Sep 012010
 

So now you’ve read about the whys of brain-injury created reading problems (and if you haven’t, have a gander at it first), you’re probably wondering: how do I fix it!?!

As I mentioned before, going straight to the behavioural model after sustaining a brain injury is an exercise in frustration for the person with the injury, especially when it comes to reading. Perhaps it works for infrequent readers, but we live in the information age, the knowledge economy. You cannot participate without reading. And compensating strategies alone, without knowing the organic cause, are insufficient to get you participating. You can only achieve that with treatment (and then the strategies if still needed.) In short, the goal of all brain injury rehabilitation should not be surviving on one’s own but on reintegrating fully into society. There’s just one problem: no one seems to have devised a treatment protocol specifically for reading issues that are beyond the recognizing-letters-and-words phase. But I looked anyway and eventually found these methods.

Brain Biofeedback

I’ve written about this before (and must finish up that series!). It’s an active protocol using computers, guided by a trainer that requires you to use your brain to effect changes. It’s exhausting but worth it. After I was assessed at the ADD Clinic, where I received brain biofeedback, we discussed what they could do for me. They bluntly told me that they didn’t know if they could improve my reading. However, they would give it a try. Shades of what my father told Judy Taylor, which told me I’d found a place that truly cared about its clients and dared to be innovative to help them.

Basically, brain biofeedback works by connecting you to the computer via stick-on electrodes — two on your ears, one on the scalp above the brain location to be activated — in order to increase the desired brain waves and decrease unwanted brain waves through playing a computer game.

They have good research proving this method works to increase concentration, stamina, and persistence, all cognitive skills one needs to read. By improving my concentration, stamina, and persistence, the biofeedback increased my reading time from 5 to 10 minutes (in a day) to about 20 in one go. But reading also has a learned emotional aspect. Because of repeated failure and frustration, I had developed a fear of reading. The biofeedback got rid of the fear. When we worked on increasing the frequency of my alpha waves, I had this surreal moment of reading a page and my mind opening up suddenly to “see” everything I had read up to that point, the picture of it that is, not the actual words. It didn’t last long. But since then, the ability to see the big picture has been slowly, slowly returning. The biofeedback also started a chain of spontaneous healing that’s lasted to this day and that has occurred in every area that’s been injured. However, if I try to read twice in one day anything that is at a higher grade level than an Agatha Christie, that is new, that I must learn and retain, I literally zonk out for up to 2 hours on the couch. It’s as if my brain has gone into overload. Also, if I’m going to respond to written material (like an e-mail or article I want to blog on) or if I must follow something to learn about, I have to reread it a few times. Rereading is easier with each pass. But there are days when I’d just like to read already!

Audiovisual entrainment (AVE)

As I wrote earlier, AVE is a way to entrain the brain into certain brain wave states. It does that by using the brain’s natural input areas of ears and eyes, creating audiovisual patterns of sound and light. An AVE device will have several preset protocols or sessions, each of which entrains the brain into producing different brain waves, which leads to improved focus, creativity, relaxation, sleep, and so on, depending on the brain wave(s) entrained. Although an AVE device is not meant to improve reading, by stimulating certain brain waves, it does help. I am not sure which session is the most beneficial, but it’s generally believed that relaxed, focused attention (not the hyper, adrenaline-fuelled kind of attention we’re so familiar with) is best for learning. That relaxed, focused attention comes from SMR or 14Hz brain waves. Since I also have ADD-like problems, the ADD session of the MindAlive AVE Health-Canada-approved medical device helps as well. It entrains two levels of beta waves and alpha waves. Entraining alpha waves alone helps me with the big picture and with creativity – synthesizing old and new information into new ideas.

It’s best to read soon after using a session. Alternatively, you could use a relaxing alpha-wave session afterwards to recover from a bout of reading. In general, AVE energizes the brain. But you have to be careful if you have a brain injury because it can push too much, and you’ll crash. I find it best to decide beforehand what my day’s schedule of activities will be, decide on which AVE session is best, and then no matter how good it makes me feel, stick to my schedule and don’t do one thing more. Even though the effect of a session may only last hours (or days), I feel that over time its benefits accumulate so that you can progress to more demanding sessions, for example, from Brain Brightener for seniors to ADD for children/adults.

Increase Blood Flow to Increase Energy for Reading

As we’re beginning to know, especially after hearing the same thing over and over again from those with MS who’ve undergone the Zamboni treatment, reduced blood flow leads to increased fatigue. Anything that can increase blood flow may alleviate fatigue and thus make reading easier, certainly make the brain function better when it’s getting full nourishment in real time. For sure, opening up blocked veins helps blood flow. But blocked veins may not be the issue here, plus surgery is risky. Far better to use non-invasive methods. Meditation improves blood flow as does exercise. I’ve been told that cranial electrostimulation (CES) is another way to improve blood flow, and Hyperbaric oxygen therapy may too. At this point, it’s all experimental. But that isn’t a reason not to try if you have the money, the time, and/or the energy. Except for occasional temporary dizziness, there don’t seem to be side effects. But always, always check the literature to make sure.

Food and Moving Your Body to Increase Energy Available for Reading

Glucose: Brain biofeedback is one of the most mentally demanding activities I’ve done since my brain injury. Before I started it, I had no interest in drinking pop; afterwards…well, I couldn’t guzzle down a fizzy, sugary drink fast enough. I always felt better and didn’t experience the low that usually follows. No surprise really because unlike the rest of the body, the brain consumes glucose for energy. A quick way to refuel a tired brain is to eat or drink a shot of glucose, and I guess my brain decided that pop was it. (I lost all desire for it as soon as I stopped the treatments.) One can also have glucose tablets or dextrose syrup or dissolve a teaspoon of honey in a small glass of water for a quick hit of fuel for the brain and a quick recovery of energy. I’d like to point out to those who don’t have a brain injury that the fatigue induced from overuse of the brain makes you feel sick, it freezes you in its tracks, it empties your mind of all thoughts — you’re literally like a snoozing blob staring vacantly at the TV. Getting some glucose in feels very good, and doing it in response to increased mental activity meant rarely did I feel a down after the recovery. Of course, you’re probably asking, er, won’t you gain weight? That is a problem. Fuelling up prior to mental activity with complex carbs in order to create a slow increase in blood glucose doesn’t solve the problem either. First off, since your brain won’t need extra amounts until during or after the activity, it won’t take it. Your body will, right into the fat stores. Second, it’s difficult to time how far in advance you’ll need to eat something so that it hits the brain at the exact moment it needs it and so will take it ahead of your fat stores. Twenty minutes is standard, but you may have noticed that one’s internal organs don’t exactly work in standard fashion anymore. So if after mental activity, you feel like death on toast, I wouldn’t be critical if you gulped a sugary drink or had chocolate!

Coffee and Chocolate: An ADD expert said once that his Ritalin is coffee. There’s no doubt that it perks up the mind. The problem with coffee is it’s addictive physiologically, meaning that if you drink the exact same amount every day at the same time of day with the same preceding cues, then you’ll develop a tolerance for it, and it’ll become less effective. You’ll then have to up your “dose” to get the same result. So what I do is drink it at different times of the day, sometimes skip a day, and consume different amounts from half a cup to a cup. Chocolate too can perk a person up, as well as making one feel good. I remember being advised in a University of Toronto nutrition class to have a bar of chocolate 20 minutes before sitting for a university exam to enhance performance. Chocolate has other good effects as well. And it’s just plain enjoyable to eat.

Water: A dehydrated brain is a tired brain. Drink up! Nuff said.

Exercise: People with brain injuries need to exercise but our ability to exercise is often impaired. I discovered last year that I’d been exercising too much; instead of energizing me, it was making my physical issues and mental fatigue worse. However, exercising too little had the same effect. The best way to figure out what your tolerance is is to find a trainer who’s familiar with brain injuries and then experiment. For me, we took my exercise down to 10 minutes, 3 times a week. That’s the minimum I need to benefit from exercise. We tried taking it down to 8 minutes, 3 times a week, but I worsened. Then we slowly increased my exercise by 1 to 2 minutes per session, and after a few weeks, added a session. Certain kinds of exercise deemed too strenuous are nixed. This is an area that doctors know so little about, and the research has yet to catch up with what’s known in the field, it seems.

Compensating Strategies for Reading Problems

In addition to what you learn in rehab — highlight, take notes, write notes in the margins, cover off text, pace yourself, read for a short period of time, reread — there are additional ways to compensate and to make reading slightly easier. These are ideas only and may not work well enough to take you back to where you were, but they have made some diff for me after I underwent brain biofeedback. In other words, I believe you need to reach a certain level of functionality in reading to benefit from compensating strategies.

Format

The easier it is to perceive the written word, the less energy your brain requires to see and understand the words on a page, the more that’s available for processing, retaining, learning, and synthesizing. Paper is easy on the eyes, but has several drawbacks with regards to comprehension. With the advent of eReaders, we now have a choice of format.

Traditional compensating strategies include masking text that you’re not reading, folding newspapers and magazines up so all you see is the column of text you’re focusing on. eReaders are like automatic masks and folds. You only see the text and as little of it as you need to be able to focus and read well. With the advent of the iPad, magazines are starting, barely, to come out in interactive formats that with a click of an icon, all you see is the text. No distracting photos, no distracting ads, no distracting computer or browser bars. However the screen, like that of computers, is harder on the eyes than the eInk screens of eReaders, which mimic paper. That means your brain is going to get tired faster. Computers are a more difficult medium as they have so much real estate and sometimes have eye-straining screens, that even with software that shows you only the text on websites, it’s too hard to take in.

Pain Control

If one is injured in a car crash, one usually ends up with some area of the body hurting. If so, pain control is crucial to being able to focus. If your body is distracting you, you’re not going to be able to read well. The usual pain medications have always had zero effect on me. So after this injury, I turned to acupuncture, physiotherapy, massage, weight lifting, AVE, and the Stress Eraser, which cues deep breathing, an effective way to relax and reduce pain. I also tried CES, but I believe the device I was given way back when was not the most effective kind. I am trying a new one from MindAlive that comes with micro-TENS as well.

Practice

Like learning to read the first time when you were 3 or 6 years old, you gotta practice. But when you have to practice something you were so very good at, it’s a bit frustrating and grieving. It’s necessary to have someone in your corner to encourage you and to be your “practice police.” But what if you don’t have that person? Then begin with reading something you enjoy at a time that makes sense for you. For example, people often read the paper over breakfast. Begin with that; read one article from beginning to end, no skipping around, each morning at breakfast. Another way I’ve recently discovered is through using the iPad and being on Twitter. Many people link to articles that catch their interest. iPad apps like Twitterrific make it easy to press the link and have the page fill the screen instantly, ready to read. Or Flipboard is a magazine-style way to read the links your Facebook friends post, making it faster and easier to read. Faster and easier, clicking links posted by others, are ways that cue you to read.

When trying to decide on a book or more difficult reading material, ask yourself these questions in order to decide what to read and when: is it new (harder than material you’ve already read); how much energy do you have (if low, don’t read); is it relevant; is it long or short; is it complex; can you just read it or must you retain and learn from it; what format is it in; is it interesting. Always set a timer, ensure a quiet environment, use the appropriate AVE session beforehand, use the compensating strategies that work for you, have a glass of water at hand, and do not repeat a reading session that day. You want to set yourself up for success so that you are likely to keep reading.

And that’s what I got so far. I’d love to hear what’s worked for you!

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