Fatigue and the heat wave


There is a saying, ‘no two brain injuries are alike.’

This is true, every acquired brain injury is indeed different. But these horrid ABIs share some commonalities, and one in particular is fatigue.

people walking on a busy sidewalk in the summer
photo credit: Holographic Circus Wume / Aural States via photopin (license)

Similar to brain injury, fatigue is invisible. I find it to be hiding in the corners of my brain, lurking in the shadows. It seems to be ready to jump into action at any given time of the day. A nap, or extra rest, does not cure it.


extreme drowsiness, typically resulting from mental or physical exertion or illness.

I’m not sure if people understand the effect fatigue has on someone living with a brain injury. I find it comes in waves and at various levels of low, mild and extreme.

It is a silent paralyzer, and never a pleasant experience. It is disorienting. One could almost wonder how much worse it possibly get?

Remember last summer? 2016 was the hottest year on record. This summer we have some relief, but the heat and humidity persist on most days, and they are a lethal instigator of fatigue.

Close up of an outdoor thermometer reading 100 degrees
photo credit: jo3design [DSP] May 18: Heat Wave via photopin (license)
While I’m not sure what is the best way to beat this devastating duo of fatigue and the heat wave, I know there must be a way to deal with it.

Perhaps it is inner strength, or knowing how to slow yourself down and breathe. Maybe the answer is to go for a nice cool swim or take a cold shower. Regardless of how staggering it can get, like with many things, I will get through it and survive.

I’m sure any of us who come up against these monsters can do the same. (And remember, fall is just around the corner.)

But sometimes I wonder, which is harder? Dealing with the fatigue or dealing with the fact that others don’t understand why I’m dealing with the fatigue. Maybe it is me not always telling people that I’m trying to deal with the fatigue.

Wow, that’s confusing, but that is also brain injury.

Mark’s passion to lend a helping hand, offer advice and give back has developed into a moral and social responsibility with the goal of sharing, inspiring and growing – for others as well as himself. His experience as a survivor, caregiver, mentor and writer has led to his credibility as an ABI Advocate and author of his life’s story, Challenging Barriers & Walking the Path. Follow him on Twitter @Mark_Koning or go to www.markkoning.com

The top 5 ways summer is out to get you


Hot fun in the summertime!

Those words are just as true today as they were when recorded by Sly and the Family Stone back in 1969. Summer is about having fun in warmer temperatures, especially after another brutal winter and a cool spring, we certainly deserve it. Just a few short months ago we were protecting ourselves from the -30 wind chill, right?.


But warmer temperatures can also be too much of a good thing if the thermometer climbs above a certain level. Our body deals with the heat in different ways, by increasing the rate and depth of blood circulation, by losing water through the skin and sweat glands as perspiration and when coupled with strenuous activity, causing us to pant when the blood is heated above 37 degrees (98.6.) Under conditions of high temperature (above 32 degrees) and high humidity, the body does everything it can to maintain its regular normal temperature.

Spending too much time outside on a hot day can affect the body in a number of different ways, some of them debilitating. Little wonder that the dangers associated with high seasonal temperatures are sometimes referred to as silent killers.

Here are a few of them that we have to watch out for as we enjoy this all-too-brief season:

1. Dehydration

photo credit: Cold drinks via photopin (license)
photo credit: Cold drinks via photopin (license)

When the body becomes overheated, the blood is circulated closer to the skin’s surface and excess heat drains off into the cooler atmosphere. You body is always trying to maintain an even body temperature. Sweating reduces body heat through a process known as evaporative cooling. When we perspire, our bodies are cooled through evaporation from the skin, but if there is high humidity, the sweat stays on our skin and we feel little relief from the heat.

Hence, sweating by itself does nothing to cool the body, unless the water is removed by evaporation. Dehydration occurs when more than two per cent of normal water volume is lost. Symptoms may include thirst, headache, general discomfort, loss of appetite and dry skin. Severe dehydration can lead to dizziness or fainting, decreased blood pressure and listlessness. Whether it means carrying a water bottle or making frequent stops at a public fountain, keeping hydrated on a hot day is a given.

2. Heat Cramps

Source: http://media.mnn.com/assets/images/2009/04/main_egg_0407.jpg
Source: http://media.mnn.com/assets/images/2009/04/main_egg_0407.jpg

Anyone who has ever done heavy physical labour on a hot day may well have experienced muscle sprains or spasms known as heat cramps. They may occur in the abdominal area or the legs and can be very painful. Anyone suffering from heat cramps should immediately stop the activity and rest, while drinking sips of water or a sports drink. Try to gently stretch the cramped muscle, holding it for about 20 seconds before massaging it. If the sufferer ceases to have any symptoms of heat cramps he or she may resume some activity, but should refrain from any strenuous exercise for at least 24 hours.

3. Heat Exhaustion

photo credit: IMG_20150705_143248 via photopin (license)
photo credit: IMG_20150705_143248 via photopin (license)

Heat exhaustion is closely tied in with dehydration – it results from the loss of large quantities of water and salt. When these are not replaced, blood circulation diminishes, affecting not only the heart, but also the lungs and the brain. When heat exhaustion occurs, high humidity may cause perspiration not to evaporate so the body doesn’t cool properly. Symptoms may include skin which is moist, cool, pale – or sometimes red – heavy sweating headache, nausea, vomiting, dizziness and general inertia. Body temperature is usually normal. Heat exhaustion is best treated when the person afflicted rests in a cool place and consumes small amounts of water every 15 minutes. Clothing should either loosened or removed altogether and cool wet cloths applied to different parts of the body. If left untreated, the condition could potentially lead to heat stroke.

4. Heat Stroke

photo credit: Suck It Heat Wave! via photopin (license)
photo credit: Suck It Heat Wave! via photopin (license)

Heat stroke occurs when a person’s temperature control system – which produces perspiration to cool the body – stops functioning. This creates an increase in body temperature so high that either brain damage or death can result if steps are not taken immediately. Symptoms may include hot, red and dry skin, a rapid but weak pulse shallow breathing, high body temperature, dilated pupils, dizziness and weakness, vomiting and mental confusion. If you suspect a person is affected by heat stroke, it is imperative he or she be moved to a cool place and be wrapped in wet sheets. Ice packs should be placed on the victim’s wrists and ankles, in the armpits and on the neck in order to cool large blood vessels. Call 9-1-1 if the treatment is not producing the desired results.

5. Sun burn

photo credit: Bruceys Neck via photopin (license)
photo credit: Bruceys Neck via photopin (license)

Are you old enough to remember the days of, “I’m just going to lie out in the sun for a couple of hours and try to get a nice healthy tan?” The world has moved on since then, and most of us realize a tan is not healthy! Yes, the sun is life-giving and contributes to the production of vitamin D in the body, but over-exposure to ultraviolet rays over time have negative effects on the skin including sunburn, premature aging or an increased risk of skin cancer. After the winter, some people may wish to acquire the healthy glow a tan gives by starting out with a base tan using the facilities of an indoor tanning bed. But Dr. Anne Marie McNeill, a dermatologist with Newport Beach Dermatology and Plastic Surgery in California states on skincancer.org:

The problem is that ultraviolet (UV) tanning, whether from indoor tanning beds or from the sun, is harmful to the skin. Therefore, I don’t recommend tanning at all, during the summer or any other season. A tan is a sign of sun damage to your skin’s DNA. Skin cells respond to damage from UV rays by producing more of the pigment melanin to protect themselves from further injury.

Over-exposure to the sun results in a burn. Symptoms may include redness and pain, swelling of the skin blisters and in some cases, headaches and fever. It is best treated with ointments or in the case of broken blisters, dry sterile dressings. During the past twenty years, doctors have seen an alarming rate of increase in skin cancer of a type referred to as nonmylenoma – as much as 300 per cent and more than all other cancers combined . If detected early enough it can be treated successfully. If you must take some sun, do so for small intervals of time and always wear a lotion for protection.

Don’t let the heat get you

photo credit: 12/365: Beat red after spinning via photopin (license)
photo credit: 12/365: Beat red after spinning via photopin (license)

Enjoy the season! It’s a time for patios, cool drinks and taking life a little easier than at other times of the year – but never forget to take those precautions that come with the increase in warmer weather.

Dress for it! An all-black ensemble may be trendy, but leave it in the closet until September. Light-colored clothing reflects heat and sunlight, and helps your body maintain normal temperatures. Wear a hat to protect your face and head.

Even if you aren’t thirsty, be sure to drink plenty of liquids, and cut back on those iced lattes and cool pints of beer. Caffeine increases water loss through urination, and alcoholic drinks can also cause dehydration. Soft drinks and fruit juices usually contain high amounts of sugar, which means they aren’t absorbed as easily as water or a commercial sports drink.

It’s impossible to avoid the sun altogether during the summer, but don’t bask in it. Wear a protective sunscreen if you plan to be outside for any length of time-and go indoors to a cool environment if you feel any of the effect of too many ultraviolet rays.

But we’re not total downers – summer lasts only a few months, so make the most of it. Walk, hike, swim, bike, go for a leisurely stroll in a park or along the waterfront, or enjoy drinks (in moderation if they’re alcholholic!) on a patio. Because we all know how quickly -30 is going to come back..

BIST’s summer fun + water safety reminder

Nothing beats hanging out by the water during hot, lazy summer days.

young family sitting in a lake

It’s easy to feel free and relaxed. And you should.

But it’s also important to remember the hard facts, that more people die from drowning in Ontario than anywhere else in Canada. Certain groups are at increased risk, especially two to four-year-olds, adults 60 and over, people who have lived in Canada for five years or less and men 18 to 49-years-old.

As most people connected with BIST know, surviving a near-drowning doesn’t guarantee things will be easy from then on. Brain damage can occur after the body has been deprived of oxygen for four to five minutes, which makes water safety a crucial component of summer-fun.

Here are some tips to remember when you’re out:

  • Two to four-year-olds are the highest risk group for drowning in the under-five age bracket, and these drownings usually occur near the water. The problem: curious little ones fall into water (such as an outdoor pool) they’ve wandered into in the brief moments their parents aren’t looking. Adults aren’t paying attention, because no one is actually swimming, they’re just near the water. Lack of adult supervision is the biggest risk factor that leads to young children drowning.
  • Young and mid-life men are at increased risk of drowning, particularly due to these at-risk behaviours: consuming alcohol while out in the water, not using a PFD (personal flotation device) when boating, going out in cold, rough waters and being out after dark. Another risk factor: going out on the water alone.
people swimming in an outdoor pool
  • New Canadians, especially folks who have been in the country for five years or less are four times more likely to be unable to swim than people born in Canada. Meanwhile, most people in this group consider swimming to be a very safe activity for themselves and their children.
  • Older adults can be at-risk of drowning if they suffer a medical condition while in the water, such as a heart attack. They may also be at risk if they do not modify activities they did when they were younger,  such as swimming across a small lake, that they’re no longer able to do. At the same time, not wearing a PFD, consuming alcohol while out on the water and going out alone are all risk factors which lead to drowning.
man and girl in a boat wearing life jackets

It’s important to reminder that drowning is a quiet, hard-to-notice event.

A young child can silently slip under the water in the bath, something a parent in another room wouldn’t notice. And most drowning victims can’t call out for help.

This video shows someone drowning in a crowded swimming area, while no one but the lifeguard notices:

 Here’s how to stay safe:

  • Watch kids all the time – especially when you’re near water but not necessarily swimming. That means if there’s a party at the beach or a pool, someone should be ‘assigned’ to watch the young children at all times. Take shifts, so everyone can have grown up fun and keep the kids safe.
  • Don’t swim or boat alone.
  • Wear a life jacket every time you’re in a boat.
  • If you’ve consumed drugs or alcohol, don’t go in the water.
  • Little kids who are not strong swimmers should wear PDFs.
  • Kids under five should not be further away than an arm’s reach from an adult.

Learn how to swim!

Learning how to swim is one of the best things you can do to keep you and your family safe in the water. Free or low-cost lessons are available from the City of Toronto – including lessons for adults. So dive in (safely) and have fun!

Sources: Life Saving Society + Ontario Medical Association

Cycling, accidents and ABI

By Richard Haskell

It’s July, 1947, and an ominous headline appears on the front page of the Newmarket Era and Express: ‘Boy on Bicycle Collides with Car on Way to Wedding.’

The story begins: “Trevor Shier, 14, son of Mr. and Mrs. John Shier, 78 Prospect St., is unconscious in Toronto Western Hospital with a compound fracture of the skull.”

Sixty-five years later, it seems that things haven’t changed all that much. Cycling is still popular with people of all ages, bikes and cars continue to share the roads with some degree of trepidation, and accidents are still far too prevalent, many of them serious enough to result in acquired brain injuries (ABIs).

A woman wearing a helmet cycles near Yonge-Dundas Square in Toronto. A report in The Globe and Mail in February revealed that more than 1,200 cyclists are injured in Toronto annually.
A woman wearing a helmet cycles on Yonge Street near Yonge-Dundas Square in Toronto. A report in The Globe and Mail in February revealed that more than 1,200 cyclists are injured in Toronto annually. Photo by Richard Haskell.

As a pastime, cycling has had a long history in Toronto. Bicycles appeared on city streets during the late 19th century, and indeed, it was cyclists who were responsible for many major thoroughfares being paved (asphalt made for a considerably smoother ride than dirt roads or cobblestones!) As automobiles became more prevalent into the 20th century, cycling became less popular, as it was now possible for urban dwellers to commute longer distances by car. Yet, with the increasing awareness of the environment and healthier lifestyles of the 1970s, biking regained its popularity.

Today, studies indicate that more than a million people in Toronto are regular cyclists, with roughly 30,000 bikes entering and leaving the downtown core on a daily basis.

Bikes, Cars and Trucks – An Uneasy Relationship

But what about cycling safety? Most bike accidents involve cars or trucks, and traditionally, motorists and cyclists have never been the best of friends, though many cyclists also drive and vice versa.

Motorists claim that cyclists take too many risks and don’t always adhere to the rules of the road. On the other hand, cyclists claim that drivers monopolize roadways and disregard bicycles with which they’re sharing a common space. Only a few years ago, a letter to Now sparked a controversy focusing on this very subject. It seems that the writer was a man who drove for a living, and it was his feeling that streets were intended for cars and cars alone, and that cyclists should stick to designated bike paths where he felt they belonged. He concluded by comparing cyclists to Luddites who were not only destined, but begging to become “hood ornaments.” Ouch! Cyclists were outraged, and a deluge of angry responses filled Now’s inbox in protest.

Continue reading