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H E A D W A Y  G A U T E N G

Dedicated to assisting brain injured people and their families

June 2008

Dear Members

In the last newsletter I discussed the Ranchos Los Amigos Scale of Cognitive Functioning which can be used as a tool to predict outcome of a brain injured patient and this is “Pre Injury Characteristics” (as taken from “Living With Head Injury – A Guide for Families” by Richard Senelick and Cathy Ryan).

Research has suggested that head injury may not always strike entirely at random.  Learning disabled children, impulsive and aggressive young adults, alcohol and drug abusing adolescents – all are predisposed to injury.  In fact, one particular study of head-injured patients with a pre injury history of drug abuse discovered that they had twice as many behavioural problems as patients who had never abused drugs.  The behavioural problems didn’t surface until late in the recovery process – frustrating family members and hospital staff alike.

The family circle also plays a role.  Families with a brain injured member have been found to have more depression, more instability, and more social disadvantages than other families.

There are several pre-injury traits that predict a favourable outcome –

• A “fighter” personality.  Someone who had been strong before her accident, who was patient, who was motivated and achievement-oriented, stands a good chance of regaining these traits and getting through the rehabilitation process with success.
• Youth.  Studies have found that fewer children die from brain injuries than their adult counterparts.  In fact, the younger the person the better the chances of successful rehabilitation.
• Intelligence.  The smarter the person, the more likely he will benefit from rehabilitation techniques.
• Self Control.  If a brain injured person has been able to retain (or re-master) his self control, he’ll also be better able to control inappropriate behaviour and impulsiveness – possibly re-entering the community much sooner than his out of-control, undisciplined counterparts.
• Strong family ties.  The more love, support and encouragement the patient feels from his family, the more it will help his rehabilitation – and his future care. 
• Similarity of pre-injury career skills and post-injury skills.  If a brain injured person had a fairly uncomplicated job, he’ll probably have an easier time re-entering the job market than someone who is, say a lawyer – whose organisational and memory problems will prevent him from exercising his profession.
• Good coping skills.  Someone who knew how to relay and handle stress before her injury will cope better with the stress and trauma associated with brain injury.
• Solid financial support.  It’s a fact of life:  Rehabilitation hospitals are expensive.  In order to receive the best possible care, patients need either good financial resources or adequate health insurance.  Unfortunately, the majority of brain injury patients don’t get help because they don’t have adequate coverage – and they don’t know where to turn.  If only they were aware of all the potential sources of aid!  Good rehabilitation hospitals have case managers or social workers to help families find the money they need – either through government funding or private foundations.
• Deficit Awareness.  More than anything else, a brain injured patient must become aware of his problems.  Even the most reputable and sophisticated rehabilitation programme will not work if a person is unaware of his deficits.  Deficit awareness is crucial.  A person must ultimately recognise his new limitations if he’s to actively participate and return to his community.

As time marches on, their pre-injury characteristics become more and more important as diagnostic tools.  A patient’s personality, his lifestyle, his coping skills, his home or hospital environment – all these play a major role in predicting ultimate success.

Before we close the file on this particular piece of detective work, it’s important to remember that predictions can be wrong.  Diagnostic tools, research and scientific studies can only show us so much.  We cannot tell which of the billions of brain cells are dead – and which are merely damaged.  We cannot tell if or when a person will suddenly have some spontaneous recovery.  We cannot tell with any certainty which patient will plateau and never get beyond say Ranchos Los Amigos Level Five.  Recovery takes time.  The symptoms that appear after a brain injury can linger for a long while.  They can even create more symptoms, with a life of their own.  To cope with this confusing time, you should understand what the possible symptoms are – and why they may exist in your brain injured loved one.  I will discuss this further in future newsletter.

The Jägers Family:
As mentioned previously families play a very important role in the recovery of a brain injured person and the Jägers are just such a family.  This is the story of their brain injured daughter, Natalie as told by her mother Patricia.

“Natalie – through the eyes of her Mother

It simply cannot be thirty-four years ago that John, my husband, burst into the delivery room and found me giggling uncontrollably. What was so funny? Who knows? So began the life of our youngest child, Natalie. It is this ability to make people smile and her highly infectious laughter that gives us strength today.

Natalie ran around at nine months old and chatted happily with her older brother and sister while very young. Maybe she needed to achieve a great deal in a great hurry. In her early twenties she was highly degreed, an accomplished dancer and dance teacher as well as a beautiful person.

On the fateful day in April 2000, we came home a day early from our holiday to avoid the Easter traffic and Natalie went out shopping. So in bumper to bumper traffic at 45 kilometres per hour our lives changed forever.

At the hospital a grim-faced neurosurgeon told us that Natalie had a slim chance of survival. Feelings of utter shock, disbelief and anger surged through me. This kind of thing happens only to those unknown people we read about in the news papers, not to our beloved Natalie. How could this have happened? How could God have allowed our precious daughter to suffer so? Why were rapists allowed to walk and talk while our gentle daughter lay in a silent coma?

We realised, however, that we must never lose sight of the fact that she had been dancing for twenty years, was strong and healthy and had an amazing zest for life. Friends and family rallied around us and prayers were being said as far afield as Australia and Ireland.

Natalie had a very badly torn and broken left leg, a fractured pelvis, three broken ribs, a pierced lung, a broken hand and severe head injuries.

I moved into the hospital and as I sat next to Natalie the one thought that haunted me was that I would never be happy again! Never feel that warmth and overwhelming joy when gazing at my husband and three children with utter contentment! How wrong I was! Real happiness comes when we truly accept what life has to offer and accept people the way they are!

After several operations and many ups and downs it was the wonderful and scary time to take Natalie home. A few months later, the ‘silent’ Natalie burst out laughing and it is this sense of humour that is God’s blessing to us. Although she is unable to walk or talk, she never fails to see the funny side of most situations and never tires of jokes and comedies.

Natalie was and still is supported by an amazing group of specialists in their fields. She receives physiotherapy daily, speech therapy and reflexology weekly and has a nursing sister who pops in for any medical emergency.

She is now getting botox injections in her neck to release tightened muscles. She no longer is tube fed and has a healthy appetite. We were lucky to be able to put in a Jacuzzi and the freedom of movement in the water is a joy for Natalie and her legs are moving more freely.

Natalie has learnt to communicate using her computer, with programmes  her father has written for her. She also wears a laser light and points to pictures and words and completes comprehensions.

Eight years later she has said her first few words so who knows what the future holds? Sometimes at night, when I finally flop into a chair I gaze at my beautiful daughter and thank God for the privilege of being with Natalie 24 hours a day and thus witnessing miracles in a world that is so rushed and stressed that no-one takes time to believe in a higher being who has plans for all of us.

Has this story got a happy ending? Some people may not think so! We know there is a difficult road ahead but with my husband there to hold my hand and the wonderful support of my children, family and friends, getting up in the morning is still a joyful event.”

Thank you Patricia for this really inspiring and uplifting story. 

Feedback from HFC Meeting on 12th June:
Heather Picton, a nutritionist, was the guest speaker at this meeting and her talk was entitled ‘Healing the Body with Nutrition”.

“Whether ill or healthy, if we give the body what it needs, it will improve our level of functioning.”  This is the message that Heather Picton, nutritionist, mother and founder of the Attention Deficit Disorder Association of South Africa, brought to us at HFC this Thursday, 12 June.

Heather stressed the point that the eating habits we should all adopt is not just to be practiced for a few days, weeks or even months. This should become a lifestyle.  Heather discussed the role of essential fatty acids (EFA) in the healthy functioning of cells. A deficiency of these in the body are often characterised by thirst, dry skin and mood fluctuations. Multivitamins and mineral supplements are also important in regulating the metabolism, but artificial colorants and flavourants prevent the absorption of EFAs.

Heather cautioned us to compare the difference between different items in the same product range – for example, Strawberry Pronutro is filled with unhealthy colorants, whilst the whole-wheat Pronutro contains no artificial colorants or flavours. Heather also discussed the lethal effect of MSG and aspartame (an ingredient in “sugar-free” products) on the cells of the brain. Sulphites are also dangerous chemicals in our food, which needs to be avoided at all costs. Labels should also be read, and we should watch out for a label that says “permitted flavourants and colorants” – these vague descriptions should be read with caution. Bread is made with calcium propionate, which again has a lethal effect on the body, and particularly on the brain cells.

Sugar intake, as we know, should be monitored, as it affects the absorption of Vitamin B, resulting in mood changes. Should the body not have nutrients to assist with the absorption of sugar, it will “rob” other areas of the body of nutrients to compensate for the absorption process. More often than not, the nutrients are robbed from the brain – and whether you have had a head injury or not, this is something you would want to avoid! Heather advised sugar to be taken with a small amount of protein in order to aid the metabolism of the sugar in the body.”

Heather was joined by her colleague, Richard, who discussed the benefits of glyconutrients, and their role in brain health. Glyconutrients are responsible for cell synthesis in the body and the metabolism of cells.  There was much interest in the concept that glyconutrients stimulate the growth and distribution of stem cells in the body.

We thank Heather for this very enlightening talk.

Anniversaries of Accident:
“You cannot escape the responsibility of tomorrow by evading it today” – Abraham Lincoln.

Chris Bredenkamp                                           2001                       Joan Vermeulen                                               2002
Henk Krüger                                                       2000                       Cliff Rahme                                                         2003
Alison Edwards                                                 1998                       Nicholas Rey                                                      2004
Gideon Ellis                                                         1999                       Russel Rodwell                                                  2007
Patrick Hennessy                                             1997                       Michael Shilleto                                                                2007
Nikki Janse van Rensburg                             2000                       Liesl van der Westhuizen                              2004
Mike Morton                                                     1998                       Fabian Williams                                                 2007
Daniel Pooe                                                        2002                       Samantha Wagener                                        2001

Welcome to new members:
We welcome Davanthra and Angie Kistensamy as new members of Headway.  We hope that their association with us will be a happy and fruitful one.

Condolences:
Our special love and sympathy go to Vernon and Barbara Klopper on the passing away of their daughter Lesley on 3rd June after a short illness.  Lesley was a very popular volunteer at Headway – she helped her dad with the woodworking class on a Wednesday and then continued volunteering on a regular basis after the woodworking class came to an end.  During the eulogy at her memorial service Lesley’s cousin said that Lesley had died on a dark and stormy night.  However, suddenly the clouds parted and there shining brightly was one perfect star.  Vernon felt that this was a message from Lesley to say ‘here I am – my light will never go out!”  I was amazed because previous to that, as I was sitting in the church reflecting on Lesley, the thought that was uppermost in my mind was what a bright and sparkling person she was.  Lesley was also very creative and talented.  She made the most beautiful miniatures and was a member of The Johannesburg Society of Miniature Enthusiasts for many years.  She will be sadly missed by all who knew her.

Thank you for donations:
A big thank you to the Molobi family who brought in a huge heap of groceries.  This is really appreciated as we do go through a lot of tea, coffee, sugar, long life milk, biscuits etc in a week.

Thank you to Margaret Sutcliffe for making lovely new curtains for our gents’ bathrooms.  They look really chic.

We thank Johnson’s Crane Hire and the Haggie Trust for their generous monetary donations.  We also thank VR Dragline who donate R5000 per month for our outreach branch in Alexandra.

Thank you to Woolworths in Hyde Park who donate food on a weekly basis.  This provides our Alex attendees with a hot meal every day.

Concert at the Linder Auditorium:
Richard Cock will be conducting his full festival orchestra along with massed choirs from 12 schools at the Linder Auditorium on 14th and 15th July at 7pm as a joint fundraising effort for Headway and Hospice.  This promises to be a brilliant evening’s entertainment.  Contact me (Ann Coe) on (011)442-5733 for further information.  Tickets cost R100 per person.

Art Exhibition:
Headway will be holding an art exhibition on Friday 15th August at 6:30 pm – 9:00 pm and 16th August from 9:00am – 12:30 pm at our centre in Hyde Park (85 1st Road).  Amongst those exhibiting will be well known artists such as Derek van Rensburg, Alison Butterworth and Hester van den Bergh as well as students from Hester’s art studio.  Our Wednesday attendees who do art therapy with Arabella will also be exhibiting.  A percentage of the money raised from the sale of paintings will come to Headway.  Even if you don’t want to buy anything, pop in and have a look at all the beautiful art on display and meet the Headway team.  Entrance is free and cheese and wine will be served.

Next Meeting:
The next HFC meeting will be held on 26th June at 85 1st Road at 6 pm and will be a general discussion on problems relating to brain injury.  Brain injured people, their family and friends are welcome to attend and a snack will be served after the meeting.

---ooo0ooo---

Editor and compiler – Annie Coe

Thought for the day:
If you love what you do, you will never work another day in your life. – Confucius

FORREST GUMP GOES TO HEAVEN
The day finally arrived.   Forrest Gump dies and goes to Heaven.   He is at the Pearly Gates, met by St. Peter himself.  However, the gates are closed, and Forrest approaches the gatekeeper.
St. Peter said, "Well, Forrest, it is certainly good to see you.   We have heard a lot about you   I must tell you, though, that the place is filling up fast, and we have been administering an entrance examination for everyone.  The test is short, but you have to pass it before you can get into Heaven."
Forrest responds, "It sure is good to be here, St. Peter, sir.   But nobody ever told me about any entrance exam.  I sure hope that the test ain't too hard. Life was a big enough test as it was."
St. Peter continued, "Yes, I know, Forrest, but the test is only three questions. First: What two days of the week begin with the letter T? Second: How many seconds are there in a year? Third: What is God's first name?"
Forrest leaves to think the questions over.  He returns the next day and sees St. Peter, who waves him up, and says, "Now that you have had a chance to think the questions over, tell me your answers."
Forrest replied, "Well, the first one -- which two days in the week begins with the letter "T"? Shucks, that one is easy.   That would be Today and Tomorrow."
The Saint's eyes opened wide and he exclaimed, "Forrest, that is not what I was thinking, but you do have a point, and I guess I did not specify, so I will give you credit for that answer.   How about the next one?" asked St. Peter.
"How many seconds in a year?”
“Now that one is harder," replied Forrest, but I thunk and thunk about that, and I guess the only answer can be twelve."
Astounded, St. Peter said, "Twelve? Twelve?  Forrest, how in Heaven's name could you come up with twelve seconds in a year?"
Forrest replied, "Shucks, there's got to be twelve: January 2nd, February 2nd, March 2nd... "
"Hold it," interrupts St. Peter.   "I see where you are going with this, and I see your point, though that was not quite what I had in mind....but I will have to give you credit for that one, too.  Let us go on with the third and final question. Can you tell me God's first name"?
"Sure," Forrest replied, "it's Andy."
"Andy?" exclaimed an exasperated and frustrated St Peter. "Ok, I can understand how you came up with your answers to my first two questions, but just how in the world did you come up with the name Andy as the first name of God?"
 “Shucks, that was the easiest one of all," Forrest replied.  “I learnt it from the song,’ ANDY WALKS WITH ME, ANDY TALKS WITH ME, ANDY TELLS ME I AM HIS OWN’."
St. Peter opened the Pearly Gates, and said: "Run Forrest, run."