Intimate partner violence sources

[1] Femicide is preventable | Femicide in Canada. (n.d.). Retrieved November 24, 2021, from https://femicideincanada.ca/callitfemicide2020.pdf.

[2] Gender Based Violence in Canada: Learn the facts. Canadian Women’s Foundation. (2021, November 5). Retrieved November 24, 2021, from https://canadianwomen.org/the-facts/gender-based-violence/.

[3] Mollayeva, T. et. al. “Sex & gender considerations in concussion research,” Concussion, 3(1), March 2018

[4] A. St. Ivany and D. Schminkey, “Intimate partner violence and traumatic brain injury: State of the science and next steps,” Fam. Community Heal., vol. 39, no. 2, pp. 129–137, 2016.

[5] N. Glass et. al, “Non-fatal Strangulation is an Important Risk Factor for Homicide of Women,” J. Emerg. Med., vol. 35, no. 3, pp. 329–335, 2008.

[6] Alberta Justice and Solicitor General and Alberta Crown Prosecution Service, “Domestic Violence Handbook for Police and Crown Prosecutors in Alberta,” Edmonton, AB, 2014.

[7] Haag, H. (L., Sokoloff, S., MacGregor, N., Broekstra, S., Cullen, N., & Colantonio, A. (2019). Battered and brain injured: Assessing knowledge of traumatic brain injury among intimate partner Violence Service Providers. Journal of Women’s Health, 28(7), 990–996. https://doi.org/10.1089/jwh.2018.7299

[8] K. M. Iverson, C. Dardis, A. Grillo, T.E. Galovski, & T. Pogoda. “Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women,” Compr. Psychiatry, vol. 92. pp. 13-21, 2019. https://doi.org/10.1016/j.comppsych.2019.05.001

[9] K. M. Iverson, C. Dardis, and T. K. Pogoda. “Traumatic brain injury and PTSD symptoms as a consequence of intimate partner violence,” Compr. Psychiatry, vol. 74. pp. 80-87, 2009.

[10, 11] Violent victimization of women with disabilities, 2014. The Government of Canada

[12] SOAR project Survivor Brochure

Motivate yourself to complete physical activity

For many people, a barrier to physical activity is that they don’t want to do it. This could be because they view it as challenging or unenjoyable. You may feel the same way, even though you know physical activity of any kind is good for you.

If you struggle with motivation when it comes to physical activity, here are some tips to help get you excited about moving.

1. Set goals

Many people work better when they have something to move towards. The same is true of physical activity. By setting goals, you will be more motivated to complete activities.

Example: Sarah wants to be able to walk a 5 kilometre race route. Every time she goes on a walk, she goes a little further each time.

Example: Bill wants to be able to touch his toes. He does simple yoga stretches each week to help improve his flexibility.

Your personal goals can be set around time, distance, an action – whatever you want. And when you reach those goals, don’t forget to celebrate them!

2. Create a reward system

Rewards are a great way to motivate yourself, particularly if you find that other motivation tips haven’t worked for you. By incorporating rewards into your physical activity plan, you associate the activity with something you want.

Example: If Ian goes on a walk 5 days a week for a month, he’ll get himself a present he’s wanted for a long time.

Example: If Eleanor completes all her at-home exercises for 6 months, she’ll reward herself with a trip to see the Atlantic Ocean.

Rewards can be short-term or long-term, and they can be anything. This could include a take-out dinner, a new outfit, or an hour of television. The choice is up to you!

3. Pick activities you enjoy

You won’t like every activity, and that’s totally normal. Many people engage in activities they don’t love because they think they have to do it to be healthy. But that’s not true!

For example, if you don’t like running, you don’t have to run. There are plenty of ways to move. By picking the activities you enjoy, you’ll be more likely to exercise – and like it.

Example: Jamie feels good when they stretch, so they do yoga 3 times a week.

Example: Cynthia tried doing pushups, but they weren’t the right fit for her. She now uses small wrist weights.

4. Ask friends or family to do it with you

When you have someone completing activities with you, it’s another external motivator that can make physical activity enjoyable. You can set goals or set up a friendly competition, and spend some quality time with them.

Example: Joanna and her sister use Zoom to perform a series of exercises together.

Example: Glen and his son go on walks together.

5. Track your progress

It can be kind of discouraging not to see any progress when you exercise. Progress with exercise isn’t something you can see quickly or easily. It’ll take time.

One way to see your progress and keep yourself motivated is to track your exercise. You can use this downloadable physical activity tracker, or use your own system (like an app on your phone) to record your exercise. Over time you will see your progress: you may lift more weight, walk farther, or do something faster.

Example: Marcus started being able to walk 1 kilometre in 20 minutes. 6 months later he can walk 1 kilometre in 15 minutes.

Example: Sandra started lifting 3 lbs. weight, and 3 months later was up to 5 lbs. weights.

6. Use music to motivate you

Many people enjoy music. It can be incredibly uplifting and influence mood and attitude. By incorporating music into your physical activity, you can increase your enjoyment.

It also doesn’t have to be music. Some people like to watch television or movies or listen to podcasts while they exercise.

7. Adjust how you define successful physical activity

Physical activity can quickly become a chore or feel like an obligation. While it is an important part of healthy living and rehabilitation, you should not punish yourself if you miss a session or don’t reach a goal.

Instead, change how you view successful physical activity. It doesn’t have to be all or nothing. Any exercise is better than none. And if you miss a day? That’s okay!

8. Schedule your exercise, and pick a time when you have the most energy

Many people have full days with lots going on, and try to cram physical activity into an already packed schedule. This can lead to some stress and often a lack of motivation.

Scheduling your physical activity can help ensure you have the time for it. You should also pick the times you have the most energy: for example, in the morning after you have breakfast.

Ideas for physical activity

Physical activity has a broad definition, and there are plenty of ways you can move. And remember – any sort of movement is better than nothing. If you are concerned about what forms of activity you can engage in, speak with your medical/rehabilitation team. They will have recommendations for you.

Some examples of physical activity include:

  • Walking
  • Dancing
  • Running
  • Swimming
  • Bicycling
  • Online fitness classes
  • Yoga
  • Stretching
  • Lifting weights
  • Outdoor games like catch
  • Jump rope
  • Community sports clubs for soccer, basketball, baseball, etc.
  • Skating
  • Tennis
  • Cleaning/yard work

This is just a small selection of possible physical activities. And remember, exercise is not just for your physical health – it helps with your mental and emotional health as well. That’s why it’s important to find activities you enjoy and make sure you include them in your daily living.

Ways to cope with pain at home

Pain can impact quality of life and rehabilitation. This is detrimental for both physical and mental health [1]. Chronic pain (which is consistent, long-term pain) can keep you from engaging in activities you like and engaging with others.

It can also contribute to sleep problems and impact your emotions. When you’re tired, you may notice that your pain threshold is actually worse, which then again contributes to bad sleep.

By learning to manage pain, you can improve your quality of life, manage other symptoms and focus on your rehabilitation and activities of daily living (ADLs).

Ask for help
If you are feeling pain and don’t know what to do about it, ask someone to help you. Your friends and family know you’re going through a lot, and they may be able to help you find specialists or help with other pain management techniques.
Attend counselling or support groups
Pain can lead to other issues: for example, depression [2]. Counselling and support groups can be helpful to manage your overall health and well-being. You may also find that there are other people going through something similar to you.
Avoid stressors
There are many possible sources of stress. Stress can make your pain worse [3], which can then lead to more stress.

If something is stressing you out, take a break from it. You should also make sure to keep track of your stressors, and ask for help if necessary.

Avoid substances such as alcohol, caffeine, and tobacco

Excessive consumption of substances such as alcohol can actually contribute to pain [4]. Any questions about substances should be directed to your medical team.

Care for yourself through healthy eating
We feel our best when we eat healthy foods and prioritize our nutrition. While you may be experiencing pain that makes it hard to focus on anything else, nutrition is still important. It can help you combat other potential health issues that may contribute to your pain.

Commit to developing a healthy sleep routine

Pain can interrupt sleep, which in turn leads to feelings of fatigue, anxiety, and more awareness of pain. It’s a cycle that can be incredibly difficult to break unless you start getting proper rest.

One way to work towards better sleep is to develop a healthy sleep routine.

Exercise (gently)
Sometimes pain can be related to stiffness or a lack of movement. In those cases, gentle exercises can provide some relief.
Find distractions
The more you focus on your pain, the more you may feel it. While you shouldn’t ignore your pain, finding distractions can be a good way to reduce/control your pain. This is because you’re specifically focusing on something else, which takes more of your attention away from the pain.

While this management strategy is often recommended, it may have different levels of effectiveness depending on the kind and severity of the pain [5] you are experiencing.

Track your pain
Pain is difficult for others to understand because everyone experiences pain in their own way. But the more information your treatment and rehabilitation teams have, the more they may be able to help you.

Tracking your pain using a chart or journal will not only help identify instances of pain, but may help identify what influences your pain. For example, you may feel more pain before bed because you’re fatigued. Taking more breaks throughout the day may help with that.

Work on breathing and meditation
Many people use breathing and meditation exercises to support both their mental and physical health. This can include pain management.

Two common ways to treat pain are physical therapy and medication. Physical therapy can help with improving mobility, identifying pain points, teaching proper stretching and exercise form and building your endurance for activities. Pacing strategies (strategies that help you move slowly through your day) taught to you by your therapist are also very important for managing chronic pain. It’s a long process but can yield positive results with time and patience.

Doctors may provide prescriptions for medication if appropriate. The prescription could be as simple as an over-the-counter medication. However, in some cases they may prescribe medications targeted to the type of pain that you are experiencing. It’s important for the patient to use prescribed medication correctly, and work with doctors continually for effective pain management.

Resources


Sources

[1] https://pubmed.ncbi.nlm.nih.gov/21752179/

[2] https://onlinelibrary.wiley.com/doi/abs/10.1046/j.0007-1331.2001.00727.x

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385458/

[5] https://pubmed.ncbi.nlm.nih.gov/15745617/

15 ways to stimulate creativity

The pandemic has been stressful for everyone, and for the majority of people has led to an increase in time at home and alone time. For some people, this has meant more time – and more inspiration – for creative projects. For others, it’s the opposite: they’re struggling to feel any inspiration.

Creative activities are when you make or participate in an enjoyable and fulfilling project. Whether you like to write, paint, draw, craft, cook, play music or do something else entirely, these are all examples of creative activities.

Reconnecting with your creativity can help improve your mental health during the pandemic and beyond. There have been several studies that explored how creativity can improve moods and cognitive health [1, 2, 3]. These studies explored a variety of creative activities, including visual arts, music, and writing.

Here are some ways you can stimulate your creativity.

1. Accept mistakes

Some people get frustrated when a creative project doesn’t turn out exactly how they wanted. If you’re constantly wanting everything to be perfect, you may find yourself struggling with your creativity. It can be discouraging to make or find a mistake, but instead of giving up on your creative endeavour, embrace it.

Practice reframing your view on mistakes. Don’t think of them as flaws, but as details that make your creative project unique. And remember – practice will help you make improvements to your skills in all areas of life.

2. Check in with your mood

How are you feeling today?

Your mood can impact your creativity. Studies have shown that positive moods can enhance creativity. So, if you’re feeling unhappy, angry, or sad, you may not want to engage in a creative activity.

Don’t push yourself to be creative if it’s not helping your mood. Instead, turn your attention to other ways you can make yourself happy.

3. Collaborate with others

Creativity doesn’t have to be a solo mission. Often asking for feedback from others or collaborating on a creative project with friends/family will help jumpstart your imagination.

4. Daydream

We’ve all been there – we’re supposed to be focusing on one thing, but our mind wanders. Why not let it?

You should keep safety in mind (you don’t want to daydream while cooking or doing your exercises), but having some daydreaming time can be a great way to spark creativity. Keep a journal close at hand so that if you have a good idea, you can jot it down.

5. Dedicate a space to creating

Many people are working, living, and entertaining themselves at home. This means a lot of home areas are serving multiple purposes. For example, dining room tables have become offices and homework stations. When an area serves multiple roles, it can feel hard to escape to a creative place.

It may take some reorganizing, but if creative projects are a priority for you, dedicating a space in your home can help give you the separation you need to be creative.

6. Don’t compare yourself to others

You are your own person, and what you create is uniquely yours. It’s important not to compare yourself to others who have more years of experience or do things differently than you. This will only lead to discouragement, and may make you want to stop creating altogether.

7. Exercise

Exercise is another building block of healthy daily living. When you feel good and let your mind take a break by focusing just on the exercise, you will feel refreshed both physically and mentally.

Remember, there are several different forms of exercise, and any sort of movement or activity has benefits.

8. Get outdoors

Fresh air and outdoor activity is an important part of taking care of your overall health and well-being. It can improve your mood, make you feel more energetic, and help your mental health and creativity.

9. If you don’t love something, don’t be afraid to walk away

Creativity thrives when you enjoy the activity. If you don’t love painting or drawing or writing or any other extracurricular/hobby, you don’t have to keep doing it. There are hundreds of ways you can spend your time, and you should spend it enjoying yourself.

10. Journal your thoughts

There’s a lot of thoughts running through our minds at any given point, particularly during stressful times such as a pandemic. If you’re working on your recovery, balancing work, and coping with a pandemic all at the same time, that’s a lot of thoughts racing through your mind. It can be overwhelming.

Journaling your thoughts can be a way to get them out of your mind and help you process the information. It can also leave your mind free for more creative activities.

11. Keep an inspiration list

Anything can be a source of inspiration. Maybe you follow a crafting blog; maybe you saw a video on your social media. Wherever you find inspiration, write it down or bookmark it on your computer. When you need ideas or inspiration, you can use that list as a resource.

12. Listen to music

While some people work well in silence, others need more background noise. Or maybe you need to shake things up. Music is an excellent way to improve your mood while simultaneously helping spark creativity.

13. Reset with meditation

Sometimes we need to walk away from what we’re doing in the moment and have a reset. Meditation can help you clear your mind, find your focus, and give yourself a rest.

14. Take a break

While there is something to be said for perseverance, sometimes taking a break from an activity or project can do just as much good for your creativity. Giving your brain a break and turning your attention to something else may trigger your imagination.

If you find yourself struggling, remove yourself from the situation and try something else (grab a snack, take a nap, put on a television show – anything that will help you rest).

15. Trust your gut and make more spontaneous decisions

Creativity often comes from trying new things. But many of us want to take some extra time to think before we come to a yes or no decision. There’s absolutely nothing wrong with that. However, if creativity is something you’re struggling with right now, thinking a little less may actually help.

Aim to be a bit more spontaneous by trusting your first instinct. This could be about trying new activities, new foods, new books – anything you want! You may discover new things about yourself in the process.

If you are someone who needs assistance with impulsive behaviours, keep in mind that this tip is specifically for creative projects. When in doubt, ask someone you trust for their opinion on your decision.


Sources

[1] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101035

[2] https://www.psychologytoday.com/us/blog/arts-and-health/201512/creativity-wellness-practice

[3] https://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1257049

 

Journaling prompts sources

[1] Prompts are drawn from or inspired by these two books:

  • After Brain Injury: Telling Your Story, A Journaling Workbook (2009) by Barbara Strahura and Susan B. Schuster, M.A., CCC-SLP, Library of Congress Number: 2009935810, Published by Lash & Associates Publishing, Inc., Youngsville, NC
     
  • The Story You Need to Tell, Writing to Heal from Trauma, Illness, or Loss (2017) by Sandra Marinella, MA Med (ISBN: 978-1-60868-483-0), Published by New World Library, Novato, California

Mindful Based Cognitive Therapy sources

[1]    Bédard M, Felteau M, Marshall S, Cullen N, Gibbons C, Dubois S, Maxwell H, Mazmanian D, Weaver B, Rees L, Gainer R, Klein R, Moustgaard A. Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury: Results from a randomized controlled trial. Journal Head Trauma Rehabilitation, 2013;28(6).

[2]    Bédard M, Felteau M, Mazmanian D, Fedyk K, Klein R, Richardson J, Parkinson W, Minthorn-Biggs MB. Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries. Disability Rehabilitation, 2003;25(13):722-31.

[3]    Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: NY: Delta; 1990, revised 2013.

[4]    Segal SV, Williams JMG, Teasdale JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York, NY: The Guilford Press; 2002

[5]    Felteau M. (2010). Understanding the transformative dimensions of mindfulness therapies, unpublished master’s thesis, St. Francis Xavier University, Antigonish, Nova Scotia.

[6]     Bédard M, Felteau M, Gibbons C, Klein R, Mazmanian D, Fedyk K, Mack G. A mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries: One-year follow-up. Journal of Cognitive Rehabilitation, 2005.

[7]    Bédard M, Felteau M, Marshall S, Weaver B, Dubois S, Gibbons C, Maxwell H, Klein R, Mindfulness-based cognitive therapy: Benefits in reducing depression following a traumatic brain injury. Advances in Mind-Body Medicine, 2012;26(1):14-20.

[8]    Bédard M. European Congress of Psychiatry presentation, 2013.

[9]     Guideline for Concussion/mTBI and Prolonged Symptoms. 2017. 3rd edition, Ontario Neurotrauma Foundation.

[10]    INESS ONF Clinical Practice Guidelines for the Rehabilitation of Adults with Moderate to Severe TBI. Patient version, 2020.

[11]    Holzel B, Carmody J, Vangel M, Congleton C, Yerramsetti SM, Gard T, Lazar SW.

Mindfulness and mental health sources

[1] Ponsford et al, Factors associated with response to adapted cognitive behavioral therapy for anxiety and depression following traumatic brain injury. Journal of Head Trauma Rehabilitation, 2020;35(2):117-126. 

[2] Bédard M, Felteau M, Marshall S, Cullen N, Gibbons C, Dubois S, Maxwell H, Mazmanian D, Weaver B, Rees L, Gainer R, Klein R, Moustgaard A. Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury: Results from a randomized controlled trial. Journal Head Trauma Rehabilitation, 2013;28(6).

[3]  https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01099/full

[4] Jewel Lingo K, Mind Life Institute Science & Wisdom of Emotions Summit, 2021.

[5] Kabat-Zinn J. Mind Life Institute Science & Wisdom of Emotions Summit, 2021

[6] Felteau M, Marshall S, Gainer R. The role of clinician training in mindfulness-based cognitive therapy for TBI. Brain Injury 2012;(26):4-5 Abstract for IBIA World Congress in Brain Injury.

[7] Felteau M & Gainer R. Applied mindfulness-based cognitive therapy for TBI reduces symptoms of depression: Results from a randomized controlled trial. Presentation to American Congress of Rehabilitation Medicine, 2014.

[8] Bédard M, Felteau M, Gibbons C, Klein R, Mazmanian D, Fedyk K, Mack G. A mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries: One-year follow-up. Journal of Cognitive Rehabilitation, 2005.

[9] Farb N, Anderson AK, Mayberg H, Bean J, McKeon D, Segal ZV. Minding one’s emotions: Mindfulness training alters the neural expression of sadness. Emotion. 2010;10(1);25-33.
 

Mindfulness Based Cognitive Therapy (MBCT)

Mindfulness meditation has been found to be helpful in coping with depression among people with brain injuries [1]. Canadian studies have shown it can help lessen the symptoms of depression and anxiety, decrease pain, increase energy, and improve quality of life [2].

Mindfulness meditation is often taught as an 8-week program in Mindfulness-Based Stress
Reduction and taught in clinical or community settings [3]. Mindfulness-Based Cognitive Therapy (MBCT) [4] has been adapted and tested in the traumatic brain injury population to treat depression in people of all severity levels [1,5]. Some hospitals and clinicians offer this program.

Since 2000, several clinical trials in MBCT have been conducted in the field of brain injury. Initially in two smaller pilot studies, the researchers found a 59% statistically significant reduction in depression symptoms, as well as improvements in anxiety, pain, energy, and quality of life [6] and at the one-year follow-up, the participants maintained improvements [6].

Another study in Ottawa found MBCT significantly reduced depression symptoms on all scales used. Similarly, it reduced pain intensity and increased energy levels [7]. The groups met for 1.5 hours a week over 8 – 12 weeks to learn modified mindfulness meditation, breathing practices, body scans, walking meditation, yoga, and reflective inquiry. It was recommended that participants meditate for 20 – 30 minutes daily.

The same research team conducted a randomized controlled trial in Thunder Bay, Ottawa, and Toronto where participants learned modified mindfulness meditation, breathing practices, body scans, walking meditation, yoga, and reflective inquiry. The groups met for 1.5 hours over 10 weeks with the recommendation to practice mindfulness meditation at home for 20-30 minutes daily. The results found a statistically significant 26% reduction in depression symptoms as measured by the Beck Depression Index-ll (BDI-ll) compared with the control group (results from larger RCTs often differ from smaller studies [1]. Three-months after the research trial finished, researchers completed follow-up tests where depression scores were shown to continue to improve. Interestingly, tests showed greater mindfulness was found to be associated with improvements in depression symptoms suggesting that MBCT for TBI may be the mechanism for improvement in symptoms [8].

Following these studies, MBCT for TBI has been accepted as a best practice and included in two Canadian clinical guidelines [9, 10]. Other research [11] has brought important insights to how mindfulness changes the brain. Following an 8-week Mindfulness-Based Stress Reduction program like the program adapted for people with brain injuries found:

  • Increased volume in the hippocampus, as structure important for learning & memory
  • Increased volume in the cingulate cortex, as structure associated with self-awareness, compassion & introspection

See sources

Journaling sources

[1] Pennebaker, J.W., 2004, Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval, New Harbinger.

[2] Pennebaker, J.W. & Beall, S.K., 1986: Confronting a traumatic event:  Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274-281

[3] Baikie, Karen A. and Wilhelm, Kay, “Emotional and Physical Health Benefits of Expressive Writing,” published online by Cambridge University Press, January 2018, Emotional and physical health benefits of expressive writing | Advances in Psychiatric Treatment | Cambridge Core.

[4] Self-reported physical health outcomes 
Expressive writing also produces longer-term benefits in self-reported health outcomes such as visits to the doctor (Cameron & Nicholls, 1998), physical symptoms (Park & Blumberg, 2002) and number of days out of role because of illness (Pennebaker & Beall, 1986Smyth et al., 2001).

Self-reported emotional health outcomes
Some studies have also found longer-term benefits of expressive writing for emotional health outcomes, including mood/affect (Pennebaker et al., 1988Páez et al., 1999), psychological well-being (Park & Blumberg, 2002), depressive symptoms before examinations (Lepore, 1997) and post-traumatic intrusion and avoidance symptoms (Klein & Boals, 2001).

[5] Pennebaker, J.W., and Seagal, J.D., 1999, “Forming a Story: The Health Benefits of Narrative,” Journal of Clinical Psychology, Vol. 55(10), 1243–1254.

[6] Stahura, Barbara, Schuster, S.B., MA, 2009, “After Brain Injury: Telling Your Story,”  Youngsville, NC, Lash & Associates Publishing.

[7] Various authors, edited by Thompson, K., and Adams, K., 2015, “Expressive Writing Counseling and Healthcare,” Lanham, Maryland, Rowman & Littlefield, Chapter 10, 175-191.

[8] Denton, G.L. Ph.D., 2008, “Brainlash, Maximize Your Recovery from Mild Brain Injury,” New York, New York, Demos Medical Publishing.

 

 

Evan Wall

evan-wallEvan Wall was a bright 19-year-old from the small town of Shellbrook, Saskatchewan whose only concerns were football, engineering college and partying. He was a top student with every reason to look forward to a very bright future until 2016, when a severe car accident and resulting traumatic brain injury brought his carefree life to a screeching halt.

Evan still doesn’t remember the late-night accident on a country highway. He was a passenger in a truck that flipped and ejected him through the windshield into a roadside ditch. Paramedics weren’t hopeful about his survival as a Shock Trauma Air Rescue Service (STARS) air ambulance carried him to Saskatoon’s Royal University Hospital. He spent two weeks unconscious in critical care. Along with bruised lungs and other more minor injuries, Evan sustained a diffuse axonal brain injury (DAI). The neurologists couldn’t predict whether Evan would wake up or spend the remainder of his life in a vegetative state.

His anxious family was thrilled when Evan did open his eyes after a few weeks, but alertness took much longer to return. Evan spent six weeks in the neurology ward learning to communicate with head shakes and hand signals. During this time, he wore diapers, was fed by a stomach tube, and learned to sit in a wheelchair.

 

“After six weeks, I was more alert but still not talking or responsive beyond answering yes or no questions with hand gestures. Degree of alertness after a brain injury can vary greatly, and diminished alertness can be one of the permanent effects. Fatigue from not just physical but also cognitive activity is a very common condition after a brain injury, one that I still live with.”

Evan’s speech and motor coordination had been badly damaged. He spent the following winter in the rehabilitation unit of Saskatoon City Hospital, where he undertook a daily regimen of speech, occupational, recreational and physio therapies in hope of recovering his abilities to walk, talk, eat unassisted and many other basic life skills.

“Everything I was doing now was incredibly painstaking and slow going. You might think the frustration would have driven me through the roof, but my mind was fully engaged just dealing with the tasks at hand. In this new headspace, my sense of self-reliance was challenged at every turn and there was no more room for my former blasé attitude toward achievement. The option of that mindset had been plucked out of my life. The humbling was sudden and absolute.”

When he was released from in-patient care to return to his parents’ home in Shellbrook Saskatchewan, Evan had spent a total of six months in the hospital. Evan now faced a life irrevocably altered. Gone were the athletic skills and facile academic prowess he had built his life on in the past. He would have to recreate himself.

“The work was grueling and very lonely. What I was doing and experiencing was present in my mind, but higher-order thinking would take time. A few months earlier, I had been a sharp engineering student able to solve calculus equations in my head. Now, my consciousness was fully occupied with seemingly mundane tasks and movements. Ironically, the learning and adaptation going on inside my brain was more dynamic and demanding than a healthy adult would ever have to endure. I was working harder at learning basic life skills than I ever had before, in university or any other aspect of my life.”

“I wasn’t that Evan Wall anymore, and I truly didn’t know what that was going to mean yet. Everything was new and scary without the hospital support I was used to. All I knew for sure was that I wanted to get to work and heal as soon and as much as possible.”

Daily strength training at his local gym soon became a saving grace. Over time, Evan’s body grew stronger and there were improvements in his coordination as a result. When he realized that good health would help optimize his recovery, Evan also started taking better care of himself, and put drinking and smoking behind him for good.

Evan’s family connected with the Saskatchewan Brain Injury Association and through it, Saskatchewan Health’s ABI Outreach Team, which runs the PARTY Program (Prevent Alcohol and Risk-related Trauma in Youth) for high schoolers. Evan was invited to team up with paramedics, fire fighters and police to help educate high school classes about the potential outcomes of risky behaviours. Since 2018, Evan has presented talks at high schools across Saskatchewan and is known to be a very relatable and engaging speaker.

“Hearing from a brain-injured kid close to their age really brought the message home. There was little difference between me and the current students when it came to interests and party lifestyle. The students were very engaged when I described the nitty gritty details about living with a brain injury and seemed to take the subject of safety seriously when they heard about my having to wear diapers, how I no longer work or attend school, even what it’s like to talk to girls now. I was happy to help contribute to brain injury education and do something with my time to help keep other teenagers out of hospitals.”

Five years after his accident, Evan has recovered an altered form of his voice that gives some people the erroneous impression that he is mentally challenged. He also walks unassisted, but his walk is slow and cumbersome. Evan lives on his own in Saskatoon, where he still visits his local gym daily. In fact, Evan has become an avid body builder and has even competed in physique building competitions.

“Bodybuilding is one of the purest forms of self-discipline because you’re literally fighting yourself all the time. Even during exertion, the body shouts loudly and constantly that it wants more carbs, but it’s not getting them. The results can be spectacular, but the self-discipline required to get there is enormous. I don’t think I’d be where I am now if I hadn’t gone through the physical and emotional rigors of coming back from the dead.”

“Challenging my limits has always been part of my journey. I did it physically in my youth. Since my injury, I’ve had to challenge my limits mentally and emotionally as well. And I’m still doing it today. I can say in all sincerity that living with this brain injury, I have become well acquainted with physical weakness and, in dealing with it, have become tougher than I would have ever imagined.”

To his dismay, Evan has found that the outside world reacts differently to him since his accident. Some acquaintances speak to him differently than they used to. Strangers look away or, when they do interact with him, often talk to him like a small child. Evan feels there is much society can learn about interacting with disabled people more respectfully.

“If there is one thing I know first-hand from being both an abled and a disabled person, it’s that able-bodied people react distinctly differently to one versus the other. Before my accident, I never would have imagined I would one day talk about ableism, ableist fragility, and microaggressions. I was a strong, agile, and capable teenager who, having grown up with a sister with autism and epilepsy, was raised to be considerate of other peoples’ differences. Prejudice in any form never crossed my mind or my path. I hadn’t even heard of the word ‘ableism’ before my injury.”

In 2020, Evan took on a collaborative writing project about his journey with a writer friend, Susanne Gauthier. Over many coffees and interviews with family, friends and colleagues in the brain injury community, Susanne drafted Evan’s story in full detail – from his point of view. Their co-authored memoir is entitled Rebuilding a Brick Wall, published by DriverWorks Ink, Regina SK 2021, and available in Canadian bookstores.

What does Evan want people to take away from his story?

“For someone with an injury, that you will always move forward if you refuse to give up. Even though life looks completely different from before, there are always successes and joyful moments that make the journey worth it, not to mention wisdom!”

“For able-bodied people; you may not think you get uncomfortable when you meet a person with a disability or treat them differently, but are you sure? Microaggressions are still heavily embedded in our culture. We have only just begun to acknowledge the variety of microaggressions towards those with ability differences that are still rampant.”
More information can be found on Evan and Susan’s website