A little about TBI
March 12th, 2010Traumatic Brain Injury (TBI)
I don’t know how many know, or care to remember that I am a survivor of TBI. I think many forget that fact, especially when I “look” so normal. I try to pick projects that don’t force my TBI difficulties, so I may also “look” like I’m functioning just fine. Odds are, if I’m selective enough, I am functioning fine for that project.
Well, here’s some background information on TBI. Hopefully, those who think they know me will remember to support me if I make a mistake, or just can’t recall something they have already told me.
What types of TBI are there?
Any injury to the head may cause traumatic brain injury (TBI). There are two major types of TBI:
Penetrating Injuries: In these injuries, a foreign object (e.g., a bullet) enters the brain and causes damage to specific brain parts. This focal, or localized, damage occurs along the route the object has traveled in the brain. Symptoms vary depending on the part of the brain that is damaged.
Closed Head Injuries: Closed head injuries result from a blow to the head as occurs, for example, in a car accident when the head strikes the windshield or dashboard. These injuries cause two types of brain damage:
Primary brain damage, which is damage that is complete at the time of impact, may include:
- skull fracture: breaking of the bony skull
- contusions/bruises: often occur right under the location of impact or at points where the force of the blow has driven the brain against the bony ridges inside the skull
- hematomas/blood clots: occur between the skull and the brain or inside the brain itself
- lacerations: tearing of the frontal (front) and temporal (on the side) lobes or blood vessels of the brain (the force of the blow causes the brain to rotate across the hard ridges of the skull, causing the tears)
- nerve damage (diffuse axonal injury): arises from a cutting, or shearing, force from the blow that damages nerve cells in the brain’s connecting nerve fibers
Secondary brain damage, which is damage that evolves over time after the trauma, may include:
- brain swelling (edema)
- increased pressure inside of the skull (intracranial pressure)
- epilepsy
- intracranial infection
- fever
- hematoma
- low or high blood pressure
- low sodium
- anemia
- too much or too little carbon dioxide
- abnormal blood coagulation
- cardiac changes
- lung changes
- nutritional changes
What physical problems occur after TBI?
Physical problems may include hearing loss, tinnitus (ringing or buzzing in the ears), headaches, seizures, dizziness, nausea, vomiting, blurred vision, decreased smell or taste, and reduced strength and coordination in the body, arms, and legs.
What communication problems occur after TBI?
People with a brain injury often have cognitive (thinking) and communication problems that significantly impair their ability to live independently. These problems vary depending on how widespread brain damage is and the location of the injury.
Brain injury survivors may have trouble finding the words they need to express an idea or explain themselves through speaking and/or writing. It may be an effort for them to understand both written and spoken messages, as if they were trying to comprehend a foreign language. They may have difficulty with spelling, writing, and reading, as well.
The person may have trouble with social communication, including:
- taking turns in conversation
- maintaining a topic of conversation
- using an appropriate tone of voice
- interpreting the subtleties of conversation (e.g., the difference between sarcasm and a serious statement)
- responding to facial expressions and body language
- keeping up with others in a fast-paced conversation
Individuals may seem overemotional (overreacting) or “flat” (without emotional affect). Most frustrating to families and friends, a person may have little to no awareness of just how inappropriate he or she is acting. In general, communication can be very frustrating and unsuccessful.
In addition to all of the above, muscles of the lips and tongue may be weaker or less coordinated after TBI. The person may have trouble speaking clearly. The person may not be able to speak loudly enough to be heard in conversation. Muscles may be so weak that the person is unable to speak at all. Weak muscles may also limit the ability to chew and swallow effectively.
What cognitive problems occur after TBI?
Cognitive difficulties are very common in people with TBI. Cognition (thinking skills) includes an awareness of one’s surroundings, attention to tasks, memory, reasoning, problem solving, and executive functioning (e.g., goal setting, planning, initiating, self-awareness, self-monitoring and evaluation). Problems vary depending on the location and severity of the injury to the brain and may include the following:
- Trouble concentrating when there are distractions (e.g., carrying on a conversation in a noisy restaurant or working on a few tasks at once).
- Slower processing or “taking in” of new information. Longer messages may have to be “chunked,” or broken down into smaller pieces. The person may have to repeat/rehearse messages to make sure he or she has processed the crucial information. Communication partners may have to slow down their rate of speech.
- Problems with recent memory. New learning can be difficult. Long-term memory for events and things that occurred before the injury, however, is generally unaffected (e.g., the person will remember names of friends and family).
- Executive functioning problems. The person may have trouble starting tasks and setting goals to complete them. Planning and organizing a task is an effort, and it is difficult to self-evaluate work. Individuals often seem disorganized and need the assistance of families and friends. They also may have difficulty solving problems, and they may react impulsively (without thinking first) to situations.









When I reviewed the proposed standards, I found many reasons for concern. The writing teams had recommended the removal of Nathan Hale, Daniel Boone, and General George Patton; they eradicated Columbus Day, Martin Luther King Day, and Christmas (but they did add Diwali as a holiday). They also declared that to say there was “an American love of individualism, inventiveness, and freedom” was to express inappropriate “value language,” and they also rejected the concept of identifying specific beliefs that contributed to our “national identity.” In fact, they declared that students needed to be shaped “for responsible citizenship in a global society,” but not citizenship in American society. And instead of an emphasis on the positive things about America (i.e., American Exceptionalism), America was often shown as fault-ridden – as a global villain.
Those two official reviews were 43,538 words in length, and contained three mentions of Christianity. In the first review, I pointed out how early colonial Christian leaders such as William Penn and Roger Williams insisted on having written constitutions to limit the government; I also showed how American Christians and Jews cooperated together in the American Revolution. In the second review, I noted the current polling on religious affiliation in America to demonstrate that the mention of Christmas should be reinstated in the standards. Those three simple mentions of Christianity caused the Left to explode.
While there is no such recommendation in the standards, consider the stupidity of what he purports. According to Dr. Davis, it would “violate the Constitution” if the history texts were to include information from the more than 300 court rulings over the past two centuries that have declared America to be a Christian nation. Imagine! He believes it would be unconstitutional to let students know what courts have affirmed for 200 years!
Intelligence, patriotism, Christianity, and a firm reliance on that God Who has never yet forsaken this favored land are still competent to adjust in the best way all our present difficulty [i.e., the Civil War]. 1 PRESIDENT ABRAHAM LINCOLN
America was born a Christian nation – America was born to exemplify that devotion to the elements of righteousness which are derived from the revelations of Holy Scripture. 4 PRESIDENT WOODROW WILSON
If the spirit of God is not in us and if we will not prepare to give all that we have and all that we are to preserve Christian civilization in our land, we shall go to destruction. 6 We cannot read the history of our rise and development as a Nation without reckoning with the place the Bible has occupied in shaping the advances of the Republic. 7 PRESIDENT FRANKLIN DELANO ROOSEVELT
In these last 200 years, we have guided the building of our Nation and our society by those principles and precepts brought to earth nearly 2,000 years ago on that first Christmas. 11 PRESIDENT LYNDON BAINES JOHNSON
Of the many influences that have shaped the United States of America into a distinctive Nation and people, none may be said to be more fundamental and enduring than the Bible. 13 PRESIDENT RONALD REAGAN
FINALLY, when the intolerant anti-religious bigots try to intimidate Americans from presenting an accurate view of American history, let’s make our voices heard on talk shows and in letters to the editors, denouncing their attempt to rewrite American history and censor expressions of religious faith.
