Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person’s level of consciousness after a brain injury.  The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. 

These three behaviours make up the three elements of the scale: eye, verbal, and motor. A person’s GCS score can range from 3 (completely unresponsive) to 15 (responsive).

This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalized patients and track their level of consciousness.

Unlike pretty much every other score, the lower GCS scores means a higher risk of death. However, the GCS score alone should not be used on its own to predict the outcome for an individual person with brain injury.  It’s simply a guide, that’s pretty much all.

ABI vs. TBI

ABI vs. TBI
What’s the Difference?

Acquired Brain Injury (ABI)

The position of the Brain Injury Network is that acquired brain injury (ABI) includes traumatic brain injuries (TBI’s), strokes, brain illness, and any other kind of brain injury acquired after birth. However, ABI does not include what are classified as degenerative brain conditions such as Alzheimer’s Disease or Parkinson’s Disease.

Traumatic Brain Injury (TBI)

“A traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new onset or worsening of at least one of the following clinical signs, immediately following the event:

  • Any period of loss of or a decreased level of consciousness;
  • Any loss of memory for events immediately before or after the injury;
  • Any alternation in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc.);
  • Neurological deficits (weakness, loss of balance,  change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc.) that may or may not be transient;
  • Intracranial lesion.
  • External forces may include any of the following events: the head being struck by an object, the head striking an object, the brain undergoing an acceleration/deceleration movement without direct external trauma to the head, a foreign body penetrating the brain forces generated from events such as a blast or explosion, or other force yet to be defined.”

Birth Trauma and Brain Injury

There is one subject regarding forms of TBI that is the source of some disagreement and that is with regard to the subject of brain injury produced by birth trauma. Generally speaking, brain trauma produced by the process of birth has been specifically excluded from being classified as a form of TBI by medical definitions. However, there are many mothers of babies being born with these birth brain injuries who are upset by that exclusion.

They see birth complications that result in these brain injuries as being forms of TBI. Some of these mothers see their children as being survivors of TBI, and they do not like that their children are excluded from this category.

Click the logo to read what does the OBIA (Ontario Brain Injury Association) say about the difference?

Types of facilities for long-term health

Long-term care is provided in different places by different caregivers, depending on a person's needs. Most long-term care is provided at home by unpaid family members and friends. It can also be given in a facility such as a nursing home or in the community, for example, in an adult day care center.
For the most part, and more often than not, people who'd consider "unsupported living" remain at home for as long as they can. A decline of their self-support skills would necessitate the move into a long-term facility. Basically, they need some help with what's done every day.
Independent Living Apartments
Independent living apartments are ideal for seniors who do not need personal or medical care but who would like to live with other seniors who share similar interests. In most independent living facilities seniors can take advantage of planned community events, field trips, shopping excursions and on-premise projects.
Adult Homes
Adult homes are licensed and regulated for temporary or long-term residence by adults unable to live independently. They usually include supervision, personal care, housekeeping, and three meals a day.
Assisted Living Program (ALP)
An excellent alternative to nursing homes for seniors who need help with their daily routines, but who do not need 24-hour care. Room, board, case management, and skilled nursing services come from an outside agency.
Nursing Home (Skilled Nursing Facility)
Nursing homes offer 24-hour-a-day care for those who can no longer live independently. In nursing homes, trained medical professionals provide specialized care to seniors with severe illnesses or injuries. Specially trained staff assist residents with daily activities such as bathing, eating, laundry and housekeeping. They may specialize in short-term or acute nursing care, intermediate care or long-term skilled nursing care.
What it comes down to is that whatever you need, is available. The more that you'd get, the more that it will cost. If you want to be happy, and not worried about the cost, trust me, you'll find something.

Take hits to the head seriously

The president of the US knocked NFL on rules: ‘Concussions — ‘Uh oh, got a little ding on the head?' in 2016, and calling the rules “soft”.
While he's wrong, he's not alone in thinking that way. The reason for that is that if someone hasn't had an injury, or knows someone who has, they don't understand.
While concussions are sometimes invisible to the eye, the effects aren't.
I've got plenty of challenges, of that there's no doubt, but the fact that I'm visibly-disabled is a plus. Why? Because if I stop for a few seconds, and do something that isn't simply moving forward, someone usually stops, and asks me if I'd like some help.
What I don't understand is that some doctors consider traumatic brain injury and concussion as two separate diagnostic categories, when in truth, both reflect brain injury.
When people go to the hospital, after getting hit on the head, what's weird (wrong) is that concussion is sometimes termed, over "brain injury." The reason for that is strongly associated with earlier discharge from the hospital and earlier return to school activities, the researchers say.
But, with the reality that they're the same, and post-crash effects can appear later, researchers recommend that more specific descriptions of concussion and brain injury should be used. The reason for that is that a more detailed explanation can include elements that would warn of the potential occurrences of issues.
Using the term “mild traumatic brain injury” rather than “concussion” might help people better understand what they are dealing with and improve decisions about what the children should be allowed to do.

Visionary – Steve Jobs and now Elon Musk

This entry doesn't immediately seem to fit into this blog, because what it's about doesn't immediately fit with what this story is about. But, it is. Why? Because what I'm about is the minimizing the differences between myself, and someone who hasn't suffered an injury that's rendered them unable to drive. Put it this way, with what Elon is thinking, while the notion of my being able get into a Tesla is highly-unlikely (simply because of cost), the concept of taking one alone is impossible. However, with what he's proposing, not only will riding in one be possible, but doing so alone.
Teslas, are cooler than pretty much anything, of that there's no doubt, but they're not cheap! But, as with everything, while the price starts high, as skills/production/everything else improves, the cost to make will reduce.
Visionaries don't see the cost of making things, nor do they worry about "little things" that would get in the way, because all they see is the result.
Everything that's designed follows a 3-step process of questions, which is "what do we need?", followed by "how do we do it". At the centre is why it's being thought of. Nearly every invention follows the process, starting at the outside, and working in. Steve Jobs, who invented the Mac computers, followed it, but reversed the order. He thought of why what he's inventing is needed. He solved it, and worked out.
Elon Musk is a visionary, of that there's no doubt, because he's making going to space more of a common-thing, and now he's announced that he'll be into making self-driving taxis.
I'm looking at my computer, the where I store my info for backup, and this will show more of what I just said.
Everything that's somewhat standard now was "holy cow, that's awesome!!" when it was first launched, and cost a fortune. In a long time, cars like this will likely simply be "just a car", and the fact that it's driverless, and a taxi, won't be anything weird.

This is summary information as best we can find

Concussion

The most common type of traumatic brain injury is called a Concussion. The word comes from the Latin concutere, which means “to shake violently.”

According to the CDC, in the US, between 2001 and 2009, an estimated 173,285 people under age 19 were treated in hospital emergency rooms for concussions related to sports and recreation activities.

Other causes include car and bicycle accidents, work-related injuries, falls, and fighting.

WHAT IS A CONCUSSION?

As seen in countless Saturday morning cartoons, a concussion is most often caused by a sudden direct blow or bump to the head.

The brain is made of soft tissue. It’s cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves.

The result? Your brain doesn’t function normally. If you’ve suffered a concussion, vision may be disturbed, you may lose equilibrium, or you may fall unconscious. In short, the brain is confused. That’s why Bugs Bunny often saw stars.

WHAT ARE THE SIGNS OF A CONCUSSION?

Concussions can be tricky to diagnose. Though you may have a visible cut or bruise on your head, you can’t actually see a concussion. Signs may not appear for days or weeks after the injury. Some symptoms last for just seconds; others may linger.

Concussions are fairly common. Some estimates say a mild brain trauma is sustained every 21 seconds in the U.S. But it’s important to recognize the signs of a concussion so you can take the proper steps to treat the injury.

There are some common physical, mental, and emotional symptoms a person may display following a concussion. Any of these could be a sign of traumatic brain injury:

My scooters

I can’t drive (well, legally that is), but thanks to the benefits that I’ve got, because I was working for the government, what I’m able to get is pretty awesome. I’ve got 2 scooters, because of what I need them for. The first, and most significant, factor that needs to be addressed is the weather. We live in Canada, so snow’s an issue. However, while OC Transpo buses are accessible, getting on the bus means that I’m required to take a tight-90 degree turn, which dramatically limits what I can use.

This is my "not deep snow" scooter. It's a lot like what it looks - not intended for use in snow. I've have to use it in snow, because my big one arrived with an error! However, it's not meant to be used in the snow! If the snow was deeper than about 1" it could have gotten stuck! The first time I learned that, I didn't see it before I'd advanced, and got stuck! Thankfully, even though I was stuck, within a few minutes someone saw me, and immediately came to help. After that, If I see that on the road ahead of me is snow, I avoid it.
Here's what the manufacturer says about it:

  • CTS Suspension (Comfort-Trac front and rear suspension) provides a smooth, comfortable ride over varied terrain

  • Feather-touch disassembly easily disassembles into 5 lightweight pieces for transport and storage

  • 300 lb. weight capacity

  • Delta Tiller with ergonomic wraparound handles lets you operate the scooter with one hand and rest your wrist

  • A standard front basket provides storage

  • Charger port located on the tiller lets you conveniently charge your scooter

  • The dual voltage charger permits charging the battery pack on-board or off-board for added convenience

  • Pride’s exclusive black, non-scuffing tires

  • Standard LED lighting

  • Includes two sets of easily changeable, red and blue colored shrouds

This is my 4-season scooter, that I can take anytime, to anywhere.
Granted that as it doesn't have a roof, it shouldn't be taken in the rain, but I was told that if the steering wheel electronics are covered, it's able to go anywhere, anytime.
Rugged and built to last, the Wrangler is everything I want in an outdoor scooter! Equipped with front and rear suspension (suspension - really? Yup, and it's awesome) this aggressive scooter is designed for cruising on walking trails or driving around. Enjoy total visibility with complete LED lighting. With a user-friendly console and dual hydraulic brakes for added safety, the Wrangler is the perfect way to embrace life in the great outdoors!

And, get this - it's top speed is ~20 km/h


  • CTS Suspension includes adjustable shocks for greater comfort

  • User friendly LED console displays time, temperature, miles driven, and trips taken

  • Adjustable delta tiller with ergonomic, wraparound handles

  • USB charger built into the tiller for convenient charging of smart phones and portable devices

  • Durable and stylish rear bumper

  • Easily accessible tie-down points (for transport of unoccupied scooter)

  • Full LED lighting package includes headlights, hazard lights, rear backup sensor LED lights and directional signals

Here's some visual evidence as to the difference. They say size isn't everything, but with respect to scooters in the snow, it matters. Check out the size differential between the two wheels.
Yes, being disabled sucks (when comparing to how I was), but with both the realization that I'd had (that while the past was cool, it's gone) and looking forward with what I'm building, it's awesome. And, thanks to the fact that I worked for the government, and was awarded a generous settlement, though I lost a cool job, I'm not paid less. So, the financial stress isn't here. As I'd said above, while it's not-good that they don't have a roof, with an umbrella, and the electronics are covered, I can go out in the rain. Not hard, but drizzles, but it's ok.

The new liquor store – fully accessible!

Yes, alcohol can help cause a significant number of Acquired Brain Injuries, but it’s the person who uses it, not the store. The store, brand new this year, is fully accessible, a far cry from the previous location.

The old store was, by technicality, accessible - but it was by no means so.
The new store is fully accessible.
The door opens, widely, through which I'm able to drive my scooter straight in.
Not only can I drive all through the store to choose what I'd like, I'm able to pay for it, easily.

Actions speak louder than words

Doing something for someone, without being asked, is usually somewhat insulting.
I used to think that I show that I'm useless, and didn't correct them when they simply assumed that, which was bad. I'm trying to adjust my thinking to that they simply don't know, and are trying their best. I honestly don't know what's the best way to tell people that.
On the whole, it's hard to say "what's right", because how it's received is like the injury itself, in that it's unique to the individual. I've basically gotten used to accepting the fact that people want to help, so if they want to do something that I know I can do myself, I don't do anything, and say thank you. If I objected, or acted badly, then that person might change from wanting to help, to someone who'd walk on by, thinking that they'd be annoyed.