Featuring Bob Woodruff `s Story of Recovery

Transcription

RainbowVisions
A Quarterly News Magazine for Acquired Brain Injury Professionals, Survivors and Families
www.rainbowrehab.com
Fall 2007
Rainbow Rehabilitation Centers, Inc.
Volume IV
No. 4
Featuring Bob Woodruff’s Story of Recovery
Lee Woodruff and ABC Producer Vinnie Malhotra
give their first-hand account of Bob Woodruff ’s tragic accident and recovery.
Clinical News on Returning to Work
after a traumatic brain injury.
What’s News in the
Industry
D
Life Under PIP Choice
By
Bill Buccalo, President
id you ever wonder how choice of coverage in Michigan’s Auto No-Fault system would affect auto accident victims?
Here’s a hypothetical scenario that may shed some light.
PIP Choice of a 20-year-old Driver
When Michael landed his first steady job, he purchased a
car and auto insurance. The insurance agent told him he could
save $25 every six months ($50 per year) if he opted for the $1
million personal injury protection (PIP) limit on medical benefits.
One million dollars sounded like a ton of coverage, and he
could use the 50 bucks, so he chose that option.
A couple of months later, Michael was hit by a car. The driver
of the other car ran a red light and crushed the driver’s side of
Michael’s car. It was a horrific accident and Michael sustained
a catastrophic brain injury. After a three-month hospitalization
(including a coma), multiple surgeries, and a year and a half of
aggressive rehabilitation, medical experts predict that Michael
will never live independently. He will require ongoing care,
supervision around the clock, assistance with activities of
daily living, medication management and ongoing medical
appointments.
Michael is living in a community-based home for people
with brain injury. It is expected that he will require this type of
specialized service for the remainder of his life. It is projected
that Michael will most likely live to the “normal” 78 years of
age.
As a result of the brain injury, Michael has both significant
physical and cognitive limitations. He uses a walker for short
distances and a wheelchair for longer distances. He tires easily
and must depend on caregivers for all transportation needs.
Due to the brain injury, Michael cannot control his temper and
sometimes becomes violent causing physical damage to people
and property. As a result, he requires the help of individuals
specially trained in dealing with these types of behaviors.
Michael is still quite well aware of who he is, where he lives
and what he wants. He loves to visit with family, attends music
concerts (he likes hip hop and modern rock), enjoys socializing
and pursues some hobbies. Michael will never work competitively
but likes to volunteer in the community when possible.
Michael’s brain injury treatment facility, along with medications,
medical equipment, various physician services, etc., averages
about $15,000 per month. In addition, these costs are expected to
rise at a rate of 2.5 – 3.0 percent per year into the future.
Michael’s Projected Lifetime Care Costs
$15,000/month, 2.75% Inflation, 58 years
$25,025,000
Funds Available for ‘Lifelong Care’
($ 1,000,000)
Michael chose the $1 Million limit instead of ‘Unlimited’
Shortfall
$24,025,000
Premium Dollars Saved on the Insurance
Net Shortfall (Costs shifted to family or to state Medicaid)
($
$24,024,950
In the case of a catastrophic accident involving (fictitious)
Michael, an extra $50 could have provided him an additional
$24,024,950 for necessary services over the remainder of his life.
Instead, he ran out of coverage before his 26th birthday.
There are thousands of people in Michigan living with
similar injuries due to automobile accidents. Auto No-Fault
(PIP) coverage providing funds for catastrophic life-long care is
important. We cannot let news reports or legislators oversimplify
and effectively dismiss the issues facing the large population of
traumatic brain injury survivors, their families, and the community.
Implementation of lower PIP options in Michigan would be a
disservice to all Michigan residents. t
House Bill 4702 was introduced May 2, 2007, by Representative Joe Hune, and referred to the House Insurance Committee. This
proposed legislation may be heard by the House Insurance Committee this summer or fall. The bill would allow Michigan drivers to
select lower levels of personal injury protection. As described in the story above, this choice would be disastrous for many, as even
$1,000,000 is quickly spent in caring for those who are severely injured.
We encourage you to contact your representative and senator in Lansing regarding the negative impact HB 4702 would have on TBI
survivors, families, the Medicaid system and the state as a whole.
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50)
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On the
Cover
Table of
Contents
This issue of RainbowVisions
RainbowVisions
Survivors and Families
for Acquired Brain Injury Professionals,
A Quarterly News Magazine
Centers, Inc. Volume IV
Fall 2007
Rainbow Rehabili tation
No. 4
Recovery
Featuring Bob Woodruff’s Story of
Vinnie Malhotra
Lee Woodruff and ABC Producer’s tragic accident and recovery.
give their first-hand account of Bob
Woodruff
Clinical News on Returning to Work
after a traumatic brain injury.
2007
follows the recovery of ABC
INDUSTRY NEWS
Journalist Bob Woodruff.
What’s News in the Industry – Life under PIP choice
1
ABI Clinical News – Returning to work after a TBI
3
IED exploded near the tank
Perspective from a Professional – Special Needs Trusts
7
he was riding in. His wife Lee
Guardianship
8
and ABC Producer Vinnie
Technology Corner – Lee Silverman Voice Treatment
9
While on assignment in Iraq,
he sustained a TBI after an
Malhotra, give their firsthand account of Bob’s injury
and recovery.
Cover photo of Bob & Lee
Woodruff taken by
Cathrine White.
AACBIS – Post-Traumatic Stress Disorder
14
Medical News – Complications of Type 2 Diabetes
15
Industry Conference & Event Calendar 29
TBI SURVIVOR STORIES
Survivor Corner – An Interview with Lee Woodruff
5
Survivor Corner – An Interview with Vinnie Malhotra - ABC Producer
12
From Rainbow’s Residential Homes – Gabe Mussehl
21
Executive editor & designer – Kimberly Paetzold
Assistant editor & staff writer – Kirstin Olmstead
Staff photographer – Heidi Reyst
Please e-mail questions or comments to:
[email protected]
INSIDE RAINBOW
Rainbow Community Education
17
Rainbow Client Activities – Summer 2007
22
The Last Word – Staff of Professionals
33
Employee of the Season – Winter 2007
34
After School
& Saturday Day
Programs
To register or for more information call
1.800.968.6644
E-mail: [email protected] • www.rainbowrehab.com
RainbowVisions
2
Clinical
News
OT AND SLP THERAPY PERSPECTIVE
Returning to Work After a TBI
By
R
Angie McCalla, MS, CCC-SLP, CBIS
- Speech Language Pathologist
& Laura
Konrad, OTR, NDTC, CBIS
- Occupational Therapist
ecent research in traumatic brain injury (TBI) rehabilitation has focused on measuring outcomes,
specifically the impact rehabilitation has on a survivor’s
quality of life. Because there is a clear link between
financial status and self-esteem, vocational success has
become one of the most important outcomes measured
in brain injury rehabilitation and research (Jacobs,
1997). However, it is often difficult for individuals
with brain injuries to achieve vocational success. Many
survivors suffer with significant psychological, cognitive
and physical deficits that negatively affect their ability
to seek and maintain employment. Research points
to the importance of addressing these deficits using a
supportive rehabilitation team approach focused on
assessing the wide range of physical, cognitive and
functional variables (Vandiver, et al, 2003).
Factors Affecting Employability
Difficulties with physical changes, thinking abilities
(such as problem solving and memory), behavior
and social skills can delay the success of post-acute
treatment. These issues must be addressed in order to
promote and ensure employability. Addressing these
challenges with occupational and speech-language
pathology sessions can promote a greater ease of
transition into the work place. This is accomplished
through the development of foundational skills that are
easily generalized.
Physical Changes
Physical deficits, if they exist, are always the
most obvious or noticeable. Unlike subtle cognitive
impairments, physical deficits frequently become the
central issue. They often are the result of damage to
the brain centers that control motor functions rather
than by direct injury to the extremities. Deficits may
include loss of motor coordination, spasticity (muscular
hypertonicity with increased tendon reflexes), poor
balance, an inability to walk unassisted, and a loss of
eye-hand coordination. Hemiplegia (paralysis affecting
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one side of the body) and hemiparesis (weakness of one side of the body or
part of it) may further complicate employment issues, particularly when these
conditions affect the use of the dominant hand.
Cognitive Changes
Individuals with brain injury may exhibit problems in a variety of cognitive
areas such as:
• basic arousal
• alertness
• attention
• concentration
• memory
• abstract thinking & conceptualization
• planning
• organizing
• problem solving • judgment
They may also have difficulty processing verbal and visual information.
Arousal
Hallmark signs of arousal problems include an inability to attend to the
environment, a lack of (or reduced) alertness; an inability to accurately
observe environmental details and occurrences; and a severely slowed
capacity for information processing. People with arousal impairments are
slow in reacting and responding to others
and are highly susceptible to fatigue
following cognitive or physical exertion
(Western Neuro Sensory Stimulation
Profile, 1989).
Attention and Concentration
Impaired attention and concentration
abilities can exhibit as distractibility. This
may be a response to interference either
by external or internal stimuli. For the
person with brain injury, the inability
to “screen out” external noises makes
concentration difficult. Environmental
noise is found in most work settings, such
as conversation, office traffic, humming of
machines and the general related “buzz” of
activity. If external noise can be controlled
or minimized, concentration usually
improves.
For the person with brain injury, another
possible source of distracting noise is
internal conversation, which takes place in
the mind. Intrusive inner thoughts can limit
productivity and are exceedingly hard to
manage. They become visible (observable)
only when they interrupt performance
(Sohlberg and Mateer, 1989).
Memory
Loss of adequate memory function and
the inability to immediately recall new
information (anterograde amnesia) are
common symptoms following brain injury.
While significant improvement in memory
function may be noted during initial
recovery, this deficit is often observed in
varying degrees for most survivors.
Inadequate memory function is one
of the primary complaints reported by
people who have sustained a brain injury.
Often it is their social environment that
causes them to develop this awareness.
The reprimands of others for missed
appointments, appliances left on or bills
unpaid compel them to acknowledge that
they forget important things. However,
memory impairments can be compensated
for by a variety of memory aids (Green,
Stevens, & Wolfe, 1997).
Practically all persons with brain injury
retain a clear pre-injury memory of
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2007
Predicting Employability
Predicting the employability of an individual following a brain injury is
a complex process. Many variables affect productivity outcomes. Reported
unemployment rates vary widely, from 10–99 percent (Cifu, 1997; Gollaher,
1998). Most samples show about a 30 percent return to employment; although
a 2003 study by Kreutzer and his colleagues found in that 42 percent were
employed and 34 percent were stably employed three years after their injury
date. Those who were unemployed were most likely to be members of ethnic
minority groups, non-high school graduates, unmarried, unable to drive their
own vehicles and had severe impairments (2003).
In 1998, Gollaher and colleagues reported that individuals with higher
education levels and less disabilities were most likely to be employed at one
to three years post-injury. Sherer and associates (1999) found that individuals
with no history of substance abuse were eight times more likely to be employed
at two years post-injury.
TBI Model Systems researchers established that early neuropsychological
testing appeared to be useful for predicting outcome after injury. Boake and
colleagues (2001) noted that early completion of neuropsychological tests
(completed less than two months from injury) with scores in the normal
range increased the likelihood of a productive outcome by 40–130 percent.
Further, early neuropsychological test results were predictive of productivity
outcomes one year post-injury Scherer et al 2002). At one year follow-up, 43
percent of the 388 participants were classified as productive. Scherer and fellow
researchers also found in a subsequent study (2003), that those with more
accurate self-awareness were nearly twice as likely to be working as those with
less accurate self-awareness.
Continued on page 23
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4
Photo by Cathrine White
Traumatic Brain Injury
Survivor
Corner
AN INTERVIEW WITH
I
Lee Woodruff
Interview by
Kimberly Paetzold, Editor
n January, 2006 Bob Woodruff was
promoted to the position of “World News
Tonight” anchor along with Elizabeth
Vargas, replacing the late Peter Jennings.
This new dual-anchor setup was designed
to keep one in the anchor chair and
the other on location reporting world
events. Two days before President Bush’s
State of the Union address, Bob was in
Iraq covering a story when he and his
cameraman Doug Vogt were hit by an
improvised explosive device (IED). Both
men suffered traumatic brain injuries
(TBIs).
Lee Woodruff, Bob’s wife, was kind
enough to interview with “RainbowVisions.”
Here’s what she had to say about her
husband’s recovery and their future plans.
Hello Lee, thank you so much for your
time. Your husband has had a remarkable
Pictured above: Bob and Lee Woodruff with their four children – twin daughters,
Nora and Claire (top), son, Mack and daughter, Cathryn.
recovery since incurring a severe brain
injury in Iraq on January 29, 2006.
Bob isn’t receiving formal therapy at
with words. Since Bob’s initial recovery,
According to information published in
this time, but he still sometimes fishes for
what type of projects has he worked on
your book, “In an Instant,” Bob’s focal
a word. The more fatigued he is, the more
and what is he currently doing?
point of injury was in the left temporal
you see it. He falls apart much more easily
Earlier this year both of us were on
lobe, potentially affecting his speech and
at night. I noticed that when Bob has a lot
our book tour and very recently Bob just
word recall. I watched Bob in the “ABC
of balls in the air, it’s harder for him now.
returned to journalism with ABC. He
News Special: To Iraq and Back – Bob
Overall, I would have to say his recovery is
works on stories for “World News Tonight,”
Woodruff Reports” (2/27/07). In that
miraculous, and he can tolerate quite a bit.
“Nightline” and “Good Morning America.”
special, his commentary was flawless
Most people think he’s perfectly fine. But as
He’ll do a series of hour-long specials like
– very professional. Also, I had the
his wife, I do see everything.
the documentary that aired in February –
“Bob Woodruff: To Iraq and Back.”
opportunity to meet him in person, and
he showed very few signs of having ever
In your book, Bob wrote about his love
He just returned from a trip to Syria
been injured.
for reporting. He wrote that he viewed
covering the refugee story. Currently, there
Is your husband still participating in
journalism as the perfect career because
are a large number of refugees coming
active therapy? Could you tell us how
he learned about a new subject or story
from Iraq into Syria. It’s really sad because
he is doing and what challenges he is
every day, enjoyed the adrenaline rush
there is nothing for them in Syria, but Iraq
currently facing?
of deadlines and loved marrying pictures
is a war-torn country and people want to
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2007
get out. He was covering the consequences
and issues associated with the refugees. One of the issues he’s investigated is the
young Iraqi girls coming into Syria who are
turning to prostitution because there is no
other way for them [and their families] to
make money. It breaks the parents’ hearts,
but there is not food for the refugees and
nobody wants to deal with them. Because
there are different tribes within these
groups, it is a difficult situation.
Bob will continue to cover brain injury
stories. But what has been really great
is to see him get back to journalism as a
whole, which is what he is now focusing
on full-time. He recently went to Cuba to
see if he could get an interview with Fidel
Castro, which didn’t work out. But he did
cover what’s going on there and what the
political future might be going forward.
That was really interesting for Bob – he’s
always wanted to go to Cuba.
Does he have help from his producer or
other staff assigned to his projects?
Bob has a producer and a camera
person, but all of that is standard. There are
some differences following his injury. He
gets more tired and probably needs more
help with his writing compared to what he
used to need. I think his hours are going to
have to change because he requires more
rest. For the most part, his recovery really is
miraculous, and I am amazed that he has
stayed pretty true to how he has worked in
the past.
Pictured above: The tank Bob Woodruff was traveling in just seconds before an IED
exploded. ABC cameraman Doug Vogt took the picture as he and Bob were preparing to
report. The Iraqi solder pictured reportedly lost his hand in the attack.
Taji, Iraq
January 29, 2006
Two days before President Bush was scheduled to deliver his State of the Union address,
Bob Woodruff’s ABC News group – producer Vinnie Malhotra, cameraman Doug Vogt and
soundman Magnus Macedo – wanted to get a first-hand look at the U.S. Military hand over
of security to the Iraqi forces. The group was looking for concrete examples of U.S. and
Iraqi troop cooperation, and the American troops felt that Taji was a good example.
The morning of January 29, the military was scheduled to take the ABC group to a local
water treatment plant. Now under Iraqi security, the plant provided fresh water for the
Is ABC providing more supports for Bob
out in the field?
It’s really early in the process, maybe too
early to tell. Bob is trying to get his group
together and talking about the specials they
are going to cover. He is still just getting
his feet on the ground, so time will tell. I
will have more to say in six months or so,
but for now, so far so good.
town outfitted with helmets and body armor. The news group decided to ride in an
Iraqi tank to get a good look at what was happening from the perspective of the local
troops. After mounting a camera on the front of the tank, all four newsmen along with
an Iraqi interpreter climbed inside, unaware the tank was to take the lead position in the
convoy. Hoping to do a stand-up interview through the tank hatch, Bob kept moving
back and forth from inside the tank to outside trying to help the soundman figure out
how to compensate for the tank’s loud roar. Magnus and Vinnie remained inside, and after
traveling only three miles, they approached an area (pictured above) where insurgents
often positioned themselves. The interpreter advised both Doug and Bob to get inside the
tank. Suddenly, there was a horrific blast – A band of Iraqi insurgents detonated a remote-
I would like to ask a question regarding
controlled IED. Both Doug Vogt and Bob Woodruff suffered traumatic brain injuries. 
your personal outlook. In 1994, you lost
For a first hand account of the incident, go to page 12 – Interview with Vinnie Malhotra.
RainbowVisions
6
Perspective from an
Industry
Professional
that leaves a share of their estate to a
new special needs trust for the benefit
of their son or daughter. Sometimes
D
ADVANTAGES OF A
parents also find it helpful to set up
Special Needs Trust
an additional, but separate living
By
(intervivos) special needs trust in their
Daniel Blauw, Attorney at Law
will. This is done to facilitate gifts or
bequests by other relatives or to begin
building up a trust fund before the
aniel Blauw lives in Grand Rapids, parents die.
Michigan. As a lawyer in solo practice,
Both of these third party special needs
he primarily helps families across Michigan
medical care related to a long-term
trusts are quite flexible – even revocable.
set up special needs trusts and arranges for
disability. People with and without no-
They can leave a remainder interest to any
services when they have a family member
fault insurance coverage must learn
other party or charity without a Medicaid
with life-long disabilities. He has served as
quickly about Medicaid, Social Security
payback provision, when the loved one
Director of Creative Housing Services at
and Supplemental Security Income (SSI)
passes away. These third party special needs
Hope Network and as Executive Director
disability benefits. The family’s next set
trust options have been widely used for the
of the ARC of Kent County, an advocacy
of questions often involves how to set-
past twenty-five years.
group for people with disabilities. Daniel is
up a special needs trust that will provide
a 1980 graduate of Valparaiso University
some private funds while preserving
Self-funded Special Needs Trusts
School of Law and a 1977 graduate of
governmental benefits. What follows are
Third party trusts have one drawback–
Hope College.
some tips about the use of special needs
they cannot be used to shelter assets if
trusts.
the person with disabilities already holds
When a family faces the crisis of
a catastrophic injury of a loved one,
first there is shock, and then there is
In common law legal systems, a trust is an arrangement whereby
almost a total submersion into medical
money or property is owned and managed by one person (or
decision-making. Before long, however,
persons or organizations) for the benefit of another.
scary questions arise about how to pay
for all the increased living costs and
How Can I Set Up a Special Needs Trust?
the money. Fortunately, federal law in the
Start by recognizing whose money will
mid 1990s began to allow a person with
be funding the trust. A common mistake
disabilities to self-fund a special needs trust,
is to fail to define who will be funding the
even with money that is already “in the
trust. SSI and Medicaid programs have one
pocket” of the person with disabilities.
set of rules for a parent or “third party”
For example, an individual with a
funded trusts and another set of rules for
disability can shelter proceeds from a
trusts set up directly by the person with
lawsuit settlement or a large lump sum from
the disability. As an attorney who helps
Social Security in a special needs trust.
clients qualify for benefits, I have seen
This puts the assets in a “non-countable”
many instances where even governmental
category and allows the individual to
workers apply the wrong rules and
preserve governmental benefits. They can
incorrectly deny benefits.
even shelter funds owned prior to the
If parents want to make sure that their
injury, such as a house they no longer live
adult child’s inheritance will not reduce
in, bank accounts and IRAs.
his or her governmental benefits, they
The federal statute spells out two different
should prepare a last will or a living trust
types of self-funded special needs trusts.
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2007
Guardianship
Information taken from the
National Guardianship Association
www.guardianship.org
W
hen parents have a child with a
traumatic brain injury, it is important
that they understand their rights and the
legal system as it applies to caring for their
When a child reaches legal adulthood,
guardianship for those with disabilities
child. Guardianship is often misunderstood.
parents do not automatically remain
has little to do with the capacity to handle
For example, many people believe
the natural guardian. If your child is
finances. There are other mechanisms
that parents are automatically the legal
disabled and over 18, you must seek legal
for dealing with financial matters such
guardians of their minor children. Legally,
guardianship through the courts in order
as power of attorney and representative
parents are the “natural” guardians of their
to decide residence, take care of financial
payees for government benefits and trusts.
minor children but not automatically the
affairs or make medical decisions for him.
In addition, some states offer limited
legal guardians. A minor child (under 18
All adults with disabilities do not require
guardianships, which may give a guardian
in most states) needs a legal guardian or
a guardian. This process should only be
the right to make medical decisions but not
conservator when he is orphaned. If a child
pursued if a disabled individual’s parents,
decisions regarding residence.
under 18 inherits property, the parent must
doctor, psychologist and/or caregiver all
be appointed by the court to become the
agree that they are incapable of making
guardian, the following information may
legal guardian of the estate – They cannot
independent and informed decisions.
help. (NOTE: Local law and court rules
automatically control, safekeep or manage
It is a misconception that an individual
may be different in each county and
their child’s property legally without this
who is not able to balance a checkbook
state. For specific rules applied to your
appointment.
is in need of a guardian. In today’s world,
circumstances, consult a local professional
If you feel your loved one needs a legal
elder law advocate or the National
Guardianship Association.)
Guardianship
Guardian of the Person – Cares for the
personal needs of the ward
Guardian of the Estate – Cares for the
property of the ward
Plenary Guardianship – Cares for
personal needs and the property
of the ward.
Guardianship
Guardianship, or conservatorship, is a
legal process that occurs when a person
can no longer make or communicate
decisions about his/her person and/or
property. Appointed guardianship may
occur when an individual is in need of
legal protection and it is the opinion of the
individual’s treating physician (or other
caregivers/family/professionals) that they
are unable to provide food, clothing or
shelter for themselves or mange their own
financial affairs. When a court appoints
a guardian, they may have the following
responsibilities:
•Determine and monitor residence
RainbowVisions
8
ABI
Technology
Corner
N
Description
Lee Silverman Voice Treatment
By
The LSVT program teaches patients
to “think LOUD” and to focus their
efforts on increasing voice volume.
Angie McCalla, MS, CCC-SLP, CBIS
With intensive treatment and frequent
encouragement, patients learn to
eurological disorders can often impair
consistently increase their voice
speech and voice production, making
volume. As patients progress in therapy,
communication difficult. One therapy,
patients suffering from Parkinson’s disease,
that has proven effective in treating
LSVT is now being used to help individuals
the length and complexity of their
speech increases as does their volume.
patients with neurological disorders,
with swallowing dysfunctions, head trauma
Practice and feedback begin with a single
specifically Parkinson’s Disease, is the
and multiple sclerosis.
sound to train the patient about the correct
Lee Silverman Voice Treatment (LSVT®).
Early research studies assessing the
volume and the breath support required
Based upon nearly 15 years of research
impact of LSVT in treating communication
to produce increased sound. Training
data, this treatment offers the opportunity
problems are yielding positive outcomes.
moves on to simple and frequently used
to consistently improve speech and voice
The treatment offers powerful results to
phrases so that loudness becomes habitual.
production in individuals with neurological
patients who previously had very limited
Speaking full sentences, reading aloud and
disorders and significantly improve their
opportunities to improve their speech and
engaging in conversation are also part of
quality of life. Designed exclusively for
voice.
the therapy.
Repetition and reinforcement are also
Medical Illustration Copyright © 2007 Nucleus Medical Art,
All rights reserved.
www.nucleusinc.com
essential parts of the program. Through
constant practice, patients learn to
“recalibrate” and become accustomed
to using a louder voice. Reinforcement
from family and others in the community
is also important to solidify the treatment
gains. Patients practice with tape recorders
and use sound pressure level meters for
feedback.
Currently, the LSVT treatment program
requires four one-hour sessions with a
qualified therapist each week over the
course of a month. In addition, patients
are required to complete home exercises
for 1-2 hours each day in order for the
therapy to be successful. The sessions are
always lead by a trained speech-language
How the Vocal Cords Work
The vocal folds (vocal cords) are composed of twin infoldings of mucous membrane
Documented Results
stretched horizontally across the larynx. They vibrate, modulating the flow of air being
LSVT is the first and only documented
expelled from the lungs during phonation (a voiced sound). The vocal vibration is varied
efficacious speech treatment for individuals
to produce intonation and tone. This is accomplished by varying the pressure of the
air column under the glottis as well as the tension in the vocal folds themselves. These
actions produce changes in the frequency of vocal-cord vibration, which generates the
fundamental pitch of the voice.
9
pathologists certified in LSVT.
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with Parkinson’s disease – over 400 have
been treated and included in efficacy
research studies. Ninety percent of patients
studied showed improvements in vocal
intensity from pre- to post-treatment.
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Parkinson’s Disease
Approximately 80 percent maintained
improvements in volume for 12-24 months
post-treatment. Additional published
data supports improvements in speech
articulation, respiratory excursion, facial
expression, communication gesture and
neural functioning.
LSVT at Rainbow
Rainbow Rehabilitation Centers
has two speech-language pathologists
certified in LSVT: Kerri Torzewski, MA,
2007
Parkinson’s disease is a neurological disorder that impacts the brain’s
ability to coordinate muscle function and movement. It can diminish a
patient’s vocal effort resulting in volume loss and makes it difficult for them
to differentiate between low and normal conversational volume. LSVT
makes patients aware that their pre-treatment voice level is too soft and
helps them find the correct level for normal speech. Patients are trained to
reach the correct volume and to self-correct even when they feel they are
speaking too loudly.
Pictured below: Human genome view with a focus on PARK9 - one of the
genes linked to Parkinson’s Disease.
CCC-SLP and Angie McCalla, MS, CCCSLP. Both clinicians were certified in
April 2007 and have begun to employ
the program with two patients, Jeff Terry
and Yaseni Caballero-Amaya. Chosen
based on the nature of their speech
disorders – low volume and decreased
mandibular excursion (movement of the
jaw) – both have demonstrated significant
improvements.
In just three weeks, Jeff’s average length
of sustained phonation (audible sound)
improved from 11.16 to 17.6 seconds and
his loudness (sound pressure level) for
functional phrases gained a decibel.
Yaseni’s therapy also yielded exciting
results. For the past year, she has been
unable to sustain voice for greater than
a second in spite of consistent breathing
exercises and voice training during therapy.
family have noted that Yaseni’s improved
A recent vocal cord surgery enabled her
communication has bolstered her self-
to speak just above a whisper, and she
confidence and improved her social
still struggled to articulate her words. She
interactions.
depended heavily on an alphabet board in
order to communicate with others.
Using the LSVT program, her individual
Future Research
The LSVT Foundation continues to
gains have been extraordinary. Her
advocate for future research. Research has
sustained phonation (audible sound)
begun in the areas of multiple sclerosis,
levels improved from 1.36 seconds to
ataxic dysarthria, swallowing, aging voice,
2.42 with a range of up to 5.91 seconds.
vocal fold paralysis, cerebral palsy in
Her sound intensity (voice loudness)
children and down syndrome. t
improved approximately 7 decibels for
sustained phonation, words and phrases.
These improvements took place in just
two short months! Her therapists and
The LSVT Foundation is a nonprofit
almost exclusively volunteer organization
dedicated to preserving the quality
of LSVT and facilitating access to
this powerful treatment to patients
worldwide. The organization also seeks to
increase awareness among the medical
community and advocate for LSVT. In
addition, the foundation educates family
members about ways they can help
their loved one(s) maintain functional
communication while living with the
challenges of Parkinson’s disease.
Resources
LSVT Foundation. (2007). Retrieved July 23,
2007. http://www.lsvt.org/
Cleveland Hearing and Speech Center Fact Sheet
RainbowVisions
10
Interview with Lee Woodruff
Continued from page 6
I was on familiar ground. I was grieving
deficits we were dealing with, I didn’t want
over what happened to Bob.
to make assumptions, and I didn’t want
people telling me what it was going to be
a child, and the grief was overwhelming.
Did you find this experience to be
In your book, you stated, “The journey
different than the loss of your child?
through that grief prepared me, in some
It was different because when you lose
So what was it like when Bob woke up?
way, for the grief to come.” Could you
a child, at least you have your husband to
When Bob woke up, his first words
explain your thoughts?
commiserate with, even though men and
when I walked into the room were, “Where
I think if you’ve never experienced grief
women grieve differently. But when you
have you been, Sweetie?” I was thrilled.
before in your life it’s a very shocking
lose your husband, that’s your life partner;
And after that, I took every little step
experience. The sudden tragedy takes your
and when it’s brain injury, nobody can truly
toward recovery as a positive. Of course
breath away, and of course you are not
tell you how they will recover or what’s
I had worries, Bob was missing a lot of
ready for it. It completely destroys your
going to happen or what it’s going to be
words. But just having him awake after five
sense of normalcy, and you feel awful for
like. You get stuck in limbo.
weeks was amazing – for a while, that was
a long time after the incident. If you’re
like.
enough for me.
not prepared for that, it is really shocking.
During the first few months of Bob’s
You tend to feel that the rest of your life
recovery, you wrote, “I was living in a
Has Bob suffered from depression or
will end up that way. The loss of our child
fog of optimism.” Was that your defense
post-traumatic stress disorder (PTSD)?
prepared me because I learned that time
mechanism, and did it help you cope?
No PTSD, although sometimes Bob gets
really does heal – the situation really does
Absolutely. I did not want to learn too
a little down, but it’s not much different
get better, but it takes time as trite and
much about brain injury; I didn’t want to
from the way he was prior to the injury. He
cliché as that sounds. Having gone through
get on the Internet, and I didn’t want to
hasn’t had the difficulties with depression
that experience at the time, I felt like that
google brain injury. I didn’t want to read
like so many others with TBI. Amazingly,
was the worst thing that could ever happen
articles or hear stories. Until Bob woke
he has escaped much of the worst of that
to me. So when Bob was injured, I felt like
up from his coma and until I knew what
aspect of brain injury recovery. What I
do see that’s different is that Bob can get
overwhelmed more easily, and sometimes
Figure 3
his emotions are more on the surface.
What, if any, benefits have come from this
tragedy?
It’s been a crazy year, and the pace
hasn’t slowed down. So, the dishes sit in
the sink a whole lot more. But as a family,
I think we are more conscious of living in
the moment. We are all together and we
are all appreciative of life – it’s so precious.
The kids are doing great. They get a little
sad when Bob is out of town, but they are
not afraid.
What advice would you like to share
with spouses going through the same
experience?
I think you need to hold onto your
hope and your faith. Family plays such an
Pictured above: A 3-D CT scan of Bob’s face taken January 31, 2006 at the Bethesda Naval Hospital
11
RainbowVisions
important role in the healing process. It
FA L L
2007
AN INTERVIEW WITH
Vinnie Malhotra Executive Producer at ABC
By
Kimberly Paetzold, Editor
Vinnie Malhotra, an executive producer at ABC, was part of the news
team traveling with Bob Woodruff when Iraqi insurgents detonated an
improvised explosive device (IED) near the tank in which the news
team was riding. Vinnie shares his first-hand account of the terrifying
moments that immediately followed the blast.
Hello, Vinnie. We greatly appreciate your taking the time to
interview with “RainbowVisions.” We interviewed Lee Woodruff on
her husband’s rehabilitation and recovery, but we wanted to get
your perspective on the actual bombing incident. First, how did you
get to know Bob Woodruff and become his producer at ABC?
I came to “World News Tonight” as an anchor producer for Peter
Jennings. Then 9/11 happened, and our lives were turned upside
down. I started going overseas covering stories in Afghanistan,
Pakistan and eventually Iraq. Even though I was the producer for Peter
Jennings, Bob Woodruff and I ended up working on various projects
together. After Peter got sick, he had to stop working and that’s
when I started to work more with Bob. We went to Rome together
to cover the death of Pope John Paul II and the election of the new
pope. When it was officially announced that Bob was going to be
the anchor of “World News Tonight” along with Elizabeth Vargas, we
ended up on the road together non-stop.
You were with Bob Woodruff and Doug Vogt inside an Iraqi tank
when both were hit by a roadside improvised explosive device.
Could you tell us what happened?
Usually when we report, Bob is talking directly to the camera
explaining what is going on. Bob was going to talk about the corridor,
this road we were traveling down, and
how the Iraqi’s had taken over the security
responsibilities from the American troops.
It was an example of how things were
starting to work with the security forces in
Iraq.
Bob and Doug Vogt [the cameraman]
were standing up through the hatch so I
could see Bob from the waist down. I was
in the tank with our soundman, Magnus
Macedo, and that is when the IED went off.
They were waiting for us, watching the
convoy. When they saw four targets [two
Iraqi soldiers on the top of the tank along
with Bob and Doug] they detonated the
bomb remotely. The IED went off in the
median of the road on the left side of the
tank. It was a homemade bomb made of
rocks, pebbles and stones.
[The blast] shook the entire tank and
Pictured above: Vinnie Malhotra in his office at
“ABC Nightline” in New York, New York
Pictured below Part of the “ABC Nightline” set in New York City
Pictures & interview by Kimberly Paetzold
RainbowVisions
12
Interview with Lee Woodruff
improve the lives of servicemen – those
anywhere if we do not work together.
with traumatic brain injuries (TBIs)
We also want to advocate so that
who were wounded in service to their
returning veterans are able to access private
definitely takes a will to live and recover,
country and their families. TBI is the
providers when it doesn’t make sense to
but it’s also helping someone heal with
signature wound of this war. We are not
go to a veteran’s hospital. Many soldiers
love and touch. There are so many different
only interested in helping those who
are from small towns or rural areas and
tools that can be used in recovery.
sustain severe injuries like Bob, but those
don’t have reasonable access to therapy
You have to let yourself acknowledge
with mild brain injuries suffering with
or supports. I am actually going down
that there are bad days because they will
depression, post-traumatic stress disorder
to Capitol Hill to speak with a group of
come. For a while, I had to just live hour to
(PTSD), combat fatigue and other stress
senators working on bills to help correct
hour, not even day by day to get through.
disorders.
this situation.
But anything is possible.
We just hired an executive director Will you be working with the Veterans
René Bardorf. She has worked with Marines
Your family established the Bob Woodruff
Administration to accomplish your goals?
with brain injuries for a long time. She was
Family Fund for Traumatic Brain Injury
Yes. We are going to need participation
with Marines for Life, an organization that
to assist military veterans with cognitive
from the U.S. Department of Veteran’s
provides transition assistance to Marines
rehabilitation and other care needs. Could
Affairs as well as from the U.S. Department
leaving active service. René is going to help
you tell us about this foundation?
of Defense. It’s going to have to be a
determine what is viable and possible for
Our number one mission is to help
combined effort. This project will not go
this foundation. t
Photo by Cathrine White
Lee Woodruff
Lee Woodruff is a public relations executive and freelance writer. With more than 20
years experience in marketing and public relations, she works with international cosmetic
company Benefit Cosmetics and Built NY, a line of home products. Since opening her own
business in 1991, she has handled a wide variety of clients from the healthcare and travel
industry to electronics and accessories market.
As a freelance writer, Lee has written numerous corporate materials, and her
articles have appeared in Health magazine, Redbook, Country Living magazine and
Family Fun, to name a few. Over the years, she has written articles with a personal slant
about family life and the often humorous and poignant moments of being a parent.
Currently, Lee is also a contributing editor of Family Fun magazine
where she writes about health and travel. She also serves as a
spokesperson, appearing on national and regional broadcasts
about various topics on behalf of the magazine.
Lee and her husband Bob are authors of “In an Instant”– a
book about their family’s difficult journey during Bob’s critical
injury in Iraq while anchoring a broadcast for ABC News. It is
also a story of life, relationship and family.
The mother of four children, she lives in Westchester
County, New York, with her husband Bob, an anchor/reporter
for ABC News. 
13
RainbowVisions
FA L L
2007
AACBIS
Corner
BRAIN INJURY SPECIALIST
Post-Traumatic Stress Disorder & Families
By Heidi
Reyst, PhD, CBIST Systems Director
Most people understand the word “trauma”, but few can
define what an individual or family may experience following
a traumatic event. Most cases of post-traumatic stress disorder
(PTSD), or acute or delayed situational stress, are healable – but
the trauma experience can scar an individual and family. PTSD
can affect an entire family because it’s an anxiety reaction. For
families who have a loved one with a brain injury, anxiety is
usually one of the first emotions following the knowledge of
the incident. As families attempt to grasp what has occurred,
symptoms may appear that are often confused with mourning.
It is important to be able to identify symptoms of PTSD. If
individuals start exhibiting many of the symptoms listed (see
chart below), a counselor should be contacted. It is essential to
differentiate between normal mourning and PTSD, as trauma is the
precursor to PTSD for some individuals. Recognizing and treating
symptoms before they develop into a psychiatric disorder should
become a primary concern. t
Symptoms of Post-Traumatic Stress Disorder
1. Vigilance and scanning – Constant checking on what is going on beyond normal questions and answers
2. Elevated startle responses – Being overly jumpy when startled and surprised.
3. Blunted affect or psychic numbing – There is a reduction in or of loss of the ability to feel. This may include a reduced ability to
bond with others, especially other family members. It is usually a form of distancing in preparation for experiencing more pain.
4. Aggressive, controlling behavior – This form of aggression is not usually from the survivor but from family members. The person
acts somewhat viciously to responses from people or to situations.
5. Interruption of memory and concentration – Difficulty concentrating and remembering, even if just told about something
6. Depression – Deep feelings of despondency, exhaustion, negative attitude and apathy toward others.
7. Generalized anxiety – Tension in the body, cramps, headaches, stomachaches, etc. for no physical reason.
8. Episodes of rage – Not mild anger, this refers to violent eruptions to situations or people, often following a minor incident.
9. Substance abuse – In an attempt to reduce stress-related symptoms, the person may seek substances such as alcohol to numb
feelings.
10. Intrusive recall – Old and negative memories suddenly appear from the past in the mind. These are the same type of responses that
a person experiences during a nightmare, making the person feel very uncomfortable.
11. Dissociative “flashback” experiences – A form of intrusive recall where the person’s mind replays a particular form of action
that feels like it is happening now. It is an extremely emotionally charged memory.
12. Insomnia – Difficulty falling asleep or staying asleep. Sometimes the person has experienced nightmares or has reached a level of
exhaustion that affects the ability to reach a restful sleep.
13. Suicidal ideation – Thoughts of not wanting to live should their loved one die. The person is at a very low point in life because of
what has occurred.
14. Survivor guilt – A common “trade off ” belief where the family member prays for God to take him instead of the loved one. This is a
very common reaction when the survivor is a child.
RainbowVisions
14
Pediatric
Medical
News
COMPLICATIONS OF
Type 2 Diabetes in Children
By
Vicky Scott, RNC, NP - Nurse Practitioner
This is part II of “The Obesity / Diabetes
Connection – Overweight kids are at
Various treatments and tools for diabetes
an increased risk for type 2 diabetes.” A
download of the complete article and
accompanying list of references, is available
at our web site: www.rainbowrehab.com
Signs and Symptoms
ability to heal and resist infections.
Select Education & Publications > Article
Type 2 diabetes often develops gradually.
Some children with type 2 diabetes have
Downloads > Medical and Nutritional> The
Signs or symptoms may include:
patches of dark, velvety skin in the folds
Obesity/Diabetes Connection.
• Increased thirst and frequent
and creases of their bodies – usually in the
urination: As excess sugar builds in the
armpits and neck. This condition, called
bloodstream, fluid is pulled from the cells.
acanthosis nigricans, may be a sign of
ype 2 diabetes (formerly referred to
This may leave the child thirsty causing
insulin resistance.
as adult-onset diabetes) is on the rise in
them to drink and urinate more than usual.
children – largely fueled by the current
• Extreme hunger: Without enough
Risk Factors
obesity epidemic. This increasingly
insulin to move sugar into the cells,
Researchers don’t fully understand why
T
some children develop type 2 diabetes and
common condition presents special
challenges for parents and children alike.
It is a chronic condition that affects the
Type 2 diabetes can affect nearly
way the body metabolizes sugar (glucose).
every major organ in the body,
Type 2 diabetes in children develops when
including the heart, blood vessels,
the body becomes resistant to the effects
of insulin, a hormone that regulates the
nerves, eyes and kidneys.
others don’t. It’s clear that certain factors
increase the risk:
• Weight: Being overweight is a primary
risk factor for type 2 diabetes in children.
The more fatty tissue a child has, the more
resistant the cells become to insulin. The
good news is that many children who have
absorption of sugar into the body’s cells. It
also occurs when the pancreas produces
muscles and organs become depleted of
type 2 diabetes can improve their blood
some but not enough insulin to maintain
energy. This triggers intense hunger.
sugar levels simply by losing excess weight.
a normal blood sugar level. Prediabetes,
• Weight loss: Despite eating more than
• Inactivity: The less active the child is, the
a precursor to type 2 diabetes, is also a
usual to relieve hunger, the child may lose
greater the risk of type 2 diabetes. Physical
concern. Left untreated, prediabetes can
weight. Without the energy sugar supplies,
activity helps the child control his or her
progress to type 2 diabetes.
muscle tissues and fat stores simply shrink.
weight, uses glucose as energy, and makes
There’s no cure for type 2 diabetes, but
• Fatigue: If the child’s cells are deprived
the cells more sensitive to insulin.
there’s plenty that can be done to help a
of sugar, he or she may become tired and
• Family history: The risk of type 2 diabetes
child manage or prevent the condition.
irritable.
increases if a parent or sibling has type 2
Encourage the child to eat healthy foods,
• Blurred vision: If the child’s blood sugar
diabetes, but it’s difficult to tell if this is
get plenty of physical activity and maintain
is too high, fluid may be pulled from the
related to lifestyle, genetics or both.
a healthy weight. If diet and exercise
lenses of the eyes. This may affect the
• Race: Although it’s unclear why, children
aren’t enough, the child may need oral
ability to focus clearly.
of certain races – especially blacks,
medication or insulin treatment to manage
• Slow-healing sores or frequent
Hispanics, Native Americans and Asians —
his or her blood sugar.
infections: Type 2 diabetes affects the
are more likely to develop type 2 diabetes.
15
RainbowVisions
FA L L
2007
About the Author...
When to Seek Medical Advice
To diagnose type 2 diabetes
before it does serious damage,
Vicky Scott,
Nurse Practitioner
Education: Vicky Scott has a Master of Science Degree
diabetes screening is recommended
in Nursing from the University of Michigan in Ann Arbor,
for all children and adolescents
Michigan. She is a Certified Nurse Practitioner and Certified
at high risk, even if they have no
Neuroscience Registered Nurse.
signs or symptoms of the condition.
Experience/Specialty: Ms. Scott has many years of
Consult your health care provider if
you are concerned about diabetes
or if you notice any of the signs or
symptoms including increased thirst
and frequent urination, extreme
hunger, weight loss, blurred vision,
fatigue, slow-healing sores or
varied clinical experiences, including her role as a Nurse
Practitioner with Neurosurgical practices in Ann Arbor,
Michigan and Lexington, Kentucky. She has experience as a Clinical Nurse Specialist
in neuroscience at Genesys Regional Medical Center working closely with the trauma
team and neurosurgeons treating acute traumatic brain injury. Vicky also has four years
experience providing primary care in a rural Michigan Family Practice.
frequent infections.
Complications
Type 2 diabetes can be easy
night, a child might wake with sweat-
to break down fat, producing toxic acids
to ignore, especially in the early stages
soaked pajamas or a headache. Thanks
known as ketones. Watch for loss of
when the child is feeling fine – but the
to a natural rebound effect, nighttime
appetite, nausea, vomiting, fever, stomach
condition must be taken seriously. It can
hypoglycemia might cause an unusually
pain and a sweet, fruity smell on the child’s
affect nearly every major organ in the body,
high blood sugar reading first thing in the
including the heart, blood vessels, nerves,
morning.
eyes and kidneys. Keeping blood sugar
If signs or symptoms of low blood sugar
levels close to normal most of the time
develop, give the child fruit juice, glucose
can dramatically reduce the risk of these
tablets, hard candy, regular (not diet) soda
complications.
or another source of sugar. If the child loses
consciousness, an emergency injection of
Short-term Complications
glucagon may be needed. (Glucagon is
Short-term complications of type 2
a hormone that stimulates the release of
diabetes require immediate care. Left
sugar into the blood.)
untreated, these conditions can cause
• High blood sugar (hyperglycemia):
seizures and loss of consciousness (coma).
Likewise, blood sugars can rise for many
• Low blood sugar (hypoglycemia): If
reasons including overeating, insufficient
the blood sugar level drops below the
insulin amounts or illness. Watch for
target range, it’s known as low blood
frequent urination, increased thirst, dry
sugar. Blood sugar level can drop for many
mouth, blurred vision, fatigue and nausea.
reasons including skipping a meal, getting
If you suspect hyperglycemia, check the
more physical activity than normal or
child’s blood sugar. You might need to
injecting too much insulin. Watch for early
adjust the child’s meal plan or medications.
signs and symptoms of low blood sugar
If the child’s blood sugar is dangerously
such as sweating, shakiness, weakness,
high, call the child’s health care provider
hunger, dizziness and nausea. Later signs
right away or seek emergency care.
and symptoms include slurred speech,
• Increased ketones in your child’s urine
drowsiness and confusion.
(diabetic ketoacidosis): If the cells are
If hypoglycemia develops during the
starved for energy, the body may begin
RainbowVisions
16
TBI
Community
Education Series
Presentation on:
Improving Behaviors
November 2007
Speakers:
Colin King, PhD, LLP
Scott Gray, MS, LLP
Robert Wancha, MA, LLP, CBIS
Joseph J. Welch, MS, LLP
Jennifer D’Angela, MS, LLP, CBIS
Mary Newton, LMSW, CBIS
Are you coping with a loved one or patient with antisocial or destructive behaviors? In this presentation,
Improving Behaviors: Strategies and techniques for
improving difficult behaviors in individuals with
TBI, a panel of mental health professionals will speak
on principles of behavioral management as well as
strategies and techniques for developing and monitoring
effective behavior modification plans. Following a
short presentation, the panel will open the floor for an
interactive question and answer period.
This meeting will afford you answers and education on:
Improving Behaviors Presentation:
When: Wednesday, November 7, 2007
11:00 a.m. – 1:00 p.m.
(Lunch & beverages provided)
• Current behavior management approaches
• Avoiding negative methods
Where: Ypsilanti Public Library
• Promoting responsible behavior
• Effective teaching and coaching
• Averting problems before they start
• Special challenges in working with TBI survivors
• How to implement an appropriate behavioral intervention
• Ideas and resources that can help
• Understanding the behavior-change process
5577 Whittaker Road in Ypsilanti
(Across the street from Rainbow’s
Ypsilanti Treatment Center)
Cost:
Free-of-charge for registered guests
Please register by October 31, 2007
• The role of rules and routines
Phone: Fax: E-mail:
• Reinforcement techniques
• Maintaining and increasing desirable behaviors
• Effective plan monitoring
17
RainbowVisions
(734) 482-1200 x172
(734) 482-5212
[email protected]
FA L L
2008
2007
Upcoming Community Education events...
Accessible
Home Modifications
Covering clinical evaluations, the building process
and new available accessible home products.
Coming 2008
About Rainbow’s Community Education Series...
Do you find that it’s more difficult to relate to your loved one following their brain injury? Do they have
difficulty coping? Perhaps they act out or are struggling with depression.
Rainbow Rehabilitation Centers, Inc. offers quarterly community education seminars that cover topics
related to brain injury rehabilitation. A leader in the field, Rainbow has treated individuals with mild,
moderate and severe brain injuries as well as dual-diagnosis of brain and spinal cord injury for 24
years. Our comprehensive rehabilitation services are delivered through a vast network of treatment
environments including Therapy Treatment Centers, Residential Community Homes and Apartments, a
NeuroRehab Campus and a Vocational Center.
1.800.968.6644
For up-to-date information on our quarterly
Community Education presentations, log on to
RainbowVisions
18
An Interview with
Vinnie Malhotra
stopped it in its tracks. That’s when Bob
collapsed. Thank God Magnus and I
weren’t injured because we were able to
provide some assistance. We were stuck in
the tank for a few minutes after the initial
blast. There was screaming, yelling and
gunfire – I remember trying to get Bob to
open his eyes and wake up. There was a
gaping hole in Bob’s neck, and I put my
hand over it to stop the bleeding.
The gunfire was all around us because
our convoy was hit with an ambush after
the blast. Our friends were bleeding to
death – on the verge of dying and we
couldn’t get out. Our troops [the U.S.
Military] embedded in the convoy created
a parameter around the tank and fought off
the ambush. At that point, the back hatch
of the tank opened and Bob was put on a
stretcher. I was screaming to Bob, “You’re
going to be OK. You’re going to be OK.”
And he asked, “Am I alive?” Eventually,
they got Bob and Doug into the MedEVAC
helicopter. Altogether it was a relatively
quick process, but it felt like an eternity.
Bob was in a coma for over a month.
I spent a lot of time with Lee and with
Vivian, Doug Vogt’s wife. Doug was never
in a coma, and I was there through a lot of
his recovery.
Doug Vogt incurred a brain injury but
not as severe as Bob, who was in a coma
for five weeks and was diagnosed with a
severe TBI. Could you tell us what it was
like watching him wake up from his coma,
go through rehabilitation and eventually
come back to work?
For me it was a very emotional and trying
experience. I remember the day we got the
phone call that Bob had woken up from
the coma. That was an incredible day. I
remember seeing Bob and realizing that
he had a long road to recovery. Watching
his development from week to week – his
progress was just incredible. There were
times where he seemed to have leveled
off, but then all of a sudden he would pick
back up. Bob’s personality is gracious,
compassionate, curious and very sharp,
and it was all coming back.
Pictured above: A 3-D CT scan of Bob’s skull showing all the rocks that
were embedded into his face, neck and around his eyes. Taken at the
Bethesda Naval Hospital.
19
RainbowVisions
The doctors were concerned about his
speech. Did that come back quickly?
The moment Bob came out of that coma,
he was speaking. I always felt confident
about [his speech] because after the bomb
blast, he asked me in a very clear voice,
“Am I alive?”
I think Bob has gotten back to television
journalism because he is one of the most
driven individuals I have ever met. He
approached his rehab with exceptional
drive. He tried to read The New York
Times very early on, would engage in
conversations about Fidel Castro and
Middle East politics, and wanted a world
map so he could study it. I was always
amazed that he never lost steam. I’m sure
he went through some very dark periods
and dealt with depression, but every time I
saw Bob he was very positive and driven.
Bob himself will tell you that nobody gets
back 100 percent after a severe TBI but his
recovery has been more than I could have
ever hoped for. He’s a great inspiration for
anybody who has survived a brain injury.
Bob worked on the documentary “Bob
Woodruff: To Iraq and Back” (February
2007) and has worked on some additional
stories – following some of the soldiers
that you see in the February documentary.
Is Bob dedicating a great deal of his time
to reporting on the war veterans?
Very much so. U.S. veterans of the war in
Iraq are a big part of who Bob is now. Long
after this war is over, we are going to still
have thousands of survivors with massive
brain trauma, lost limbs and other injuries.
IEDs are vicious, and even though we
have much more sophisticated protective
armor, it does not protect your limbs and
head from bombs. The post-traumatic
stress disorder and the psychological
ramifications of this war are tremendous.
Soldiers are coming back shell-shocked –
witnesses to exceptionally violent acts. We
have to consider these are 18, 19 and 20
year olds. Regardless of what the debate in
the country is about, whether we should
be in this war or not, the one thing that
there is no debate about is the soldiers
and what they are doing out there. It’s just
unbelievable.
As a producer, do you still work with Bob
Woodruff?
I do work with Bob, but not directly. I
work closely with him in terms of helping
shape and develop stories for different
shows. Bob is an excellent journalist. He’s
been through an incredible traumatic brain
injury, yet he can still carve out a script.
He still has vision of how he wants to
approach a story, and he can still ask the
tough questions. He’s a walking miracle.
Nobody should ever be fooled if they are
having a conversation with Bob Woodruff.
He may slip on a word here or there, but
he is still very sharp and knows exactly
what’s going on.
Has this incident changed you in any way?
It has changed me a great deal. I really
don’t want to be that close to the action
anymore, but I still have an incredibly
large respect for that style of coverage. If
someone’s not doing it [reporting in the
war zones], then we’re not going to get it.
A lot of people say that news media shows
FA L L
are too violent, but it is important to show
because it is a daily occurrence. There
are soldiers coming back wounded with
brain injuries, with missing limbs, etc. Not
covering this news is disrespectful.
When you hit the ground in Iraq, you feel
danger, and you feel it very closely. You can
– dare I say – smell violence in the air. It is
a very angry place, and you have to watch
your back at all times. If this is not reflected
in news coverage, then I think it becomes
rather disingenuous.
You spent time in Afghanistan, a
very violent country. How does the
atmosphere there compare to Iraq?
There was a totally different feel to Iraq
compared to Afghanistan. In Afghanistan
there was not the ever-present feeling of
danger, and we were able to travel a bit
more freely. There were pockets that were
very violent, but as a whole, the country
was rebuilding itself and trying to get out
of the fog of war. In Iraq you can’t escape
the violence. In the beginning we traveled a
2007
little more freely but the situation worsened
over time. Now the violence is everywhere.
A very close friend of mine, James Brolan,
who worked for CBS News was with
Kimberly Dozier (CBS News correspondent)
in Baghdad on Memorial Day 2006 when
a car bomb went off right next to them. He
was killed instantly, and they had not even
left the city. 
When Mr. Malhotra was interviewed in June,
he was a senior producer for ABC’s “Nightline”
managing production staff and editorial content
for the show. Shortly after that interview, he
became executive producer of news content for
ABC News weekend programming, overseeing
editorial content and production of ABC’s two
weekend evening news broadcasts, “World News
Saturday” and “World News Sunday” including
material for ABC News.com and “ABC News Now.”
He also is a senior producer of “World News With
Charles Gibson.”
Mr. Malhotra has been with ABC News since
1997 and has received four Emmys for his
coverage of Iraq.
Below: ABC “Nightline” anchor chair at the studio in New York City
RainbowVisions
20
From
Rainbow’s
Residential Program
RAINBOW CLIENT
G
Gabe Mussehl
By
Kirstin Olmstead, staff writer
abe Mussehl has always loved books.
As a young girl growing up in France,
she remembers hiding her books in
between the sheets and reading at night.
Her father was also an avid reader and
instilled in Gabe a love for books.“I think
that is where I get it from,” said Gabe, “At
Gabe Mussehl (pictured above) volunteers at the Canton Library three days a week.
For her dedication and service, she was recently recognized as “Volunteer of the Year”
by the library’s staff.
night sometimes my mother could not
find him. He had made a little room in the
her case manager. “It keeps her mind active
consistency volunteering three days a
basement with a chair and a lamp in there.
and stimulates her by providing time for her
week earned her special recognition by
He had his books, and he would read.”
to interact with different people.”
the library staff. She was named “Volunteer
Prior to joining Rainbow Rehabilitation
One of Gabe’s responsibilities at the
of the Year!” in April. “It makes me feel
as a patient in early 2001, Gabe and
library is to remove the radio-frequency
good,” said Gabe of her volunteer work,
her husband would frequent the Canton
identification (RFID) tags from the books
“especially when you are doing good
Library weekly. It soon became a familiar
being discontinued from the library’s
for other people. Then they appreciate
you. They tell me every time, ‘Gabe, we
place, but a tragic automobile accident in
the fall of 2000 would prevent Gabe from
returning to the library for a long time.
With extensive injuries following
her accident, Gabe faced several years
of therapy and rehabilitation. As her
strength returned, she began to search for
“It’s a joy having her [Gabe] here.
Over the years, she’s become a
valuable part of our team. “
– Gale Forster, Canton Library Associate
appreciate it. You don’t know what [good
work] you are doing.’”
“It’s a joy having her here,” said Gale
Forster a library associate responsible
for coordinating work for the volunteers.
“Over the years, she’s become a valuable
part of our team.”
opportunities to keep her busy.
With the assistance of Rainbow’s
circulation. She then scans the tags to
In addition to volunteering at the library,
Residential Program Director Tanya Lee
prepare them for use in new books the
Gabe also works behind the counter at
and Vocational Specialist Laurie Cooke,
library will be adding to its collection.
Rainbow’s Ypsilanti Treatment Center
Gabe began looking for employment. That’s
“I like it there, and I like to help. I will
Corner Café twice a week. She offers a
when she remembered the Canton Library.
ask them [the library staff], ‘What would
friendly face to those looking for a mid-
After approaching Laurie Cooke about the
you like me to do today?’ Then they would
afternoon pick-me-up candy bar or a can
opportunity, Laurie helped coordinate a
tell me they have the stuff ready for me. I
of soda. Gabe also loves knitting and
schedule with the library, and Gabe soon
[attach] the little tags that you put in the
crocheting. Her beautiful afghans are
returned as a volunteer there in the spring
books.”
available for purchase at the Van Buren
of 2004.
With 45 service volunteers who donate
Senior Center. “Volunteer work has helped
“I wanted something to do. It just came
2,500 combined hours of their time each
her feel better about herself because she is
to me. I could go to Canton [library].”
year, it would be easy to be just one face
helping people,” said Tanya Lee, “Gabe is
“She initiated it,” said Kathleen Sobczak,
among many. Gabe’s dedication and
more confident, and it’s helped reintegrate
her into the community.” 
21
RainbowVisions
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Rainbow Client Activities
Summer 2007
Throughout the year, Rainbow offers both
adult and pediatric clients the opportunity
to engage in a variety of communitybased activities. Facilitated by recreational
therapists, these organized events provide
clients with the chance to participate in
favorite pastimes and gain exposure to new
activities.
“Our basic goal is to offer our clients
community reintegration and quality of
life opportunities,” said Nancy Miller,
recreational therapist at Rainbow’s Ypsilanti
Treatment Center.
This past summer, she planned a variety
of outings for adults in Rainbow’s treatment
program ranging from Detroit Tigers games
to trout fishing.
“Going trout fishing is usually a big hit,”
said Miller. “Everybody catches a fish, no
matter what level. We see so many smiles
when that occurs.”
The program offers several monthly
events for its participants, and Miller takes
great pains to vary the outings so that they
remain interesting for Rainbow’s adult
clients.
Adult Outings – Summer 2007
Ethnic Restaurant Dining
Detroit Tigers Game
Local Entertainers
Trout Fishing
Detroit Zoo
Henry Ford Museum
Natural History Museum, U of M
Musical Performing Groups
African-American Museum
2007
Summer Fun! Outings 2007
Kensington Metropark
Crossroads Village & Huckleberry Railroad
Water Parks
Rock Climbing & Ropes Course
Horseback Riding
Belle Isle Nature Park
Camping
Ford Community Performing Arts Center
Detroit Tigers Game
•
FALL 2006
Above: Cooper Loose sits astride a horse at
the riding stable. He and fellow “Summer Fun!”
participants eagerly awaited a trail ride led by the
stable’s staff.
Pediatric program participants also look
forward to summer activities planned for
the “Summer Fun!” program. Created
by pediatric rehabilitation specialists,
“Summer Fun!” offers children and teens
with brain injuries a structured Monday
to Friday schedule when school is not in
session.
Valerie Tuomi is the recreational therapist
for the pediatric group. She recently
coordinated a horseback riding activity at
the Brighton Recreation Area Riding Stable
for children enrolled in the program.
Staff at the stables hand-led the horses
during a 45-minute trail ride, and all of
the riders were required to wear a helmet,
reinforcing the importance of safety.
“We’re working on community
independence and definitely safety skills,
especially for our little ones – how to deal
with strangers and awareness of their
surroundings,” said Tuomi of the outings.
“It’s also just an opportunity for them to
have fun with their group and work on
social skills while they’re hanging out.”
A resident in Rainbow’s apartment
program, Mark Fornetti is an avid
outdoorsman. He loves to hunt and each
fall joins family members at the hunting
camp his father built, located north of Iron
Mountain in Michigan’s Upper Peninsula.
He loves the sport and the peace and
quiet of the woods. His sister, Arlene, notes
that Mark also enjoys camp because he
plays a pretty mean card game, frequently
defeating his brothers.
Although he may have a knack for card
playing, his true passion is hunting. After
many days of sitting quietly in his deer post
surrounded by pine trees from sunrise until
sunset, Mark finally shot the “big one” – a
huge six-point buck – just three days before
deer season ended! Afterward, he dragged
the buck more than 300 yards back to
camp.
A quiet man, who rarely proclaims his
own accolades, Mark beamed when his
sister said she is having the deer head
mounted. He hopes to get another deer
when he returns to the Upper Peninsula this
coming fall. 
Below: Mark Fornetti with his six-point buck
RainbowVisions
22
themselves. Intact memories and overlearned information (for example, riding a
bike or performing a sequence of job tasks)
frequently represent areas of strength. These
preserved skills can be drawn upon when
helping redevelop vocational goals.
Sometimes an individual may appear
to have a memory impairment when, in
fact, they have difficulty paying attention.
Inattentiveness can be remediated or, at
least improved by cognitive rehabilitation
(Sohlberg and Mateer, 1989).
Abstract Thinking and Conceptualization
An important concern for return to
work is whether the individual with
brain injury is able to engage in abstract
thought. They may find it difficult to shift
to other aspects of a problem or to readily
search for alternatives. They may lack
the capacity for imaginative thought and
remain poor problem solvers. Difficulty
with abstract reasoning limits the types
of productive activity an individual can
pursue autonomously and impacts the
range, complexity and variety of tasks they
can successfully attempt.
Conceptualization, which is dependent
on the capacity to think abstractly, is
another area in which the individual may
exhibit cognitive deficits. The ability to
effectively conceptualize lies within the
realm of higher-level cognition. One must
possess a store of learned material that is
reliably and readily drawn upon in order
to “imagine” or form a mental picture,
organize these mental events and be able
to translate this cognitive activity into an
observable behavior/skill. Problems in the
ability to conceptualize can significantly
impact employment pursuits (Brain Injury
Handbook, 2006).
Executive Functioning
Deficits in executive functioning are
the result of frontal lobe damage. Intact
executive functions allow an individual to
engage in autonomous, independent, well
23
RainbowVisions
planned, effectively organized, sufficiently
monitored, self-regulated, purposeful
or goal-directed tasks or behaviors.
When these capabilities are diminished
as the result of brain injury, individuals
have difficulty sustaining employment,
maintaining satisfactory social relationships
and, at times, maintaining adequate selfcare, regardless of how well other cognitive
capacities are retained.
Frontal Lobe
When executive skills are impaired,
individuals have difficulty functioning
productively. These individuals are viewed
as poor self-managers. Those who appear
capable are probably the most difficult to
treat or evaluate vocationally. They cannot
accurately monitor their abilities and need
frequent feedback. Without feedback, they
do not understand how their weaknesses
impact their ability to work.
While capable of engaging in complex
activities, those impaired in executive
functioning may lack the capacity to
develop plans or initiate purposeful activity.
In extreme cases, these individuals may
appear apathetic and unable to initiate
except in response to external stimuli. The
ability to become engaged dynamically
in interactive and intentional behavior is
basic to executive skills. As mentioned
earlier, when this capacity falters, persons
with brain injury can erroneously be
labeled lazy or unmotivated (Brain Injury
Handbook, 2006).
Psychosocial Issues
Work, both volunteer and paid
employment, is deeply valued in our
society. Because of this, more than just an
injured worker’s physical and cognitive
abilities should be considered when
trying to help him or her return to work.
Work helps to establish personal identity,
self-worth and standing in the community,
family and social groups. When a person is
engaged in meaningful, gratifying work, it
contributes to his overall sense of wellbeing and life balance.
When a person’s ability to work is
affected by a brain injury, psychosocial
issues must be considered. They can be
equally if not more debilitating than the
physical and cognitive effects. When
unable to return to their former work role,
individuals may experience many or all of
the following psychosocial effects:
• Grief and feelings of loss related to
personal identity in the role of worker and
wage earner
• Grief and loss of standing or authority in
FA L L
2007
About the Authors...
the family
• Actual loss of wages/income
• Lack of appropriate leisure skills
or interests, especially if the person
was considered a “workaholic”
previous to his or her disability
• Excessive idle time that could
lead to unhealthy or inappropriate
use of time (e.g. recreational drug
use or abuse)
• Loss of social contact or social
network
• Isolation or withdrawal that can
lead to depression, anxiety and
other forms of emotional distress.
As mentioned previously, many
types of cognitive and physical
R
disabilities can be overcome with
adaptations and compensations.
However, psychosocial issues are
often more difficult to identify
and accommodate. When
accommodations and adaptations
are used, they are often rejected by
the worker and/or the employer.
When a person experiences an
injury resulting in a permanent
disability, several psychosocial
factors may influence their
willingness or reluctance to return
to work:
• Fear of the employer and/or
employee that the worker no longer
possesses the skills or abilities to
perform the job
• Adaptations that are required
are seen as bothersome by the
employer, or the employee may feel
embarrassed and uncomfortable
asking for the adaptations
• Subtle or non-tangible disabilities
such as cognitive deficits, mental
illness or substance abuse disorders
are difficult to accommodate and may
significantly impact a worker’s performance
• Obvious or known use of adaptations or supports on the job could be related to feelings of inadequacy and a reluctance to
return to work.
A psychosocial effect often seen in brain
Angie McCalla,
Speech Language Pathologist (SLP)
Education: Angie McCalla, MS, CCC-SLP, CBIS has a master of science degree in speechlanguage pathology from Bowling Green State University in
Ohio and a bachelor of science in communication disorders
from Central Michigan University in Mt. Pleasant, Michigan.
Experience/Specialty: Angie is the Lead Speech-Language
Pathologist with over 11 years of experience at Rainbow
and 13 years experience treating persons with a range of
neurological impairments. She currently holds specialty
certification in Deep Pharyngeal Neuromuscular Stimulation
(DPNS) and the Lee Silverman Voice Treatment (LSVT). Angie
is also a certified Brain Injury Specialist (CBIS), a member of
the American Speech Language Hearing Association (ASHA)
and the Michigan Speech Language Hearing Association (MSHA.)
Laura Konrad,
Occupational Therapist (OTR)
Education: Laura Konrad, OTR, NDTC, CBIS has a Bachelor of Science degree in
Occupational Therapy from Eastern Michigan University in
Ypsilanti, Michigan.
Experience/Specialty: Laura is the Lead Occupational
Therapist at Rainbow and has over 14 years of experience
working with people with brain injuries and neurological
disorders at all levels of recovery. She has been with Rainbow
for 12 years and holds certifications in Neuro-Dynamic Therapy
and Brain Injury Specialty. Laura is a member of the American
Occupational Therapy Association (AOTA), the Michigan
Occupation Therapy Association (MiOTA) and is a certified
Brain Injury Specialist (CBIS).
injury that further confounds potential
success is that a person may not be able
to return to the same level or position
they previously held. This can lead to
resentment and bitterness because they are
taking a position that is “beneath” them
or that has “less importance” than their
previous job. This presents a challenge
to the rehabilitation team, family and
the injured worker. They must identify a
work experience that suits their current
abilities and interests and that will promote
satisfaction and pride.
RainbowVisions
24
Type 2 Diabetes
diabetes is a leading cause of blindness.
Even if the child eats on a rigid schedule,
• Foot damage: Nerve damage in the feet
the amount of sugar in the blood can
or poor blood flow to the feet increases
change unpredictably. With help from a
the risk of various foot complications. Left
diabetes treatment team, you’ll learn how
breath. If you suspect ketoacidosis, check
untreated, cuts and blisters can become
blood sugar levels change in response to:
the child’s urine for excess ketones with
serious infections.
• Food: What and how much the child
an over-the-counter ketones test kit. If the
• Skin conditions: Diabetes may increase
eats will affect the blood sugar level. Blood
child has excess ketones in his or her urine,
susceptibility to skin problems including
sugar is typically highest one to two hours
call the child’s health care provider right
bacterial infections, fungal infections and
after a meal.
away or seek emergency care.
itching.
• Physical activity: Physical activity moves
• Osteoporosis: Diabetes may lead to
sugar from the blood into the cells. The
Long-term Complications
lower than normal bone mineral density,
more active the child is, the lower the
Long-term complications of type 2
increasing the risk of adult osteoporosis.
blood sugar level.
diabetes develop gradually. The earlier
• Medication: Any medications the child
the child develops diabetes and the less
Treatment
takes may affect the blood sugar level,
controlled the blood sugar has been, the
Treatment for type 2 diabetes is a lifelong
sometimes requiring changes in the child’s
higher the risk of complications. Eventually,
commitment to blood sugar monitoring,
diabetes treatment plan.
diabetes complications may be disabling or
healthy eating, regular exercise and,
• Illness: During a cold or other illness, the
even life-threatening.
sometimes, insulin or other medications.
child’s body will produce hormones that
• Heart and blood vessel disease: Diabetes
The decision about which treatment is best
raise the blood sugar level.
dramatically increases the risk of various
depends on the child, his or her blood
In addition to frequent blood sugar
cardiovascular problems, including
sugar level and the presence of any other
monitoring, regular glycated hemoglobin
coronary artery disease with chest pain
health problems.
(A1c) testing may be recommended. This
(angina), heart attack, stroke, narrowing of
blood test indicates the average blood
the arteries (atherosclerosis) and high blood
Blood Sugar Monitoring
sugar level for the past two to three months.
pressure.
Depending on the treatment plan,
It works by measuring the percentage of
• Nerve damage (neuropathy): Excess
blood sugar may need to be checked and
blood sugar attached to hemoglobin, the
sugar can injure the walls of the tiny
recorded several times a day. This requires
oxygen-carrying protein in red blood cells.
blood vessels (capillaries) that nourish
frequent finger sticks and is the only way
The higher the blood sugar levels, the more
the nerves, especially in the legs. This can
to ensure the blood sugar level remains
hemoglobin will have sugar attached. The
cause tingling, numbness, burning or pain
within the target range. This may change as
target A1c goal may vary depending on the
that usually begins at the tips of the toes
the child grows and changes.
child’s age and various other factors.
or fingers and over a period of months
Compared with repeated daily blood sugar
or years gradually spreads upward. Left
tests, A1c testing better indicates how well
untreated, the child could lose all sense of
the diabetes treatment plan is working. An
feeling in the affected limbs.
elevated A1c level may signal the need for
• Kidney damage (nephropathy): The
a change in the treatment plan.
kidneys contain millions of tiny blood
vessel clusters that filter waste from the
Healthy Eating
blood. Diabetes can damage this delicate
There is no diabetes diet. A child with
filtering system. The earlier diabetes
type 2 diabetes won’t be restricted to a
develops, the greater the concern. Severe
lifetime of boring, bland foods. Instead,
damage can lead to kidney failure or
he will need plenty of fruits, vegetables
irreversible end-stage kidney disease,
and whole grains – foods that are high in
requiring dialysis or a kidney transplant.
nutrition and low in fat and calories – and
• Eye damage: Diabetes can damage
fewer animal products and sweets. In fact,
the blood vessels of the retina (diabetic
it’s the best eating plan for the entire family.
retinopathy), can also lead to cataracts and
Sugary foods are OK once in a while, as
a greater risk of glaucoma. By adulthood,
long as they’re included in the meal plan.
25
RainbowVisions
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2007
Insulin Pump
Understanding what and how much
include:
to feed a child with diabetes can be a
• Eating healthy foods: Offer foods low in
challenge. A registered dietitian can help
fat and calories. Focus on fruits, vegetables
you create a meal plan that fits the child’s
and whole grains. Strive for variety to
health goals, food preferences and lifestyle.
prevent boredom.
Remember the importance of consistency
• Getting more physical activity:
to keep the blood sugar levels on an even
Encourage the child to get active. Sign up
keel and encourage the same amount of
for a sports team or dance lessons, or look
food (same proportion of carbohydrates,
for active things to do as a family.
proteins and fats) at the same time every
• Losing excess pounds: Make permanent
day.
It is a device about the size of a cell
changes in eating and exercise habits.Better
phone worn on the outside of the body. A
yet, make it a family affair.
Physical Activity
tube connects the reservoir of insulin to
The same lifestyle choices that can help
Everyone needs regular aerobic exercise,
a catheter inserted under the skin of the
prevent type 2 diabetes in children can do
and children with type 2 diabetes are no
abdomen. The pump is programmed to
the same for adults. 
exception. Encourage regular physical
automatically dispense specific amounts of
activity, and make it part of the daily
insulin and can be adjusted to deliver more
routine. Remember that physical activity
or less depending on meals, activity and
lowers blood sugar. If the child requires
blood sugar level.
insulin treatment, check blood sugar level
Many types of insulin are available,
before any activity. A snack might be
including rapid-acting insulin, long-acting
needed before exercising to help prevent
insulin and intermediate options. Examples
low blood sugar.
include regular insulin (Humulin R and
Novolin R), NPH insulin (Humulin N,
Insulin and Other Medications
Novolin N), insulin lispro (Humalog),
Some children who have type 2 diabetes
insulin aspart (NovoLog) and insulin
can control their blood sugar with diet and
glargine (Lantus). Depending on need, a
exercise alone, but many also need oral
mixture of insulin types may be prescribed
medication or insulin treatment.
to use throughout the day and night.
Metformin is the only oral medication
Inhaled insulin (Exubera) hasn’t been
approved for children and adolescents (age
approved for children.
10+) who have type 2 diabetes. Metformin
reduces the amount of sugar the liver
Conclusion
releases into the bloodstream between
Healthy living choices are necessary
meals. Although the drug is effective,
to maintain normal weight and decrease
some brands are only for adult use. Side
the risk of developing type 2 diabetes in
effects may include nausea, upset stomach,
children and adolescents. Similar strategies
diarrhea and, in rare occasions, a harmful
can be used to control weight and blood
buildup of lactic acid (lactic acidosis).
sugar. Healthy lifestyle choices that can
Metformin isn’t safe for anyone who has
help prevent type 2 diabetes in children
liver, kidney or heart failure.
Because stomach enzymes interfere with
insulin taken by mouth, oral insulin isn’t
an option for lowering blood sugar. Often,
insulin is injected using a fine needle and
syringe or an insulin pen (a device that
resembles an ink pen with an insulin-filled
cartridge.)
An insulin pump also may be an option.
Insulin Pen
SOURCES:
1.CDC, National Center for Health Statistics.
National Health and Nutrition Examination
Survey. Ogden et al. JAMA. 2002; 288L 17281732.
2.Fact Sheet: Obesity in Youth – 2002.
American Obesity Association.
3.Ogden CL, Flegal KM, Carroll MD, Johnson
CL. Prevalence and trends in overweight among
US children and adolescents, 1999-2000.
Journal of the American Medical Association
2002; 288: 1728-32.
4.Source: CDC, Youth Risk Behavior
Surveillance- United States, 2005. Morbidity &
Mortality Weekly Report 2006; 55: 1-108.
5.Ogden CL, Carroll MD, Curtin LR, McDowell
MA, Tabak CJ, Flegal KM. Prevalence of
overweight and obesity in the United States,
1999-2004. Journal of the American Medical
Association 2006; 195: 1549-1555.
6.UCSF Children’s Hospital, Childhood Obesity
(2002) Retrieved 3/15/07 from http://www.
ucsfhealth.org/childrens/medical_services/
hdisorder/obesity/
7.Source: Evaluation and Treatment of
Childhood Obesity (American Family Physician
February 15, 1999, http://www.aafp.org/
afp/990215ap/861.html)
8.Mayo Clinic Staff (March 31, 2006) Childhood
Obesity. Mayo Foundation for Medical Education
and Research (MFMER). Retrieved 3/15/07 from
MayoClinic.com, http://wwwmayoclinic.com/
childhood-obesity/DS00698
9.Fact Sheet: Childhood Obesity – 2002.
American Obesity Association. http://www.
obesity.org/subs/childhood/
10. Source: Centers for Disease Control and
Prevention, retrieved 3/15/07 from http://www.
cdc.gov/ website last updated 5/4/07.
RainbowVisions
26
The Roles and the Challenges of the
Rehabilitation Team
Rehabilitation professionals work to
provide remediation in core work skills
and help develop greater self- acceptance.
This is done by focusing on remaining or
new abilities and strengths. When skills
and strengths are identified and optimized,
appropriate placement can be determined,
ensuring work success and satisfaction.
While our society is more accepting of
people with disabilities than it has been
historically, many roadblocks to acceptance
still exist. Rehabilitation professionals can
educate employers and the public of the
value of workers with differing abilities.
Our society and communities are enriched by diversity, especially when a
worker is matched with the right work
environment.
When assisting a person with a brain
injury in ‘return to work’ skills, some
objectives of the rehabilitation team
include:
• Assisting the person to resume and value the role of worker
• Facilitating self-worth and self-image through graded experiences providing a balance of challenge and success
• Improving work skills related to the actual job: Physical, cognitive, technical, social (interaction with peers, ability to take direction from a supervisor) and
executive skills (self-monitoring, evaluation of work completed, problem solving, initiation and motivation)
• Acting as a liaison between the
workplace, insurance companies, government agencies and the worker
• Educating employers and the public of
the value of workers with differing abilities.
Conclusion
Returning to work is an important aspect
of brain injury recovery and rehabilitation.
Gainful employment is highly respected
in our culture. The ability to achieve
successful employment not only leads to
financial stability and independence, it also
provides a sense of purpose, well-being
and social status.
For individuals lacking necessary work
skills, assistive therapies and interventions
by trained professionals can help survivors
reach employment goals. Therapists can
help individuals with brain injuries match
their skills with meaningful jobs, help
them acquire new skills or regain abilities.
Assistance is often necessary in order to
return to work and attain employment
goals. 
See next page for reference list.
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attentive and expert transportation services for individuals with
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References
Boake, C., Millis, S. R., High, W.M., Delmonico, R.L.,
Kreutzer, J.S., Rosenthal, M., Sherer, M., & Ivanhoe,
C.B. (2001). Using early neuropsychologic testing to
predict long-term productivity outcome from traumatic
brain injury. Archives of Physical Medicine and
Rehabilitation, 82, 761-768.
Cifu, D.X., Keyser-Marcus, L., Lopez, E., Wehman, P.,
Kreutzer, J. S., Englander, J., & High, W. (1997) Acute
predictors of successful return to work one year after
traumatic brain injury: A multicenter analysis. Archives
of Physical Medicine and Rehabilitation, 78, 125-131.
Gollaher, K., High, W., Sherer, M., Bergloff, P., Boake,
C., Young, M. E., & Ivanhoe, C. (1998). Prediction of
employment outcome one to three years following
traumatic brain injury. Brain Injury, 12, 255-263.
Gupta, Jyothi, (2006), Workplace Accomodations:
Challenges and Opportunities, OT Practice, 11, 9-14
Jacobs, H.E. (1997) The Clubhouse: Addressing WorkRelated Behavioral Challenges Through a Supportive
Social Community. The Journal of Head Trauma
Rehabilitation; vol. 4 number 5: 42-56.
Kreutzer, J. S., Marwitz, J. H., Walker, W., Sander, A.,
Sherer, M., Bogner, J., Fraser, R., & Bushnik, T. (2003).
Moderating factors in return to work and job stability
after traumatic brain injury. Journal of Head Trauma
Rehabilitation, 18, 128-138.
Miller, Denise, (2004), Psychosocial Issues and the
Return-to-Work Process, OT Practice, 9, 16-20
Sherer, M., Bergloff, P., High, Jr., W., & Nick, T. G.
(1999). Contribution of functional ratings to prediction
of long-term employment outcome after traumatic brain
injury. Brain Injury, 13, 973-981.
Sherer, M., Hart, T., Nick, T.G., Whyte, J., Thompson,
R.N., & Yablon,S. A. (2003) Early impaired selfawareness after traumatic brain injury. Archives of
Physical Medicine Rehabilitation, 84, 168-192.
Sherer, M., Sander, A.M., Nick, T.G., High, W.M., Jr.,
Malec, J.F., & Rosenthal, M. (2002). Early cognitive
status and productivity outcome after traumatic brain
injury: Findings from the TBI Model Systems. Archives
of Physical Medicine and Rehabilitation, 82, 183-192.
Sohlberg, M.M. & Mateer, C. A. (1989) Introduction
to Cognitive Rehabilitation: Theory and Practice. The
Guilford Press
The Brain Injury Handbook: An Introductory Guide to
Understanding Brain Injury for Vocational Rehabilitation
Professionals (2006) Brain Injury Association of New
Jersey, Inc. Adapted from The Brain Injury Handbook:
An Introductory Guide to Understanding Brain Injury
for Vocational Rehabilitation Professionals (1991) Brain
Injury Association of Florida.
Jacobs, H.E. (1997) The Clubhouse: Addressing WorkRelated Behavioral Challenges Through a Supportive
Social Community. The Journal of Head Trauma
Rehabilitation; vol. 4 number 5: 42-56.
Vandiver, V.L., Johnson, J., &Christofero-Snider, C.
(2003) Supporting Employment for Adults with Aquired
Brain Injury: A conceptual model. Journal of Head
Trauma Rehabilitation, 4, 445-456.
Ansell, B.J., Keenan, J.E., Dela Roche, O. (1989)
Western Neuro Sensory Stimulation Profile: A tool for
assessing slow to recover head-injury patients. Western
Neuro Care Center, Tustin, California. 
Garden City Apartments
Family & Pet Friendly
Garden City Apartments offer a unique and supportive family environment where
residents with traumatic brain injury are empowered to work toward therapy and recovery goals.
At Rainbow’s Garden City Apartments, adults can reside as a single, as part of a family,
or as parents caring for their children – Rainbow’s Staff provides the necessary support.
To download a brochure log on to:
For a tour or more information call...
1.800.968.6644
Select Education & Publications
Rainbow Literature
RainbowVisions
28
2007
Conference
& Event Schedule
September – November
September
October
September 5 - 8, 2007
October 3 - 6, 2007
National Association of State Head Injury Administrators
Gateway to What Works in the World of TBI at the Adams Mark
ARN 33rd Annual Educational Conference Reshaping Our
Future at the Hilton Washington in Washington, DC
Hotel in St. Louis, MO
For info log on to: www.nashia.org
For info log on to: www.rehabnurse.org
October 4, 2007
September 11, 2007
CMSA Detroit Chapter Dinner Conference at Burton Manor,
Livonia, MI
For info log on to: www.cmsadetroit.org
October 6 - 7, 2007
September 11 - 12, 2007
MPRO Quality Expo for Healthcare Providers at the Radisson
Hotel in Kalamazoo, MI
For info log on to: www.mpro.org
International Symposium on Life Care Planning at the Hilton
Bayfront in St. Petersburg, FL
For info log on to: http://conferences.dce.ufl.edu/lcp/
October 7 - 10, 2007
September 18, 2007
CMSA Grand Rapids - Kalamazoo Chapter in Grand Rapids, MI
Call: (616) 534-1650
September 23 - 25, 2007
AANLCP Conference at Disney’s Coronado Springs Resort in
Orlando, FL
For info log on to: www.aanlcp.org
September 26 - 28, 2007
4th Annual Texas Workers’ Comp Forum Embassy Suites Dallas
- Frisco Hotel & Conference Center, Dallas, TX
For info log on to: www.txwcforum.com
American Neurological Assoc. 132nd Annual Meeting at the
Marriott Wardman Park Hotel in Washington, DC
For info log on to: www.aneuroa.org
October 13, 2007
2nd Annual Brain Injury Conference at the William Beaumont
Hospital in Royal Oak, MI
For info e-mail: [email protected]
October 19 - 20, 2007
Michigan Occupational Therapy Association at the Macomb
Community College, Warren, MI
For info log on to: www.mi-ota.com
September 27 - 28, 2007
27th Annual BIA of Michigan Conference at the Lansing Center
in Lansing, MI
For info log on to: www.biami.org
October 22 - 23, 2007
Michigan CMH Fall Conference at the Grand Traverse Resort &
Spa in Traverse City, MI
For info log on to: www.macmhb.org
September 27 - 29, 2007
NABIS 5th Annual Conference on Brain Injury & 20th Annual
Conference on Legal Issues in Brain Injury at the Westin
Riverwalk Hotel in San Antonio, TX
For info log on to: www.nabis.org
ACMA Great Lakes Chapter Case Management Conference at
St. John Macomb Hospital in Warren, MI
For info log on to: www.acmaweb.org
October 24 - 26, 2007
MRC/MARO Michigan Rehab Conference at the DeVos Place in
Grand Rapids, MI
Call: (517) 484-5588
October 29 - 30, 2007
Hospital Case Management Administration at the Hyatt
Regency Boston in Boston, MA
For info log on to: www.contemporaryforums.com
For up-to-date additions, changes and 2008 conference dates log on to:
www.rainbowrehab.com > Select Education & Publications >
Select Conferences & Events
Visit our website for past Visions’ article downloads!
29
RainbowVisions
FA L L
November
2007
MBIPC
Michigan Brain Injury Providers Council
November 1- 3, 2007
IARP 2007 Forensic Conference at the Bally’s Las Vegas in Las
Vegas, NV
For info log on to: www.rehabpro.org
Learn over Lunch
Scheduled meeting times are 12:00 - 2:00 p.m.
(Registration at 11:30 a.m.)
November 2 - 4, 2007
Pediatric Brain & Spinal Cord Injury Conference at the Sonesta
Hotel in Coconut Grove, FL
For info log on to: www.pedibrain.org
Society for Neuroscience, 37th Annual Meeting at the San
Diego Convention Center in San Diego, CA
For info log on to: www.sfn.org
BIAA Brain Injury Practice College at the Westin Casuarina Resort
& Spa in Las Vegas, NV
For info log on to: www.biausa.org
Workers’ Compensation and Disability Conference & Expo at
the McCormick Place in Chicago, IL
For info log on to: www.wcconference.com
November 12 - 14, 2007
Case Management Along the Continuum at the Las Vegas Hilton
in Las Vegas, NV
For info log on to: www.contemporaryforums.com
Cost: Member $20 / Non-member $50
For information e-mail: [email protected]
For Fall dates, locations and topics, please log on to
Select Education & Publications / Conferences & Events
Select the “Learn Over Lunch Series 2007” link
October 9, 2007
Location: Grand Rapids or Lansing / Topic: TBA
November 13, 2007
Location: Livonia / Topic: TBA
December 11, 2007
Location: Grand Rapids or Lansing / Topic: TBA
For up-to-date topic information, locations and the
2008 calendar log on to:
www.rainbowrehab.com > Select Education & Publications >
Then select Conferences & Events
November 13, 2007
CMSA Detroit Chapter Dinner Conference at Burton Manor in
Livonia, MI
For info log on to: www.cmsadetroit.org
RINC Meetings
Rehabilitation & Insurance Nursing Council
November 13, 2007
CMSA Grand Rapids - Kalamazoo Chapter in Kalamazoo, MI
Call: (616) 534-1650
November 14 - 15, 2007
MSU Case Management Conference at the Kellogg Center
in East Lansing, MI
For info log on to: www.nursing.msu.edu
Members Only
Registration begins at 11:30 a.m.
Followed by lunch / presentation at 12:45 p.m.
For more information contact
Adrienne Shepperd: (248) 656-6681
September 21, 2007
Topic: IEPC & Special Education of the TBI Patient
November 14 - 17, 2007
The 27th Annual National Academy of Neuropsychology
Conference at the Westin Kierland Resort & Spa in Scottsdale, AZ
For info log on to: www.nanonline.org
Location: Pasquale’s Restaurant, Royal Oak
Speaker: Jerome Burman
October 19, 2007
Topic: Dizziness & Headache caused by TBI – A New Treatment
Using Prismatic Corrective Spectacle Lenses
TBI
Community
Education Series
Location: Radisson Kingsley Inn, Bloomfield Hills
Speaker: Debby Feinberg, O.D.
November 16, 2007
Topic: Differential Diagnosis of Shoulder vs Cervical Spine Injury
Location: No. VI Chophouse in Novi, MI
Speaker: Louis Radden, D.O., Orthopedic Surgeon
See page 17 for details
RainbowVisions
30
Special Needs Trust
Pooled Trusts Set up by a Nonprofit
commingled but are pooled for investment
Organization
purposes to obtain a better return.
While an individualized, self-funded
Sometimes parents, grandparents,
option is fine for some, others prefer a
or individuals with disabilities (if no
The first, sometimes called a Medicaid
second self-funded option – the pooled
guardianship is in place) can initiate
Payback Trust or a Section d(4)(A) Trust,
trust. This option may be preferable if:
participation in a pooled trust by signing a
is more individualized and requires that
• the family cannot identify a suitable
joining agreement. If a guardian is in place
any funds remaining at the death of the
private trustee
and no other person is able to sign the
beneficiary must be paid back to Medicaid.
• the bank trust department fees are cost-
joining agreement, a petition must be filed
This option is perfectly fine with many
prohibitive
in probate court to establish an account in
families–they believe it is only fair that
• the family has a desire to have the
the pooled trust.
any remainder funds after the death of
remainder funds, after their relative’s death,
the primary beneficiary should reimburse
stay in their community to assist other
An Example of a Pooled Trust
Medicaid for what it paid during the
persons with disabilities rather than go
The Brain Injury Association of Michigan
person’s lifetime.
back to Medicaid
has recently entered into an agreement
To set up this type of individualized,
A pooled trust is authorized by the
with one of the largest pooled trust projects
self-funded trust, the family must identify
same federal statute as the individualized
in Michigan – the Hope Network Pooled
someone who can serve as the trustee
Medicaid Payback Trust and is recognized
Trust. Their goal is to make this option more
and then hire a private attorney with
by the Michigan Program Eligibility
available to BIAMI constituency.
experience in this area of the law. The
Manual at item 401. It must be set up by
Individuals with brain injuries or other
individualized nature of the trust makes
a nonprofit agency. Its most interesting
disabilities can self-fund an account within
it a little more expensive to set up but
feature is that remaining funds are held
the Hope Network Pooled Trust and use
gives the family more individual control
by the pooled trust after the person dies,
it throughout their lifetime. If any funds
over disbursements. They should also be
and they are not required to pay back
remain after the person passes away, it
aware that it obligates the trustee to know
to Medicaid. The remaining funds can
need not be repaid to Medicaid – a portion
what disbursements will not jeopardize
be used to help others with disabilities
of it can be earmarked for use by BIAMI’s
government benefits and make wise
who are known to the nonprofit agency.
constituency. It’s a win-win situation!
investments as a fiduciary.
Administratively, individual funds are not
What Can a Special Needs Trust Pay For?
Either the third-party or a self-funded
special needs trust can pay for a wide
variety of things for which there is no other
source of payment. Examples include:
• extra in-home support services
• uncovered health care or therapies
• amenities, trips, or recreational activities
If the beneficiary is receiving SSI, the
trustee must be careful not to use the trust
funds for items that the SSI is meant to
cover, such as food and shelter, so there is
not a reduction in SSI benefits. t
For more information on special needs trusts,
contact Daniel L. Blauw, Attorney at Law:
E-mail: [email protected]
Phone: (616) 336-5098
Address:1515 Michigan Street NE, Grand
Rapids, MI 49503
31
RainbowVisions
FA L L
2007
NeuroRehab Campus
Clinical Programing:
The NeuroRehab Campus for adults with brain & spinal cord injuries offers Rainbow’s full Continuum of Care
including active therapy, community outings and supported living for individuals with medical needs. Some of
the unique features offered through the residential portion of the campus include...
• Two 20-bed facilities with private bedrooms and private baths. Each room offers optional cable TV, internet access, telephone access and call light/intercom system access.
• Physician visits on-site
• Executive chef
• Nursing services available on-site 24/7
• Professional treatment team on-site
Guardianship of the estate or property is
Guardianship
Continued from
page 8
assigned the following responsibilities:
•Marshall and protect assets
•Obtain appraisals of property
•Protect property and assets from loss
•Receive income for the estate
•Make appropriate disbursements
•Obtain court approval prior to
•Consent to / monitor medical
selling any asset
treatment
•Report to the court on estate status
•Consent to / monitor non-medical
When appointing guardianship, courts
rights may be removed:
The right to...
•Determine residence
•Consent to medical treatment
•Make end-of-life decisions
•Possess a driver’s license
•Manage, buy or sell property
•Own or possess a firearm or weapon
•Contract or file lawsuits
•Marry
•Vote
services (example: education)
will take several things into consideration.
•Consent to the release of
They will likely select a guardian based
of the guardianship process. Parents need
confidential information
on the ability to enhance the disabled
to consider who will be the guardian for
•Make end-of-life decisions
•Act as representative payee
•Maximize independence in the least
person’s lifestyle. Guardians are expected
their child when they are no longer able to
to consider the wishes and goals of their
make decisions. In some states, there are
ward, include them in making decisions
not-for-profit organizations that provide
restrictive manner
(when possible) and advocate on their
guardianship services. In many states,
•Report to the court about the
behalf. It is not the role of the guardian to
parents can designate a substitute guardian
guardianship status at least annually
limit activity or social interactions. When
or can name someone in their will. t
Long-term planning should also be part
a court appoints a guardian, the following
RainbowVisions
32
The
Last Word
will become known as the intellectual
force behind effective rehabilitation. (By
the way she was the manager at Stoneham
on Sherri’s first day.)
RAINBOW’S VALUED
Staff of Professionals
I
Written by
Buzz Wilson, CEO
n prior articles, I have tried to focus on
behind-the-scenes vignettes of Rainbow’s
leadership. Bill Buccalo and Sherri
McDaniel were in lights. Rainbow has a
flat hierarchy with lines of communication
all over the place. This is confusing to
everyone but me, and that’s another story.
Out of this confusion emerges an
incredible company, recognized by
everyone as a haven for leaders in the
industry. Among others who will be
honored in future articles (lest I forget
them) are folks who are simply the best
in the business – Rainbow’s management
team including Heidi Reyst, Sean Youngren,
Chad Fife, Lisha Clevenger, Mariann
Young, Vicky Scott, Pawan Galholtra, Colin
King, Mark Evans, Bill Buccalo and Sherri
McDaniel. While Rainbow’s personnel are
not perfect, to suggest that anyone knows
this industry better, well – the tooth fairy is
alive and well.
A visit to Rainbow’s Pediatric
Rehabilitation Program at the Oakland
Center (ROC) is a must see. This is what
rehabilitation is all about – passion and
hope. At Rainbow, you have to believe in
what you are doing because the stories
are so tragic. You can’t give lip service
to rehabilitation; you have to feel it, and
the folks at the ROC are incredible. Dr.
Mariann Young has molded our pediatric/
adolescent program into a haven of caring
individuals, which isn’t so easy, although
they make it look that way (they work
their keisters off). There was the day
when the entire ROC team was in tears,
leading me to get off my duff and shake up
management. It’s been a labor of love with
some gentle tugging and shoving mixed in.
In past years I was always asked to manage
the pediatric team. To what purpose?
33
RainbowVisions
How the Pediatric Program Got Started
A former colleague and personal friend
of mine – Heather Ramsey at Kalamazoo
College – helped in the development of our
pediatric program. We were having trouble
getting the good folks at Farmington Hills
City Hall to issue us an occupancy permit
for one of our pediatric residential homes.
Heather occupied the city offices and
refused to leave until the form was signed
by the city manager. The pediatric program
began that day. Its growth, both in numbers
and respect, has grown immensely.
For a long time I had posted on the
recruiting halls of Kalamazoo College an
open invitation for any graduate to come
and work at Rainbow. Rebecca, Heather,
Valerie (I am forgetting some) and Heidi
came to Rainbow.
CARF Recertification
If you want a picture taken, a nail driven,
a therapist aided, a management decision
made, and the entire organization ready
for the triennial CARF survey, you call Dr.
Heidi Reyst. Rainbow is what it is today
because of Heidi. To test the math skills
of new hires, we give them the task of
determining her length of service. She
started and stopped so many times, that her
path is an exercise in mobility. Oftentimes,
you don’t start out to become irreplaceable,
but through being dependable as well as
smart, you end up that way. The harder
tasks are always handed to the people
like Heidi. Our growing cutting edge
reputation for developing and utilizing
data measurement is due to Heidi. I have a
prediction: In addition to helping develop
the training standards in the industry, she
Rainbow’s Softball Team
Kalamazoo College was the home of the
women’s softball training ground. Heidi is
in retirement, but last year’s championship
team, under the careful management of
Kim Waddell (Rainbow’s Administrative
Coordinator), was known as the team
where the weak spots were men. I never
realized that we hired so many professional
women to fill our ranks.
As a professional softball player, the
man with the worst on-base percentage
was Sean Youngren. It was probably zero.
If he didn’t hit a home run, he was out.
Read between the lines. In any event, I
gave Sean the task of handling all things
administrative. At one time or another, he
supervised house managers, maintenance
staff, interfaced with accounting and
finance, dealt with licensing our many
facilities, helped develop training modules,
helped in the development of new
facilities, and still had time to eat lunch.
Like me, he never met a lunch hour he
didn’t like. Though to be honest about it, he
doesn’t have much time to indulge in such
mundane pastimes. Sean has been assigned
the tasks of opening up Macomb County,
developing a medical complex, developing
a therapy center, developing a behavior
complex, and finding time to keep me
involved in the day to day – as much as I
want. We have never had a bad licensing
since Sean has been in charge.
It has been fun watching these guys
develop into experts. Rainbow is a place
where personal growth doesn’t just happen
– it evolves (proving that good things
happen to good people who work hard.)
Until next time, Chad (I count), Lisha (I
count clients), Vicky (I count medications),
Pawan (I count spines), Colin (I count
bruises), Mark (I count the number of times
I had to evict Heather). We work hard to
do well and do good, and we sure have
fun. Next time. t
FA L L
2007
Employee of the Season - Winter 2007
Rehabilitation Assistants
Ann Arbor Apts: Juanita Thomas
& Lakesha Shell
After School Program: Reggie Day & Robin Baker
APFK I: Troy Green
APFK II: Chris George
Bell Creek: David Prince
Belleville: Leslie Gregory & April Fifer
Bemis:  Janifer Eddins
Brookside:  Rebecca Staples
Carpenter: LaTease Lykes
Elwell: Terrance Wilson
Paint Creek: Maureen Hartigan
Garden City Apts:  Yvonne El-Badry
Parkview: Terri Schweim
Gill:  Alicia Shaw
Shady Lane: Adrienne Gazdag
Glenmuer:  Lisa Reese-Williams & Kenyatta Young
Southbrook: Shawnte Simmons
Highmeadow: Robert Menefee
Talladay: Adam Orrison & Tonya Nougaisse
Hillside: Cynthia Schneider
Textile:  Tilia Finklea
Home Health: Andrea Willis (LS), Lori Bailey (MG)
Whittaker:  Michele Murphy
Maple: Evelyn Williams
Woodside I:  Angelina Baker
NRC: Vonnette Williams & Kecia Dixson
Woodside II:  Elmarie Dixon
Page: Pat Bauld
House Managers
Pierre Chatman Betty Williams
Karen Gayles Beth Flory
Tammy Zentz
Professional / Therapy Staff
Jonietta Crawford
Stacey Clark
Mary Mitchell
Nicole Rondini
Marty Humphrey Valerie Tuomi
Joe Welch
Administration/
OEI / RehabTransport
Susan Gibbons
Bob Adams
Ben Wood
Matt Totton
Congratulations to our Outstanding Staff! 
2007 Rainbow Scholarship Recipient
We are pleased to announce the 2007 Rainbow Rehabilitation Centers
Scholarship for High School Seniors Award Winner – Ms. Amanda
Ardner.  Rainbow awards a scholarship to graduating seniors from
area high schools who (1) would be full-time students in an accredited
Michigan college or university and (2) have the intent to pursue a health
care or health services course of study.  One student from each area
district may be selected to receive a $1,000 award. 
Amanda Ardner met with Rainbow Rehabilitation Centers’ staff
on June 13, 2007 where she was presented with a scholarship award
certificate.  She is a graduate of Lincoln High School with an impressive
record of leadership and academic achievement.  She plans to attend
Eastern Michigan University and we wish her all the best in her bright
future!
Pictured: Bill Buccalo, Amanda Ardner & Lisha Clevenger
RainbowVisions
34
Rainbow Rehabilitation Center
Locations:
Ypsilanti Treatment Center
5570 Whittaker - PO Box 970230
Ypsilanti, MI 48197
734.482.1200
Oakland Treatment Center
32715 Grand River Avenue
Farmington, MI 48336
248.427.1310
NeuroRehab Campus
25911 Middlebelt Road
Farmington Hills, MI 48336
248.471.9580
For more information call toll free...
1.800.968.6644
E-mail: [email protected]
P.O. Box 970230
Ypsilanti, Michigan 48197
Presorted Standard
U.S. Postage
PAID
Permit 991
Ypsilanti, MI
If you do not wish to receive copies of RainbowVisions, please e-mail: [email protected]

Featuring Bob Woodruff `s Story of Recovery

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