronto (GTA) York Region Brain Injury Society of Toronto Brain Injury Association of York Region #205-40 St. Clair Ave. East Toronto, ON M4T 1M9 Phone: 416-830-1485 Email: info@bist.ca Website: www.bist.ca Contact: Michelle McDonald 11181 Yonge St., 3rd Floor Richmond Hill, ON L4S 1L2 Office Voicemail: 905-780-1236 Fax: 905-780-1524 Email: baebristow@rogers.com Website: www.biayr.org Contact: Bev Bristow #200 - 201 West Grand Blvd. Windsor, ON N9E 3W7 Phone: 519-981-1329 Email: info@biawe.com Website: www.biawe.com Contact: Mary-Ann Fuduric JUNE 2015 ), - ./#0 ,#1)2 #3 4 . ,) 15 6 !" # $ #$ %$&%'!& %(#)*%'+* !" " !" # !"# # !" 49 OBIA REVIEW SUPPORT Provincial Associations Brain Injury Canada/Lésion Cérébrale Canada 200 - 440 Laurier Ave. West Ottawa, ON K1R 7X6 Phone: 613-762-1222, Toll Free Line: 1-866-977-2492 Fax: 613-782-2228 Website: www.braininjurycanada.ca Email: info@braininjurycanada.ca British Columbia Brain Injury Association Newfoundland and Labrador Brain Injury Association Sea to Sky Meeting Management Inc. Suite 206, 201 Bewicke Avenue North Vancouver, BC V7M 3M7 Phone: 604-984-1212 Fax: 604-984-6434 Website: www.brainstreams.ca Email: info@brainstreams.ca PO Box 21063 St. John’s, NF A1A 5B8 Phone: 709-579-3070 Fax: n/a Website: www.nlbia.ca/index.php Email: nlbia2011@gmail.com Central Alberta Brain Injury Society (CABIS) Regroupement des associations de personnes traumatisées cranio-cérébrales du Québec #202, 4805 - 48 Street Red Deer, AB T4N 1S6 Phone: 403-341-3463 Fax: 403-346-1035 Website: www.cabis.info Email: cabis@telus.net 220, avenue de Parc Laval, QC H7N 3X4 Phone: 450-575-8227 Fax: 514-274-1717 Website: www.raptccq.com Email: info@raptccq.com Saskatchewan Brain Injury Association Brain Injury Association of Nova Scotia Mail: P.O. Box 3843 Regina, SK S4P 3Y3 Office: #322 - 310 Main St. N. Moose Jaw, SK S6H 3K1 Phone: 306-373-1555 or Toll Free (in Sask) 866-373-1555 Fax: 306-373-5655 Website: www.sbia.ca Email: info_sbia@sasktel.net PO Box 8804 Halifax, NS B3K 5M4 Phone: 902-473-7301 Fax: 902-473-7302 Website: http://braininjuryns.com/ Email: info@braininjuryns.com Manitoba Brain Injury Association 50 Brain Injury Association of Canada (New Brunswick) Phone: 506-721-8003 Website: www.biacnb.org Email: biacnb@icloud.com 204 - 825 Sherbrook St. Winnipeg, MB R3A 1M5 Phone: 204-975-3280 or Toll Free: 866-327-1998 Fax: 204-975-3027 Website: www.mbia.ca Email: info@mbia.ca #5 - 81 Prince Street Charlottetown, PE C1A 4R3 Phone: 902-314-4228 or 902-367-3216 Website: www.biapei.com Email: info@biapei.com Ontario Brain Injury Association Alberta Brain Injury Association PO Box 2338 St. Catharines, ON L2R 7R9 Phone: 905-641-8877 or 800-263-5404 (support) 855-642-8877 (admin) Fax: 905-641-0323 Website: www.obia.ca Email: obia@obia.on.ca Website: www.biaa.ca Brain Injury Association of PEI JUNE 2015 51 OBIA REVIEW EDUCATION OBIA Training The Ontario Brain Injury Association in conjunction with Brock University has developed a Certificate Training Program to provide professionals with the tools and knowledge to assist clients with recovery and function in everyday life following acquired brain injury. Brock Certificate Training Programs: The program is currently composed of two separate levels and feature guest faculty. Both levels are directed primarily at personnel working in community and home based rehabilitation programs that serve individuals with acquired brain injury. Featured course Children and Youth with Acquired Brain Injury Approved by VRA Canada for 11.75 Continuing Education Hours This Certificate Training Program will focus on providing information about behaviours after ABI that relate to learning and an a nd co ccommunity comm omm mmun unit itty p pa participation. art r iccip pat atio on. n. E Emphasis mph mp ha asis is o on n de d describing escr cribin ng tthe ng he ccognitive-communicative co gniittiv gn ivee-co c mm mmun mun unic icat ativ ive problems prrob p oble lem mss that tha at aff ffe ect ctt classroom cla lasssroom lass room ro learning, lear le arni ar ning ni ng,, beha ng b be behaviour eha havi viou vi ourr an ou and d co comm community m un mm unit ity yp pa participation. artic rticip ip pat attio io ion on. G Group roup ro up p problem-solving problem solving activities will develop methods for assessing and treating educational and social challenges for these individuals from a functional perspective. Details Lo Location: ocat cation: Date: Hotels: Professors: H Holiday ollid da ay y IInn nn S nn Suites uiite tes & Co C Conf Conference onf nfer eren nce ce C Centre entre 3 327 27 O 27 Ontario nttar ario oS Street tree tr eet ee S St. t C t. Catharines, atha at ha h ari rine n s,, O ne ON N October 23 to October 24, 24 2015 Holiday Inn & Suites - 905.688.2324 Roberta DePompei, Ph.D Some topics covered during this training program include: 52 • Characteristics that impact learning and behaviour • Environmental scans and communication partners and treatment strategies • Transitions, functional outcomes and collaborations For more information about this and/or other Certificate Training Programs visit: www.obia.ca 905.641.8877 1.855.642.8877 training@obia.on.ca JUNE 2015 DISCLAIMER: Articles may be reproduced from the OBIA Review provided credit is given to the authors wherever possible. Note: the opinions expressed herein are those of the respective authors and advertisers and not necessarily those of the Ontario Brain Injury Association (OBIA). OBIA will not be liable for any damages or losses howsoever sustained, as a result of the reliance on or use by a reader or any other person of the information, opinion, or products expressed, advertised or otherwise contained herein. Where appropriate, professional advice should be sought. 53 OBIA REVIEW Advertiser Index Bartimaeus Rehabilitation Services Inc. - 6 Bayshore - 37 Bergeron Clifford LLP - 24 Brainworks Rehabilitation - 54 Carranza Barristers & Solicitors - 22 Champaigne Klassen - 31 Community Solutions - 30 Dale Brain Injury Services - 53 Gluckstein Personal Injury Lawyers - 55 Henderson Structured Settlements LP - 26 Hill Program - 39 Himelfarb Proszanski LLP - 51 Inter-Action Rehabilitation Inc. - 54 Judith Hull & Associates - 8 Lawlor Therapy Support Services Inc. - 53 Mazin Associates - 20 McKellar Structured Settlements - 2 McLeish Orlando - back cover Melamed, Beverlee C. - 54 Mindworks - 40 NHI Health Care - 37 NRIO - 40 Oatley, Vigmond LLP - 9 Pathways to Independence - 6 Rehab First - 34 ResCare Premier - 22 Shekter, Dychtenberg - 35 Singer, Kwinter - 36 Step Up! ABI Recovery - 49 Thomson Rogers Lawyers - 15 Wallbridge Wallbridge - 32 INTERESTED in advertising in the OBIA REVIEW? AD SPACE starting from $900 for one full year! Call OBIA 905-641-8877 54 JUNE 2015 55
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