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FREQUENTLY ASKED QUESTIONS


This page has three sections:

Common Questions About Concussion and Brain Injury

Question: Dear Dr. Diane, 
I loved your book and it was most helpful. I'm living with most of the symptoms of brain injury, including fatigue, memory problems, headaches, light sensitivity, mood swings, depression, low energy. I saw in your book and on your website that certain foods and vitamins can significantly impact my recovery. I want to know is there anything that would help me feel better or improve my life. Could you please write back ASAP? Thanks ahead of time. Carol 

Answer: Dear Carol, 
Over the past 10 years, I have found that certain foods and vitamins can really make a significant difference in recovery. To obtain an optimum result for you, it is important to know your specific needs, such as do you have a cholesterol problem or are you diabetic, etc.. 
In general the following would be helpful. 

1) Eliminate all alcohol and wine. 
2) Eliminate all sugar and sugar substitutes, instead eat fruit with low sugar content. 
3) Eat lots and lots of protein 
4) Eat lots of vegetables 
5) Drink plenty of water 
For a more in-depth and personalized recommendation of the types of foods, vitamins and their amount, you can set up a consultation with me at 978-352-6349. To see how my diet has helped other people, please read the letters to me on the testimonial page
With Warmest Regards, 
Diane 

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Question: Hi! I am still reading your book. I know a little slowly, but I am trying to absorb all that I can. My husband has been leery about discontinuing your diet. He reads it every day, (sometimes 2 or 3 times). He feels desperate to get better. I do not want to discontinue everything. I think the vitamins, magnesium, etc., and no sugar he should stay with, as well as no ice cream. He alsowants to keep carbs at a bare minimum, if any. Could you tell me about cereal and bread please? Thanks, Cindy 
Answer: Dear Cindy, 
Grains, such as corn, wheat, rye, oats, barley, rice all can be made into alcohol. All of these grains in the brain are converted to glucose. Thus, eating them, to the brain is like drinking a high concentration of glucose. Now the brain needs glucose and amino acids to function. But as you know if you eat too much sugar at first you feel great, but then you get fatigued and foggy. Like after a few drinks. This is the same when a person with a brain injury eats too much grains.

My suggestion, if your husband needs some carbohydrates to increase his quantity of legumes, such as black bean soup, lentils, soy products and soy cereal. He can have more fruits. You can balance his diet with legumes, nuts, fruits and various vegetables. I would never suggest that he not have a balanced diet. 

I hope this has helped. 
Dr. Diane 
 
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Question: What are some of the danger signs in children? 

Answer: Your child should be taken to the hospital emergency department immediately if she has had a fall or blow to the head and won't stop crying; can't be comforted; won't eat, or has any of the signs listed above. Vomiting once or twice is more common in children and may not be the danger sign that it is in an adult. Call your pediatrician if you notice: irritability; change in eating or sleeping patterns; lack of interest at play; loss of balance; change in performance at school; fatigue. 

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Question: What are the symptoms of a Mild Traumatic Brain Injury? 

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Question: What is Post Concussive Syndrome? 

Answer: It is a clustering of symptoms that may appear immediately after injury. Often these symptoms, get better with time, usually in 6 weeks following injury. However, they can continue. If they do and are causing problems in your daily living, Coping with Mild Traumatic Brain Injury can help you. 

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Question: Since my brain injury, I struggle each day just to do the ordinary things I used to do. I'm afraid and I don't know what's ahead. Will I get better? 

Answer: Every brain injury is different. With time most people recover from their injuries. However, recovery depends on the severity of injury, the part of the brain injured, your age, and how healthy you were before injury. Medical and psychological help is available to help you cope with the challenges and uncertainties of living with brain injury. 

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Question: Is treatment available? Whom should I contact in my local area? 

Answer: Treatment is available to help in dealing with the effects of brain injury. Brain injury can be life-changing and presents new physical and psychological challenges. Loss or change in former abilities brings fear and uncertainty. My book, Coping with Mild Traumatic Brain Injury, can help you understand your injury and direct you to qualified health-care providers. Consult The Brain Injury Resource Network on this website for referrals, or contact the Brain Injury Association (BIA) national helpline (1-800-444-6443). 

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Question: My family member has a brain injury. What do I do? 

Answer: If you notice a family member or a friend has long-term symptoms of brain injury, talk to them and their doctor about getting help. Coping with Mild Traumatic Brain Injury deals with the causes and effects of brain injury and offers practical suggestions for coping with the problem. 

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Question: What are some tips for recovery? 

Answer: The brain heals slowly, given rest and time. But there are some things you can do to speed up the healing process: get plenty of rest; gradually resume your normal activities; avoid activities that could result in re-injury to the brain; ask your doctor for help in dealing with your injury; avoid alcohol and unnecessary drugs; talk with your employer about adjusting your work conditions; and if you have difficulty remembering things, write them down. Above all, be patient with yourself. 

Questions by e-mail

Question: How long should I expect to suffer headaches from the concussion? 

Answer: Have you been diagnosed with a concussion? Have you seen a physician? If you have a concussion, in general the symptoms will go away in 6 weeks. If they continue, you are experiencing what is called Post Concussive Syndrome. My book goes into extensive detail about it. 

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Question: If I were to have a bruise on the brain, can medication dissolve this, without surgery? 

Answer: If you bruise your brain, rest, water, higher protein diet can help. Medication is used for specific symptoms.

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Question: Are there any lasting side effects from a concussion? 

Answer: Maybe. Once you have a concussion, the symptoms from the next brain injury (concussion) will be more intense. Please take care of yourself. 

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Question: How long does it usually take to get back to "normal"? 

Answer: It depends on whether you've had other injuries to your brain. 

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Question: Hello, my name is Trina and I'm writing a school report. What is a Stroke? I was wondering if you could answer
this question."Is there ever going to be a treatment about strokes?" If you have time to respond, I would greatly appreciate it. Thanks. 

Answer: Dear Trina, I'd be more than glad to help you. You did not say what age you are or the level of education. I will try and explain about stroke. A Stroke is often called a Brain Attack or Ischemic Stroke. Blood is supplied to the brain through veins and arteries. A stroke can be from 2 different causes. Either when the blood supply is blocked off because of a blood clot in the blood supply to the brain thus depriving the brain of blood. This is called an Embolic Stroke. Another cause is when there is a bleed called a hemorrhage in the brain. This is called a Thrombotic Stroke. 

Once the brain has been injured this is called a brain injury. On my web site is a list of all the various symptoms from a brain injury regardless if it is from a Stroke or from an outside force. That is called a Traumatic Brain Injury or TBI. A stroke is called an acquired brain injury since it is not caused from an outside force. Regardless of the cause the symptoms are all the same. 

My book Coping with Mild Traumatic Brain Injury does explain how to treat every single symptom of a brain injury, this includes a stroke. So to answer your question, yes you can treat a stroke and often very effectively if given proper treatment. Depending where you live your local library should have a copy of my book. If not, you can always purchase it on my web site. I hope this has helped. Let me know how the report turned out and your grade. If I can be of any further help let me know. 

With Warmest Regards, 
Dr. Diane Roberts Stoler, Ed.D. 

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Question: I have been recently diagnosed with MTBI. I've been living with lightheadedness, nightly sleep disturbances, irritability, depression, etc, etc, for the past 3 years. My question is: What are the effects of alcohol on a person with a brain injury and where can I find detailed information? I had a drinking episode before I was diagnosed and DO NOT REMEMBER a thing. I have never had this happen to me before. Could it be related to my illness? I would greatly appreciate any information you can provide. Thanks. 

Answer: Alcohol is not good for brain injury. Have you read my book? It is clearly stated. As for your symptoms these too are addressed in my book. To help with your symptoms, you have to eliminate all food that converts to sugar in the brain, that includes alcohol. The foods you need to eliminate are the following:

All wheat, rye, oat or rice products--flour, cereals, pasta, bread. Increase your proteins with nuts, eggs, meat, fish, legumes, soy products. Eat fruits and vegetables. If you are diabetic, then you may have to eat more fruits or vegetables. The higher protein diet, the better you'll be. As for your irritability and moods, Beta Blockers are your best bet. You need to have your primary care physician or neurologist prescribe them for you. Try the diet for two weeks, if you don't see a difference in your symptoms, go back to your present diet. Regardless, alcohol is definitely not good for a person with a brain injury.

As for your loss of memory, this is part of the diagnosis of brain injury. Otherwise you would have been diagnosed as just having a concussion. 

With Warm Regards, 

Dr. Diane 

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Question: I had a concussion 2 weeks ago in an auto accident. The MRI shows a hemorrhage on the left outer surface of my brain. No fluid built up yet. I was just released from the hospital, however, am having headaches and am extremely tired. Doctor has advised to take Tylenol for the headaches and to take it easy. Is there anything else I can do to speed up my recovery. I am having another MRI on Monday. I am 31 years old and am very athletic. 

Answer: It is extremely important at this stage of your healing to rest. Think of a wounded animal who goes into their cave to heal. Initially that is when they rest, then they exercise. As part of my clinical practice I work with professional athletes and even they take time off. 

Be prepared that in the next few weeks you may experience more symptoms. Remember all of these symptoms can be treated or compensated for and you can and will eventually resume an active life again. However, once an injury of this type happens to the brain, the next injury is exponential. You need to keep a record of this brain injury. 

If you choose not to rest, the recovery is longer and you can possibly have more long term symptoms. Now rest doesn't mean you have to stay in bed all day. It means common sense. Take a walk, not run and listen to your body. Walking in the water is also helpful, however if you feel fatigued pace yourself. 

Eat a higher protein diet and eliminate all forms of sugar, except fruit. This means eliminate wheat, oats, rye, rice, and potatoes, pasta, and cereal. Increase legumes, nuts, soy products, eggs, (whites if high cholesterol), meats, fish and seafood. Eat lots of vegetables and fruits. 

Please write back in a couple of weeks and let me know how you're doing. 

With Warmest Regards, 
Dr. Diane 

Transcript of Chat Sessions

VHL Family Alliance Online Chat: Getting Over Brain Surgery 
A Chat with Diane Roberts Stoler, January 23, 2000. 

Chatter: Did you have headaches before and after? A lot of the people I'm in touch with still have headaches after surgery. 
Dr. Stoler: I never had headaches before this happened, except when I had a high fever. I had no sign that this was going on, other than lassitude.

After the brain surgery I had three distinct types of headaches: One was the icepick headache, one that feels like someone is taking a hot metal poker and shoving it into your brain. It's a very localized headache. The second was the pressure headache from the brain surgery where you just feel general pressure. And the last was the "headache that's not a headache" atypical migraines with blurred vision, slurred speech, and weakness on one side of the body. You do get an aura before it, but there's no real headache. For four years it was diagnosed as "sensory motor seizures". These are usually caused by brain surgery (opening the skull) or whiplash (closed skull injury). 

Chatter: Did you have any memory loss? 

Dr. Stoler: Yes, I had various types of memory loss. There's retrograde (loss of memory before the accident), then after the surgery, then short-term memory loss, and finally what I call "swiss cheese" memory loss. 

Retrograde: I do not remember the accident. I passed out two miles before the accident. I remember getting woozy, but nothing after that. We think of memory only as cognitive memory, but our cells and muscles also remember. That's called muscular or body or cell memory. I have no cognitive memory of the accident. I am a health psychologist, a consultant in clinical hypnosis, and I did age regression to see if I could remember anything about the accident. I have only little snippets of cognitive memory about the accident. However I had a mild fascial release from muscular pain, and from that release I had flash-backs from the accident. But what I still have somewhere is sensory memory. So when I hear sounds like a car crashing, my body reacts. Events in the past that I can only remember portions of, that's the swiss cheese effect. I can't remember all of it, and no clues help me. For example, my husband says we were at a party. I can remember being there, but I can't remember what happened, no matter how many clues he gives me. 

Then there's the short-term memory. A higher-protein diet can help memory loss. 

Chatter: What about motion sickness. Do you now experience motion sickness? 

Dr. Stoler: I did, but no longer, thanks to a wonderful man, Dr. Igor Burdenko of Lexington, Massachusetts (http://www.burdenko.com). If you have balance problems, or motion problems, balance or gait, Dr. Burdenko has revolutionized water and land therapy. I credit him for my ability to ride a bike again, to dance, to stand on one foot, and to walk normally rather than like a drunken sailor. I used to stagger and fall down and then I couldn't get up. Now I ride my bike and do hikes. 

Chatter: Did you have these symptoms right after the brain surgery? 

Dr. Stoler: Yes, I had them for four years! Then the psychiatrist (MD rehab doctor) said to me, "Lady, you are probably brain damaged and you are probably not going to get better. You need to go to a psychotherapist and learn how to cope with your brain damage." By luck or fate I met a woman at my local health club who told me about Dr. Burdenko. She assured me he would help me. He's the one who helped skaters Nancy Kerrigan and Oksana Baiul.  Chatter: How?  Dr. Stoler: You go to the doctor and request physical therapy/water therapy. It is covered under most health insurances. I recommend it to all my patients. 

Chatter: You ride a bike without nausea? I never got my balance back after surgery. 

Dr. Stoler: Yes, without nausea. Try water therapy. I do not go on roller-coasters or certain rides, and at the Omni theater there are certain effects that will cause me to get nauseous. Another suggestion for nausea is ginger tea. Take fresh ginger root. Do not peel it. Slice it in thin slices and boil it up with a pinch of salt, then strain it and drink it with a teaspoon of honey. This will help the nausea. Do this whenever you are feeling the symptoms. At a sushi bar you can get sliced ginger, or you can get ginger candy, but with memory problems you don't want to do sugar. 

For memory problems, you want to eliminate all sugar from your diet except those from fruits. And that includes things that convert to sugar in the body like rice, potatoes, pasta, corn, all the heavy carbohydrates.

Questions about Stroke/Aneurysm

Dear Doctor Diane,

My Aunt Pauline was diagnosed with a brain aneurysm. Can it be prevented and how would I know I might have it.
Thanks for being there.

Stephanie


Dear Stephanie,

A brain aneurysm, which is a form of a stroke called a Hemorrhagic Stroke, can not be prevented like a Ischemic stroke, which is caused from a blood being cut off from the brain. In your aunt situation, there was some form of bulging like a thin balloon then breaks. The causes can be from injury, infection or inherited.

If you are concern about having one, you might want to discuss with your primary care doctor about having a MRI. As for any warning signs, the classic symptom is " the worst headache of your life'! Other signs include: headache, blurred or double vision, neck pain, sensitivity light and lethargy.

Prior to my own aneurysm, I never had any headaches, rather only periods of extreme lethargy. I hope this has helped.
If you have any further questions, please don't hesitate to write or call me for a consult.

Warmest Regards,

Dr. Diane

Excerpts from On-line Chat-The Health Network, December 27th, 1999.

kath_1967 asks: My nephew has had nightmares ever since his car accident. What can be done to help him overcome his sleeping problems?  Dr. Diane: If he is having nightmares, this could be the result of trauma. An event only becomes traumatic when you don't get the right kind of support. You should go to a psychologist trained in post traumatic stress disorder. You can call the American Psychological Organization and get a referral for your state. 

karent3 asks: What do trauma psychologists mean when they use the term "coping mechanisms"?  Dr.Diane: When you were a child, you learned one way to react to events. It may not be the best way to handle things in later situations in life, however. Coping mechanisms are learning a variety of new ways of interacting with people that are both helpful and healthful in any given situation. For example, if you are feeling very anxious, learning ways of relaxing is a coping mechanism.

hiply9_9 asks: I've been working with a trauma psychologist, but I just don't feel comfortable with her. Should I seek someone else?  Dr. Diane: Yes, you should talk to her about your concern. The first rule of good therapy is to ask yourself if it is healthful. If you are not finding it is helping you, then you should find someone else. Most therapists will want to help you if things are not going well. If they can't talk about it, then interview other therapists. 

Transcript of Discovery Health-Online Conference held on September 29, 1999 with Dr. Diane Roberts Stoler 

MODERATOR: From her own experience, training and extensive research, Dr. Stoler co-authored, with Barbara Albers Hill, a reference book on brain trauma -- Coping with Mild Traumatic Brain Injury: A Guide to Living with the Challenges Associated with Concussion/Brain Injury. It is the first reference book that applies to all aspects of brain trauma, including concussion, stroke and brain tumor. Please join us as we welcome Dr. Diane Stoler.  Diane Stoler: Happy to be here. I welcome all questions and hope that I can give insight, inspiration and hope to people with brain injuries. 

James Jacks: If you have a head injury, does that mean you have injured your brain?  Diane Stoler: Not necessarily. Not all head injuries are brain injuries; not all brain injuries are head injuries. You can hit your head and crack your skull but that does not mean you have injured your brain. You can have whiplash where you do not crack your skull or hit your head and have a brain injury. That is why the term "head injuryä is no longer used; instead ãbrain injuryä is used. It refers to the symptoms that people suffer from. 

lydjim: Do strokes and aneurysms count as brain injuries?  Diane Stoler: Yes, when we are talking about brain injury we are talking about anything you were not born with ö that is not a congenital birth defect. Any injury that is developmental, that is acquired after birth -- and that would include strokes and aneurysms. 

lydjim: When your doctor said your injury was mild, how did he describe mild?  Diane Stoler: The biggest misunderstanding is when the terms "mild", "moderate" and "severe" are used to refer to brain injury. In all other areas of life, these terms mean the level of severity. When it relates to brain injury, it only means the length of time a person is unconscious.For mild it's from not being unconscious to being unconscious up to one hour. That is all it means. It does not tell the consequences of the injury or the level of severity of the injuries. 

fyr151: Where can I get information on pediatric TBI?  Diane Stoler: On pediatric Traumatic Brain Injury or TBI, you can refer to my book. An injury to the brain has certain symptoms including fatigue, headaches, sleep disturbances, and dizziness. The symptoms you see in a child are explained in my book. The symptoms relate to both children and adults. 

Rob Wilson: What gender and age group have the highest risk of brain injury?  Diane Stoler: Males ages 14-24 are the highest risk, followed by infants and the elderly. Males are two times as likely as females to sustain mild TBI due to differences in risk exposure and lifestyle. My own son has had three concussions. 

 
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