Paul Szmal: It is 8.15 on FLX Morning on Finger Lakes News Radio. Happy to be joined by Jennifer Cox, who is a therapist with Family Counseling Service of the Finger Lakes. Jennifer, good morning. How are you this morning?
Jennifer Cox: I'm happy to be back. Thanks for having me.
Paul Szmal: Yes. Appreciate it very much. And we wanted to focus today's conversation on TBI. What is a TBI?
Jennifer Cox: A TBI stands for a traumatic brain injury. That's when a brain's ability to function is impacted by an external force like a hit or a fall.
Paul Szmal: All right. What generally are some of the effects of a TBI?
Jennifer Cox: The effects really depend on the cause of the injury, where it's located in the brain, the severity of the injury. But general effects can include anything from cognitive functioning to mood regulation. Some people who have a TBI can either have short-term impacts, which they can feel from with the assistance of treatment, or sometimes there's long-term, lifelong effects. This can impact their ability to maintain relationships, to keep a job, to focus, to regulate their emotions, and it can have a really big impact on their life.
Paul Szmal: How commonplace are TBI injuries like this, Jennifer?
Jennifer Cox: They're actually very common. Everyone in the U.S. sustains a brain injury every nine seconds, and there are 190 TBI-related deaths every day based on 2021 estimates.
Paul Szmal: Wow, that's a lot. Does it affect women more than men, or is it about 50-50?
Jennifer Cox: Honestly, it's hard to tell because men are less likely to go to the doctor and report when something has happened. They're more likely to try and just walk it off. Some of the people who are likely to be seen for TBIs include women who are in domestic violence relationships. Women seeking medical care for injuries to their head, neck, and face are seven and a half times more likely to be survivors of domestic violence than women who are seeking care for other injuries. And TBIs are actually often missed in older adults of both genders. Especially if they've sustained a fall, medical attention tends to focus on other effects like their broken hips. So TBIs are a particular risk for older adults that are on blood thinner medications, falling frequently, or car crashes.
Paul Szmal: So this is something that could happen and you may not even realize it's happened.
Jennifer Cox: Absolutely. If the effect itself is subtle enough, if you don't have really severe pain, or if you convince yourself that it's just a headache and you're going to try and walk it off, TBIs are the type of thing that could happen to anybody. It takes one bad car crash or one bad fall and anyone of any gender or any group can have a TBI.
Paul Szmal: Jennifer Cox from Family Counseling Service of the Finger Lakes joining us here on FLX Morning. There are both what, short and long-term effects of a TBI?
Jennifer Cox: Yes, yes there are. So treatment can range in a lot of ways. Based on both short-term and long-term effects, treatment sometimes includes rehabilitation for any lost skills through physical therapy, occupational therapy, recreational therapy. Long-term treatment is going to involve creating a caregiving team that includes the patient, their loved ones, and qualified medical and caregiving professionals. And because TBIs can happen to anyone at any time, the impact can be felt not only on the person who sustains the injury, but their family members, friends, even coworkers.
Paul Szmal: Absolutely. When you have a loved one that has a TBI, they may be more likely to mood swings or to spikes of aggression, and that can have obviously a severe drain on your relationship with them. And if they lose some of their independent living skills and they become more dependent on caregiving, you might have family members then find themselves in the position of choosing between their careers and being available as a full-time caregiver.
Jennifer Cox: When it comes to the physical aspects of TBI, we know what the effects are. The mental and emotional aspects, though, can be far longer reaching than the physical.
Paul Szmal: Absolutely, they can, especially because this is something that we don't talk about very often despite how common it is. Most people's knowledge about the impacts of a TBI is actually very limited. So it can be a very isolating experience. You can often feel like you are losing control or you've become unreliable. You might blame yourself for what you're experiencing, even though it's something that's physically happened to your brain that you don't have control over and you need support.
Jennifer Cox: And I imagine that's probably a pretty stark realization to come to when you think about the fact that you may not even realize that you've had some type of traumatic brain injury that could be causing the problems to begin with.
Paul Szmal: Absolutely. And part of why TBIs are so difficult for people to recognize is that sometimes health insurance companies won't acknowledge a diagnosis of a TBI if you don't have a before and after brain scan. This obviously differs depending on your insurance company, but I don't think most of us are walking around with brain scans that we just casually took because we were healthy. So trying to demonstrate that unless it's a very significant injury where we can point to something on a scan and say, that's definitely wouldn't have been possible for you to have before. It can be hard sometimes even with scans to prove that a TBI is what happened.
Jennifer Cox: How important is the role of counseling and therapy and caring for someone with a TBI?
Paul Szmal: So, excuse me, a TBI is going to help partially with acceptance. Part of it is going to be recognizing that you have gone through a change, your brain is not the same brain that it was before the TBI, and that you can still have a fulfilling life experience afterwards. And it's just getting to know your brain in a nonjudgmental and accepting way. Therapy is also important for caregivers who find themselves in a new position of stress and are trying to manage that stress in a way where it doesn't lash out against their loved one that they're taking care of. It's also an opportunity to learn some skills to help with executive functioning, finding new ways to be able to strengthen those independent living skills that maybe you took for granted before. And it can be an opportunity for things like group therapy to connect with other people who have similar impacts so that you know that you're not alone.
Jennifer Cox: Does every TBI require long-term therapy or are the cases different depending on the person and the injury?
Paul Szmal: Every case is very individual. Every single individual has to create their own treatment plan based off of recommendations by their doctor. Sometimes a TBI can have very short-term impacts where all you might need for a while is some occupational therapy. Sometimes it's going to be a bit more long-term, so you're going to want the support of somebody that can help you accept the changes.
Jennifer Cox: I'm glad you mentioned the fact that therapy and counseling is sometimes a good idea for family members of someone who's had a TBI or people that are associated with the person associated with a TBI because they have their own issues that they're going to be dealing with in dealing with the person that has experienced the injury.
Paul Szmal: Absolutely. No one ever wants to say that they are burnt out by caregiving because everyone loves their loved one. No one wants to say, I'm stressed because I'm taking care of somebody that's important to me. But that stress is very real and it's important to have a nonjudgmental space to acknowledge the impact that this is having on you so that we can try to prevent or treat caregiver and empathy burnout.
Jennifer Cox: Thankfully, there are resources for both survivors of TBI and their caregivers. For example, the Brain Injury Association of America, who you can find at biausa.org, has all kinds of information about how to find qualified treatment professionals, support resources for caregivers, guidance of if and when you should involve a lawyer. There are resources out there and we just need to spread the information so that people know they're not alone.
Paul Szmal: Absolutely. And if people want to reach out to Family Counseling Service or the Finger Lakes Center, maybe find out more information about TBI-related therapy and counseling, how would they go about doing that?
Jennifer Cox: You can always find us at fcsfl.org to know what services we have available. We have in-office therapy services. We have in-school therapy services for youth because something we didn't talk about much today is that TBI in children can have a big developmental impact as well. We also have some advocacy services for domestic violence survivors. So understanding how TBI can impact surviving domestic violence is important. So find us at fcsfl.org to learn about what we have and we'd be happy to talk to you. If you reach out to us, the first step would be speaking with a care coordinator who will get to know your individual situation and then help connect you with the appropriate resources.
Paul Szmal: Fantastic. Jennifer, thanks so much for joining us this morning. We appreciate it.
Jennifer Cox: I absolutely love being here. Thank you. It's 825 on FLX Morning.
