While reading the paper this past weekend, I came upon an article addressing two issues that are near and dear to my life:  cycling and brain injury.  I commute by bike approximately 14 km each way every day to our offices where I then represent individuals with mild, moderate and severe brain injuries.  Reading this article, in which Mr. Cox described being hit by a street race 25 years ago at the age of 31, really struck home:  “There’s a lot to lose by not wearing a bike helmet.”  Although I have been fortunate enough not to have had any major altercations with vehicles in my cycling career, it is something I think about every day as I put on my helmet and turn on the 4 lights on my bike.  Wearing a helmet is required according to section 184 of the Motor Vehicle Act, and for good reason.  Time and time again, I hear about catastrophic injuries to cyclists and think that at least some of them may have been avoided had the rider been properly equipped and wearing a helmet.  As Mr. Cox quotes, and as is sometimes the experience of our clients:

Cyclists who flout the law by not wearing a helmet might lose more than just their lives – they might lose who they are.  They might become so impossible to live with that all they love leave them.

Certainly, if you or a family member is in this situation where a brain injury is affecting every aspect of your life and you require legal assistance, please contact us.  Otherwise, be safe out there and wear your helmet!

Filed under: Uncategorized by Kara Naish | No Comments »

Physical disabilities and cognitive impairment are the main reasons that an individual may be unable to drive after a traumatic brain injury.

Doctors are required to inform the Superintendent of Motor Vehicles that a person has a health condition which impairs their ability to drive. However, this does not mean a person will never drive again. Nonetheless, individuals that have sustained serious should not drive unless their doctor tells says it is safe to do so.

Some of the factors that affect the likelihood that a TBI survivor will eventually be able to drive include:

• Age (Younger TBI survivors are more likely to recover than older ones.)
• Mental outlook and effort in recovery
• Support team, including his or her doctors, therapists, family and friends (strong, reliable support teams aid recovery.)
• The severity of the primary injury and the resulting complications
• Whether or not the individual had driving experience before the injury (prior driving experience makes re-learning driving easier.)

Evaluating Individual’s Driving Ability
Determining whether a person with an acquired brain injury can safely drive again involves a number of professionals and assessments, including: medical or neurophysical exams, visual tests, and active driving tests (simulated or on-road).

Getting Back on the Road, in British Columbia
In British Columbia, once the survivor, their doctor, and/or healthcare team are confident in their ability to drive safely, the Office of the Superintendent of Motor Vehicles (OSMV) determines the legality of driving – usually authorized testing is all that is required.

Office of the Superintendent of Motor Vehicles (OSMV)
The OSMV is a BC provincial agency that is in charge or road safety and driver behaviour. The OSMV reviews information from the medical community, law enforcement agencies, and Insurance Corporation of British Columbia (ICBC) licensing when making decisions about a driver’s license.

The Superintendent of Motor Vehicles may require a driver to take a vision test, a functional driving assessment, a medical and/or other evaluation, in order to help determine whether they are able to drive safely. These may include:

1. Driver Medical Examination (DME)
   The driver’s doctor must conduct a driver medical examination at the request of the OSMV and submit a completed assessment form to the OSMV
2. Functional Driving Assessment
   The driver may be asked to complete one of these two assessments:

• Driver Rehab Assessment
  • For persons who are seen as being likely to drive safely again after an illness or injury
  • The goal is to help the individual to get driving again by offering assessments, lessons, strategies and vehicle modification, if necessary
  • This assessment may be the best one for persons with a brain injury
  • Community Therapists
    Unlike other services which are heavily computerized and focus on a rigid “pass/fail” methodology with little or no opportunity for training, the Community Therapists methodology focuses on the assessment of the client’s rehabilitation potential to return to driving. Where appropriate, clients are offered a comprehensive driver rehabilitation program to facilitate a return to this vital daily activity. For more information about Community Therapists, visit their website.

• DriveABLE
  • Assessment involves an in-clinic perceptual and cognitive assessment, and may be followed by an on-road evaluation
  • Rehabilitation and compensatory strategies are not addressed
  • Not appropriate for those with visual or physical impairment
  • Is best for persons with progressive cognitive conditions and impairments
  • For more information about DriveABLE visit their website.

Where can I get a functional driver assessment?

• For information about driver rehabilitation programs in British Columbia, visit the brainstreams.ca website.
• Do an OT search through BC Society of Occupational Therapists and select “Driver Rehab Assessment”

How long does the whole process take?
The entire process can take a significant amount of time. The duration depends on the individual’s injury as well as the activity of the groups involved – healthcare team, driver rehab centre, OSMV, licensing.

How much does it cost?

• You may need to pay for the cost of the assessment yourself. The cost can usually be submitted as a medical expense on your income tax return.
• If you have a claim against a third party, speak to your lawyer or call Workers Compensation Board if it covers your claim.
• Functional Driving Assessments centres set their own fees
• Funding may be available from third party funders (e.g. ICBC, WorkSafe BC) and extended health plans, or through OSMV.

Article References:

• Office of the Superintendent of Motor Vehicles website
• Brainstreams.ca website
• DriveAble website
• Community Therapists website

Filed under: Living with Brain Injury by Daniel Corrin | 1 Comment »

Date: February 15-17, 2012,
Location: Sheraton Vancouver Wall Centre in Vancouver, BC
Satellite Conferences held simultaneously in Victoria and Kamloops, BC.

The Annual Pacific Coast Brain Inury Conference will return February 15-17, 2012. The theme for 2012 is: Real people with Real Lives: It takes a Village. Sign up to receive the conference e-newsletter and keep up-to-date on event developments.

Check out highlights and presentations from the November 2010 Conference.

• Browse Keynote Speakers presentation slides and audio recordings.
• Videos from participants sharing some of their thoughts on connecting with others and what they would most want to share with people about brain injury.

Filed under: Brain Injury Community Events & Programs by Daniel Corrin | No Comments »

Not all head injuries arise from car, motorcycle or truck collisions.

Webster & Associates has successfully concluded serious injury claims that followed a variety of accidents, including those involving:

• Golf carts
• Aircraft
• Snowplows
• Bicycles
• Boats
• Ladder failures
• Windsurfing
• Sailboarding

Maritime boating collisions have unique rules that require specialized knowledge and there may be possible limits on the amount of damages that can be claimed. Speak to a lawyer experienced in maritime law claims as well as brain injury if a member of your family is involved in such a tragedy. As in bicycle collisions, many of those injured on the water have recoveries complicated by numerous fractures, infections, and internal injuries. We work with medical advisors and occupational therapists to help ensure all the client’s unique injuries and needs are considered in their rehabilitation and in any settlement.

It costs nothing to have a phone call with one of our lawyers. If you think you might benefit from our experience, contact us any time.

Greater Vancouver: 604.713.8030

Victoria, Vancouver Island: 250.589.8030

Within North America: 1.877.873.0699

Filed under: Uncategorized by Barbara Webster-Evans | No Comments »

G.F. Strong hosts a number of workshops for suvivors of brain injury and stroke, their family and friends. These workshops provide an open, informal forum in which to discuss and learn about the brain, how it works, and its recovery. Attendees concerns, questions and experiences guide the session.

Understanding Traumatic Brain Injury: A Workshop for Families & Friends

This open, informal workshop is facilitated by a doctor and educator from the Acquired Brain Injury Program at GF Strong Rehab Centre.

Topics of discussion include:

• the brain and how it works
• the many changes that happen after a brain injury
• practical rehabilitation strategies to help
• life after brain injury and resources to help you through your journey

Dates:
September 21, 2011: 6.00 – 9.00pm
November 17, 2011: 6.00 – 9.00pm

Understanding Stroke: A Workshop for Families & Friends

Topics of discussion include:

• the brain and how it works
• the many changes that happen after a stroke
• practical rehabilitation strategies to help
• life after stroke and resources to help you through your journey

Dates:
October 19, 2011: 6.00 – 9.00pm
December 15, 2011: 6.00 – 9.00pm

Building Community Connections: A Workshop for Suvivors, Families and Friends

This workshop is facilitated by the Community Intervention Coordinator. The workshop is interactive, with open group discussions, opportunities for sharing and problem solving with others. Survivors and caregivers share their personal journeys and discuss some of the successes and challenges they encountered in returning to the community.

Learn more about:

• What is community and why is it important to link people with resources in their local community?
• How do we build community connections?
• What are some of the available resources in my community?
• What experiences have others had connecting with resources?

Dates:
September 14, 2011: 6.00 – 8.00 pm
November 9, 2011: 6.00 – 8.00 pm

Location
GF Strong Rehab Centre
4255 Laurel Street
Vancouver, BC V5Z 2G9
Social Services Seminar Room (#189, main floor)

Do I need to register?
Registration is not needed and these workshops are free to attend, but please contact GF Strong at 604-737-6221 to let them know how many of your family and friends will be attending.

More questions?
For more information please call the GF Strong Educator at 604-737-6221.

Filed under: Brain Injury Community Events & Programs, Living with Brain Injury by Daniel Corrin | No Comments »

Days 2 and 3 at the SickKids Centre for Brain and Behaviour Conference in Toronto focused on abusive head trauma in children and the management of severe brain injury. Here are some of the interesting topics that were discussed.

Shaken Baby Syndrome – now referred to as “abusive head trauma”
The abusive head trauma sessions focussed on identification of abusive head trauma. There seems to be an emerging consensus amongst leading researchers that radiology is going to play a major role in identifying abusive head trauma in infants. While clinical examination is also needed, it is hoped that brain biomarkers will become the new gold standard for identifying this type of injury.

New treatments for paediatric brain injury
New treatments for paediatric brain injury are showing great results! When a baby or child has suffered a severe brain injury it is usually incorrect to assume that the brain injury occurred in the moment the accident occurs. Rather the injury is often progressive in the minutes and hours following the initial insult and gets worse unless the child receives proper care. New research has proven that head cooling or whole body cooling (through hypothermia) can prevent this worsening of injuries and it is now being used in many jurisdictions including BC. In fact it is not difficult to do and should be used everywhere. The research results are clear that young children with brain injuries treated with hypothermia have a much reduced risk of death and severe injury than those young children who were not cooled following injury. Some research suggests that 60-70% can benefit from cooling. Clearly quick recognition of brain injury is vital so that cooling treatment can be properly and quickly initiated.

Functional neuro-imaging detects conscious awareness after severe brain injury
Using functional MRI has allowed doctors to prove that some patients assumed to be in a vegetative state without awareness or ability to respond to the outside world in fact are aware of what is happening around them and are able to communicate through MRI.
The scientific test protocols went something like this:

A number of healthy adult volunteers were placed in an MRI machine and while there were asked to imagine playing tennis. A particular area of the brains of each of the volunteers lit up showing where brain activity associated with playing tennis was taking place.
A severely brain injured “vegetative” patient with no previously known responsiveness to stimulation was then placed in an MRI and asked to imagine playing tennis. Through functional MRI the doctors were able to see that the exact same area of the patient’s brain lit up, showing that the patient had heard and responded to the instructions given by the researchers.

The volunteers were again placed in the MRI machines and then asked to imagine walking through the various rooms in their homes. This time a different area of the brains of each of the adult volunteers lit up, showing the areas where the brain activity was occurring. When the brain injured patient was placed in the MRI, the same question was asked and the same area of the brain that had lit up in the brains of healthy volunteers lit up in the injured patient’s brain.

The researchers continued the experiment by asking the brain injured patient to think about playing tennis when he wanted to answer yes to various questions that were asked of him. Every time the patient answered yes correctly (by thinking about palying tennis) when asked about the name of his father, his address, and his dog’s name. When asked questions that had “no” answers the area of the brain associated with tennis playing did not light up. This remarkable experiment has now given people who have severe brain injuries and those who love them reason for hope. Researchers think that other less expensive technologies, like EEG’s might be used in the future in the same way that the functional MRI was used in this experiment to help these severely injured patients let us know they are still with us and aware of the world around them.

Filed under: Brain Injury Community Events & Programs, Brain Injury Research by Barbara Webster-Evans | No Comments »

The Brain Injury Association of America authors a quarterly publication, THE Challenge!, which offers readers advice, support and guidance for those who have sustained a traumatic brain injury and their families.

The latest issue of THE Challenge! features several compelling stories including Communication Strategies Following a Brain Injury, Caregiving, Year after Year: How to Ask the Family for Help, and Classifying Brain Injury as a Chronic Disease. Read it online now.

Webster & Associates are proud supporters of Brain Injury Associations across British Columbia. We are proud to provide legal services, guidance and support to survivors of traumatic brain injury and their families.

Filed under: Brain Injury Community Events & Programs, Living with Brain Injury by Daniel Corrin | No Comments »

SickKids Centre for Brain & Behaviour 2nd Biennial Conference
- Brain Injury in Children
July 12 – 14, 2011 – Toronto, Canada

Day one of the conference was dedicated to a review of issues relating to birth injury and neonatal encephalopathy. We had some excellent speakers involved in leading edge research in this area, many of whom suggest that there is hope for families of babies who will be born with birth asphyxia. New research is showing that treatments like hypothermia, if provided quickly following neonatal injury, reduces neuro-developmental disability in survivors of encephalopathy. The bad news is many hospitals in Canada are still not using hypothermia despite numerous studies showing its effectiveness in decreasing infant deaths and the progression of injuries.

There is continuing controversy around what will be included in the new definitions of encephalopathy – the present ACOG and AAP standards require that an infant suffer from cerebral palsy before that baby will be included. Neuro-imaging is crucial to determine the type of injury and the timing of the injury and will be vital when we try to prove that an infant’s injury occurred during labour and was preventable. Seizures are an ongoing problem. Research has shown that most of the babies with seizures are not recognised as having seizures because they are happening “sub-clinically” and not observable. Those babies still need treatment so that these seizures do not cause further injury. Careful monitoring with EEG’s is required for all babies who are at serious risk of seizures. Visual observation can miss as many as 90 percent of all seizures!

Filed under: Brain Injury Community Events & Programs, Brain Injury Research by Barbara Webster-Evans | No Comments »

Brain injury survivor David McGuire is running a marathon a day across Canada to raise awareness of brain injury.

The New Westminister native sustained a brain injury in 2005 and, although he was told that he may never walk again, David completed his first marathon a year after his injury. Determined to raise awareness of brain injury and brain injury prevention, on April 1st 2011 David began A Run to Remember – an epic, 7 month run across Canada.

“I am not an athlete… I am not a rock star…or the relative of a famous person. I am just a guy with a brain injury – like so many others – but I can run, and I have a story to tell…Some may call me crazy but I am trying to get people talking about brain injury… This run will bring awareness and understanding to the issue of brain injury…”

David is currently making his way through Quebec and will finish in Victoria, BC this October. To find out more about this amazing journey and to track David’s progress visit run to remember.com.

Read a 3 page article on David’s journey from sustaining brain injury to running across Canada in Headline Magazine’s summer edition.

Follow David’s blog: http://r2rcanada.blogspot.com

Filed under: Brain Injury Community Events & Programs by Daniel Corrin | No Comments »

Not all brain injury arises from a traumatic event. A number of our clients have developed a often irreversible brain disorder called tardive dyskinesia (tardive means “delayed” and dyskinesia means “abnormal movement”). Tardive dyskinesia is a serious side effect that can arise as a result of certain prescribed medications. Closely related conditions include tardive dystonia and tardive akathisia. It seems that the risk a patient of developing the disorder increases the longer a patient takes the drug. If caught early and the drug is no longer taken the condition can sometimes be reversed.

Tardive dyskinesia is actually a “brain injury”, which causes involuntary facial movements that can include involuntary repetitive movements of the tongue, lips, face, and extremities. It may include facial disfigurement, tongue thrusting, grimacing, difficulties eating, speaking and may interfere with usual activities of daily living.

Some of our clients developed tariff dyskinesia following the administration of anti psychotic medications, including those sometimes prescribed as an adjunctive therapy for depression like Risperidone, also known as Risperdal, or metoclopramide also called Reglan, which is prescribed for certain stomach problems.

Other drugs which have been associated with the disorder include:

• Chlorpromazine (CPZ)
• Fluphenazine (Prolixin)
• Haloperidol (Haldol)
• Olanzapine (Zyprexa)
• Trifluoperazine
• Flunarizine (Sibelium)
• Prochlorperazine

Sometimes the condition is not preventable, but at other times, the condition is the result of medical malpractice- such as prescribing the wrong drug or prescribing the right drug for too long. Doctors must be very careful to limit the use of these drugs and thoroughly monitor patients for signs of abnormal movements. Physicians should educate patients and families about the dangers and warning signs of tardive dyskinesia. If they fail to do so and the condition develops, the patient may have the ability to commence a legal action for damages.

Seek experienced legal advice.

Filed under: Uncategorized by Barbara Webster-Evans | No Comments »