Neuro Note #3

For my third neuro note, I watched a TED Talk on post-concussion syndrome and chronic traumatic encephalopathy (CTE). The talk was given by Chris Nowinski, titled Can I have your brain? The quest for truth on concussions and CTE. Nowinski is a former Harvard football player as well as a former WWE performer. During both of these high-impact sport careers, Nowinski experienced multiple concussions and was diagnosed with permanent post-concussion symptoms. This lead to the end of his athletic career but the beginning of his scientific journey to learn all he can about CTE and to share it with the world.

CTE is a degenerative brain disease caused by reoccurring brain trauma. A brain with CTE forms Tau protein clumps throughout the brain which kill living brain cells. Not surprisingly, CTE is most commonly found in athletes and military veterans, due to repetitive brain trauma. CTE is commonly referred to as “punch drunk” because boxers often experienced symptoms after being hit in the head during a match. Symptoms of CTE include memory loss, confusion, impaired judgement and progressive dementia. These symptoms lead to mood and behavior changes, sometimes leading to suicide.

Chris Nowinski started the Concussion Legacy Foundation, the first center focused on CTE. They started the first ever brain bank – a “bank” of brains dedicated to CTE research. They also started a brain donation registry for athletes to publically pledge to donate brains to science. So far, over 2,5000 athletes have registered. While there is no way to detect CTE in a living person, Nowinski reminds us that we can prevent it – if we stop hitting ourselves in the head!

CTE and post-concussion syndrome are personal to me because I have known multiple individuals who I believe have experienced too many hits to the head. Specifically, my high school football team. I was very close to many of the players, my best friend being one of the captains, a running back. Particularly in his position, he was taught to dodge and dive through small openings between defensive players, often leading to hits in the head. On multiple occasions, I saw his helmet break loose and roll across the field after a tackle. It seemed like every other week, he was diagnosed with a concussion, given a day off, and then put right back into practice.

He was naturally short-tempered, impulsive, and easily distracted. Or at least at the time, I believed these were natural qualities of his personality. Now, after our neuro aspects class and after watching this TED Talk, I am more inclined to believe that these behaviors were directly linked to repeated blows to the head.  While I find this topic very interesting, I also look back at those teenage boys on our football team, risking their health, damaging their brains, and affecting the rest of their lives without knowing it. I am glad that this topic is getting more public awareness and that individuals like Chris Nowinski and the Concussion Legacy Foundation are making steps towards studying and preventing post-concussion syndrome and CTE. Click on the link below for more information

Concussion Legacy Foundation website:

https://concussionfoundation.org/

References:

Concussion Legacy Foundation. (n.d.). Retrieved May 23, 2018, from https://concussionfoundation.org/

Nowinski, C. (2017, November). Chris Nowinski: Can I have your brain? The quest for truth on concussions and CTE. Retrieved from https://www.ted.com/talks/

Inside the O'Briens Reflection

Client OP Report - Joe O'Brien 4/20/2018

Client Report	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	Client has been recently diagnosed with Huntington’s Disease (HD). Symptoms are affecting his daily occupations. 2 of his 4 children are HD positive. The other 2 have yet to be tested. Grandson may be affected as well.
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	Successful in: dressing, personal hygiene, self-feeding (with adaptations) Barriers: chorea, decreased coordination, irritability, difficulty thinking, depression
	Personal interests and values (p. S7)	Interests: Red Sox (baseball), spending time with family and friends Values: weekly family dinners, providing for his family
	The client’s occupational history/life experiences	Former Boston Police officer. Lives on first story of three story house shared with wife, two daughters, two sons, one daughter in law, and grandson. Mother died of HD when he was young. Work/home duties: none due to HD symptoms. Would like to remodel home to make more room for family activities.
	Performance patterns (routines, habits, & rituals) – what are the client’s patterns of engagement in occupations and how have they changed over time? What are the client’s daily life roles? Note patterns that support and hinder occupational performance. (p. S8)	Roles: husband, father, police officer (former), Red Sox fan, member of Boston’s Irish community Routines: Wakes up, watches sports TV, drinks beer, eats dinner with family Habits: Walks dog Yaz daily
Context	Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	First floor bedroom eliminates barrier of stairs	Uneven cobblestones and stairs for walking around town
	Social	Two best friends from the police force	N/A
	Cultural	Sees children often (live on upper stories of home)	Spending time in a bar often encourages over-indulging
	Personal	Middle-age man. Used to physical activity from police force.	Shame, depression, and stress from recent diagnosis and the effects on his children.
	Temporal	N/A	Schedule is now non-consistent since retirement. Increased time required to complete tasks.
	Virtual	Cell phone allows easy communication with family when they are not around.	N/A
Client Goals Context	Client’s priorities and desired target outcomes (consider occupational performance – improvement and enhancement, prevention, participation, role competence, health & wellness, quality of life, well-being, and/or occupational justice) (p. S34)	Be able to walk up/down stairs in neighborhood without falling. Assist wife with household duties without destroying objects/hurting himself. Hold grandson without fear of dropping/hurting him.

As expected, the book Inside the O’Briens is very sad. To read a first-hand account of how a condition such as Huntington’s Disease (HD) can affect not only the individual diagnosed, but the family unit, is horrible. I enjoyed Lisa Genova’s writing very much! I thought she did a great job expressing both Joe and Katie’s perspective and made it a very enjoyable read. I am also glad she wrote this book because hopefully it will help spread awareness about HD and how it develops and manifests itself.

The one thing I did not like about the story is that we do not find out whether or not Katie has the genetic marker for HD. I am glad she has decided to move to Portland and not let HD hold her hostage within her own mind, but I do wish we could have found out what her results said. I also am left wondering if JJ’s son, Patrick, and Patrick’s (unborn) child will develop HD. Although I appreciate some things being left to the reader’s imagination, for my own personal curiosity, I wish there had been some sort of epilogue to answer those questions.

I believe the underlying purpose of the book (besides providing awareness of HD) is to get the reader to ponder whether he/she would get the genetic test in order to find out if he/she is HD positive or negative. While I understand both sides, as conveyed through the children and their differing opinions, I personally think I would have the genetic test done. While I would be slightly concerned that, should I be HD positive, I would “see” signs in myself very early, I think I would want to plan my life accordingly. I would want to know if having a child would be affected by HD, much like JJ and Patrick are wondering. Unlike JJ and Colleen, if I found out that I was HD positive after my child was conceived or born, I would want to get them tested as well. That way, the child can become aware and, when at later age, he/she can plan his/her future accordingly as well.

I would strongly recommend this book to anyone interested in health care, neuroscience, and/or psychology. After reading this book, I plan to explore others written by Lisa Genova.