Fighting for better diagnosis of traumatic brain injuries

On March 5, 1990, Diane Roberts Stoler, EdD, was driving to her home office after seeing one of her cancer patients at Beth Israel Hospital in Boston. Stoler, a health psychologist, says the last thing she remembers is pulling off the highway onto the off ramp. The next thing she recalls is waking up in a hospital and being told she had hit another car in a head-on collision.

Stoler was diagnosed with a cerebral bleed that required brain surgery. Doctors also told Stoler that she had suffered a mild traumatic brain injury (MTBI) from the 60-mile-per-hour crash that left the other driver with a scratched cornea and a dislocated elbow. When she was released from the hospital, doctors told her she would be back to work by January 1991.

But the consequences of her brain injury were greater than doctors had predicted. The MTBI caused Stoler to have right-sided muscle weakness, blurred vision, slurred speech, language problems and vacillation in her moods. She couldn?t read or hold a pen. She couldn?t continue her practice as a psychologist because of chronic pain and problems recalling information. 'If I was cooking, I had no idea if I put the same spice in five times,' she says.

Before her injury, Stoler maintained a busy schedule, rising at 7:30 each morning, managing a practice of seven psychologists, seeing five to six clients a day, working out at the gym and spending time with her family. For the first two months after her injury, she slept 19 hours a day, and when she was awake, she felt constant mental fatigue. Despite her limitations, Stoler?s physician never sent her for rehabilitation or suggested she join a support group, she says.

A slow recovery

Eventually, Stoler found a neuropsychologist who had experience treating patients with MTBI. A psychophysiologist trained in brain injury used EEG biofeedback, which tracks changes in brain-wave activity with electronic sensors, to treat her attention disorder and chronic pain in her neck and shoulders, she says.

Although it has been eight years since her injury, Stoler still has problems with fatigue and finding correct words when she is speaking, she says. She wants to help psychologists and other doctors to recognize the signs of MTBI because, she says, it is one of the most commonly misdiagnosed conditions in the United States. She also wants to assist people with MTBI to cope with their injury.

As a start, she recently wrote a book entitled 'Coping with Mild Traumatic Brain Injury' (Avery Publishing Group, 1998).

'I want to enlighten people that this exists; there is treatment available; and people can recover,' she says. 'Psychologists can help people with a brain injury by acknowledging the physical and mental changes as a result of a brain injury, giving legitimacy to the sense of loss of self, supporting the person?s grief over this loss and helping guide them to go on with a productive life.'

?Lisa Rabasca

To order a copy of 'Coping with Mild Traumatic Brain Injury,' call (888) 760-8730 or log on to web site www.health-helper.com.