Living Well Magazine

A BRAIN INJURY

Currently there is not one single definition of a concussion, minor head injury, or mild traumatic brain injury that is universally accepted. However most experts agree and use this statement as a starting point.“ A complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.”

The Mayo Clinic defines a concussion “is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary, but can include problems with headache, concentration, memory, judgment, balance and coordination.”“Many people assume they do not have a concussion if they have not lost consciousness. However, significant injury can occur without losing consciousness at all.” Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. These injuries can cause a loss of consciousness, but most concussions do not. Because of this, some people have concussions and don’t realize it.Roughly 2 million concussions/TBI annually are being reported, and it is estimated that nearly 50% of all concussions are not being reported. After motor vehicle accidents, sports such as football, hockey, lacrosse, snowboarding, skiing, bicycling and roller blading are the next leading causes of traumatic brain injury among people ages 15 to 24 years.According to the Brain Injury Association of America males are twice as likely as females to sustain a brain injury. Those at highest risk of a brain injury are males aged 15 to 24 years. People who have had a brain injury are more likely to experience a subsequent brain injury. Concussion is usually classified into 3 different grades. Colorado Medical Society guidelines: Grade 1 - Confusion. No loss of consciousness. Grade 2 - Confusion. Amnesia. No loss of consciousness. Grade 3 - Any loss of consciousness.Signs and symptoms of concussion may not be noticeable straight away. (A sign is what a doctor can see, hear or feel, such as a rash, or slurred speech. A symptom is something the patient describes, such as a headache, or ringing in the ears.)There are serious misconceptions about concussions among most athletes, coaches and parents when it comes to understanding the signs and symptoms . One of the biggest problem that has been occurring recently is that on field diagnosis is virtually impossible unless the player loses consciousness. Most concussion or mild traumatic brain injury (MTBI) symptoms will go away without treatment. In the USA approximately 1% of patients with MTBI require surgery. Second impact syndromePeople should also be aware of second impact syndrome. Second impact syndrome describes the situation in which an individual sustains a second concussion before the symptoms from the first have resolved. A second brain injury, or cumulative concussions, can be more dangerous than the first one.Sex and prior history - prior history of concussion and gender account for significant differences in test results following injury, researchers from the Department of Orthopedics at the University of Pittsburgh Medical Center, reported. Because of these differences, the researchers urge physicians and coaches to take an individualized approach to treating people with concussion.In a report authored by Robert C. Cantu, M.D., FACSM and published in Medicine & Science in Sports & Exercise, a study of 2,552 retired professional football players revealed that recurrent sport-related concussion appears to be related to an increased risk of clinical depression in retired professional football players.Possible Complications:Complications from a concussion can include:Bleeding in the brain (intracerebral hemorrhage)Brain injury that results in physical, emotional, or intellectual changes.Prevention of concussion:Attention to safety, including the use of appropriate athletic gear, such as bike helmets and seat belts, can reduce the risk of head injuryIt is important to buy new protective headgear, not second-hand ones. Headgear should be replaced periodically because of newly developed technologies that are being used for better protection.Seat belt: wearing a seat belt has been proven to massively reduce the risk of head injury during vehicle accidents.Driving under influence: avoiding drinking and driving, or driving under the influence of illegal drugs or as well as some medications.Mouthguard: a good mouth guard can help prevent concussion in such contact sports as boxing, martial arts, rugby, football,lacrosse,soccer etc.Nutrition and exercise: A well balanced diet and plenty of exercise can help maintain good bone mass and bone density. This is especially important for seniors and post-menopausal women. Stronger bones may reduce the severity of brain injury following a blow to the head.TreatmentsMost concussion symptoms will go away without treatment. In the USA approximately 1% of patients with MTBI require surgery. In more severe cases the patient will be hospitalized and will require intensive care. Treatments for concussion should always be under doctor supervision. These are some of the most recommended treatments. Rest,(free from TV,cellphones,computers) Fora couple of days. Acetaminophen(Tylenol), avoid ibuprofen and aspirin. Avoid exercise and lifting. Try to eat a lighter diet and avoid Alcohol.There are several alternative treatments to concussion and together they may be able to facilitate a faster and better healing.Arnica is a popular homeopathic remedy for concussions. Homeopathy is an alternative therapy, and not a substitute for conventional medical treatment. Consult a doctor before using arnica for a head injury.Arnica is recommended for sudden traumas, shocks or impacts, and was originally chewed by Alpine mountain climbers to treat bruises and broken bones. Homeopaths use the highly diluted form to treat both concussion and post-concussion syndrome which features headache, dizziness, amnesia and depression. Dr. George Guess, a homeopathic doctor in Crozet, Virginia, and the editor of the American Journal of Homeopathic Medicine, endorses arnica as the remedy of choice for concussion. Blue Shield Complementary and Alternative Health notes that arnica can also help prevent shock.

According to the National Center for Complementary and Alternative Medicine, homeopathic remedies, when used in high dilutions and taken under the supervision of trained professionals, are generally regarded as safe and are not likely to cause severe adverse reactions. The website adds that although little clinical evidence supports homeopathy as effective for any specific condition, some studies and trials demonstrate positive effects of homeopathic remedies.

A new University of Colorado, Boulder study indicates an ancient form of complementary medicine may be effective in helping to treat people with mild traumatic brain injury, a finding that may have implications for some U.S. war veterans returning home.
The study involved a treatment known as acupressure in which one’s fingertips are used to stimulate particular points on a person’s body points similar to those stimulated with needles in standard acupuncture treatments, said CU-Boulder Professor Theresa Hernandez, lead study author. The results indicate a link between the acupressure treatments and enhanced cognitive function in study subjects with mild traumatic brain injury, or TBI.

* Independent studies have shown that a combination of different neurotherapeutical approaches (such as neurofeedback, rTMS, tDCS) can be suggested for severe cases of TBI. ERPs can be used to assess functional brain changes induced by neurotherapeutical programs.
*National Center for Biotechnology Information, U.S. National Library of Medicine

Sexual Health & healing : Am I Normal?

Am I Normal?
As a sex therapist, I get a lot of questions from people wanting to know what is “normal.” People vary so widely in their sexual thoughts, attitudes and behavior that defining “what is normal” is difficult if not completely impossible. A good rule to follow about normalcy for you is: whatever you and your partner decide will be pleasurable for you both. This month, I’m sharing with you the most commonly asked questions, with some brief responses. Enjoy!

What is “healthy sexuality”?

I am asked this question a lot, particularly by people who have a history of sexual assault or abuse. According to the World Health Organization, “Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.” I would like to add to that definition that if your activity is consensual, pleasurable and outside the sight and sound of non-willing participants, than it is healthy. It’s that simple.

How often is normal?

The estimated average frequency for couples in their 30s and 40s seems to be 1-2 times per week. That said, frequency should be based on what you and your partner are both happy with, not what you think is “normal.” Depending on what else is going on in your life, you will find that your libido ebbs and flows. Several factors can influence your sexual libido, including: length of time in the relationship, overall health, job stress, medications, life stress, having children, aging, and/or problems in your relationship. Having children tends to put quite a bit of strain on couples physically, emotionally, and financially. This then carries over into the bedroom for them. If you think that having small children has put a damper on your sex life, I highly recommend that you carve out more time for each other—without the kids. Even a “date night” twice per month can do wonders for the quality of a couple’s relationship.
It is normal for people to have periods of time in their lives where they have less sexual interest or desire. In addition to the aforementioned stressors, what we like and what feels good to us may change as we age, especially in our 70s and 80s. Expect more time to be spent on arousal for both partners. After age 70, sexual activity may be more pleasure-focused instead of goal-focused, putting less pressure on the need for intercourse or an orgasm. This can be very intimate and bring intense feelings of closeness for couples. Another benefit is that after retirement age, couples have more time to spend with each other, without the burdens of work-related stress, child rearing, etc. So, if you are someone who is afraid of “getting old” just think about how wonderful your sex life will be when you can devote more time and energy to it!
In general, I suggest that couples focus on the quality of their sexual encounters versus the frequency of them. Chances are if both partners experience intense feelings of love, intimacy, and closeness during sexual activity, then they will both be eager to engage in it with their partner again (sooner, rather than later!). Most importantly, remember that an amazing sex life starts with open and honest communication in the bedroom.

Does size matter?

The short answer to this question is that it all depends on who you ask… If you are concerned with pleasuring a female partner, it should be noted that the average length of the vagina is between 3 and 4 inches. The average length of the male penis is between 5.1 and 5.9 inches. It is of note that circumcised men are, on average, 8 millimeters shorter than those who are uncircumcised (for obvious reasons). Given the anatomical structures, the average length is more than adequate, especially since females have the most feeling via nerve endings in the outermost section of the vagina (approximately the first 1.5 inches). With this in mind, girth may be more important than length. Girth is based on the circumference, with an average diameter being 1.5 inches. If your girth is on the slim side, encourage your partner to do Kegel exercises. This will strengthen the vaginal opening and will improve pleasurable sensations for both of you.
In general, size tends to be something than men worry about far more than women do. As noted by Cory Silverberg, “An Internet-based survey of 52,031 heterosexual men and women found that while 85% of women were satisfied with their partners’ penis size, only 55% of the men were satisfied with their penis size” (2011). This may be due to comparing themselves to unrealistic ideas or standards set in magazines or movies. Whatever the reason, clearly men seem to care about this a lot more than women and don’t seem to realize it. The constant barrage of commercials and emails offering “male enhancement” certainly aren’t helping the matter. Talk to your partner. If they are happy, you should be to!

Does menopause affect desire?

Sexuality, unlike fertility is part of who we are as humans, and continues to be a part of us throughout the lifecycle. The idea that sexual desire and sexual activity have to fade away with age is a myth. We do have to communicate our changing needs and expectations, as our bodies and what feels good to us will both change with age. As noted in the section above, our sexual interests change as we age, but our sexuality in general doesn’t just disappear. How we feel about our bodies and how we feel about our relationship(s) tend to have the most influence on our sexual feelings. Around the time of menopause, the impact of the reduction of estrogen on your body varies from woman to woman. For some women, this may cause a change in their feelings about sex. Some may be less interested, while others feel freer and less inhibited. The loss of the fear of pregnancy may be part of what makes some women feel more relaxed and free after menopause (i.e.- after one full year without a period).
Many women who experience problems with sexual functioning after menopause report increased vaginal dryness, weight gain, skin changes, and stiffness in muscles or joints. These may all contribute to lower sexual desire and decreased pleasure. If you have found this to be true for you or your partner, than it is important to take steps to try to combat these symptoms. First, make sure you are using a lubricant during sexual activity. I highly recommend Pjur Eros Bodyglide Original. It has a very natural feel, it is long-lasting, latex safe, and it doesn’t get sticky. Second, if weight gain has effected your body image or self-esteem, try to increase your daily activity to lose some of the gained weight. A walk with your partner every day can not only help to reduce some of the natural weight gain but it will also improve your blood circulation and overall health. Finally, take a warm bath to soothe stiff muscles or aching joints. If you have a tub that is big enough, have your partner join you! Need I say more?

If you have a question about sexual health or healing, and would like it answered in a future LWM article, please visit my website and go through the “Contact Us” page to send me an email with your question. Please title the subject as: Living Well Magazine Q & A

Dr. Dianna Palimere is a Psychosexual therapist and Licensed Clinical Social Worker. She has been in the field of mental health for the past 11 years, dedicating the past six years to specializing in clinical sexuality. She holds a BS in Psychology, a Masters degree in Social Work, a Masters degree in Human Sexuality Education, and a PhD in Clinical Human Sexuality. Utilizing a holistic approach to therapy, she incorporates a variety of clinical interventions in her work with individuals, couples, and families. She is devoted to helping people achieve sexual health and healing through her work as a psychotherapist in her private practice, as well as in her work with local nonprofit organizations. To learn more about her or to schedule an appointment, visit her website: www.SexTherapyInDelaware.com, or call her office at (302) 691-3730.
Copyright © 2012 Dianna Palimere, PhD, LCSW

Low Carb Beer

Approach the month of March, with the promise of pots of gold, shamrocks and little leprechauns, our thoughts turn to beer. Green beer, light beer, low-carb beer… the choices are endless. For those on a low carbohydrate diet, St. Patrick’s Day is the holiday for you. Not only is the traditional dish of corned beef and cabbage naturally low in carbohydrates, but now you can even enjoy beer and liquor, too.

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