THE PLAIN DEALER
ARTICLE
Date: Monday, March 6, 2000
Edition: FINAL / ALL
Section: HEALTH & FITNESS
PAGE: 1F
To locate resources for patients dealing
with the aftermath of traumatic brain injuries, contact board
members of the Brain Injury Association of Ohio: Deborah Zukowski
at (216) 831-6500, Ext. 182; or Dr. Lyn Turkstra, (216) 368-1791.
For information about brain injury support groups, call Linda
Rebenklau, (216) 749-0409. For educational materials, contact
the Brain Injury Association, a national advocacy group at
1-800-444-6443; or access the Web site at: http://www.biausa.org
MEMO: Debbe Geiger, a Long Island, N.Y., free-lance writer,
contributed to this story. E-mail: fhenry@plaind.com
Phone: (216) 999-4806
HELPING
THE WALKING WOUNDED: BRAIN INJURIES ACCIDENT VICTIM APPEARS
HEALTHY, BUT LIFE IS STRUGGLE
By the end of his first day as a custodian
at Euclid Avenue Christian Church, it was already clear that
Adrian Vonderlippe was floundering. Mundane distractions swamped
his limited ability to pay attention, and the work wasn't
getting done.
But he was a member of the church, and the
congregation understood that Vonderlippe's brain injury was
slowing him down.
Nonetheless, his job trainer, Kim Collins,
knew there was only one way the 26-year-old could learn the
job: She would walk him through his duties step by step.
And she did, for six months. Every Sunday
from October 1998 through March 1999, Collins met Vonderlippe
at the Cleveland Heights church and kept him focused on elements
of his job, from opening 22 doors at 8:30 a.m. to relocking
them around 1 p.m.
"I'm amazed she put up with me," said the
mischievous-eyed Vonderlippe, who is celebrating his first
year of working independently as the Sunday custodian.
"I'd say, I'm ready to leave,' and she'd
say, No, you aren't. You still have to do this, this and this.'
"I was pretty rude. If I was her, I probably
would have fired me. He's a pain in the butt, he's gone,'"
he joked.
He did his job so well, said the Rev. Houston
Bowers, that the emergency food center at the church hired
him to be its janitor as well.
Vonderlippe's success is more than a personal
triumph. It also shows that people with brain injuries can
be capable of making a contribution in the workplace, said
Collins, and have better quality of life. She is the job trainer
with Looking aHead, a program for people with acquired brain
injuries, so-named because they are caused by injuries that
are not hereditary, congenital or degenerative.
The program, at Beachwood's Menorah Park
Center for Senior Living, is the only community and work re-entry
program available to Northeast Ohioans with brain injury.
It's funded for eight participants, although there are 3,000
people in Northeast Ohio with brain injuries.
Nationwide, according to the Centers for
Disease Control and Prevention, about 5.3 million Americans
live with disabilities resulting from brain injury. The three
leading causes are motor vehicle accidents, which account
for half of the injuries; violence, mostly from firearms;
and falls, particularly among the elderly. Other major causes
include cardiac arrest, stroke and sports injuries.
Trauma to the brain, according to Michael
O'Dell, medical director of Southside Hospital's Regional
Brain Injury Rehabilitation in Bay Shore, N.Y., can cause
bruising, bleeding, swelling and an abnormal accumulation
of fluid. The result can be irrevocable damage to the areas
of the brain that control memory, behavior, attention, movement
and language.
Not
enough services
People living with brain injuries constitute
a seriously underserved population, said Deborah Zukowski,
director of Looking aHead.
"It's an expensive rehabilitation process,
and the services they need aren't available," said Zukowski.
For example, the Jewish Family Service Association was recently
funded to open two group homes for people with brain injuries,
and they'll house six people altogether, she explained.
"It's a start, but it's not enough," she
said. If Vonderlippe couldn't live with his mother, she said,
he would likely have to live in a nursing home. "How do you
stick a 26-year-old guy, who is the average person with brain
injury, in a nursing home?"
A large part of the challenge for the community
at large, she explained, is that many brain injury patients
didn't survive their injuries 10 or 15 years ago. "Services
to support their rehabilitation hasn't kept pace with the
medical technology that keeps these people alive," she said.
Vonderlippe's brain injury, caused by a high-speed
car crash in 1996, slowed down his thinking and impaired his
short-term memory and his ability to concentrate. Everyday
tasks, such as how to take a shower, had to be relearned,
said Zukowski, and he lost his sense of what constitutes socially
acceptable behavior and conversation.
Although his mother, Thon Alicia, was primarily
concerned with her son's safety after he returned home with
his brain injury, it became clear within a few months that
he needed more in his life.
"Life was getting boring for him, and I
couldn't give more of myself for training and stimulating
his mind," said Alicia, an artist at Penton Media Inc. Publishing.
"Looking aHead stimulates Adrian in a very positive way. The
program has given him a reason to get up in the morning."
Three days a week, participants attend classes,
including art, horticultural and music therapy groups; and
some, like Vonderlippe, who have demonstrated work readiness,
are placed in jobs at Menorah Park to help develop work skills.
Only one participant in the program's five-year history has
graduated to a full-time outside job.
Vonderlippe's
progress
Vonderlippe's first on-campus job was shredding
documents in the facility's medical records office, a fairly
solitary endeavor to compensate for the fact that he is easily
distracted. At first, Collins provided constant supervision
to teach him to set up his work area and stick to the task.
"Within a few weeks, he could handle the job with only intermittent
supervision," said Zukowski.
His second job was filling glasses with grape
juice for Sabbath services at Menorah Park. After he learned
the sequence of filling the glasses, sealing the tops with
plastic wrap and placing them on a tray, he was able to handle
the job unsupervised.
"He does a good job," said Collins. "He's
very, very, very dedicated. I think down the road there could
be a (full-time) job for him, as long as he can follow a checklist."
But, she emphasized, "jobs for brain-injured
people are hard to find. They don't learn in two weeks."
Brain injury is "so misunderstood," said
Zukowski.
"The brain is like a computer," she explained,
"and (people with brain injuries) just can't get to the files
anymore. They just can't process or access the information.
It's not like the information or the intelligence is gone."
People with brain injuries must be viewed
individually, said Zukowski.
"There's no cookbook for this stuff. Everyone's
needs are so specialized."
Gary O'Shanick, a neuropsychiatrist and the
Brain Injury Association's national medical director, said
people with mild brain injuries are often called the walking
wounded. "They don't show their deficits to the observer,
but the impact on their daily lives is substantial." People
think you're faking'
That just about sums up Diane Roberts Stolers'
experience. She survived a head-on collision nine years ago,
but found "nobody could believe there was anything wrong with
me" because there were no visible signs of brain injury.
For months after the accident, the 52-year-old
psychologist from Georgetown, Mass., was constantly exhausted,
had blurred vision, no sex drive, couldn't regulate her body
temperature and was bothered by light and noise - all the
classic symptoms of mild traumatic brain injury.
"If you're not drooling and not in rehab,
people don't think you really have a problem. People think
you're faking, malingering, you're complaining a lot," she
said.
Stoler, who co-authored "Coping
With Mild Traumatic Brain Injury" (Avery Publishing Group,
$14.95), contemplated suicide. "I wasn't the same person.
I couldn't function. I felt I was an inadequate mother. I
couldn't perform as a wife or psychologist. I saw no purpose
to my life."
Studies show depression, a frequent complication,
is more common in women following brain injury than in men,
says Harvey Levin, director of research in the department
of physical medicine and rehabilitation at Baylor College
of Medicine in Houston.
"Well over 90 percent (of people) who have
a mild head injury return to a pretty normal life in a couple
of months, but depression can stop them from regaining normal
function."
Accepting
a new life
Depression didn't set in for Dr. Carolyn
Osborn until she completed five months of grueling rehabilitation
and realized she would never again practice medicine.
"You begin to understand how much you've
lost intellectually. You're no longer the person you were
before. That grief is pretty devastating."
Osborn was able to build a new life for herself
by learning strategies that help her function, and accepting
the person she has become.
Today, she speaks slowly but confidently,
and is using her training as a physician to teach first-year
medical students at the Michigan State University College
of Osteopathic Medicine. She lectures around the country on
brain injury, and wrote a book, "Over My Head: A Doctor's
Own Story of Head Injury From the Inside Looking Out" (Andrews
McMeel, $21.95).
"Hopefully, the goal of rehabilitation is
to reach a stage of acceptance," she said. With acceptance,
comes the ability to move forward and build new dreams. |
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