Azee

By Eliza Marie Somers

Courtesy of Horizon Health www.horizonhealthcare.org

By Eliza Marie Somers

• Food is medicine. 

• Walking is man’s best medicine.

• Use it or lose it. 

Those sage adages were the foundation of the July 10, 2026, Brain Injury Hope Foundation’s Survivor Series: Nutrition, Physical Activity and Weight Management for the Brain Injury Community: Improving Your Health and Well-Being.

Survivor Series Presenters

• Alyssa Berg
  Clinical exercise physiologist
  Silver Strength, LLC
  https://silverstrengthllc.com/

303-912-0793

• Jessica Green

CommonSpirit Health
https://commonspiritinternational.org/

Board certified in obesity and weight management

Certified diabetes educator

Registered dietitian

• Dr. Shane Steadman
  Functional medicine doctor
  Integrated Brain Centers
  3601 South Clarkson St., Suite #420
  Englewood, Colorado 80113
  https://integratedbraincenters.com/
  303-781-0126

“I love food. And I love what the nutrients and food can do to you,” said Series presenter Jessica Green, who is a registered dietitian with CommonSpirit Health. “I can reset your metabolism with one broccoli at a time; one piece of carrot at a time.

“It's just there's so much we can do with (food) to support overall health, whether we're dealing with stroke, traumatic brain injury, heart attack, diabetes, whatever it is we're dealing with, that food can definitely be a part of that. And that more importantly, food can still be an enjoyable experience.”

• Food as medicine https://www.ihn.cuimc.columbia.edu/news/what-does-food-medicine-mean

Green stressed that last point by emphasizing that food should not be a source of stress. Even pizza can be upleveled by adding some vegetables – olives, spinach, basil, pineapple – the sky’s the limit. 

“Eating does not need to be a very complex endeavor,” Green explained. “It's innate to us as a species, so we can still enjoy that while properly fueling and making sure we're getting in all the different colors to support overall health.”

Jessica Green says eating should not be complicated. Following a diet that incorporates a variety of colors can help brain injury survivors.

Eating the rainbow is an easy way to get your fill of fruits and veggies. Think green as in leafy veggies, red as in tomatoes, berries, cherries and peppers. Blueberries and blackberries can be your intake of purple – even purple cabbage. For more on the rainbow diet.

Series presenter Dr. Shane Steadman agreed with Green on the importance of nutrition concerning brain injury survivors. 

“Nutrition is huge. I'm so glad that we actually get to talk about nutrition because it's not talked about out there. A lot of people have brain injuries, and they don't understand how important nutrition is. When you have a brain injury, you have brain inflammation,” Steadman explained. 

“I tell patients all the time, there's things you can control, and there's things that you can't. The things you can control is what you put in your mouth. So, if you have inflammation in the brain, then why would you put inflammatory foods in your mouth? That makes zero sense to me if we're trying to reduce the inflammation, trying to reduce the oxidative stress.”

What is oxidative stress:

Oxidative stress is an imbalance between two different types of molecules in your body: free radicals and antioxidants. Specifically, it means there are too many free radicals and not enough antioxidants. As a result, the excess free radicals start to harm your body’s cells and tissues. 

• https://my.clevelandclinic.org/health/articles/oxidative-stress
• https://www.hopkinsmedicine.org/health/wellness-and-prevention/anti-inflammatory-diet
• https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/want-to-ease-chronic-inflammation

Eating food rich in antioxidants is a great way to tamp down oxidative stress.

For more on what foods to eat, download this pdf from the Veterans Administration.

Green described oxidative stress as “almost like a failure on the cellular level. 

“It also adds to what are called free radical damage. You have these compounds just scavenging around the body, tearing up cells on that cellular level. So, we want to eat and get compounds in, such as omega-3s. … That way these compounds contain antioxidants, anti-oxidative stress compounds. That's where that antioxidant comes from. And they help to support keeping that cell intact. So, the foods that we eat are able to digest properly.”

Dr. Steadman agreed and added, “It's really hard for the neurons to build plasticity and connection if you're inflamed. So that to me is a big passion. And then I think the other thing that's really important is blood sugar stability.

“The research is really heavy that people with traumatic brain injuries go into hypoglycemia, and a big part of that is because the brain is trying to heal, so it uses so much glucose that people end up going low blood sugar,” he explained. “And if you have a brain injury, it also can affect your appetite. People may not feel like eating all these different things, so they end up having these insulin surges. They have insulin resistance. They go into hypoglycemic. … And how is your brain supposed to heal if it doesn't have fuel? You know, that's just another just common component of brain healing, is fuel.”

Many survivors experience a loss of appetite, smell and taste after an injury with many turning to supplements to help with recovery. However, not all supplements are useful and can be a waste of money, which can be in short supply for many brain injury survivors. 

“Supplements, in my philosophy should do exactly what they say. They should supplement a good day-in, day-out diet,” Green noted.

Leaky Gut Syndrome 

Dr. Steadman, who has a nutritionist in his office, said brain injury survivors experience inflammation because of leaky gut syndrome. He referenced a study in the early 2000s that revealed TBI survivors experience damage to the intestinal lining causing food particles to enter the blood system, which causes inflammation.

Dr. Shane Steadman emphasizes healing a leaky gut to help brain injury survivors in their recoveries.

“You have a gut barrier system, you have a blood-brain barrier system, you have a lung barrier system, you have a skin barrier system,” he explained. “When one barrier system becomes altered, all of them become abnormal, because it's kind of like your force-field system, or your first responders - everybody's heightened.” 

Dr. Steadman also pinpointed the vagus nerve becomes damaged after a TBI because “the frontal lobe and a big chunk of your cortex fires down to your vagus nerve, and then your vagus nerve fires down into your gut, so it can support digestion, absorption, kidney function, gallbladder function, but also leaky gut.”

Dr. Steadman cited a study where researchers found that mice with a vagus nerve stimulator had an intact gut after a concussion and the group without the stimulator had leaky gut syndrome. 

How to stimulate vagus nerve at home

• https://www.uvahealth.com/healthy-balance/5-vagus-nerve-exercises
• https://www.cedars-sinai.org/stories-and-insights/healthy-living/stimulating-the-vagus-nerve

“It's really kind of fascinating that they showed a direct link, cause between concussion and leaky gut syndrome.”

Dr. Steadman equated leaky gut to a picket fence, which keeps people, rabbits, cats and dogs out of the yard. When a person has leaky gut that picket fence starts missing slats, creating a “security issue.” 

“That's kind of what your body does too. It says, hey, there's some slats missing, and instead of getting vitamin A and C through, now we're getting broccoli,” Dr. Steadman said. “Then the immune system kicks up and that creates a food allergy. So, then you see people have a bunch of food allergies that have brain injuries because they have a leaky gut. They're now getting proteins crossing through, they're developing allergies, and now you get this back and forth where you get gut inflammation, brain inflammation.”

For more information on leaky gut syndrome

• https://www.flintrehab.com/brain-injury-and-gut-health/
• https://synapse.org.au/news/the-brain-gut-connection-how-gut-health-can-impact-recovery-from-a-brain-injury/
• https://stories.tamu.edu/news/2026/07/15/scientists-tame-seizures-and-heal-injured-brains-with-gut-chemical/

To heal a leaky gut, Dr. Steadman pointed to fish oil as one of the best things to help with leaky gut, along with bacillin, apigenin, luteolin, which can be found in fruits, vegetables and herbs, such as radicchio, onions, broccoli, carrots, white radishes, celery, rosemary and parsley. He also suggested glutamine, however do not self-administer as some research shows too much can cause more damage, so check with your healthcare provider before supplementing with glutamine, along with other supplements. 

For more on glutamine and foods that contain glutamine

• https://my.clevelandclinic.org/health/articles/glutamine
• https://www.lifeextension.com/wellness/superfoods/glutamine-foods?srsltid=AfmBOorE-Nkw9-fZR3ql9QwButUFvroNzcPw7iq74uC0pX6Z6ED-vgxR
• https://www.healthline.com/nutrition/glutamine#TOC_TITLE_HDR_7

Foods containing bacillin, apigenin, luteolin

• https://www.theskimm.com/health/nutrition/luteolin-foods
• https://pmc.ncbi.nlm.nih.gov/articles/PMC10934766/
• https://www.researchgate.net/figure/Main-foods-that-contain-apigenin-according-to-the-database-Phenol-Explore_fig2_349544132
• https://examine.com/faq/what-are-some-dietary-sources-of-apigenin/

Butyrate foods and gut health

• https://health.clevelandclinic.org/butyrate-benefits

More information on supplements for TBI

• https://www.flintrehab.com/vitamins-for-brain-injury-recovery/

Speaking of digestive health, Green is passionate about how food is grown and supported by the agriculture system. 

“I'm a former organic crop and livestock inspector, so it was really interesting to be out in the farm and seeing what we're doing with soil and animal husbandry.  And just to see that whole from the first raindrop to the field to when we're eating it and even when we're excreting it, you know, how is our digestion happening, how is our constipation, diarrhea, nausea, vomiting, I like to see that whole breath of nutrition,” she said. 

No one likes to talk about poop, however, one way to see how your digestive system is working is to look at your poop and using the Bristol Stool Chart. 

Bristol Stool Chart and articles on digestion 

• https://my.clevelandclinic.org/health/articles/bristol-stool-chart
• https://www.healthpartners.com/blog/healthy-poop-chart/
• https://www.webmd.com/digestive-disorders/poop-chart-bristol-stool-scale

Paleo, Keto, Mind, Dash?

Both Green and Dr. Steadman stress a diet that is rich in fruits, vegetables, protein and fiber. But which diet is best for brain injury survivors? It turns out a combination of these popular diets just might be the best bet. 

“At the end of the day, I think one of my big food philosophies is that you have to make peace in the kitchen, so we have to make this real,” Green said. “There's one in particular; it's called the MIND diet. It's the Mediterranean-DASH diet intervention. So, they took the Mediterranean diet, which has been well studied to show its anti-inflammatory and antioxidant properties. And then they took the DASH diet, which is called the Dietary Approach to Stop Hypertension. They meshed them together. And what they found is that this intervention helps with neurodegenerative delay, you know, dementia and Alzheimer's. They were looking at this diet as it helps to lower those risk factors. Will it prevent it 100 percent? We can't say that, but it does help to lower that (risk).”

The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) incorporates green leafy vegetables, berries, nuts and seeds, olive oil, whole grains, beans and fish, while limiting butter, cheese, red meat, fried foods and sweets. 

How to Incorporate the MIND Diet

• https://www.healthline.com/nutrition/mind-diet
• https://health.clevelandclinic.org/mind-diet-boost-memory

Green suggested trying teff as a whole grain. Teff originated in Ethiopia, and is prized for its high nutritional value. It contains 11% protein, 80% complex carbohydrate and 3% fat. It is an excellent source of essential amino acids, fiber and iron. Also try quinoa – rinse before cooking as it removes the bitter coating – buckwheat, millet, sorghum and amaranth. 

For more on alternative grains

• https://www.webmd.com/diet/benefits-of-teff-flour
• https://cookingforpeanuts.com/teff-recipes-ideas/
• https://gluten.org/2019/10/17/gluten-free-grains/

The Summer of No Salads 

With the outbreak of cyclosporiasis infections across the United States increasing, many people are forgoing salads this summer. As of early July 20, 2026, Taylor Farms said the U.S. Food and Drug Administration (FDA) had apologized after it emerged that testing of lettuce from the company's supplier had resulted in a "false positive" for Cyclospora. The FDA added that as of Sunday there had been "no confirmed positive sample results for product testing for Cyclospora.

How to avoid cyclosporiasis

• https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/cyclospora/overview-prevention.html
• https://my.clevelandclinic.org/health/diseases/17957-cyclosporiasis
• https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/07/04/mdhhs-makes-recommendations-on-preventing-foodborne-illness-amid-growing-cyclosporiasis-outbreak

Organic vs. Conventional Foods

Green said conventional foods have the same nutritional value as organic foods, which tend to be more expensive. 

“Where we see differences in organic, as we all know, there’s certain pesticides that can’t be used. We're looking at things like soil health. We're looking at things like how the animals were treated, what the animals were fed, how they're medically managed. If a cow gets sick, they have to treat it, but if they give it antibiotics, they have to remove that cow from the herd. They just can't let the cow be sick.”

That being said, Green noted that if you cannot afford to buy something organic then go ahead and purchase conventional items as we still need to get those nutrients in our systems. 

Another way to cut costs on organic foods is to buy organic the ones you consume the most and try to stick to the Environmental Working Group’s Clean 15 vs. the Dirty Dozen. 

The Clean 15

• Pineapples
• Sweet Corn, Fresh and Frozen
• Avocados
• Papaya
• Onion
• Sweet Peas (frozen)
• Asparagus
• Cabbage
• Cauliflower
• Watermelon
• Mangoes
• Bananas
• Carrots
• Mushrooms
• Kiwi

Dirty Dozen

• Spinach
• Kale, Collard and Mustard Greens
• Strawberries
• Grapes
• Nectarines
• Peaches
• Cherries
• Apples
• Blackberries
• Pears
• Potatoes
• Blueberries

Dr. Steadman emphasized research that suggest a ketogenic diet is helpful for the first month after a brain injury.

“So, acutely, the research shows that supplements actually may not be the best thing for you to do. Sometimes a ketogenic diet can actually be beneficial, because when the brain is very, very, very fatigued, glucose is harder to metabolize than ketones,” he explained. 

“So, to create a highly metabolic state with glucose may not be as beneficial, so that's why a ketogenic diet works. And then once your brain is starting to heal and recover, then you kind of go back into maybe normal glucose.”

Dr. Steadman also stressed that eating pork rinds and bacon is NOT the way to incorporate a keto diet. “People just eating a lot of fat and not eating carbs, and you know, that's not always the healthiest either,” he said. 

• Recently researchers at Massachusetts Institute of Technology found a keto diet may increase the risk of intestinal cancer tumors. https://news.mit.edu/2026/ketogenic-diets-may-increase-cancer-risk-small-intestine-0715 

• The Mayo Clinic suggests a healthier approach to the keto diet. For more information see https://diet.mayoclinic.org/us/blog/2022/how-to-make-the-keto-diet-healthy

The internet is chockfull of information on various diets it’s hard to tell what might be the best for TBI survivors. 

“There's so much information out there, it confuses everybody,” Dr. Steadman said. “The thing that we do in the office most often is we’ll tend toward a paleo diet. … Paleo so that we can get more fruits, veggies and meat because people tend to kind of over consume grains. Grains can be good, but grains can also be genetically modified, grains can be hybridized, and then you get into things like wheat. Wheat has glyphosate, so that's an inflammatory chemical that's sprayed on all your wheat products. You have corn, a lot of it is genetically modified.”

How to incorporate a Paleo diet

• https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/paleo-diet/art-20111182
• https://www.healthline.com/nutrition/paleo-diet-meal-plan-and-menu
• https://www.webmd.com/diet/paleo-diet

Once his patients are on a diet that emphasizes fruits, vegetables and protein, Dr. Steadman likes to have survivors slowly introduce grains into their diets, while keeping a food diary to record any interactions. 

“We tend to modify with every patient, because not one diet fits all, and that's an important feature, too,” he said. “Sometimes we'll do keto, sometimes we'll do paleo. … We try to tailor it because, yeah, everybody's a little bit different.”

Cutting out alcohol is also important to healing the brain as Dr. Steadman noted alcohol is a toxin, but in reality, people are going to want to drink. “I think if you're going to do it, I think in very limited moderation, you know, is ideal. I think if you're in acute stage, you shouldn't do it at all. You're trying to heal your brain; you don't need to add toxins to it,” he said. For more information on consuming alcohol after a brain injury https://msktc.org/tbi/factsheets/alcohol-use-after-traumatic-brain-injury

Exercise after a Brain Injury

Physical activity after a brain injury can be daunting, especially if it is introduced during the acute stage. However, exercise is extremely important and can ward off depression, increase sleep and energy. 

For more on exercise after brain injury

• https://www.flintrehab.com/exercises-for-brain-injury-recovery/
• https://biausa.org/living-with-brain-injury/getting-back-to-activities/doing-physical-activity-and-sports-after-a-brain-injury
• https://constanttherapyhealth.com/brainwire/exercises-for-traumatic-brain-injury/
• https://www.cognitivefxusa.com/blog/brain-injury-exercise

“Your brain needs three things in order to heal,” Dr. Steadman explained. “It has to have oxygen. glucose and stimulation. Glucose is something that we can control to the most part, keeping that thing stable so that your brain has fuel. And then if you have fuel, you can do more. You know, and if you can do more, then you can move. And if you can move, then we get into exercise, which is healthy for your brain, because that's stimulation. It kind of becomes this perpetual domino effect that we got to work on eating healthy, stabilizing blood sugar, healing our brain so we can move.” 

Alyssa Berg, a clinical exercise physiologist at Silver Strength, LLC., helps TBI survivors get their exercise groove back.  She became interested in helping survivors after becoming involved with Project Walk

Alyssa Berg works with clients to help them achieve exercise goals while also recognizing their limitations.

“That’s where I had the opportunity to work with individuals recovering from spinal cord injuries and traumatic brain injuries,” Berg said. “It was a very rewarding experience and taught me so much about this community's resilience, their recovery, and just the impact that movement can have on a person's life. … I'm just incredibly grateful to be doing work that helps older adults, and adults just improve their strength, mobility, quality of life through exercises.”

Berg works with clients who are recovering from strokes, TBIs, Parkinson’s disease and dementia. Silver Strength allows Berg to work with patients at home, in rehabilitation centers and senior living centers. 

Before a client is given an exercise routine, Berg assess each patient and designs a program around their needs and strengths. 

“Before beginning an exercise program, we do review the client's medical history, their diagnosis, medications. We perform baseline assessments for strength, flexibility, balance, their functional movement,” Berg explained. “We'll also check their blood pressure, resting heart rates, and then we'll determine with the clients what their goals are, so we can develop an individualized exercise prescription to work toward those goals.”

Chronic pain and arthritis can inhibit clients with their exercises; however, Berg works on patients’ range of motion to improve joint mobility, stretching exercises to decrease muscle tightness to help clients get back into movement. She also encourages aerobic exercise via walking or riding a stationary bike to improve circulation and to release endorphins. Balance and strength training exercises are incorporate to help reduce risk of falls. 

“I do believe that just simply being willing to start and just striving to be consistent is just the best prerequisite,” Berg said. “Being motivated is definitely a bonus, but not everyone is always motivated to exercise, so that's where we come in.

“We also practice goal setting,” she explained. “We believe that's very important, so we work on setting both short- and long-term goals, achievable goals, to improve clients' self-efficacy. We also discuss eating habits not so much the nutritional side, but just those late-night snacks.”  

Sage Words to Keep Survivors on Track

Green said survivors should trust their selves. “You and your body know what you need. We get a lot of information. Take that information, marinate on it, digest it, and then trust that you know what you need.”

Dr. Shane Steadman stressed self-care. “I think a lot of times we can put ourselves on the backburner for others, but I think we have to definitely focus on ourselves. I think community is probably one of the best things for us. Next, I would say movement and activation and activities.”

Berg likes to tell clients to give it their best. “I always like to tell my clients just to try your best on any given day. Your best may look different from one day to the next, and that's OK. But what matters most is that you keep showing up and persevering because the more consistent you are, the more likely you are to succeed.” 

Courtesy of LoveYourBrain Foundation

By Eliza Marie Somers

Do you have trouble falling asleep at a reasonable hour? Do you wake up in the middle of the night and can’t get back to sleep? Is your inner critic or “monkey mind” keeping you awake?

You are not alone if you answered yes to any of these questions. Roughly 50 million to 70 million Americans have trouble sleeping or about 30 percent of the population, according to HelpGuide.org. And sleep issues are quite common after a traumatic brain injury with 30 percent to 70 precent of TBI survivors experiencing problems falling asleep, “many occurring after mild injuries,” a recent study found.

• https://pmc.ncbi.nlm.nih.gov/articles/PMC3482689/
• https://msktc.org/tbi/factsheets/sleep-and-traumatic-brain-injury

To help brain injury survivors, the Brain Injury Hope Foundation’s June 12, 2026, Survivor Series: Yoga Nidra for Sleep and Mental Health after Brain Injury featured yoga instructor and program director Bridget Hearne of the LoveYourBrain Foundation. 

However, don’t be fooled by the word “yoga,” as yoga nidra is a non-movement relaxation technique that is scientifically proven to help calm the nervous system, thus making it easier to fall asleep, ease anxiety, relieve depression and rewire the brain. 

“My ultimate goal for today is that you leave here with this new understanding of how yoga nidra can help foster healing and resilience in a new way forward after a brain injury, and especially how it can support with some specific things like sleep and mental health,” Hearne explained.

What is Yoga Nidra?

Yoga Nidra is described a yogic sleep. “Yoga Nidra is an evidence-based, guided meditation technique,” Hearne said. “It's been proven to improve sleep, improve a lot of other conditions like PTSD, symptoms like headaches, anxiety, depression, specifically after a brain injury.

“We hear the words yoga a lot, and we think about moving the body around, or stretching the body, or of physical exercise, and that is part of a lot of different forms of yoga. … Whereas yoga nidra is a form of meditation. So, there's not a lot of physical movement involved. There is an awareness of the physical body, but not a lot of the movements like you see in other forms of yoga.

“What the research has shown is that Yoga Nidra actually works with our brainwaves,” Hearne continued. “It works to specifically shift our brainwaves into the frequencies that allow us to access deep rest. … Yoga Nidra promotes this really, deep state of relaxation, and it's referred to as the hypnagogic state. It's the state between being awake and being asleep.”

As with any yoga, it’s a personal practice, and each person and instructor may have different experiences and protocols. Some Yoga Nidra practices encourage sleep while other instructors inspire practitioners to stay awake. Yoga Nidra also can be practiced while lying down or in a chair. 

Hearne explained that the brain enters a state of really deep relaxation in Yoga Nidra that is similar to sleep and mimics sleep, however, it’s more like a “conscious rest.” 

“We're making a conscious decision to let our brain rest,” Hearne said. “So, that's what really sets Yoga Nidra apart from many other forms of meditation. There are traditional mindfulness meditations where the mind stays really alert and focused, but in Yoga Nidra, we have this specific protocol that really lulls the mind into this deep state of relaxation.”

Traditional yoga nidra protocol:

• Set an intention or sankalpa
• Find an inner source
• Body scan
• Breath awareness
• Emotions and feelings awareness
• Witness thoughts and beliefs
• Intention and open awareness

Hearne broke down the protocol steps and the reasoning behind them.

Setting an intention is liken to planting a seed and serves as an anchor for the practice. It should be in the present tense and short, such as I am strong. I am healthy. I fall asleep easily and wake up refreshed (if using for sleep).

“Turning our energy away from where we don't want it to go, and then pointing it, directing it, where we do want it to go,” Hearne said. 

Identifying an inner resource can be an image or thought that promotes a sense of safety or ease that the practitioner can return to during the session. 

“This is something that I think people don't talk about a lot,” Hearne said. “Sometimes meditation can bring up some difficult emotions, especially when you first start practicing. So, we always encourage people at the beginning of a practice to set an inner resource, some memory, some thought, some image that you can bring to mind if you start to feel those difficult emotions, and you just need something to come back to.” 

Scanning the body helps create the mind-body connection, and the breath awareness and controlling the breath helps regulate the nervous system. After that the protocol encourages people to observe thoughts, emotions and beliefs. 

“This creates a space more for self-inquiry,” Hearne said. “And then finally, we allow folks to kind of rest in a deep state of relaxation. So just no words – nowhere to be -- nothing to do, just this state of being.”

Benefits of Yoga Nidra

Improving and helping people achieve deep sleep is one of the more recognizable benefits of Yoga Nidra. And while Yoga Nidra can mimic sleep it is not a substitute for sleep. 

“Sleep is something that can be largely impacted after a brain injury,” Hearne said. “We all know how important sleep can be, how important rest is for recovery. And so, when you have that foundation of poor sleep, that can just undermine the recovery and creates a domino effect. It just kind of exacerbates all the other symptoms we have. So, it's really important that we address these issues, especially the issue of sleep. And that is where Yoga Nidra comes in.

“I think it is probably the most profound benefit of Yoga Nidra, because sleep is such a critical foundation for everything else,” Hearne continued. “By guiding the body into this deep state of relaxation, Yoga Nidra, in some ways helps to reset the circadian rhythm, and stimulates the release of melatonin. That's a key hormone for restful sleep, especially the natural melatonin that your body makes.

“The rest that your brain is able to access from practicing Yoga Nidra is being compared to the rest your body would get from about three hours of sleep. So, I'm excited to see what that research actually comes out to. It just speaks to how powerful it is to supporting rest, and how important rest is to supporting everything else in our lives.”

Automatic negative thought (ANTS) patterns and rumination can be intensified after a brain injury, and yoga nidra can help TBI survivors break these destructive patterns. 

“These negative thought patterns can become really deep and unconscious,” Hearne said. “What that means is that they happen without someone even trying to think them. People kind of get stuck in this loop of feeling like, no one cares; they might feel hopeless depending on what their situation is; they might feel like something's wrong with them.

“This loop just continues, and then this just exacerbates all of the other symptoms. It's kind of like how poor sleep exacerbates everything else. These negative thought patterns just exacerbate all of our other symptoms leading to poor sleep, anxiety, depression.”

Hearne credited neuroplasticity -- the brain’s ability to adapt, reorganize and create new connections -- in helping the brain break these ANTS, and yoga nidra’s ability to facilitate neuroplasticity. 

“In yoga therapy, the idea of neuroplasticity is explained by what's called a samskara. The word samskara is the mental imprint that your mind receives through thoughts and through actions,” she said. “So essentially, each time we have a thought, each time we have a thought pattern, and each time we return to it, we're really just reinforcing all of those neural pathways in our mind that kind of validate that thought pattern. … When we take into account these negative thought patterns typically or very often do accompany a brain injury.

“Those habitual and recurring thoughts are only being strengthened and reinforced by returning to them. We need to interrupt these negative thought patterns and create new and more helpful ways of thinking. And that really is the power of Yoga Nidra, and specifically that first step I mentioned -- setting an intention. Planting new seeds.”

Other benefits of Yoga Nidra are reducing muscular tension, decreasing anxiety and stress, relieving symptoms of depression by lowering cortisol, and releasing calming neurotransmitters such as GABA, melatonin and serotonin. 

Brain Monitoring Reveals Yoga Nidra’s Benefits 

Ongoing research on Yoga Nidra continues, however, one study Hearne referenced showed how brainwaves change during a Yoga Nidra session. 

Five Brainwaves Explained

• • Gamma (30+ Hz) – The fastest brainwaves, linked to peak focus, higher cognitive function, learning, retrieval
  • Beta (13-30 Hz) – Attention, problem solving, decision making
  • Alpha (8-13 Hz) – Meditation, mindfulness, light daydreaming 
  • Theta (4-8 Hz) – Rapid Eye Movement (REM) sleep, light sleep
  • Delta (0.5-4 Hz) – Non-REM sleep, deep, restorative sleep 

• Source: https://www.neuronic.online/blog/what-are-the-different-types-of-brain-waves

“One thing I like to emphasize about these brainwaves is that typically we're not just in one state or the other,” Hearne explained. “The brain can experience multiple states at the same time. And brainwave activity is not uniform across the whole brain, so different regions of the brain that are responsible for different processes, different experiences, (the brain) can be experiencing different types of brainwaves at the same time. In Yoga Nidra the brain operates as if it's in deep sleep … Yet, you're still cognizant of your experience, even if you don't remember it.” 

Hearne then showed slides of a research study involving seven people practicing Yoga Nidra while hooked up to an EEG machine to measure brainwaves while also undergoing at PET scan to show what parts of the brain were active during the different stages of Yoga Nidra.

Courtesy of LoveYourBrain Foundation

The study revealed that the frontal lobe of the brain, which controls executive functions, such as planning and decision-making, was not active during Yoga Nidra. The parts of the brain that were active control visual and emotional processing

The last photo Hearne showed was the brain in the deepest point of Yoga Nidra.

“We see that the temporal lobe (auditory and encoding memory) was particularly active here, and this is associated with empathy, with compassion, with perspective taking,” she explained. “The main takeaway of all of this is just noting the ability for individuals to be both in this deep state of relaxation while still having some control over the brain's activity with a pretty high degree of concentration. Some people describe it as this feeling of almost effortless concentration.” 

Courtesy of LoveYourBrain Foundation

When to Practice Yoga Nidra

Many people use Yoga Nidra to lull them to sleep by releasing muscle tension and quieting the busy mind. Others like to practice during the day to halt fatigue and rumination.  

“A lot of people benefit from more of a midday practice, especially to support cognitive fatigue,” Hearne said. “Again, as I mentioned, there's a lot of great research that hasn't fully come out yet, but it indicates that getting in a Yoga Nidra practice that rest can be equivalent to three or so hours of sleep. So, this can be really supportive midday if you feel an overwhelm of fatigue or cognitive fatigue to take a moment to allow yourself to access this deep rest.”

Yoga is described as a practice, and it’s the continued practice that can have the most profound impact on a TBI survivor’s life and recovery. 

“That accumulation of practicing it over a period of time is eventually going to allow you, hopefully, to access some more meaningful sleep before bed. 

“When we train our muscles, when we train any part of our physical body, we see the benefits over time. And it's the same way with meditation, any kind of mental or mindfulness practice, we're training our minds to be able to access this rest and this mindfulness. The more we practice, the stronger it'll get.”

FREE Resources for Yoga Nidra

• LoveYourBrain Foundation 

• • https://www.loveyourbrain.com/
  • https://www.loveyourbrain.com/train-with-us
  • https://www.loveyourbrain.com/meditation?ref=bar
  • https://www.loveyourbrain.com/brain-injury-holistic-resources-guide?ref=home_page_block

• Insight Timer

• • https://insighttimer.com/
  • https://insighttimer.com/meditation-topics/yoganidra
  • https://insighttimer.com/sleep/sleep-music

• iRest

• https://shop.irest.org/pages/try-irest-now

Link to LoveYourBrain PowerPoint Presentation

Jena Taylor

TBI survivor, resilience strategist, and speaker, Jena helps people reclaim their lives through practical resilience strategies rooted in real-life experience, recovery, and rebuilding. Jena teaches individuals and organizations how to navigate burnout, adversity, and life transitions with greater steadiness, strength, and resilience. Grab the resilient skills cheat sheet.

By Eliza Marie Somers

Dr. MaryAnn Keatley, a co-founder of the Brain Injury Hope Foundation, explains HBOT or hyperbaric oxygen therapy, in this graphic.

Treating a brain injury takes a team of healthcare professionals, including physical therapists, occupational therapists, speech therapists and neurologists, just to name a few. And putting together your “dream team” can be a monumental task yet an important part of recovery. 

To help brain injury survivors and their families navigate the maze of rehabilitation professionals, the Brain Injury Hope Foundation invited four specialists to its April 10, 2026, Survivor Series: Brain Injury Treatment Panel: Options for Health and Wellness.

The April 10, 2026, Panel

• Dr. Amy Elsila, OD
  Neuro-optometrist
  Neuro-Vision Therapy Institute
  https://neurovti.com/meet-dr-amy-elsila/
  https://neurovti.com/vision-rehabilitation/concussion-recovery/

720-408-1400

• Rachel Walker, ND, LMT
  Naturopathic medicine
  Dr. Borman Chiropractic & Naturopathic Medicine
  https://www.drborman.com/
  303-759-8514
• Michelle Ranae Wild
  Founder BEST – Brain Education Strategies & Technology
  https://bestconnections.org/
  michelle@bestconnections.org
• Doris Sanders
  Brain Injury Survivor

Naturopathic doctor Rachel Walker described naturopathic practitioners as healthcare providers who treat the whole person. “All the interconnectedness of all the systems,” she said. This includes but not limited to anatomy, physiology, clinical diagnosis, nutrition, lifestyle and herbal sciences. 

“We bring in different medical traditions from all over the world,” Walker said. “We're trying to use all these different tools to find what works best for the individual. And we're trying to do it with the least force intervention in a way that works with nature and works with the natural inner workings of the human body. 

“We do work alongside other providers in a complementary and also very much in the preventative side of medicine.” 

• Clinical descriptions of providers https://biausa.org/brain-injury/about-brain-injury/treatment/clinician-descriptions

• Naturopathic medical education includes a strong foundation in biomedical sciences—including anatomy, physiology, pathology, and clinical diagnosis—along with in-depth training in nutrition, lifestyle medicine, botanical medicine, and physical medicine, according to the Colorado Association of Naturopathic Doctors. All naturopathic doctors must be registered and license in the state of Colorado. https://dpo.colorado.gov/Naturopathy

One of the major tools Walker uses in her practice is nutrition and dietary recommendations as numerous benefits can be accomplished with food. 

“There’s this connection between the gut and the brain,” she said. “There’s also the blood-brain barrier, and then there's the barrier that’s the intestinal lining, and when you have a brain injury, they're both (impacted).”

Walker said these barriers can be “leaky,” which can lead to numerous health problems such as fatigue, joint pain, skin rashes (eczema/acne), brain fog and chronic inflammation. 

According to Harvard Medical Publishing when the intestines are working properly, the tight barrier controls what gets absorbed into the bloodstream. An unhealthy gut lining may have large cracks or holes, allowing partially digested food, toxins and bugs to penetrate the tissues beneath it. A common initial step some practitioners take is to remove foods that can be inflammatory and could promote changes in the gut flora. Among the most common are alcohol, processed foods, certain medications, and any foods that may cause allergies or sensitivities.

• Link to Harvard Medical Publishing article on Leaky Gut https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451

“You don't want to be too strict with the diet” Walker explained. “I mean, when you're already going through all the symptoms of a head injury and brain fog or cognitive issues, trying to stick to something that's pretty rigid is not in anyone's best interest, but we do like an anti-inflammatory diet. So really limiting processed foods, adding healthy fats … I suggest to every patient that they go on omega-3 fatty acids.”

Another supplement Walker recommends in magnesium, but not any magnesium. “Magnesium L-Threonate. The L is inconsequential. Glycinate, orotate, malate, etc. are also fine, but there is research to suggest that threonate can cross the blood brain barrier more readily,” she explained. “Magnesium citrate is generally used for GI issues, but the one side effect of magnesium you'll usually see is diarrhea, and this one would be the one to do that to you. The others can also cause looser stools.”

• For more information on Magnesium-L-threonate https://www.medicalnewstoday.com/articles/magnesium-threonate#summary

• Seven type of magnesium https://www.nebraskamed.com/health/healthy-lifestyle/primary-care/7-types-of-magnesium-which-form-is-right-for-you 

Staying hydrated and getting good quality sleep are essential, especially after a brain injury, Walker noted. She also wants patients to limit sugar, and recommends a glucose monitor as a TBI can cause survivors to become less sensitive to insulin.

• More on TBI and insulin sensitivity

•  https://neuliferehab.com/hypoglycemia-with-a-traumatic-brain-injury/

• https://www.flintrehab.com/diabetes-and-brain-injury/?srsltid=AfmBOopQqyh6Uiqg22_t9zKddSjNWBs2diB2g3F9fT7-cQkYS-oIMr0

“I do a lot of continuous glucose monitoring with some of my patients,” she said. “It's not necessarily that you have diabetes or your A1C is up or anything like that. It's so amazing, you can get so much information. With a continuous glucose monitor, you can just slap this thing on, and for a couple weeks, it goes right to your phone, so you know exactly where your blood sugar is at. It's an amazing technology.”

“It would be so great to have one that you would just slap on your forehead, and it would tell you what your brain is doing with that glucose, but of course, we're not there yet. That's not a real thing; I made that up,” she said. 

One of the obstacles Walker faces when treating TBI survivors is the nutraceutical industry or supplement industry, which is not regulated in the United States.  

“It's just overwhelming … It's expensive. It's time consuming, and it could be interacting with your other medications. It could be very dangerous,” Walker said of patients going to the internet and adding supplements to their routine. “Don't just Google. You need to come see me first, and we'll talk you down from some of this stuff. That's very important to me. And if I do put people on nutraceuticals, I like for there to be a timeline, so it's not like, here, take this forever, and that's part of who you are now. There needs to be a reason for taking it, and a reason to discontinuing it.”

• Consumer Labs a division of Consumer Reports tests supplements, along with posting recalls and warnings, drug interactions. https://www.consumerlab.com/

Walker stressed a team approach to treating a brain injury is essential and finding a naturopath who will work with your other providers can be beneficial to a survivor’s recovery.

“A brain injury affects the whole body. Nothing's in a vacuum. So, you will really do well to find a naturopath who can help you navigate with all these other specialists that you need to see, because, of course, it takes a team when you've got something this important on your hands,” she said.

Vision Therapy Is Not 20-20

A vision therapist is often recommended after a brain injury, and may be the missing link to your successful recovery. But what exactly is vision therapy or neuro-optometric rehabilitation?  

“We think a lot about the visual structure of the eyeball and how well we see,” Dr. Amy Elsila said. “We might be using terminology like clarity of vision and 20-20 vision, but our vision is so much more than that. The point that I really want to impart is that vision is located throughout the brain. It usually surprises folks that there are 34 different centers in our brain that are dedicated to processing visual information.

“And between those 34 centers, there’s 300 connections. … No matter the location or severity of the injury, it’s going to impact the visual system in some way.”

Some of the common symptoms Elsila sees in TBI survivors are:

• Light sensitivity
• Blurred vision
• Eye pain/strain
• Headaches
• Double vision
• Loss of field of vision 
• Loss of depth perception 
• Eye tracking

Eye tracking is one issue that seems to come up frequently with brain injury survivors.

“Tracking, following something in motion, like following a ball, or when you're driving a car watching another car move past,” Elsila explained. “It’s hugely important to the way that we read. So, thinking about reading a sentence across the paper, our eyes actually move in a series of jump eye movements, so imagine that sentence, jump, jump, jump to the end of the line and jump to the next. So, we're looking at tracking accuracy, and not only the accuracy, but also how the patient feels.

“Sometimes visual motion can be highly overstimulating. Nausea and dizziness are not uncommon. Patients who loved to read before their injury and now are really unable to read comfortably a few sentences, so we're looking at tracking accuracy. We're also looking at the alignment of the eyes to see if there's any misalignment that could cause double vision or visual strain.”

When the eyes don’t work together it is referred to a binocular vision dysfunction or BVD and can lead to convergence or divergence issues. 

“Looking at a cell phone or looking up close requires us to point our eyes together as a team (convergence). Looking across the room would require the eyes to move outward, divergent,” Elsila said. 

“When we have a mismatch, the brain is looking for safety, and the brain is looking for stability,” Elsila explained. “So, the brain is pretty smart. It might create an adaptation where it ignores the blurry image. We call that visual suppression. And it might become more heavily reliant on that better seeing eye.”

Some treatment options include special lenses, therapeutic prisms and therapeutic tints, along with exercises to retrain the brain-eye connection and create new pathways in the brain. 

“I think a good analogy is thinking about it like physical therapy for the visual system,” Elsila said. “So, what we’re doing is we’re retraining that eye-brain connection … it’s not typically a weak muscle that we're treating, it’s the connection and the kind of the collaboration between the two eyes that we're retraining.

“Vision is throughout the brain, and it impacts a whole lot more than just our sight or clarity of vision. … Vision therapy is also a therapy that can enhance or improve outcomes in other therapies, because the eyes are leading the body through space, that’s going to help us in our physical therapy activities. 

“Vision is our dominant sense. So, it’s certainly a great gateway into treating the brain. …. Our eyes are just an extension of our brain.” 

More on vision therapy Resources:

• https://www.impactvisiontherapy.com/eye-care-services/neuro-optometric-rehabilitation/traumatic-brain-injury-rehabilitation/

• https://www.concussionalliance.org/vision-therapy#diagnosis-and-treatment-options

• Find a provider https://nora.memberclicks.net/find-a-provider#/

• Neuro-Vision Therapy Institute Website: neurovti.com

• Neuro-Optometric Rehabilitation Association (NORA): noravisionrehab.org
• Optometric Vision Development and Rehabilitation Association (OVDRA) / College of Optometrists in Vision Development (COVD): ovdra.org

HBOT and Brain Injury Recovery 

Brain injury survivor and thriver Doris Sanders is a proponent of hyperbaric oxygen therapy (HBOT), and she has found great results with the therapy, so much so she bought a chamber to use at home.

Along with helping with her concussion symptoms, Sanders said the HBOT sessions helped activate immune system and helped heal wounds.

“I recently had quite a bad sore which was infected,” Sanders said. “I used the oxygen therapy, and the doctors were amazed at how quickly I got healed. The other thing is, it helps with your immune system.”

A hyperbaric oxygen therapy session takes about 45-60 minutes. The client sits or reclines in a chamber while concentrated oxygen is pumped into the chamber in order to increase oxygen in the blood and tissues. HBOT was first used to treat deep sea divers who experienced decompression sickness. 

TBI survivors have experienced help with cognitive abilities, including executive function, information processing speed, attention, memory, and motor skills after a session. Meanwhile some studies have revealed widespread differences in results. https://www.health.mil/Reference-Center/Publications/2025/07/25/Hyperbaric-Oxygen-Therapy-and-TBI 

Either way, Sanders said HBOT has increased her abilities to function after suffering numerous brain injuries. As a young girl, she worked on a ranch and was kicked in the head by a horse. She also loved racing her motorcycle and jumping out of airplanes. 

“Those were the kind of activities that I really enjoyed, and so I kept having blows to the head,” she said.

HBOT can be expensive and is not covered by insurance. However, Sanders put together a list of places that offer discounts for sessions.  Here is a link to the PDF.

• For more on HBOT 

• https://www.brainline.org/treatment-hub/hyperbaric-oxygen-therapy-hbot

• https://www.flintrehab.com/hyperbaric-oxygen-therapy-for-brain-injury/?srsltid=AfmBOorqxN16_tjmqrGATOPFosXB7VwkLJFU05bzAuXlnmFQW13i6PR7

• https://www.concussionalliance.org/blog/hbot-alleviates-chronic-neurocognitive-symptoms

Technology to Enhance TBI Recovery

Michelle Ranae Wild, founder of BEST – Brain Education Strategies Technology, has spent more than 40 years “teaching adults living with brain injury how to deal with the challenges that they have in an educational environment.”

Wild, who has a degree in psychology, said helping TBI survivors is a passion she holds dearly.

“It’s something that I have a huge passion for, and I’m very interested in the concept of brain injury,” she explained. “I love the idea that I can always come up with more strategies and more things to try to help people with brain injuries. 

“As we know, every person with a brain injury might have similar kinds of challenges, but what works for one person doesn’t always work for another person. That’s a huge challenge for people in my profession, because it’s not one-size-fits-all.” 

Wild said she would be “bored” if there were not challenges to helping TBI survivors. 

“I don’t get discouraged when it doesn’t work the first time or the second time because I’ve done this long enough to know that it really takes a while to find the right strategies or the right approach for each individual.”

• For more information on BEST 

• https://braininjuryhopefoundation.org/technology-tools-for-cognitive-performance/

• BESTConnections.org

Wild’s nonprofit BEST focuses on executive function challenges facing survivors. 

“Cognitive skills, I’m talking about thinking skills, organization, decision-making, and problem solving, and attention and memory. All those very standard cognitive skills, executive function skills that we talk about when we talk about brain injury,” she said, adding that she started BEST because of the financial strain people face after a brain injury.

“I understand the implication of brain injury financially. I know that many people after a brain injury deal with financial struggles,” Wild explained. “So, my goal was to really create something that would allow people to benefit, basically, from learning about the cognitive challenges they have, and to do it in an environment that they could afford and felt safe in.”

BEST offers free programs along with a paid membership program - $10 monthly or $100 yearly. The free programs include webinars and deep dive workshops, along with apps.  

“We do 24 webinars a year, the second and the fourth Saturdays of the month,” Wild said. “Some of them are cognitive in nature, some of them are behavioral.”

The Zoom webinars are also topic based, such as brain injury from the caregiver’s perspective, and how to deal with automatic negative thoughts or ANTS.  

BEST offers free apps that can help brain injury survivors navigate their day with reminders. The nonprofit is currently updating their apps and introducing a new app – StrategizeMyLife.

“App development and apps is something I’ve been interested in for about the last 15 years,” Wild explained “Before I even started BEST, I was very interested in technology and using technology with those living with brain injury. And so over the course of the last 15 years, I’ve developed quite a few different apps.

“We’re actually revamping our apps a little bit right now in order to re-release them with some of the latest technology.”

One free app BEST is currently finalizing is StrategizeMyLife, which is in beta release with an official launch in May 2026. 

Wild said that during the Survivor Series she was thinking how survivors could use her new app by adding vision therapy to their routine. 

“You could put those strategies in StrategizeMyLife,” she said. “In fact, I have a number of individuals that I've worked with over time that have vision therapy as a category. And so, when they have a flare of some issues, they go to StrategizeMyLife, and they look at those strategies, and they’re right there where they need them, and they’re able to use them.

“Same thing with fight-or-flight. If someone had fight-or-flight issues, they could enter the strategies that they know work for them when they are in that fight-or-flight state,” she explained. “It's just a common place that people can enter strategies and rate them in terms of how effective they are for that person. So, one strategy might work really well for one person, but it doesn't work for others.” 

Wild mentioned a challenge many survivors often feel is being overwhelmed by all the therapies and work they face in a lifetime of recovery, something the other panelists cited.

“Feelings of being overwhelmed, trying to do too much. A lot of people want to be able to do what they did before their injury, and that’s a huge challenge,” Wild said. “That becomes a big factor.”

Wild stressed “Scale Up Not Back” as one of her strategies to fight fatigue that comes with being overwhelmed. 

“Starting off slow and steady, and scaling up from there,” she said. “For instance, if you’re reading a book, don’t try to read the entire chapter. Maybe the entire chapter is too much for you. Read a few pages. See how that feels, and then if you have more energy and you have more time, you can always add more pages.

“My focus is really on helping people pace themselves so that they don’t end up overdoing it, and then wiping themselves out, because the negative effect of that can be several days or several hours.”

Another challenge Wild sees in TBI survivors is behavioral changes.

“I don't think it's uncommon for people’s behavior to change after a brain injury. Sometimes they just get more frustrated. They were never a person that got frustrated before, and now things just kind of frustrate them. Or they may get angry about things,” she said. 

“I get a lot of feedback from BESTies that what we do really helps guide them. It gives them a path. It serves as a guiding place for them, because we try to break things down. I try to help them identify what their particular challenges are, and then often we will spend time trying to figure out what specific things will work for them.”

By Eliza Marie Somers

Brain injury survivors and their families possess legal rights; however, many survivors don’t know about these rights or about resources that are available through federal and state government agencies.

To help survivors and their families, the Brain Injury Hope Foundation (BIHF) gathered a team of experts for its March 13, 2026, Survivor Series – Legal Panel: Avenues to Pursue if a Brain Injury Survivor Has Challenging Legal Issues.
Attorney Rebecca Albano, who is a BIHF board member, had her first TBI case in 2007 when it was even more difficult to prove to juries that brain injuries have serious consequences.

“There’s been a lot of mentions throughout this conference on the invisibility of the injury and the challenges associated with that,” Albano explained. “When I first litigated these cases, we could not get an insurance company to offer anything on these. It was like … it wasn't real, it was fake. It was horrible.”
“It became clear that it was an injury that was really underrepresented in terms of lawyers, who were willing to take the cases on,” Albano added. “Lawyers who were willing to give the time and the patience that it took to be the counselor part of the lawyer role. A lot of lawyers don't have the patience for it. And so over the years, it just was something that I had a lot of passion for, and I think it's just something that jurors have a lot of passion for because whenever I choose a jury and I ask, how many here have known someone or been affiliated with this injury, the entire pool raises their hand.”

However, having a jury pool that knows about TBI doesn’t mean going to trial against insurance companies is a victory in hand. Clients need to decide whether to risk going to court or taking a settlement, and they have to be aware that they will have to pay court costs if they lose, according to Colorado law.

“I think we in Colorado have a very good set of laws, judges, etc., to try to help folks who are injured,” Albano said. “But I also would say the system is still very difficult, especially for folks navigating a TBI. And not every case is a trial, meaning there might be risks associated with that case that I would tell the individual, ‘Hey, look, I think this is a risky case because I think the jury might not side with you, or something like that. And the reason for that is, is we are a loser-pays-cost state.”

Albano also helps her clients “navigate the systems of care. … We have been through this system so much. I can say, ‘Look, I think that you need to see your physician and outline these items, because when I'm talking with you, I'm noticing these few things.”

“We represent (clients) through the entire process in terms of the pre-litigation, meaning we're trying to work through their claim with the insurance company to try to get them compensated for lost wages and medicals, and all of those types of things. And then through trial, if that's where it leads.”

“But the main thing is, is making sure that (the client) understand the process … You know, I think that people get confused about what benefits are available, or what coverages are available. In Colorado, not everybody driving around on the road is carrying a million dollars in coverage, despite what we see on TV during daytime television.”

Almost immediately after an injury a TBI survivor may start getting phone calls and letters from insurance companies seeking information that might not be in the survivor’s best interests. An example is third party (not first party) insurance companies will ask for a medical release form, and as Albano noted this can allow an insurance company to get access to all of your medical records, for sometimes an indiscriminate period of time that they don't get under Colorado law.
“They may not have access to those full records,” Albano said. “You have to be careful in terms of phone calls, and the urgency in terms of resolving the claim. Sometimes insurance adjusters will say, ‘Oh, we're closing your claim.’ Well, they can't close your claim unless you're beyond the statute of limitation. They don't have the power to say, ‘Oh, you don't have a claim.”

Insurance companies also will try to settle claims early after an injury, and Albano cautions that the offer might look generous, but what the survivor might not realize is that you might have to pay your health insurance company back from your settlement.

“It’s also extremely important to understand the extent of your injuries,” Albano said. “You may have a long-lasting injury, and if you do sign on that line, that's it. You're out of luck. There's nothing, most of the time, that we can do for you in terms of moving forward. So, proceed with caution, take time, don't rush to any judgment in terms of how to proceed. You just need to make sure that you understand your rights.”

The legal process is not an easy task to undertake, especially after a person suffers a brain injury. It can involve a deposition, interrogatories, requests for admission and production of documents, mediation, and eventually a trial, which can range from three to 12 days. The whole process can take 12 months to up to two to three (or more) years.

“It can be an exhausting and difficult process for an injured person,” Albano said. “Especially in a complicated case. … it is incredibly hard financially, emotionally, and everything in between in terms of, of trying to survive it.”

“The best advice that I can give is to just take it one step at a time and surround yourself with supportive folks, and try to plan ahead as best you can.”

Attorney Rebecca Albano can be reached at 303-815-1592 or https://www.lawofficealbano.com

Social Security Disability Insurance

Panelist James Noel specializes in disability claims with an emphasis on Social Security disability cases.

“Social Security disability (SSDI) is an insurance program that we're all paying into,” said Noel, who has been practicing disability law for about 40 years. “I specialize in mental impairments, which is what Social Security uses a lot, or neurological impairments. They're interesting to me.”

“I'm sure we've all heard this before, you look OK. But it's really not judging a book by its cover. What we do is we look at the neurological findings, the cognitive findings, and that kind of thing in terms of whether the individual can sustain a full-time job. That's pretty much the criteria for Social Security disability.”

https://www.ssa.gov/benefits/disability/qualify.html

Noel explained SSDI is for impairments that last a period of longer than 12 months and prevent the person from sustaining full-time employment. Supplemental Security Income is another Social Security program for the disabled, and it is a welfare needs-based program. https://www.ssa.gov/ssi/eligibility

To apply for SSDI takes a bit of supporting evidence paperwork from medical diagnosis and test results to daily activities or Activities of Daily Living, which requires filling out a 10-page Function Report. https://www.ssa.gov/forms/ssa-3373-bk.pdf

“A function report is, who does the laundry, the shopping, the cooking, the cleaning, the driving, etc. the more ADLs you do, it kind of hurts your case,” Noel explained. “So, it's often helpful to have a spouse or a friend or a relative complete a function report, and describe your difficulties in performing the activities of daily living. They need to be consistent when they're finding a disability.”

The gold standard in medical evidence in brain injury cases is neuropsychological testing, which can take up to eight hours. The test includes a comprehensive evaluation of cognitive, behavioral, and emotional functioning, designed to map brain-behavior relationships. It involves standardized tests to measure memory, attention, executive function, and language. https://www.viennapsychologicalgroup.com/what-conditions-do-neuropsychologists-evaluate/

Physical limitations also are considered for SSDI cases, and add validity to a person’s case. 

“With physical injuries, we always look at the ability to sit, stand, walk, lift, carry, push, pull. Those are the basic exertional demands of employment, according to Social Security,” Noel said. “And in order to prevail in a case, you've got to have those down pretty low, certainly below eight hours a day, five days a week, or equivalent work schedule.

“The mantra here is whether the individual can engage in full-time employment.”

Noel also noted that age is a contributing factor in accessing SSDI benefits. 

“I want to get to age, age, and age -- you know, how real estate guys say, location, location, location. The older you are, the easier it is to get disability. The two points are age 50 and age 55,” Noel explained. “Being an old guy, I know you can't teach me new tricks, and that's kind of what happens with the medical vocational guidelines. But if you get to your full retirement age (generally 66 or 67), you're already getting what Social Security can offer as disability.”

Now that a client has completed all the paperwork, it can take up to 10 months or even a few years to get enrolled in SSDI. 

“I need to caution people that they're taking about eight to 10 months to make an initial decision at the Colorado Disability Determination Services. And unfortunately, 60 percent of those cases are denials,” Noel explained. “Then you go to something called reconsideration, which is another six to eight months in the process. And if you submit new evidence, you may get a reversal and an allowance of benefits. But it's really pretty hard to get into that reconsideration. About a 20 percent chance there. And from there, you get your due process. You go on to your administrative law judge.” 

However, during the Survivor Series panel discussion news sources reported that Social Security changed its determination process by transitioning the processing of medical Continuing Disability Reviews from State Disability Determination Services to the SSDI federal processing site, Disability Case Review. From the Social Security Administration https://www.ssa.gov/news/en/advocates/2026-03-12.html  and https://content.govdelivery.com/accounts/USSSA/bulletins/40df010

• More news concerning recent change

• https://www.womansworld.com/life/money/social-security-just-changed-disability-reviews-heres-what-it-means
• https://www.newsweek.com/social-security-announces-big-change-impacting-millions-11669902
• https://www.nickortizlaw.com/ssa-announces-change-to-continuing-disability-reviews/

If you are concerned about costs to hire an attorney for your SSDI case, Noel and most SSDI attorneys take cases on a contingency bases, and attorneys get paid by fee agreement that is heavily regulated by Social Security.

“Attorneys can charge a contingent fee, 25 percent of past due benefits, and there's a $9,200 cap on the contingent fee. Clients don't need any upfront money to engage a lawyer,” Noel explained. 

Attorney James Noel can be reached at 303-761-2322 https://noel.law/ 

• For more information on benefits for TBI survivors see a previous BIHF Survivor Series, which includes help from Ability Connection Colorado with educational opportunities and housing benefits. 

• https://www.abilityconnectioncolorado.org/ 

• https://braininjuryhopefoundation.org/navigating-the-benefits-system-after-a-brain-injury/

Inside a Courtroom

District Judge H. Clay Hurst, 18th District Arapahoe County, joined the BIHF Survivor Series to give TBI survivors and caretakers a glimpse inside a courtroom. Judge Hurst, who has been on the bench for almost 14 years, has been involved in family law, juvenile, probate, trusts and estates, and civil matters.

“I deal with guardianships, conservatorships, all of the mental health cases in the district that I work in. I do trust in estates,” Judge Hurst said.

“In Colorado, a guardianship is, after being proven by clear and convincing evidence, the court can appoint a guardian to take over the decision-making and responsibilities for someone incapacitated,” Judge Hurst explained. “That means a person unable to effectively receive or evaluate information, or both. Or they may not be able to communicate what they want or need to the extent that it impacts their physical health, safety, and welfare.”

“It's a little bit higher standard to be a guardian than it is a conservator. A conservator is focused on how to manage people's money, and to make sure they're not taken advantage of, or they're not wasting or dissipating what they have earned.”

District Court Judge H. Clay Hurst works with guardianships and conservatorships.

The judge gave an example of a person who worked all their life and after a serious accident the person is unable to evaluate the things that go into running an estate, such as paying bills on time, and they're susceptible to being taken advantage of by family, friends or neighbors or even on social media.

Judge Hurst said he evaluates cases by talking with family members and gauging medical records, especially if a family comes to court without attorney representation. 

“What I've learned is the ability to analyze the neuropsych testing, the information that's provided by court personnel that go out to visit, by looking at doctor letters, and then just having a general discussion with the people,” he said. “Oftentimes, I'll ask the party that's at issue questions to see how they're able to recall, how long it takes for them to make a decision, or answer a question. So, that's sort of the way I've been able to modify what I hear instead of just sitting on the bench and saying prove it to me or not. I'm willing to kind of work around that and get to what I need to find out so I can get them an order, if at all possible.” 

Dealing with TBI survivors brings a different dimension to a courtroom decision. 

“When you have somebody with a traumatic brain injury, or somebody that meets the definition of incapacitated, they often don't understand why it's happening, or that they need to have assistance,” Judge Hurst said. “In fact, I'm sure many folks that are observing or involved in this area can appreciate how somebody becomes angry because they were functioning before, and now they can't. We see that a lot with dementia people, where they start to lose their memory, and they get angry at times. … The goal is to make sure they're OK and safe and protected.” 

In Colorado, when a case is filed a court visitor is appointed who’s trained to interview people, look at their homes, talk with family and write a report for the court. 

“Another tool that's available is I can appoint a guardian ad litem. That is an attorney that is specialized in focusing on people's best interest,” Judge Hurst said. “And they are able to get all the medical records and talk to family. And maybe, come to a clearer understanding about what is in the party's best interest. We also provide them court-appointed counsel if they don't understand or want to contest the matter, or frankly, are just frustrated.”

Colorado established the Adult Protection Services program in 1983, and one of its missions is to improve the health, safety, and welfare of at-risk adult experiencing mistreatment or self-neglect. https://cdhs.colorado.gov/aps

“(APS) will provide assistance. They will give you stipends, if you're struggling. You just have to be willing to go in and ask for it. I know sometimes that can be humiliating and difficult, right?” Judge Hurst said. 

Deciding these court cases that involve family dynamics can be difficult at best. 

“You know, I think you've got to be supportive of everybody,” Judge Hurst said. “It’s difficult when you're going against a family member who doesn't understand why they need help.” 

Establishing Laws to help People with Disabilities

Meghan Baker, a senior staff attorney with Disability Law Colorado, also joined the Survivor Series to give an overview of mental health treatment in jails and prisons, nursing homes and psych hospitals, and how the law firm is helping to get state laws passed.  

“I do a sort of a variety of things,” Baker explained. “Most of my work has centered on helping people that are in facilities. I also play a role in several of our lawsuits. … I do a variety of things, from individual advocacy, systemic advocacy, legislation, so working on drafting and passing bills, working on policy changes, serving on task forces.”

As a small organization, Disability Law Colorado currently is focusing on legislation to help people with disabilities, and the law firm helped get the Colorado Olmsted bill passed last year.

The bill codified the U.S. Supreme Court’s 1999 “Olmstead” decision into Colorado state law. The Supreme Court’s decision basically states that keeping a person in a long-term care facility counts as discrimination under the Americans with Disabilities Act, and that people with disabilities have a right to live at home and receive care. 

• https://www.denver7.com/follow-up/new-law-protects-coloradans-with-disabilities-and-their-right-to-live-receive-care-at-home 

“We now have a state law that states the same thing,” Baker said “We've also been involved in Department of Justice complaints about people being warehoused in nursing homes. That one has now turned into a DOJ investigation about the state not transitioning people out of nursing facilities.”

Working with the TBI community, Baker has seen how survivors are often undiagnosed, which can lead to a person unable to follow the law. 

“I think one thing that a lot of people really don't appreciate about brain injuries is how individualized they are, and how we're talking about invisible disabilities and they’re often undiagnosed,” Baker said. “I've read a lot of statistics, and in the criminal justice system, something like 60 percent of people in prisons, they think have undiagnosed brain injuries.

“It impacts people as far as how they may struggle with some of the skills necessary to follow the laws at all times. … It can be a struggle for people in a lot of the settings in which we put people in these systems. You're expected to sort of follow very strict rules, schedules and regimens, and so there's not always a lot of awareness or accommodation of people who need help, or just need it to be approached differently.

“That adds a challenge of having to figure out how to navigate the services, and where do you fit, and what services do you need. Dealing with things like being told you need to go to a psychiatric hospital, that's not in line with what your treatment needs are.”

Baker has seen some positive changes in Colorado’s justice system with regards to helping people with disabilities get the treatment they need, 

“I think there are changes as far as a better appreciation of the differences between disabilities and not treating people all the same or having a single expectation of what an intellectual disability looks like or what a brain injury looks like.”

“But also, seeing the cross-disability issues of people don't always also fit in boxes and also, you don't have to necessarily know which box someone is in to treat them with respect and give them the accommodations that they need.”