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Transcript:

I’m Taylor Ernst of the Ernst Law Group. Can a brain injury heal? I get asked that often by the families of brain injured clients who I have, and what I tell them is this. Every brain injury is a little bit different and no two brain injuries are exactly the same. Because of that, there’s actually a lot of hope in terms of the recovery chances, but at the same time, doctors are always nervous to over promise when they aren’t sure what the outcome’s going to be. Giving it to you straight, brain injuries can heal. It just depends on the amount of progress you can make.

When a doctor says a brain injury can’t heal, one of the things they sometimes neglect to mention is a concept called neuroplasticity. This is something that’s arisen in the last decade or so. Doctors who were trained way back in the day won’t talk about it. Neuroplasticity is a way for your brain to form new connections. Often when there’s a suffering of a brain injury, there’s what’s called axonal shearing, which is damage in between some of the connections to the brain. The ways to repair that aren’t all that clear in our current medical understanding. What we do know is, we can forge new pathways. That’s why it’s called neuroplasticity. The brain has some type of a new formation that can occur and wire new pathways.

Sometimes it’s a painful rehabilitation process, but we like to encourage our clients saying, “Hey, try it. See if you can come up with new ways to participate in daily life.” That’s number one. Number two is it really depends on the social support network around the person with the brain injury. The brain injury is really isolating. It causes a lot of emotional feelings of adapting to new circumstances. A lot of times, it leads to a disconnect between family, friends and even their support group. Often people who’ve been injured with a brain injury want to have some type of organization or group that has other people who’ve gone through what they’ve gone through.

We recommend joining certain types of support groups. I know that we’re always encouraging our clients to join ours just because when they talk to people, who’ve had brain injuries before, they can ask the questions. Hey, here’s the problem I’m going through. What’d you do about this? They have a lot of people who’ve been there before, that can answer that. Number three is, it really comes down to resources, being able to get the type of medical treatment. Some types of doctors don’t take private insurance, and so you either need to pay them with a check or cash or some way outside of insurance to get some of the best treatment. That’s not accessible to everybody. It’s one of the reasons that I feel pretty strongly about providing content like this is because from a lawyer who deals with this stuff, I’m going to tell you what I know and what my clients have been told.

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I’m Taylor Ernst with the Ernst Law Group. Brain injuries will sometimes cause people to act different than they are. We’ve actually had situations where someone who’s suffered a brain injury, ends up acting like a child. Their personality changes so much, their inhibitions change, some of their impulses change, some of the way they interact with others through both their emotion and their logic will change and it makes them first off seem not like the same person. And second, sometimes they will take significant steps back in what was perceived before the incident to be their development. All of a sudden they’ll seem like they’re acting not their age and that’s not their fault. It’s not that they are intending to act that way around people. It’s just the way their brains suffered harm. Now that’s the best way their brain is currently functioning.

Now, what can you do about that? Well, there’s a lot of resources out there, but most importantly is you need to get to a doctor that believes the symptoms and believes in what’s happening. There’s doctors all across the spectrum that some think brain injuries are going to be at a plateau in 18 months, others think about stuff that’s more neuro plasticity around and the concept of always being able to be improved. You want one in the latter category. You want a doctor that believes there’s some ability or some type of therapy or some type of work that can be put in, that can help. We don’t want to promise and say, “Hey, we’re going to be able to improve someone who’s suffered brain damage,” but you want to give it the best shot you can.

So when you have a situation where someone suffers a brain injury and ends up acting like a child, what you really need to do is address, first get them to the right doctor and second, is what are the types of habits that we can encourage this person to do, to try and help with the rehabilitation the most.

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I’m Taylor Ernst at the Ernst Law Group. Will brain damage show up on an MRI? It’s a question we get asked often by our clients who’ve suffered brain injuries. And the answer is if it’s moderate or severe, most of the time it will show up on an MRI. If it’s a mild brain injury, often it will not show up on an MRI. Why is that? It’s because as the scanner looks through the brain, through the MRI, which is magnetic resonance imaging, certain things won’t show up if they’re too small. It’s like taking a photograph with a really poor camera or a Polaroid something really far away. It doesn’t mean it’s not there. You just can’t really see it because the picture quality isn’t good enough. That’s the problem.

So, what can an MRI see? An MRI can see subarachnoids hemorrhages, bleeding in the brain, old parts of brain damage that where parts of the brain have basically form scarring. That will show up on an MRI often. But if it’s at the very smallest level, which is called Axonify shearing, most of the time that will not show up. And we talk about mild, moderate, severe brain injuries. I’ve had clients who have very severe brain injuries that are able to go back to a fairly normal life and I’ve had clients with mild brain injuries that really have a tough time integrating back into their daily life because their symptoms are so significant.

So, in short, just because there’s an MRI scan that says negative, it doesn’t mean you aren’t going to have symptoms of a traumatic brain injury. That being said, just because you do have a traumatic brain injury, the next question is, is this permanent? I got a video addressing that. And the short answer is, look into neuro-plasticity. There’s lots you can do to try and help your improvement. We aren’t sure how much things will improve, but there’s always hope that you might be able to find something that’ll help rewire your brain and give you some level of improvement.

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So being lawyers that specialize in TBI, we often are asked a question that really bothers me, that doctors don’t address more is, what do I do? I’ve got a traumatic brain injury. What now? How do I deal with my daily life? What are the tips I can use to integrate back into society. And the number of clients that ask that is way too high and it personally makes me pretty irritated at the doctors that are doing some of the treatment because the doctors are just saying, “Hey, take some Tylenol or take some Advil.” And it is, what it is. It bothers me that these needs aren’t addressed because they’re real needs, they’re causing a lot of suffering. And so our office is actually kind of taking a more proactive approach where we actually tell our clients, “Hey, these are some things that go work for a bunch of our other clients who have TBIs. You should look into them.”

And here’s the list. Earplugs, dark sunglasses, ice packs that are specifically designed for the neck. Sometimes that gives a lot of relief for the headaches. Sometimes it doesn’t, but if it works for you, it’s something you should look into. Different colored light bulbs actually make quite a big difference. Certain types of super bright or super white LED lights, for some reason, cause a lot of sensitivity for traumatic brain injury suffers. And so it’s something where we’ll actually have clients that basically come in and say, “Hey, our life’s been really disrupted because when my husband comes in the room,” the husband doesn’t have a TBI, his wife does. The husband comes in the room, he always turns the lights up. And the wife always says, “I got to turn them down.” And so they’re always fiddling with the lights. He turns them all on. She turns them all off. And he basically says she wants them… The husband says he wants the lights… Oh, I misspoke.

His wife wants the lights so dim that it’s hard for him to be able to read anything. That’s how dim she wants it. And so there’s ways to get bulbs that are actually designed to have less lumens that actually make it a little bit easier.

And so really what it comes down to, more than anything else, is trying to figure out what are the symptoms? What are the symptoms that are resulting from the TBI that are interrupting the daily life the most? And it’s something we’ve actually been thinking about putting together a packet or a list or something and giving to people and saying, “Hey, what are the symptoms that are interrupting your daily life?” And then trying to provide specific things because, truthfully, some of the doctors just don’t deal with that and my clients again and again, have come to me and been like, “Hey, I’ve got these headaches I wake up with every day.” Or, “Hey, I’m sensitive to light all the time. So much so that I’ll be in the house or I’ll be in a movie theater and I’ll wear dark glasses. That’s how much light bothers me.”

And so we’ve started trying to come up with some of these workarounds just because our clients need it and there’s not really being filled any other way. So if… I think I am going to make the list, and I think if it’s something that there’s some interest in about saying, “Hey, I want a symptom list of the things that might bother me.” I think we may try and put that together and provide it to people just because it’s something that, again and again, they have a similar set of symptoms resulting from the TBI.

And it’d be nice to address those symptoms and try and figure out what are the specific things that our clients or other people in the TBI community have seen to address those specific symptoms. Medically, it doesn’t fix the problem, but it does address the symptoms and help try and integrate into daily life as a result of trying to make the symptoms a little bit better.

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I’m Taylor Ernst of the Ernst Law Group. What are zero days? Zero days are where you get absolutely nothing done to help your brain injury recovery. There’s zero days that’s discussed in a lot of different literature, but when I talk about it with my clients, it is you must do something every single day, however small, that helps with your brain injury recovery. And just like that, all brain injuries are a little bit different, some person’s version of a zero day can be wildly different than another person’s version of the zero day.

When I talk about zero days, I mean, you want to never be going to sleep at night where you feel like you’ve done absolutely nothing to help you with your recovery. Sometimes it can be as simple as look up that doctor’s phone number that you’ve been thinking about calling, or figure out a symptom specifically that you want to try and address and figure out what would be the next thing you could try to help alleviate that symptom. A lot of the times, it’s the chronic headaches. What have you done recently to try to deal with your chronic headaches? Have you tried neck stretches? Have you tried Biofreeze? Have you tried TENS units?

Each one of those things, just that decision, can be invalidating it’s a zero day. It’s no longer a zero day if you say, “Hey, I’m going to try this next to help with my recovery.” So the goal that I always bring this concept up is, figure out what you can do today to avoid it being a zero day.

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One of the questions we often get is, “How do I make my headaches go away or improve them that go along with the traumatic brain injury?” Chronic headaches is a classic symptom of a traumatic brain injury, and it’s something you really need to pay attention to. Because there’s a lot of improvement in the quality of your life if you or your loved one can deal with this. So first off is we work with experts throughout the state of California, UCSF, UCLA, Cedars, Stanford, and this is what they tell our clients and I figured I’d pass that on. First off is you want to find out, if it’s related to the traumatic brain injury or often it’ll actually be related to the neck. Often in a traumatic brain injury, there will be damage to the neck as well. And that will cause the headaches a good percentage of the time.

You can find out if it’s related to the neck by basically going in and when you get a headache or your loved one has a headache, you start rubbing the back of their neck. You rub lower, you rub higher. And if that provides some relief it’s part of the muscles of the neck, which are contributed to the headache. So I asked some of my clients, “Hey, what are the best ways to deal with that? And what have the experts told you?” And there’s three things that really ended up being a difference maker for them. First one is a product called Biofreeze. The second one, which is classic ice, put a cold pack on it, put ice on it. And the third one is some type of massage. You can either have somebody do it for you, or actually what our clients often are recommended is product like this.

It sits over your shoulders, Pull it down. And the harder you pull it against, the more it gets into your neck, that massage product, there’s a zillion of them online. You can look, there’s a bunch of them, it’s not hard to find. And those type of products actually provide quite a lot of relief for the clients saying, “Hey, what can I do to make this tension headache or headache coming from my neck, go away?” The other way that you can address some of the headaches related to TBI is if it’s actually directly related to the TBI, those are harder to find solutions for, but I wanted to mention just a couple of options, because knowledge is power. The more you know about how to take care of the TBI, often the less that affects your daily life. And so, one of the things that if it’s you, that’s the TBI suffer or a family member, you want to ask, if they’re having brief moments where they don’t really know what’s going on, and this is in a second or two.

They get described as just brief flashes where they just briefly are just not there for just a second, just a microsecond. And what it is often they’re diagnosed with what’s called micro seizure disorders. And it’s something that comes from traumatic brain injuries, it’s not life-threatening. It’s something that you just need to know about. Often they’ll occur at night. You can do EEGs to diagnose them. But what can be done is if you start and your doctor, neurologist, or the person who’s following your brain injury, diagnoses you with these types of micro seizures, they will give you drugs that prevent the micro seizures from coming on. And a lot of times that will help significantly deal with some of the pain that goes along with them. Being on some of that drugs is what some of our leading neurologists in the state of California recommend.

They see a traumatic brain injury victim, and they basically are like, “You need to get on one of these. We’re worried about this. This is going to help your symptoms.” Sometimes there’s huge improvements from it, sometimes not so much. But it’s something that I at least should recommend just because it’s something that your Doctor may want to look into. All doctors are not created equal. Some are very familiar with traumatic brain injuries and others tend to go the route of thinking it should resolve in 18 months and you’re plateaued after that. If your doctor says that, I know I’ve talked about it in some other videos, but basically there’s a thing called neuroplasticity. You can look into that. I’ll do other videos on that. You can always be improving. It just takes work. So that’s what I wanted to address. Hopefully if you’ve got additional comments or questions, feel free to leave comments below or ask additional questions you want to be followed up on. And we have a Facebook group that there’ll be a link about it, and you’re welcome to participate.

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I’m Taylor Ernst at the Ernst Law Group, and I wanted to answer a question that was privately given to us from our Facebook group. it was, “What is the number one time waster that caretakers of TBI victims have to deal with?” Really what it is, is conversations that happen again and again, where I know this isn’t what they mean to do, but it ends up blaming the victim of the TBI. For example, when the TBI victim forgets something, which a lot of the time they will, they say, “How could you forget that? Didn’t you know we needed your keys? Didn’t we know you needed to bring that item? Why didn’t we put it in the place we always did?

All that conversation does is reinforce with the victim that they made a mistake and the victim obviously didn’t mean to do it. It’s something that, it really is a time-wasting conversation. Don’t have that conversation. You want to figure out how to avoid the blame of the victim of the TBI directly. How can you have a conversation with somebody after they do something that obviously makes you unhappy, or you needed them to bring something, or you were counting on them to be somewhere at a certain time and they forget?

The question you want to ask is, ” What was it about this situation that led you to not remember this thing and how can we address it next time?” The reason for that is, it’s constructive. It’s how can me and the victim of the traumatic brain injury be on the same page and move towards not having it happen a second time, rather than, “How could you forget it? I knew I told you five times. I told you yesterday. We had the conversation five minutes ago.” That does nothing except make the TBI victim A, feel bad, and B, there wasn’t anything they really could do about it. They didn’t mean to do it. Obviously, no one wants to forget anything and it still happens anyway.

That was the answer that I wanted to provide to the community because we had one client that it caused chronic problems between their relationship, where he forgot stuff all the time and she always was angry about it. As soon as they started this more constructive approach, their entire relationship dynamic changed, and it really improved the quality of their lives.

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A question we often get is financially, how do we deal with someone into my family, a loved one, or even myself having a traumatic brain injury. Financially, how do I grasp with all this? Post-acute brain injury rehabilitation is extremely expensive. Cognitive therapy is expensive. The medical bills either at the ER or at outpatient are expensive. Physical therapy, if there were some components of the injury that caused additional physical therapy, are expensive. What do you do?

There’s a number of different avenues, and it really depends on the circumstances that gives rise to the traumatic brain injury. There’s a number of programs out there. There’s a number of support groups out there, but when you really get down to it is where’s the money? How’s the money going to be able to pay for this? And it’s split into a number of things. There’s always health insurance, and I’ll do a different video on this, but there’s always health insurance, but that’s divided into Medicare versus Medicaid, and then some of the what’s called the employer medical benefit plans. If you get it through your employer, it’s called ERISA. If you get it through somewhere else, if you get it personally, it’s non-ERISA. That’s one of the first places you want to look, but that doesn’t really pay for your copays.

So the next way is, if someone else causes you harm either at work or just out in day-to-day life, and someone else causes your brain injury, you may have a lawsuit against them. Now, lawsuits really are driven by the quality of a lawyer, but more importantly, the amount of insurance on the other side. You hear people talk about deep pockets, deep pockets. Oh, you got to go after the deep pockets. Really, it bothers me when people talk about that sometime, because really what it is is the deep pocket’s the only one who has enough insurance to be able to pay for the amount of treatment that’s needed for someone with a very serious brain injury. If you’ve got a very serious brain injury and need a couple million dollars of treatment over 50 years, no one else is going to pay for that except an expensive insurance policy. That’s it. And so if there isn’t a deep pocket or deep insurance policy that’s able to pay for some of this medical treatment, there’s no money to pay to help. So the person who was hit by a drunk driver who has very limited insurance, they’ll rely on their medical insurance and that’s it. And it’s an unfortunate situation.

Lawyers are often attacked for, “Oh, hey, you’re going after the deep pocket.” Well, really what it is is who’s got the insurance company that can actually pay for the medical bills of how harmed someone is? That’s it. And sometimes it’s there. Sometimes it’s not. It’s something that you really have to ask the lawyer who’s a specialist in understanding these insurance policies. “Hey, is there enough insurance to pay for this medical treatment?” Additionally, a lot of medical treatment can be paid before the lawsuit’s over. Experts are hired and sometimes even therapies are paid for either on a lien, which is the lawyer term for basically an IOU. “Hey, I’ll pay you back when the case is over. Here’s an IOU. Give me an MRI. Here’s an IOU for $3,000. When the case is over, I’ll give you the money for $3,000.” That’s what a lien is. There’s some reasons liens can be dangerous at trial. I may talk about that in a different video, but really lien basically is an IOU from the lawyer to the medical provider to get your medical treatment immediately.

Other ways that you can get medical treatment or some type of financial assistance, you can always apply for state or disability. SSDI is great. There are some limitations on it. Workers’ compensation. If you get hurt at work, if you’re on the job and the person, whether or not is you or someone else hurts you, you’re covered by what’s called the workers’ compensation system. The problem is flat-out, workers’ compensation doctors and doctors participating in the workers’ compensation system aren’t that great. No offense if you’re a workers’ compensation doctor watching on this, but if you consistently prescribe a lot of medical treatment for someone with a brain injury in the workers’ compensation system, the workers’ compensation system will find a way to not continue referring that doctor patients, just because it’s so expensive. The doctor keeps writing therapies that are 50 or a hundred thousand dollars for this brain injured victim that the state ends up paying, or someone ends up paying, and the state doesn’t want to keep paying for that. So they’ll find a way to make that doctor not get as many patients in the workers’ compensation system.

So, workers’ compensation tend to give a lot less money or a lot less treatment recommendations. And so, sometimes we’ll have someone on the workers’ compensation system with a lawsuit going along with it, and we find that they haven’t gotten much treatment at all. Basically they went to the ER, got seriously injured, discharged from the ER, maybe got an MRI, and that’s the extent of their brain injury rehabilitation. And let’s just say that’s not the best way to go about brain injury rehabilitation, and there’s better ways to do it. But first, you have to figure out where does the money come from. Hopefully this was helpful.

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I’m Taylor Ernst at the Ernst Law Group. The question we got from our Facebook group that I wanted to answer directly was, what issues with credibility do victims of TBIs often suffer? And I want to address this because I’ve personally seen what it does to my clients that have this happen to them, where there isn’t a thing that normal people can see with a traumatic brain injury victim. That’s why it’s called the silent epidemic of people who suffer from a TBI and continue to suffer from the symptoms of it. But doctors sometimes won’t address it. New people they meet won’t address it. And it puts the victim of the TBI in this horrible spot where they have to tell someone they just meet, “I’m sorry if I don’t remember everything, I suffered a traumatic brain injury,” and the stigma that goes with it. Because everybody looks at them, thinks they’re fine, and then communicates with them or treats them like they’re fine.

And the brain injury victim’s stuck in this horrible spot where they either need to tell their audience, “Hey, I’ve got this problem,” or not. And as a result, what do you do about that? And it depends on the circumstances. We’ve actually had clients in the past, who have some pretty significant social phobias, actually print out cards that say, “I have a traumatic brain injury. I’m sorry if I don’t remember everything.” And sometimes during the conversation, if they start getting flustered or they’re having difficulty communicating, they know they can hand the person the card and it will help alleviate some of the issues. Other people that we work with never want to admit that anything’s wrong and they want to just push forward and try and not admit that there’s an issue to anyone they’re speaking with. And they just worry about it deep inside.

And so how do you really address that? And I wish there was a better answer. I’m looking for one. I’d love some messages or comments about how to deal with it. But sometimes when you’re meeting new people, the credibility is something that our clients really struggle with and it’s something that I don’t have a great answer to, to be candid. You’re going to have to make the choice. Do you say something? Do you not say something? The brain injury’s the invisible injury. When you’re communicating with somebody that doesn’t know you have it, you’ve got to come up with ways to work around and try and figure out what’s the best method for you. And so if I had to say one thing is you got to try some methods and figure out what is the one that works best for you. And I’m sorry, I don’t have a better answer. I’d love some feedback on it. If somebody does have an idea about how to communicate with somebody that doesn’t have a TBI when you’re worried your symptoms of the TBI are going to get involved in that conversation.

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When someone suffers from a traumatic brain injury, there’s three things they often really go through often. They’re anger, anxiety, and depression. And there’s a whole lot of reasons those end up being some of the stuff that traumatic brain injury victims go through, but I wanted to give you quick, straight to the point ways you can help try and lessen the anxiety, the anger, and the depression that often results from a traumatic brain injury. So let’s get right into it.

First off, depression. Their situation’s changed, and some of the cognitive tasks they could do, some of the physical tasks, some of the social tasks that they could do, all of a sudden they’re not able to really do as well anymore. And that change in their lifestyle and who they were and who they are now causes a lot of emotional issues to derive. They’re trying to grapple with their new sense of self.

So how can you help with that? First off, there’s three main things that I would say are like legs to a stool that can really contribute to trying to minimize these effects. First off is social support. Social support, checking in with them, asking what you might be able to do to help. And sometimes asking what can you do to help is not as effective as just doing something to help. If they’re having issues with hearing where loud noises are bothering them all the time, just providing a pair of earplugs. Or if they’re having issues with sensitivity to light, bringing a dark pair of sunglasses when you go somewhere, always. You have this pair of sunglasses that’s dark, and then when they start saying, “Hey, these lights are bothering me,” you’ve got the sunglasses right there.

You don’t necessarily need to rely on the person who suffered the traumatic brain injury to remember all these things. It’s the social support that helps minimize some of that day to day impact that can really give rise to trying to lessen some of the difficulties they’re going through. If they’ve got light and sound sensitivity, having things that minimize that will obviously affect the anger, some of the emotional things that they’re going through, to a great extent.

The next thing other than social support is having some type of emotional support or outlet. Sometimes it can be art. Sometimes it can be journaling. Sometimes it can be even sticky notes. It can be as simple as that. Or some way that they can put their feelings down or talk to somebody about it. Sometimes it can be therapy in the professional context, but if you don’t have enough money for therapy or you don’t have a way to get money for therapy, some of the other ways to do it are having someone to talk to in a non-judgemental environment. Sometimes family members and friends can be great for that other times, not so much.

The last one is friends. Friends after you’ve had a traumatic brain injury are an interesting situation, and I actually may do a whole video on that, but really what it is is friendships after you suffered traumatic brain injury sometimes change. Sometimes people you were friends with, you stopped being friends with, and sometimes people with traumatic brain injury over a period of two to four years will develop a whole new set of friends. And it’s something that should be actively encouraged, and it should be encouraged with the way the person is now, as who they were before.

Sometimes people who are shy and passive will become more outgoing, or sometimes someone who’s very more outgoing and they were always out in the life of the party, all of a sudden really wants to be inside and watch TV and not be out much. That is normal for someone to have that type of change, and it needs to be supported in a way where the friends can understand the new person that they are becoming.

They always say friendships are either getting better or getting worse. That’s it. And so when it comes to someone who’s got a traumatic brain injury, it needs to be acknowledged. And having friends, even if they aren’t as close anymore, having them be there for that person to either communicate or say, “Hey, what are some things we might be able to do with you?” Those three things can really alleviate some of the problems that grow out of that. The anger, the depression, some of the fear that goes with some of the personality changes, having a good group for emotional support, social support and friendships can really help alter that course. And so it’s something that I would highly recommend that…

What are the specific things you can do to encourage that? Put the person who is the victim of the traumatic brain injury in a place once every two weeks, once a week, where they can help build some of those connections on their own, or be forced into ways that they build those connections. Traumatic brain injury support groups are great. People talking about their own experiences make people feel like they’re not the same. They aren’t alone going through these experiences. There’s groups on Facebook that do it. There’s blogs of people going through it. There’s authors who are famous that suffered traumatic brain injury that have had to work through it.

Any of those things can really be a structure that’s helpful. Taking them to support groups, in person or on the internet, trying to find ways… Planning a birthday party and inviting a bunch of people over to interact with them in a way that’s helpful for someone with a traumatic brain injury. You don’t want a ton of loud noise and stimulus, but if you did it in a way where people came over, the lights were dimmer, there wasn’t as much stimulus, or there was a really focused activity, that’s something that helps build those social connections that lead to the emotional support and friendships.

So that would be the answer of how to try and minimize the anger, the depression, and some of the other emotional components is go straight to the source where you build a support network through very specific items that can really… It’s almost like a safety net. It’s something that when they start to fall back to anger or depression, they can put their arm out and there’s nets there to help them.