WBEZ | brain injury http://www.wbez.org/tags/brain-injury Latest from WBEZ Chicago Public Radio en Few studies explore the unique impacts of brain injuries on women http://www.wbez.org/sections/work/few-studies-explore-unique-impacts-brain-injuries-women-109257 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/Women and Brain Injury.JPG" alt="" /><p><p dir="ltr" id="docs-internal-guid-3032e98d-94e0-f421-1028-2a7d34e4089f">When we talk about brain injuries, we usually talk about men. The media&rsquo;s recent focus on this health issue has focused on male-dominated fields such as<a href="http://www.pbs.org/wgbh/pages/frontline/sports/concussion-watch/concussion-watch-nfl-head-injuries-in-week-10/" target="_blank"> professional football </a>and the military.</p><p dir="ltr">Men are, in fact, far more likely to suffer brain injuries, but the numbers of women affected are nonetheless significant. <a href="http://link.springer.com/chapter/10.1007%2F978-0-387-76908-0_4" target="_blank">Over 30 percent of brain-injury patients are women.</a> And little research has focused specifically on them &mdash; which could have big consequences for their recovery.</p><p dir="ltr">Betty Tobler wears her braids tied back in a low ponytail. She doesn&rsquo;t look like someone with a severe injury. But walking around her house, it is impossible not to notice the challenges she faces nearly every moment of her life.</p><p dir="ltr">The lights in her house are kept low, because bright lights give her headaches. There are wipe boards with dates scribbled on them in the kitchen and hallways. Thanksgiving is written in big letters, because she said, &ldquo;The holiday will come and go and I will never think about it.&rdquo;</p><p dir="ltr">She has a book filled with information she does not want to forget. Her towels and potholders are all still in their packages. &ldquo;If you notice how clean my stove is. I don&rsquo;t cook. Because I could forget, and that could be dangerous,&rdquo; Tobler said. &nbsp;</p><p dir="ltr">Tobler&rsquo;s troubles began 14 years ago, when she was working as a caregiver for adults with mental disabilities. One of the clients had behavior issues, lost his temper, and got violent.</p><p dir="ltr">&ldquo;He was, first of all, 6&rsquo;8&rdquo; with size 13 shoes, 300 some pounds. I remember the punches on this side, which is my right side. And I remember hitting the floor and then something coming down like that, so that was his foot stomping the side of my head,&rdquo; Tobler said.</p><p dir="ltr">Tobler stopped working. She stopped driving. She had trouble remembering recent details, and big chunks of her past. She said she only knows her mother, who died years before her injury, through pictures.</p><p dir="ltr">&ldquo;And to be honest with you I didn&rsquo;t even knew who my dad was. It&rsquo;s like he was just a figure. Nothing made sense during that time,&rdquo; Tobler said.</p><p dir="ltr">In the nearly decade and a half since, attention to brain injuries has increased and more research has been done. Unfortunately, very little of it has focused on women.</p><p dir="ltr">&ldquo;I think it&rsquo;s essential to include women, because if we are only including men, or primarily including men, we are coming to incorrect or potentially incorrect conclusions about how to treat women and what certain patterns of behavior mean,&rdquo; said <a href="https://faculty.utah.edu/u0030255-JANIECE_L_POMPA/research/index.hml" target="_blank">Janiece Pompa, clinical professor at the University of Utah. </a></p><p dir="ltr">Experts say the lack of research is not intentional. Since more men have brain injuries, more of them are studied. But some research suggests there are gender differences that are important to understand in order to improve treatment.</p><p dir="ltr">One study, for example, showed the<a href="http://www.ncbi.nlm.nih.gov/pubmed/20469963" target="_blank"> big role hormones might play in recovery.</a>&nbsp;Other studies suggest <a href="http://www.ncbi.nlm.nih.gov/pubmed/23220341" target="_blank">women may experience more depression.</a> Another pointed to <a href="http://www.ncbi.nlm.nih.gov/pubmed/20469963" target="_blank">menstrual disturbances. </a></p><p dir="ltr">Pompa said a recent study focused on children who play soccer. &ldquo;It seems like girls actually have more severe head injuries than boys do. Which seems kinda disturbing, but valuable to know,&rdquo; she said.</p><p>Pompa says a lot of the &nbsp;research is still in its early stages and a lot more is needed to draw good conclusions.</p><p dir="ltr"><a href="https://twitter.com/BrainInjuryAssn" target="_blank">Philicia Deckard</a> works for the<a href="http://www.biail.org/" target="_blank"> Brain Injury Association of Illinois.</a>&nbsp;She says the difficulties facing women with brain injuries is not just about research, but also about who gets diagnosed.</p><p dir="ltr">She says our society has gotten better about screening professional athletes and <a href="http://www.nytimes.com/2007/07/04/us/04vets.html?ref=traumaticbraininjury&amp;gwh=164685F417EE4CFA677AF6A685CD7074" target="_blank">veterans,</a> but, &ldquo;We have to be mindful too of the segment of the population with domestic abuse. That&rsquo;s someone who could be undiagnosed. There are a lot more undiagnosed injuries than we know about.&rdquo;</p><p dir="ltr">Deckard&rsquo;s organization does outreach in shelters. She said even being shaken by a partner can bruise the brain. In a small survey of domestic violence survivors, <a href="http://www.biausa.org/tbims-abstracts/domestic-violence-related-mild-traumatic-brain-injuries-in-women" target="_blank">more than 60 percent reported signs of a brain injury.</a></p><p dir="ltr">Ginny Lazzara, a nurse who also works with the Brain Injury Association, said there is a reason brain injuries are called &ldquo;the invisible epidemic.&rdquo;</p><p dir="ltr">&ldquo;We have to understand that this goes way bigger than we would have ever imagined. There are so many people who have had brain injuries and been living with them and do not know that was why,&rdquo; said Lazzara.</p><p dir="ltr">Both Lazzara and Deckard say they are thankful for the attention professional athletes and veterans have brought to brain injuries. Now, they hope, the focus will expand. Betty Tobler hopes for that too.</p><p dir="ltr">&ldquo;I feel there is more focus toward brain injury because the men have contact sport, but there are women who play basketball, volleyball, or not even playing sports at all,&rdquo; said Tobler. &ldquo;You could be walking down the street the wrong way and hit your head. I feel there should be a lot of focus regarding brain injuries, period.&rdquo;</p><p dir="ltr">Tobler said maybe then, she and her injury won&rsquo;t be quite so invisible.</p><p dir="ltr"><a href="http://www.wbez.org/news/returning-work-after-brain-injury-109237">Read our first story on brain injuries, about workplace issues.&nbsp;</a></p><p><em>Shannon Heffernan is a WBEZ reporter. Follow her on Twitter&nbsp;<a href="https://twitter.com/shannon_h" target="_blank">@shannon_h</a></em></p></p> Tue, 26 Nov 2013 08:44:00 -0600 http://www.wbez.org/sections/work/few-studies-explore-unique-impacts-brain-injuries-women-109257 Returning to work after a brain injury http://www.wbez.org/news/returning-work-after-brain-injury-109237 <p><p>Concussions in the<a href="http://www.pbs.org/wgbh/pages/frontline/concussion-watch/"> National Football League (NFL)</a> and <a href="http://www.nytimes.com/2012/08/12/opinion/sunday/war-wounds.html?_r=0">military</a> have received a lot of attention lately. But traumatic brain injury is a much larger issue, affecting at least <a href="http://www.cdc.gov/ncipc/pub-res/mtbi/mtbireport.pdf">1.5 million Americans</a> each year.</p><p>As the impact of brain injuries becomes clearer, some experts say they are noticing a pattern. Many people with brain injuries are struggling in their efforts to return to work <a href="http://www.brainline.org/content/2008/10/fact-sheet-series-job-accommodations-people-brain-injuries-0.html">or get the accommodations</a> from their employers to deal with the aftermath.</p><p>Carey Gelfand lives in Glencoe, Ill., one of Chicago&rsquo;s North Shore suburbs. In 2006, she was working at an art consulting company. She traveled with her boss to New York City to attend an art expo. She was wearing a pair of flat-bottom cowboy boots when the temperature dropped and the rain-slicked streets froze over.</p><p>&ldquo;My feet went out from under me and my head just hit the pavement,&rdquo; said Gelfand.</p><p>Gelfand did what many of us do when we get embarrassed after a fall, she stood up and brushed herself off, declaring, &ldquo;I&rsquo;m fine, I&rsquo;m fine&hellip;&rdquo; &nbsp;She kept walking with her colleagues and then boarded a bus. &ldquo;And I looked out the window and I was thinking, &lsquo;I&rsquo;m here, but I&rsquo;m not,&rsquo;&rdquo; said Gelfand.&nbsp;</p><p>When she returned to Illinois, she began forgetting crucial details. She missed an appointment with an important client and could not concentrate at work. By most afternoons she was exhausted, and sometimes she would get terrible headaches.</p><p>&ldquo;My boss was wanting to take jobs away from me. I was very diminished in my position. I was just so frustrated and I had such poor sense of self,&rdquo; said Gelfand.</p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Concusions%20Work_GelfandPhoto.jpg" style="float: right; height: 193px; width: 210px;" title="The brain injury Carey Gelfand survived seven years ago still impacts her today. (Photo courtesy of Carey Gelfand)" />Dr. <a href="http://doctors.rush.edu/directory/profile.asp?setsize=10&amp;pict_id=0006610">James Young</a> specializes in rehabilitation neurology at Chicago&rsquo;s Rush University Medical Center. He said people like Gelfand do not always seek medical attention after a brain injury, because they do not understand how serious it can be. He said a brain injury can be serious even if the victim maintained consciousness.</div><p>Young added it is important after a brain injury see a neurologist who can administer the proper tests. Not doing so means it could be weeks or years before the injury is diagnosed.</p><p>&ldquo;People get fired from their jobs,&rdquo; said Young. &ldquo;They do worse in school. And their world starts to disintegrate, and they think it couldn&#39;t be related to this simple injury.&rdquo;</p><p>When Gelfand finally did see a doctor, weeks after her injury, he showed her a spot where her brain had bled.</p><p>&ldquo;They tell you to rest. Well, good luck,&rdquo; said Gelfand. &ldquo;You know, I couldn&rsquo;t really take time off from my job, because if I did, I&rsquo;d lose the project. I didn&rsquo;t want to risk having any losses when I was doing it, because I really wanted to come across as if I was competent.&rdquo;</p><p>The stigma of brain injury stops some employees from asking for accommodations. &ldquo;Your brain is you,&rdquo; said Gelfand. &ldquo;It is literally, in your head.&rdquo;</p><p>When employees do ask for workplace adjustments to deal with head injuries, they can be turned down. Young sometimes calls employers to advocate for his patients.</p><p>&ldquo;To sit there and say I just want them to work for four hours a day for two weeks&hellip; you would think I was asking for the world,&rdquo; Young said. He called this a double standard when compared to other injuries or illnesses, adding, &ldquo;If a person has a flu, and takes five days off, we accept that.&rdquo;</p><p>Young says one reason it&rsquo;s hard to get accommodations for a brain injury is because it&#39;s hidden. &ldquo;People who&rsquo;ve been in car accidents or who are assaulted [and get a brain injury], they said (I) wish I lost my arm so you could see my injury,&rdquo; said Young. &nbsp;</p><p><a href="http://www.athleticmed.com/staff-member/dr-morgan-wolin-psy-d/">Morgan Wolin</a>, a Chicago psychologist, says the invisibility of a brain injury can make human resources (HR) departments suspicious.</p><p>&ldquo;When you see these very vital, smart individuals and all of sudden they are aren&#39;t feeling normal, [and they have trouble with] attention spans and headaches, we start assigning they are malingering,&rdquo; said Wolin. &ldquo;And I think that is going to be the big problem understanding head injuries.&rdquo;</p><p>Wolin says she has seen her patients lose jobs. A<a href="http://www.biausa.org/tbims-abstracts/income-and-employment-status-one-year-after-brain-injury?A=SearchResult&amp;SearchID=7372036&amp;ObjectID=2758761&amp;ObjectType=35"> small study found people&#39;s incomes dropped an average of 50 percent after a brain injury and unemployment increased by more than 400</a> percent.</p><p><a href="http://www.faegrebd.com/stacey-smiricky">Stacey Smiricky</a> is an employment lawyer at the firm <a href="http://www.faegrebd.com/index.aspx">Faegre Baker Daniels.</a> She says most HR departments are understanding. But figuring out a reasonable accommodation is also the employee&rsquo;s responsibility.</p><p>&ldquo;They have to come to the party. You have to bring some suggestions of your own. You have to meet with the employer and say this might work,&rdquo; said Smiricky.</p><p>Wolin works with both athletes and non-athletes. She says sports teams have developed <a href="http://www.cdc.gov/concussion/headsup/return_to_play.html">&ldquo;back to play rules,&rdquo;</a> a plan for when and how someone can play again after an injury. She hopes he model will trickle down to HR departments.</p><p>&ldquo;I think we are in... one of those &lsquo;ah ha!&rsquo; [moments]. We know better now. But, if we know better, will we do better? Will human resources say, &lsquo;Okay concussions are a real thing, lets take it more seriously?&rsquo;&rdquo; asked Wolin.</p><p>Wolin says it is an exciting and scary moment, because we are realizing how much more we need to learn. That is especially true for a particular group: <a href="http://www.wbez.org/sections/work/few-studies-explore-unique-impacts-brain-injuries-women-109257">our second story, women with brain injurie</a>s.</p><p><em>Shannon Heffernan is a WBEZ reporter. Follow her <a href="https://twitter.com/shannon_h">@shannon_h</a></em></p><p><em>Clarification: A previous version of this story mischaracterized Gelfand&#39;s start date at her job. She had worked at the company for years before her injury. </em></p></p> Mon, 25 Nov 2013 09:46:00 -0600 http://www.wbez.org/news/returning-work-after-brain-injury-109237