Traumatic Brain Injuries

Traumatic brain injuries, or TBIs, occur when the brain undergoes damages by an external force or trauma. Depending on the amount of damage the brain sustains, symptoms of a traumatic brain injury can range from mild or moderate to severe. Types of traumatic brain injuries include concussions, contusions, coup-contrecoup injuries, diffuse axonal injuries, shaken baby syndrome and injuries due to penetration.

Common Brain Injuries: Concussions and Contusions

Concussions are the most common form of brain injuries. They occur when the head undergoes a direct hit or severe whiplash and shaking. After experiencing a concussion, a person may lose consciousness or become dazed and disoriented. A person suffering from a brain injuries such as a concussion is also at an increased risk for potentially life-threatening blood clots. Unfortunately, CAT scans are not always able to detect concussions.

Early signs of a concussion include: headache, vertigo, loss of awareness, nausea and vomiting. Some of the long lasting effects may involve persistent headaches, memory impairment, lightheadedness, an inability to concentrate, fatigue, irritability, changes in mood, vision problems, and difficulties while doing math or trying to find words. It can take anywhere from a few months to a few years for a concussion to fully heal.

Similar to a concussion, brain injuries known as contusions can result from direct impact to a person’s head; however, contusions tend to be more serious as they involve a bruise to the brain, which means there is brain injury and bleeding. Similar to bruises on other areas of the body, this brain injury cases multiple small hemorrhages that result in the leaking of small blood vessels into brain tissue. If the contusion is large enough, surgery may be required to remove it.

Signs of a contusion depend on the severity of the brain injury sustained, along with the area of the brain that was hurt. Symptoms are similar to those experienced with concussions, in addition to difficulties with coordination, movement, vision, speech and hearing.

Coup-Contrecoup Brain Injury

A coup-contrecoup brain injury involves not only one, but two contusions. A coup injury is a contusion that occurs on the side of the brain at the point of impact, while a countrecoup injury occurs on the direct opposite side of the brain. This traumatic brain injury most often occurs when the head collides with an object at rest. The force of impact is so great that, along with causing a contusion at the impact site, the brain is slammed into the opposite side of the skull, resulting in a second contusion.

Diffuse Axonal Brain Injury and Shaken Baby Syndrome

Diffuse axonal brain injuries can occur any time the head undergoes intense shaking, as is the case with shaken baby syndrome, or strong rotational forces, such as those resulting from a car accident. Injury results because the movement of the brain lags behind that of the skull, resulting in the shearing of nerve fibers, or axons, all over the brain. This tearing upsets communication within the brain, along with its chemical processes. The functional impairments resulting from such brain injuries depend on where tearing occurred. Damaged to the brain is more widespread with this kind of injury. Diffuse axonal injuries are serious, as they can cause permanent brain damage, coma or even death. For those patients who end up in a coma, over 90 percent of them never regain consciousness.

In the cases of shaken baby syndrome, a baby is shaken so violently that it causes the blood vessels between the skull and brain to rupture. The resulting influx of blood causes the brain to swell, damaging brain cells. The effects of brain injuries caused by shaken baby syndrome include seizures, lifelong disability, comas and death.

Brain Injury due to Penetration

Penetrating brain injuries occur whenever impact from a bullet or sharp object forces skin, hair, bone and fragments of the object to enter the brain. If the object happens to penetrate the skull, pass through the brain and come out the other side, serious injury can occur. Not only does the brain suffer from the penetration of the object itself, but also from the added tearing, stretching and rupturing of brain tissue. Gunshot wounds are the most common form of penetrating injuries.


What Every Woman Should Know About the Birth Control Pill

What is the Birth Control Pill?

The birth control pill is most often taken to prevent pregnancy, though doctors may prescribe it for other conditions as well. With the number of birth control options available, women should try to find the most convenient method that fits both her lifestyle and needs. Women who are interested in various birth control options, including the pill, should consult their gynecologist.

How Does the Birth Control Pill Work?

The main function of the pill is to prevent pregnancy by stopping ovulation, which occurs when an egg is released from the ovaries during a woman’s monthly cycle. Stopping ovulation means that the ovaries will not release an egg; without an egg, fertilization cannot occur. The hormones in the pill further prevent pregnancy by thickening secretions of mucus around the cervix, making it hard for sperm to reach the uterus. Even if the sperm were to reach the uterus, the hormones in the pill change the lining of the uterine wall, keeping the egg from being able to attach.

How Well Does the Birth Control Pill Work?

The birth control pill only works as well as it is taken. The pill should be taken as the same time, every day. While typically a successful form of birth control, missing even one dose can decrease the pill’s effectiveness, thereby increasing a woman’s chances of getting pregnant. If more than one pill is forgotten during the month, a backup method of birth control must be used as the woman is no longer protected against pregnancy; back up forms of birth control include abstinence, which is refraining from sex altogether, or condoms.

Statistics show that, on average, the pill is 92 percent effective; in other words, about 8 out of every 100 women who use the birth control pill will accidentally become pregnant this year. However, it is important to note that these statistics include all women on the pill, including those who do not always take their pill as prescribed. For women who take the pill correctly, it’s effectiveness increases up to 99.9 percent.

The efficacy of the pill also depends on other factors, such as any medications or herbal supplements a woman may take. Herbs like St. John’s wort, typically taken as an antidepressant, can interact with the pill by decreasing its efficacy. It’s also important to note that antibiotics are known for interfering with birth control; if a woman is on antibiotics, then a backup method should be used for that month.

Who Should Consider Using the Pill?

Birth control pills are a good choice as a method of preventing pregnancy, but the pill is not for everyone. The pill is usually taken by women who want to protect themselves from pregnancy and who are responsible enough to remember to take the pill every day. Doctors also prescribe birth control as a treatment of certain medical conditions. These other conditions may include absent or irregular periods, PMS, endometriosis and Polycystic Ovary Syndrome. Despite its success, the pill is not the best option for everyone. The pill is not usually prescribed to women who experience migraine headaches, as the hormones in the pill can worsen the frequency and severity of these migraines. On a much more serious note, women who have a history of blood clots should not take the pill, as they may experience life-threatening side effects. Also, women with certain kinds of cancer should not take the pill due to the resulting increase in hormone levels. Any women who may be pregnant or who have unexplained vaginal bleeding should consult their doctor.

Types of Birth Control: Combination Pills

There are a number of birth control pills on the market these days. Most pills contain a combination of the hormones estrogen and progesterone; these “combination” pills are sold under various brand names and come in either 21 or 28 day packs. Pills of this type should be taken at the same time every day. For women who use the 21 day pack, the pill should be taken every day for 3 weeks. After three weeks have passed, the woman usually gets her period; seven days after taking her last pill, a new pack is started. If the pack contains 28 pills, then the woman would take 21 “active” pills, followed by 7 days of “inactive” pills during which she gets her period, before starting the next pack. Whether a woman chooses the 21 or 28 day pack doesn’t make much of a difference. The seven extra pills in the 28 day packs are considered inactive pills, usually consisting of either sugar pills or iron supplements. The main purpose of these extra pills is to help keep women in the habit of taking their pill every day.

Another type of combination estrogen and progesterone birth control pill allows women to only have four periods a year. Having a period once every three months as compared to once a month is an appealing option for many women. With this pack of pills, a woman must take one every day for 12 weeks straight, as opposed to the typical 3 weeks for the month to month packs. During the seven days of inactive pills, the woman has her period, and then the cycle starts over again.

Types of Birth Control: Progesterone Only Pills

There is also a progesterone-only pill, sometimes called the mini pill, that is taken each day. Because the mini pill is meant to be taken every day, without break, a woman will no longer have her period; however, some break-through bleeding is to be expected at first. The progesterone-only pill works similarly to combination pills in that it thickens cervical mucus and changes the lining of the uterus. In some instances, this pill may also stop ovulation. Overall, the mini pill is slightly less effective than the combination pills, at about 95 percent efficacy.

Where to Get the Birth Control Pill

In order to get a prescription for the pill, a woman must schedule a visit with a physician or, preferably, a gynecologist. First, a complete family medical history is taken. The doctor will then perform a complete exam, which usually includes a pelvic exam. Before prescribing the pill, your physician will clarify how the pill works, when to begin taking it and what to do if you miss a day. A follow-up visit is usually scheduled to ensure that the pill is not causing any unwanted side effects or other problems. Any sexually active woman should see their gynecologist for routine exams every six months to a year.

How Much Does the Birth Control Pill Cost?

Depending on the type of pill you are prescribed, the cost can range anywhere from $10 to $50 a month. Fortunately, most insurance companies cover birth control pills under their prescription plans. If a woman has problems affording her birth control, she can talk to her doctor about switching brands. Another alternative is to visit a family planning clinic, like Planned Parenthood, as they usually provide the birth control pill for less.

Possible Side Effects of the Birth Control Pill

Some women taking the pill may not experience any side effects, while others may only have a few. Most side effects subside after several months on the pill; however, if the side effects become bothersome or worsen, the doctor can prescribe a different kind of pill. Women over 35 who take the pill are encouraged not to smoke, as it can lead to blood clots.

The most common side effects of the birth control pill include:

  • Nausea
  • Changes in mood
  • Weight gain
  • Tender or swollen breasts
  • Lighter periods and possible spotting between periods

If any of these serious side effects occur, a doctor should be called immediately:

  • Severe headaches
  • Eye problems, like blurred vision
  • Abdominal, or stomach, pain
  • Chest pain
  • Swelling or aching in the thighs and legs

The Birth Control Pill Does Not Prevent Sexually Transmitted Diseases

One of the most important things to remember about the birth control pill is that it does not offer protection against sexually transmitted diseases. The only way to  prevent STD’s is to practice abstinence or through the proper use of condoms.