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Taking Care of Yourself

Taking Care of Yourself

Tracy
All right, next we’re going to talk about one of the most important things that you can do as a caregiver. The very best thing you can do to take care of your family member with TBI, and all the others members in your family that depend on you, is to take care of yourself.

Seriously spending all your time dealing with your family member’s needs can leave you feeling just absolutely drained.

Travis
My mom is the worst. Sometimes she doesn’t sleep for days, and I’ve seen her skip a lot of meals. She makes sure that me and my sister eat, but she always says that she’s not hungry. I mean I just think she just doesn’t want to leave Dad alone.

Michelle
Travis.

Travis
No mom. You told me that we need to be completely honest when we’re here, that’s what I’m doing. I’m worried about you.

Michelle
I know, honey. It’s just that I’m trying to be here for your Dad, and for you and for Emily. I’m feeling like I’m being pulled in a thousand different directions.

Tracy
So Michelle how are you sleeping?

Michelle
When I go to bed, things just run through my head. When I finally do go to sleep, I wake up in the morning with reality hitting me in the face, like I can’t believe this is happening. I get out of bed and just put one foot in front of the other, trying to get through the day. I know that I have to do a better job taking care of myself.

Tracy
Well thank you both for your honesty. You know taking care of yourself, both emotionally and physically, it can help prevent something that we call caregiver burnout.

Julie
I have to admit that I went through a burnout phase, when I just felt so hopeless. I hope you guys can avoid that.

Tracy
You know you’ve already taken a really important step to avoid caregiver burnout by joining a group. Talking with others about your feelings... that really can relieve the stress and it helps reduce the anxiety because it helps you know because it confirms the fact that you’re not alone.

Another thing you can do if your stress, your sadness, or your anxiety gets… gets to feel out of control... get some help from a counselor, a therapist, your spiritual leader, religious leader, or a social worker. 

Julie
It was a few months after Sam got hurt, that I realized I needed some help. I went and saw a psychologist and that was probably one of the best things I did. She helped me process some of the stuff that was going on, which made it easier for me to cope somehow.

I saw her for about 2 months, and I even got Carl to come along sometimes.

Carl
I was surprised, but it really helped. When we were less stressed, we started to sleep better, eat better, things like that.

Tracy
That’s great. You know you can be a much more effective caregiver when you’re healthy. Let’s talk for a moment about some of the behaviors that will help. Of course, like Michelle is discovering sleep is absolutely essential.

Megan
Yeah. I guess I just want to be there when Clayton wakes up, so I’m there almost all the time. And I really just use the Fisher House to shower, or eat once in a while.

Julie
I thought it was important that I was always there and awake in case Sam needed me. Turns out, I can think clearer, make better decisions when I’ve had some sleep and something decent to eat.

Tracy
That’s right. Absolutely right. You’ve gotta give yourself a chance to sleep, and eat as well as you possibly can. I mean overeating or eating a bunch of you know comfort food, or fast food that might be tempting right now, but just really please try to stick to a healthy diet. Of course, that can be a real challenge when you’re spending most of your time in the hospital.

But another challenge involves your activity, that’s really important, particularly important for caregivers because the exercise can help relieve the stress, reduce the depression. It doesn’t have to be strenuous. You know something simple. A 30-minute walk on most days is usually enough and you know you can break that 30 minutes into 10-minute segments, if that’s any easier. Break away, take that walk. And if you already have an exercise routine, try to stick to it. Doing things that were important to you before your loved one’s TBI can… can really help. It can help you cope. It can help you be a better caregiver.

Another thing you know when life is stressful, some people turn to alcohol or other drugs. They somehow think that that’s going to help them cope. It just doesn’t. Try to find some other ways to relieve your stress.

But remember, you can’t take care of someone else unless you’re strong and you’re healthy. And that means that you should keep up with your regular appointments, be sure to pay attention to any medical problems that you might have.

Taking care of yourself is… is not being selfish. I mean it’s doing what’s absolutely necessary to make you a better caregiver. If you become sick, if you get worn out, or burned out, you just… you won’t be able to take care of them. TBI is different than a short-term illness. That caregiving journey can take a long, long time, and taking care of yourself... it allows you to be there for your loved one and for the long haul.

Carl
Yeah, I didn’t do a very good job of taking care of myself, and now it’s starting to take its toll. My blood pressure is high, and other physical things are cropping up. Julie finally forced me to go in for an exam, and my doctor wasn’t happy. I’m doing better now, but I just… I didn’t feel I could take time for myself when Sam was having such a hard time. You know what I mean?

Michelle
I do. Even though this is new to me, I know that I’ve been letting myself go in a lot of ways.

Julie
You know Tom is going to need you more and more as he recovers, Michelle. It actually took me a while to realize this but taking time for yourself is actually the unselfish thing to do. Even if you just go for a run, or take time to actually go to the cafeteria at the hospital instead of grabbing something from a vending machine…

Michelle
How did you know?

Julie
Cause I did it myself. Still do sometimes…

Travis
Hey, what’s wrong with vending machines? I mean you can get a full, 3-course meal out of those things.

Tracy
Oh I think the point here is that it’s really each of your responsibility to pay attention to your own physical and emotional health. Overall, this plays a really important part in Tom’s, and Clayton’s, and Sam’s recovery. And there are some strategies that can help you do that.

Megan
Like what?

Tracy
Oh well, controlling your stress level is definitely one. You can use what I call the “Stress Busters” to relieve stress and help keep yourself calm throughout your caregiving journey, and all of the time, really. Helps always so... For example, you could try practicing deep breathing or something called Progressive Muscle Relaxation. Both of those are described in your Guide for Caregivers.

Julie
I was surprised by how well the progressive relaxation worked for me. Sam’s PT actually told me about it when I was having a rough time. He also taught me how to meditate.

Tracy
That’s good Julie, yeah. You know another stress buster involves managing your time wisely. Plan ahead so that you have plenty of time to arrive at appointments on time. Plan your day, your week sensibly, so that you’re not trying to you know cram too much in, get too much done in too little of time.

Oh and like I mentioned before, find time to exercise.  Exercise helps your brain release endorphins, which are those natural substances in your body that reduce the stress, make you feel better, just overall well being. Also gives you some time alone, which is important.

And then there are ways to relax and take your mind off your daily routine. Read a book; watch a movie or favorite TV show, spend a little time with a friend.

Glossary

A-D   E-H   I-L   M-P   Q-Z

Absence Seizures – A non-convulsive generalized seizure when a person may appear to be staring into space with or without jerking or twitching movements of the eye muscles. These seizures may last for seconds, or even tens of seconds, with full recovery of consciousness and no confusion. People experiencing absence seizures sometimes move from one location to another without any purpose.

Abstract Thinking – Being able to apply abstract concepts to new situations and surroundings.

Acceleration – To increase speed and/or change velocity.

Alopecia – A condition of a loss of hair or baldness.

Amnesia – A loss of memory. Amnesia can be caused by brain injury, shock, fatigue, repression, illness and sometimes anesthesia.

Angiogram – A procedure in which a dye is injected through a thin tube into a blood vessel. Special x-ray pictures are taken, allowing your health care provider to view the blood vessels of the brain, heart or other part of the body. Also called an arteriogram for arteries or venogram for veins.

Anorexia – A loss of appetite, especially when prolonged over time.

Anosmia – The decrease or loss of the sense of smell.

Anoxia – Absence of oxygen supply to an organ.

Anoxic Brain Injury – Injury to the brain due to severe lack of oxygen. This usually happens when blood is unable to flow to the brain due to certain injuries,bleeding, or cardiac arrest.

Apraxia – The loss or impairment of the ability to perform complex coordinated movements despite having the desire and the physical ability to perform the movements.

Arthralgia – Joint pain or stiffness in a joint.

Ataxia – The inability to coordinate the movement of muscles. Ataxia may affect the fingers, hands, arms, legs, body, speech, or eye movements.

Axons – Also known as nerve fibers, an axon is a long, slender projection of a nerve cell, or neuron, that conducts electrical impulses away from the neuron's cell body or soma. Axons are the primary transmission lines of the nervous system.

Basal Ganglia – The deep brain structures that help start and control voluntary movements and postures.

Bipolar Disorder – Also known as manic-depressive illness, bipolar disorder is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function.

Blast Injuries – Injuries that result from the complex pressure wave generated by an explosion. The explosion causes an instantaneous rise in pressure over atmospheric pressure that creates a blast over pressurization wave. Injuries to organs surrounded by fluid, such as the brain and air filled organs such as the ear, lung and gastrointestinal tract are common.

Brain – The main organ of the central nervous system (CNS). It is divided into the cerebrum, brainstem, and cerebellum. The brain regulates virtually all human activity.

Brain Stem – The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).

Cerebellum – The portion of the brain (located in the back) that helps coordinate movement.

Cerebral Hypoxia – The inadequate oxygen supply to brain tissue. Mild or moderate cerebral hypoxia is sometimes known as diffuse cerebral hypoxia. It can cause confusion and fainting, but its effects are usually reversible.

Cerebral Spinal Fluid – A colorless fluid that is found around and inside the brain and spinal cord, offering some protection and cushioning the brain.

Cerebrum – The largest part of the brain. It is divided into two hemispheres, or halves. It controls motor, sensory, and higher mental functions, such as thought, reason, emotion, and memory.

Chronic Subdural Hematoma – An "old" collection of blood and blood breakdown products between the surface of the brain and its outermost covering (the dura).

Closed Head Injury – Injury to structures within the skull or the brain that do not result in an opening in the, such as a direct blow to the head or a blast. Injuries may range from a mild concussion to potentially fatal.

Coma – A state of unconsciousness from which the person is not aware of the environment nor able to perform voluntary actions.

Computerized Axial Tomography, or CT or CAT Scan – A painless procedure in which x-rays are passed through the affected area at different angles, detected by a scanner, and analyzed by a computer. CT scan images show bones and blood collections more clearly than conventional x-rays. The computer can combine individual images to produce a three-dimensional view.

Concussion – A blow, jarring, shaking or other non-penetrating injury to the brain which causes a temporary decrease in normal brain activity.

Consciousness – The state of awareness of the self and the environment.

Contusion – A bruise. In terms of brain injury, a contusion refers to bruising of the brain tissues.

Coup-Contrecoup – An injury to the brain that occurs when an impact or violent motion brings the head to a sudden stop, causing injury to the impact site and the opposite side of the brain. This is also known as an acceleration / deceleration injury.

Cranium – Skull.

Deceleration – To reduce speed or go more slowly.

Diffuse – Widely spread.

Diffuse Axonal Injury, or DAI – Widespread injury of large nerve fibers (axons covered with myelin).

Diffuse Brain Injury – Injury to cells in many areas of the brain rather than in one specific location.

Diplopia – Seeing two images of a single object; double vision.

Dura Mater – The outermost of three membranes protecting the brain and spinal cord. It is tough and leather like.

Dysarthria – Difficulty in forming words or speaking them because of weakness of the muscles used in speaking. Tongue movements are usually labored and the rate of speaking may be very slow. Voice quality may be abnormal, usually excessively nasal; volume may be weak; drooling may occur.

Dyskinesia – Involuntary movements most often seen in the arms or legs.

Electroencephalograph, or EEG – A test that measures electrical activity of the brain that is recorded from electrodes placed on the scalp.

Epidural Hematoma – Bleeding into the area between the skull and the dura mater.

Euphoria – An exaggerated or abnormal sense of well-being not based on reality.

Executive Functions – The ability to formulate and carry out plans effectively. These functions are essential for independent, creative and socially constructive behavior.

Expressive Aphasia – also known as Broca’s aphasia. A difficulty in expressing oneself in speech and writing. Characterized by knowing what one wants to say but being unable to find the words to say what is being thought. There is lack of spontaneous speech, words are often labored over and sentences are short and incomplete.

Focal Brain Injury – Damage confined to a small area of the brain. The focal damage is most often at the point where the head hits an object or where an object, such as a bullet, enters the brain.

Frontal Lobe – The front part of the brain; involved in planning, organizing, problem solving, selective attention, personality and a variety of "higher cognitive functions."

Generalized Tonic-Clonic Seizures – A seizure involving the entire body. It is also called a grand mal seizure. Such seizures usually involve muscle rigidity, violent muscle contractions, and loss of consciousness.

Glasgow Coma Scale – A scale used for measuring level of consciousness. Scoring is determined by three factors: eye opening ability, verbal responsiveness, and motor responsiveness. The scores range from lowest level of responsiveness a 3 to highest level of responsiveness a 15.

Hematoma – A collection of blood caused by the rupture or tearing of blood vessels.

Herniation/Herniated –Compression of brain tissue caused by high pressure inside the skull that can lead to death if not aggressively treated.

Hypertension – The medical term for high blood pressure.

Hypotension – The medical term for low blood pressure.

Hypoxia – Decreased oxygen levels in an organ, such as the brain.

Intracranial Pressure (ICP) Monitor – A monitoring device used to determine the pressure within the brain. It is used to assess potential complications resulting from increased pressure exerted on the brain.

Impaired Initiation – The diminished ability to take the first step in beginning an action.

Improvised Explosive Devices, or IEDs – An IED can be almost anything with any type of material and initiator. It is a “homemade” device that is designed to cause death or injury by using explosives alone or in combination with toxic chemicals, biological toxins, or radiological material. IEDs can be produced in varying sizes, functioning methods, containers, and delivery methods. IEDs can utilize commercial or military explosives, homemade explosives, or military ordinance and ordinance components.

Intracerebral Hematoma – Collection of blood inside the brain tissue.

Intracerebral Hemorrhage – A subtype of intracranial hemorrhage that occurs within the brain tissue itself. Intracerebral hemorrhage can be caused by brain trauma, or it can occur spontaneously in hemorrhagic stroke.

Intracranial Pressure, or ICP – The amount of pressure inside the skull resulting from the brain tissue, cerebrospinal fluid and blood volume. This pressure normally ranges from 0-10 mm Hg.

Limbic System – A group of structures deep within the brain that are associated with emotion and motivation.

Lobe – A part of the brain located in each of the two hemispheres. Each hemisphere of the cerebrum is divided into four sections known as the frontal lobe, the parietal lobe, the occipital lobe, and the temporal lobe.

Magnetic Resonance Imaging, or MRI – A test that uses a powerful magnet linked to a computer to make detailed pictures of soft tissues inside the body.

Meninges –The covering of the brain that consists of three layers: the dura mater, the arachnoid mater, and the pia mater. The primary function of the meninges and of the cerebrospinal fluid is to protect the central nervous system.

Mild Traumatic Brain Injury, or mTBI – Also referred to as a concussion, mTBI involves a disruption of brain function caused by trauma. This disruption is characterized by, but not limited to, a loss of consciousness for less than thirty minutes, and posttraumatic amnesia lasting for less than 24 hours, and a Glasgow coma Scale of 13 – 15.

Military Acute Concussion Evaluation, or MACE – A standardized mental status exam that is used to evaluate concussion in theater. This screening tool was developed to evaluate a person with a suspected concussion.

Myalgia – Pain in one or more muscles.

Neurocognitive – Of, relating to, or involving the brain and the ability to think, remember or process thoughts.

Neurons – A nerve cell that can receive and send information by way of connections with other nerve cells.

Neuropsychology – A science that combines the study of the brain’s structures and functions with psychological processes and human behaviors.

Neuroradiological Tests – Tests using computer-assisted brain scans. These tests allow providers to visualize the brain. Tests may include: CT Scan, MRI, Angiogram, EEG, SPECT Scan, PET Scan, DTI Scan.

Neurotransmitters – Chemicals found within the brain that are released from a neuron which transmit signals from neuron to neuron across gaps called synapses. These chemicals either excite or inhibit specific reactions, such as in motor neurons, the neurotransmitter causes contraction of muscles through stimulation of muscle fibers.

Nystagmus – Involuntary, usually rapid movement of the eyeballs (side to side or up and down).

Occipital Lobe – The occipital lobes are found at the back of the brain. These lobes receive signals from the eyes, process those signals, allow people to understand what they are seeing, and influence how people process colors and shapes.

Ocular – Relating to the eye.

Open Head Injury – Trauma to the brain that occurs from a skull fracture or penetrating injury.

Parietal Lobe – The part of the brain that is involved with movement, and with the processing of signals received from other areas of the brain such as vision, hearing, motor, sensory and memory.

Penetrating Head Injury – A brain injury in which an object pierces the skull and enters the brain tissue.

Perseveration – The repeated and uncontrollable use of the same words or actions regardless of the situation.

Photophobia – An intolerance to light; or a painful sensitivity to strong light.

Positron Emission Tomography, or PET Scan – a specialized imaging technique that uses an injection of a short-lived radioactive substance and special CT scans. PET scanning provides information about the body's chemistry not available through other procedures. Unlike other imaging techniques that look at structures of the brain, PET looks at the energy use of different parts of the brain.

Post Deployment Health Assessment, or PDHA – The military’s global health screening that occurs when a unit or service member returns from an overseas deployment. The purpose of this screening is to review each service member's current health, mental health or psychosocial issues commonly associated with deployments, special medications taken during the deployment, possible deployment-related occupational/environmental exposures, and to discuss deployment-related health concerns.

Post Deployment Health Reassessment, or PDHRA – A second assessment used 3-6 months following redeployment or return of service members from overseas deployment. PDHRA extends the continuum of care for deployment related heath concerns and provides education, screening, assessment and access to care.

Post Traumatic Stress Disorder, or PTSD – A condition where memories of traumatic events are re-lived after the fact.

Post-traumatic Amnesia, or PTA – The inability to remember things following a traumatic event. Memory loss caused by brain damage or severe emotional injury.

Rancho Los Amigos Scale of Cognitive Functioning – A scale used to follow the recovery of the TBI survivor and to determine when he or she is ready to begin a structured rehabilitation program.

Receptive Aphasia – Also known as Wernicke’s aphasia characterized by difficulty understanding spoken words. The aphasic individual themselves have difficulty interpreting and categorizing sounds and speak in what is referred to as a “word salad” with random words put together unintelligibly to form sentences.

Seizure – Uncontrolled electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms. Seizures fall into two main groups. Focal seizures, also called partial seizures, happen in just one part of the brain. Generalized seizures are a result of abnormal activity throughout the brain.

Seizures – A sudden or severe change in behavior due to excessive electrical activity in the brain. Many types of seizures cause loss of consciousness with twitching or shaking of the body. Occasionally, seizures can cause temporary abnormal sensations or visual disturbances.

Shaken Baby Syndrome – A severe form of head injury that occurs when an infant or small child is shaken forcibly enough to cause the brain to bounce against the skull, causing brain injury.

Single-photon Emission Computed Tomography, or SPECT Scan – Test that uses the injection of a weak radioactive substance into a vein, followed by pictures taken with special cameras. This test is similar to a PET scan and provides information on the energy being used by the brain.

Skull Fracture – A break, split or crack in the skull.

Subdural Hematoma – Bleeding confined to the area between the outer-most covering of the brain (dura) and the brain.

Temporal Lobes – Temporal lobes are located at about ear level, and are the main memory center of the brain, contributing to both long-term and short-term memories. The temporal lobe is also involved with understanding what is heard, and with the ability to speak. An area on the right side is involved in visual memory and helps people recognize objects and faces. An area on the left side is involved in verbal memory and helps people remember and understand language. The back area of the temporal lobes helps people interpret the emotions and reactions of others.

Thalamus – A part of the brain that is primarily responsible for relaying sensory information from other parts of the brain to the cerebral cortex.

Tinnitus – “Ringing in the ears" or another noise that seems to originate in the ears or head.

Traumatic Brain Injury, or TBI – An injury to the brain as the result of trauma to the head.

Whiplash – An injury to the neck caused when the head is violently thrown back and forth such as in a rear end car collision.

Related Information:
Your Emotional Health
Coping With Caregiver Challenges
Your Physical Health
Problem Solving
Stress Busters
Stress Test
Caregiver Self-Assessment
Glossary
Frequently Asked Questions
"He really won’t tell me the whole story because I think he doesn’t want to scare me. But, he brought me a piece of metal back home that was embedded in the wall right behind him. He said it missed his head by a few inches. He said that he thanks God every day that he’s still alive, and that’s why he brought the piece of metal home, to show me that that’s how close he had come to dying." -  Lynn C-S.

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