This is the post excerpt.
This July marks one full year of brain injury rehabilitation for a moderate TBI suffered late 2015. Treatment professionals and doctors had a lot to say. They told me I wouldn’t walk, write, see, or talk the same – properly and safely; that I would never be the same person. I was told that I should give up on my dreams, because I would never be able to work again in any capacity close to prior functioning. From the start I had the encouragement and guidance of my best friend and life partner. She helped remind me who I am, and was one of the only people who stuck around to help, to love, and to remain loyal in my life.
I am a fighter. I refuse limitation. I work to develop my mind and my heart during these couple years . Through this season of challenge, I lived in skilled nursing facilities, assisted rehab day programs, and brain injury outpatient services. Neurologists, neuro-endocrinologist, psychiatrist, speech, occupational therapy, cognitive rehabilitation therapy, physical therapy, education therapy, and the list goes on. I am nowhere near healed or back in action. But every day is a small shuffle towards progress, pride, and self empowerment.
Never give up on yourself. Never give up on your dreams – dreams keep you alive, and nobody can take them from you. Nobody.
Changing and challenges are inevitable for all of us. Do not only heal the wound, work always to develop both your heart and your body. It can be very difficult to get through life – all of us to know this, from time to time. So take the challenge as an opportunity to heal your wounds, relationships, and also to cultivate self compassion, acceptance, and belief in the myth and magic that life ceaselessly offers with every new dawn we wake to find.
I love and respect you all. Good luck and stay strong, no matter what your story.
I’ve fallen in love. I’ve been in love. But I’ve never thought about what it is to be in love. My girlfriend of over 10 years now quit her job and it’s a grad program early and flew home to be a full-time caretaker for me when I first had my TBI in late 2015. Things between us are so much different now, she and I are both so traumatized; we are so scared for the future. We don’t often sit and exist to gather like we used to, just having fun and being in the moment living life.
Now, I know she has become resentful because we have had to watch all of her friends and the people around us move forward and onward with their lives, while we seem to stay stuck on the sidelines -waiting for a breeze to lift us up and back into the night; padded softly between the aspirations and dreams we shared and held together. None of them may even come in the slightest given reality. But the dreams we held were never as inportant as the bond of love we held together. While this recovery process threatens to rip us apart, it will never leave us truly separate. Dreams will form anew, and this wake up call has shown me they’re just celestial symphonies playing to us each and setting us up to want and expect to figure out the path, to reach the dream, to settle at last and know the universe is a puzzle we’ve figured out. But the problem is this sojourn towards the skies, towards dreams of reverence and feeling special sharing the lies that achievement ends our search and breaks some finishing line at the outer bounds of the universe. Every time you reach those Outabounds the universe will expand once again, new dreams will be there for you to follow in the dreams of the past whether you cheat them where they fell to the wayside will never let you settle yourself; you’ll never rest when we light our life’s satisfaction like thousands of fireflies cauught in a lantern. Brief sparks of beauty and the inevitable opposite experience. But there is one way to be sure life held you right – to hold your love for another human being and feel, in every moment that you remind yourself, the person changes and the world around us will never stop for our selfish wish. So I cherish my girlfriend’s compassion and companionship like the grace of a sunset. Even right now, she is in my head and in my moment, and that’s all I need to feel alive. That’s all I need to feel fulfilled from life and all its spirals of defeat and oppositely wonderful grandeurs.
So tomorrow I’ll go back to battle; but now I’ll be thinking about how fortunate I am to have all of those years with my lover; to be in love with such harmony and meaningful purpose too far in the mysteries of the depths to understand why life is love; why it is that life is to be in love. If we can remind ourselves of that, none shall lay buried with the loneliness of a single headstone. But instead we may all become dreamers again, sleeping in our new bed of flowers.
Tritos NA, et al. Endocr Pract. 2015.
Show full citation
OBJECTIVE: Traumatic brain injury (TBI) is now recognized as a major public health concern in the United States and is associated with substantial morbidity and mortality in both children and adults. Several lines of evidence indicate that TBI-induced hypopituitarism is not infrequent in TBI survivors and may contribute to the burden of illness in this population. The goal of this article is to review the published data and propose an approach for the neuroendocrine evaluation and management of these patients.
METHODS: To identify pertinent articles, electronic literature searches were conducted using the following keywords: “traumatic brain injury,” “pituitary,” “hypopituitarism,” “growth hormone deficiency,” “hypogonadism,” “hypoadrenalism,” and “hypothyroidism.” Relevant articles were identified and considered for inclusion in the present article.
RESULTS: TBI-induced hypopituitarism appears to be more common in patients with severe TBI. However, patients with mild TBI or those with repeated, sports-, or blast-related TBI are also at risk for hypopituitarism. Deficiencies of growth hormone and gonadotropins appear to be most common and have been associated with increased morbidity in this population. A systematic approach is advised in order to establish the presence of pituitary hormone deficiencies and implement appropriate replacement therapies.
CONCLUSION: The presence of traumatic hypopituitarism should be considered during the acute phase as well as during the rehabilitation phase of patients with TBI. All patients with moderate to severe TBI require evaluation of pituitary function. In addition, symptomatic patients with mild TBI and impaired quality of life are at risk for hypopituitarism and should be offered neuroendocrine testing.
PMID 26172127 [PubMed – indexed for MEDLINE]
Full text at journal site
Endocr Pract. 2015 Jul;21(7):851-3.
[Neuroendocrine dysfunction and brain damage. A consensus statement].
Leal-Cerro A, et al. Endocrinol Nutr. 2009 Jun-Jul.
Show full citation
This consensus statement aims to enhance awareness of the incidence and risks of hypopituitarism in patients with traumatic brain injury (TBI) and/or brain hemorrhages among physicians treating patients with brain damage. The importance of this problem is related not only to the frequency of TBI but also to its prevalence in younger populations. The consequences of TBI are characterized by a series of symptoms that depend on the type of sequels related to neuroendocrine dysfunction. The signs and symptoms of hypopituitarism are often confused with those of other sequels of TBI. Consequently, patients with posttraumatic hypopituitarism may receive suboptimal rehabilitation unless the underlying hormone deficiency is identified and treated. This consensus is based on the recommendation supported by expert opinion that patients with a TBI and/or brain hemorrhage should undergo endocrine evaluation in order to assess pituitary function and, if deficiency is detected, should receive hormone replacement therapy.
PMID 19695511 [PubMed – indexed for MEDLINE]
Ghigo E, et al. Brain Inj. 2005.
Show full citation
PRIMARY OBJECTIVE: The goal of this consensus statement is to increase awareness among endocrinologists and physicians treating patients with traumatic brain injury (TBI) of the incidence and risks of hypopituitarism among patients with TBI.
RATIONALE: TBI poses significant risk to the pituitary gland, leading to elevated risks of diabetes, hypopituitarism and other endocrinopathies. Signs and symptoms associated with hypopituitarism often mimic the sequellae of TBI, although the severity of symptoms is not necessarily related to the severity of the injury. Patients with TBI-induced hypopituitarism may benefit both physically and psychologically from appropriate hormone replacement therapy (HRT). Participants at this unique consensus meeting attempted to define and spearhead an approach to increase awareness of the risks of TBI-induced endocrinopathies, in particular growth hormone deficiency (GHD), and to outline necessary and practical objectives for managing this condition.
RECOMMENDATIONS: Systematic screening of pituitary function is recommended for all patients with moderate-to-severe TBI at risk of developing pituitary deficits. Patients with hypopituitarism benefit from appropriate hormonal replacement and prospects for rehabilitation of patients with TBI-induced hypopituitarism may be enhanced by appropriate HRT. Further exploration of this possibility requires: (1) active collaboration between divisions of endocrinology and rehabilitation at the local level to perform a screening of pituitary function in patients after TBI, (2) creation of a consultancy service by endocrine societies for use by rehabilitation centres, (3) development of continuing medical education (CME) programmes that can be offered as crossover training to the physicians who manage the care of patients with TBIs, (4) targeting of patient organizations with educational information for dissemination to patients and their families, (5) continued efforts to more clearly define the population at greatest risk of TBI-induced hypopituitarism and (6) monitor results of efficacy studies as they become available to evaluate whether and how much replacement therapy can improve the symptoms of individuals with TBI-induced hypopituitarism.
PMID 16195185 [PubMed – indexed for MEDLINE]
Full text at journal site
Urban RJ, et al. Brain Inj. 2005.
Show full citation
PRIMARY OBJECTIVES: To review evidence that there exists a substantial sub-population of patients with endocrine disorders as a result of traumatic brain injury (TBI) and to underscore the importance of screening patients with TBI considered most at risk for hypopituitarism with the goal of attaining beneficial effects in terms of morbidity and quality of life.
DESIGN AND METHODS: Reviewed recent literature regarding the frequency of TBI-induced hypopituitarism.
MAIN OUTCOMES AND RESULTS: Studies by Kelly DF, Gaw Gonzalo IT, Cohan P, et al. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: A preliminary report. Journal of Neurosurgery 2000;93:743-751, Lieberman SA, Oberoi AL, Gilkison CR, et al. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. Journal of Clinical Endocrinology and Metabolism 2001;86:2752-2756 and Aimaretti G, Ambrosio MR, Di Somma C, et al. Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism. Screening study at 3 months after the brain injury, In press., found that about one-half to one-third of patients with TBI had anterior pituitary hormone deficiencies, including growth hormone (GH) deficiency in 15-21%, and subtle deficiencies in thyroid, adrenal and gonadal axes. One or more hormonal deficiencies produce diverse physical and psychological symptoms that may mimic symptoms attributed to brain trauma and may impair rehabilitation. A more general concern is the fact that hypopituitarism increases the risk of significant morbidity (e.g. ischaemic heart disease) and mortality (shortened life span).
CONCLUSIONS: To attain maximal improvement in mental and physical functioning as well as in quality of life for victims of TBI, it is crucial that anterior pituitary hormonal function be assessed. Appropriate hormone replacement therapy for those patients with both TBI and TBI-induced pituitary function impairment could, for the first time, allow treatment and correction of underlying causes of TBI sequelae rather than merely symptomatic treatment.
PMID 16094782 [PubMed – indexed for MEDLINE]
Silva PP, et al. J Neurotrauma. 2015.
Show full citation
Hypopituitarism may often occur in association with traumatic brain injury (TBI). Identification of reliable predictors of pituitary dysfunction is of importance in order to establish a rational testing approach. We searched the records of patients with TBI, who underwent neuroendocrine evaluation in our institution between 2007 and 2013. One hundred sixty-six adults (70% men) with TBI (median age: 41.6 years; range: 18-76) were evaluated at a median interval of 40.4 months (0.2-430.4).Of these, 31% had ≥1 pituitary deficiency, including 29% of patients with mild TBI and 35% with moderate/severe TBI. Growth hormone deficiency was the most common deficiency (21%); when body mass index (BMI)-dependent cutpoints were used, this was reduced to 15%. Central hypoadrenalism occurred in10%, who were more likely to have suffered a motor vehicle accident (MVA, p = 0.04), experienced post-traumatic seizures (p = 0.04), demonstrated any intracranial hemorrhage (p = 0.05), petechial brain hemorrhages (p = 0.017), or focal cortical parenchymal contusions (p = 0.02). Central hypothyroidism occurred in 8% and central hypogonadism in 12%; the latter subgroup had higher BMI (p = 0.03), were less likely to be working after TBI (p = 0.002), and had lower Global Assessment of Functioning (GAF) scores (p = 0.03). Central diabetes insipidus (DI) occurred in 6%, who were more likely to have experienced MVA (p < 0.001) or sustained moderate/severe TBI (p < 0.001). Patients with MVA and those with post-traumatic seizures, intracranial hemorrhage, petechial brain hemorrhages, and/or focal cortical contusions are at particular risk for serious pituitary dysfunction, including adrenal insufficiency and DI, and should be referred for neuroendocrine testing. However, a substantial proportion of patients without these risk factors also developed hypopituitarism.
PMID 26413767 [PubMed – indexed for MEDLINE]
Full text at journal site
Fan E, et al. Childs Nerv Syst. 2017.
Show full citation
BACKGROUND: High-dose steroid administration is no longer recommended in the treatment of acute traumatic brain injury (TBI) as it failed to prove beneficial in improving patients’ outcome. However, a masked benefit of steroid administration in TBI management was that it provided corticosteroid replacement therapy in patients with TBI-related central adrenal insufficiency.
CASE PRESENTATION: We report the case of a 12-year-old boy who suffered a severe TBI from a motor vehicle accident that resulted in complete deficiency of anterior pituitary function. Central adrenal insufficiency was not ruled out by a near normal response to a low-dose ACTH test performed on D11.
CONCLUSION: Consideration should be given to the empirical treatment of TBI pediatric patients with stress doses of corticosteroids if injury to the hypothalamus or pituitary gland is possible until a formal assessment of the hypothalamic-pituitary-adrenal axis can be made.
PMID 28721596 [PubMed – as supplied by publisher]
Yehuda R. J Clin Psychiatry. 2001.
J Clin Psychiatry. 2001;62 Suppl 17:41-6.
Most biological findings in posttraumatic stress disorder (PTSD) are compatible with those of the chronic stress response, such as increased corticotropin-releasing factor (CRF) concentrations, catecholamine depletion within the central nervous system, and reduced hippocampal volume. However, over the last 10 years, biological observations have been made in PTSD that are different from what has been typically associated with chronic stress, notably certain hypothalamic-pituitary-adrenal (HPA) axis findings. In particular, urinary and plasma cortisol levels are considerably lower in PTSD patients than in non-PTSD trauma survivors and normal controls. Furthermore, the circadian pattern of cortisol release from the adrenal glands follows a greater dynamic range in PTSD than in patients with major depression or in normal controls. The reduction in cortisol levels results from an enhanced negative feedback by cortisol, which is secondary to an increased sensitivity of glucocorticoid receptors in target tissues. This HPA axis alteration contrasts with the well-known chronic stress cascade in which CRF release results in erosion of negative feedback and down-regulation of glucocorticoid receptors. Sensitization of the HPA axis is consistent with the clinical picture of hyperreactivity and hyperresponsiveness in PTSD.
PMID 11495096 [PubMed – indexed for MEDLINE]
Full text at journal site
Yehuda R, et al. Biol Psychiatry. 1991.
Yehuda R1, Giller EL, Southwick SM, Lowy MT, Mason JW.
Biol Psychiatry. 1991 Nov 15;30(10):1031-48.
Neuroendocrine studies examining the hypothalamic-pituitary-adrenal (HPA) axis under baseline conditions and in response to neuroendocrine challenges have supported the hypothesis of altered HPA functioning in posttraumatic stress disorder (PTSD). However, to date, there is much debate concerning the nature of HPA changes in PTSD. Furthermore, in studies showing parallel findings in PTSD and major depressive disorder there is controversy regarding whether the HPA alterations suggest a specific pathophysiology of PTSD, or, rather, reflect comorbid major depressive disorder. This review summarizes findings of HPA axis dysfunction in both PTSD and major depressive disorder, and shows distinct patterns of HPA changes, which are probably due to different mechanisms of action for cortisol and its regulatory factors.
PMID 1661614 [PubMed – indexed for MEDLINE]
Psychiatr Clin North Am. 1998 Jun;21(2):359-79.
In 1980, the diagnosis of post-traumatic stress disorder (PTSD) was established to describe the long-lasting symptoms that can occur following exposure to extremely stressful life events. This article reviews the findings of neuroendocrinologic alterations in PTSD and summarizes the finding of hypothalamic-pituitary-adrenal (HPA), catecholamine, hypothalamic-pituitary-thyroid (HPT) and hypothalamic-pituitary-gonadal (HPG) systems. These are the neuroendocrine systems that have been studied in PTSD. Also included is a review of the basic facts about PTSD and biologic data.
PMID 9670231 [PubMed – indexed for MEDLINE]
Source: Report: Majority of military misconduct dismissals linked to brain injury, mental health
Source: <a href=”https://lookingforthelightblog.wordpress.com/2017/05/16/report-majority-of-military-misconduct-dismissals-linked-to-brain-injury-mental-health/”>Report: Majority of military misconduct dismissals linked to brain injury, mental health</a>
May 16, 2017 / 5 Comments
by Looking For The Light Blog
Mem and Women have given their lives since we landed in the country, we called America. Enlisting to fight for freedom, they knew the cost and it’s not free. With technology, our government is paying for state of the art equipment to protect and defend. The highest ranks of Military Officials lied to every Soldier enlisted the Military will take care of your health whatever it takes.
No war is pretty, nor free, every war comes advances in technology. International Relations is not looking good for America. The numbers of enemies are growing. The past several weeks North Korea is testing bombs and making threats against American. We can’t fight every country who hates America. Who is standing by our side and ready to fight if needed.
If we are to remain a free country, the Military needs to quit playing games and using dishonorable discharge for PTSD, Brain Injuries, Mental Illness, the list goes on as you will see in the video.
From the President, Chief of Staff and Military decision makers to take away the right to health is the least our government owes them. If you are dishonorably discharged you loose your benefits. The White House and Military are responsible for this horrific treatment of PTSD, Brain Injury and Mental Illness if they don’t fit another category.
Our government has to live with every suicide. Suicide which leaves widows, children left without a mom or dad. Mothers, Fathers, extended family and church family.
Our government lies to get what it needs and change the terms to suit them. This is not a government I have faith in and my naive blinders are off. The public does not serve our government, we vote on the bullshit theme of a campaign which is rarely delivered once voted in.
THE AMERICAN GOVERNMENT SERVES THE PUBLIC, NOT VICE VERSA.
Please reblog to everyone who will or may care about the abuse of Military Soldiers.
US Military not keeping their promise