The Monarch - Brain Injury Association of London and Region
Transcription
The Monarch - Brain Injury Association of London and Region
The Monarch March 2011 See our Special Section on The Military and Acquired Brain Injury In this issue: starting on Page 20 ABI Across the Province Page 3 2011 ABI Survivor and Family Education Series Page 9 14th Annual Brain Injury Conference Centre Insert A Message to Family Members and Friends Page 30 In every issue: Executive Director’s Report Page 2 Peer Support Mentoring Program Page 6 Ask A Lawyer Page 12 Monthly Support Groups Page 19 The Brain Injury Association of London and Region acknowledges the generosity of Legate & Associates as sponsors of this publication. PROTECT With a longstanding record of successes combined with a genuinely caring attitude, the personal injury team at Thomson, Rogers will always make sure that things are well taken care of. At Thomson, Rogers we’ve been protecting the rights of people who have suffered serious injuries, for more than 75 years. That’s a lot of people and a lot of protection. To find out more about how we can protect you or someone you love, visit: www.thomsonrogers.com/personal-injury-litigation. Or call us today for a free consultation and a copy of our Personal Injury Information Kit. THOMSON ROGERS | Toll Free: 1-888-223-0448 | T: 416-868-3100 | thomsonrogers.com Brain Injury Association of London and Region Serving London, Middlesex, Huron, Perth, Oxford and Elgin 560 Wellington Street, Lower Level, London, ON N6A 3R4 Phone: 519 642-4539 Fax: 519 642-4124 Toll Free: 1-888-642-4539 Email: [email protected] Website: www.braininjurylondon.on.ca Registered Charitable: 139093736RR0001 r: de min Re Membership Renewals are now due! Dual Memberships now available with Ontario Brain Injury Association and the Brain Injury Association of London and Region. See OBIA.BIALR Dual Membership Application Inside The Monarch is published by the Brain Injury Association of London and Region. Opinions expressed are those of the authors and do not necessarily reflect the opinion of the Board of Directors. Submissions to the Monarch are welcome at any time, but should consist of no more than 325 words. When you send in an article from a paper/magazine, please include the date and name of publication. Please include a cover letter with your name and telephone number. Published letters can be anonymous, but the editors must verify the information and obtain permission to reprint the letters, as well as have a contact for questions and responses. Advertising rates are available on request. The publication of an advertisement does not imply support of the advertiser by the Association. All submissions must be received by the first Wednesday of the month prior to publication, at the office located at: 560 Wellington Street, Lower Level, London, ON, N6A 3R4 Phone: (519) 642-4539 Fax: (519) 642-4124 E-Mail:[email protected] Editors: Editorial Committee Layout & Design: Cindy Evans, Advance Imaging Copyright 2011 All rights Reserved The Monarch Board of Directors & Staff President: Mary Carter Vice President: Doug Bryce Treasurer: Gary Phelps Secretary: Larry Norton Directors: Angie Blazkowski Talaal Bond Jamie Fairles Lorrinda Mabee Nancy McAuley Joanne Ruediger Mary Hansen Executive Director: Donna Thomson Program Assistant: Becky LeCouteur Canada Post Publications Mail Agreement N umber 40790545 Return undeliverable Canadian addresses to : 560 Wellington Street, Lower Level London, ON N6A 3R4 Page 1 EXECUTIVE DIRECTOR’S REPORT This edition of the Monarch is dedicated to the courageous people who dedicate their lives to service in the military, many who lose their lives, or sustain traumatic injuries that affect the rest of their lives. At the writing of this report, we are scrambling to get the last minute details completed for our 11th Annual Dinner Dance & Silent Auction, ‘Mac to the Future’. It is shaping up to be another fun filled evening! We are seeking sponsors and exhibitors for our th 14 Annual Conference, Tech Talk … Technological Supports for Brain Injury Challenges. You will find the registration form in the middle insert of this issue. This year we continue to partner with sponsors Legate & Associates, Lerners and Siskinds the Law Firm to host ½ day workshops. On February 4, 2011 we had a very successful workshop on Growing Your Business with Randy Timmins as our guest presenter. Plans are well underway for the next ½ day workshop scheduled on April 29, 2011 on chronic pain & brain injury, with experts Gloria Gilbert & Dr. Sarah Vernon Scott. The Community A w a r e n e s s Committee is gearing up to gather pertinent information for the 5th edition of our popular Brain Injury Services Directory. This year, we are offering two addi- Page 2 tional options to go along with the free listing. Information will be distributed in the near future via email & on our website at www.braininjurylondon.on.ca. We are hoping to have the Directory ready to distribute at our June conference. The Helmets on Kids partnership is approaching its 10th Anniversary this year of providing helmets to needy children. This partnership has given out over 14,000 helmets and the program is now used as a model for other communities throughout the province. We are currently partnering with students from UWO to develop an updated version of the Helmets on Kids video. On a very sad note, the brain injury community has suffered a tremendous loss in the passing of Dr. Jane Gillett. We have lost a good friend and a woman who has influenced so many of our lives and those of others. She created and developed the Pediatric Acquired Brain Injury Community Outreach Program (PABICOP) at the Children’s Hospital of Western Ontario and was the medical director for four years. She was the medical director of the Acquired Brain Injury Program at Hamilton Health Sciences and was an associate professor at McMaster University. She will be greatly missed by her parents, friends, and her many colleagues in the pediatric TBI community. Donna Thomson The Monarch “Across the Province” An OBIA Advisory Council (OAC) Update February 1, 2011 Tammy Dumas, Community Association Liaison, OBIA The OAC met on January 22, 2011 in Toronto at the Miles Nadel Jewish Community Centre. Ruth Wilcock provided an OBIA Executive Director’s report. Her report was distributed to each association with the OAC meeting minutes. Tammy Dumas also provided an update on the Peer Support Mentoring Program and her ongoing work with local community associations. A written report was also attached to the minutes. Following the OBIA updates, Jeff Chartier from the Head Injury Association of Durham presented on the Transitional Coordinator Support Initiative. This initiative is a collaborative effort among service providers aimed at assisting individuals with completing applications for ODSP or CPP Disability. The primary target groups for the initiative are those that are disconnected from any type of support. HIA Durham is the lead agency on this project, with Jeff in the role of Transitional Support Coordinator. Stats for the program indicate that there is a significant need for this type of service. This is a three year program funded by Trillium. For more information on the program, you can contact Jeff at HIA Durham at 905.723.2732. Following lunch, there was a roundtable discussion regarding having an Annual Provincial ABI Event. The purpose of the discussion was to determine the level of support amongst the group for holding an event across the province on the same day in each community to collectively raise awareness of ABI. Ideas included: golf tournament; triathlon in each region with finalists competing in one final race; relay; transit advertising campaign; candle vigils/virtual candles on website. A survey link will be sent to all local associations for their input regarding an annual provincial event. There was also some discussion about OBIA’s current re-branding exercise, which includes the development of one unified database at OBIA and a new logo, tagline and website for OBIA. One idea that was put forward, as suggested by the marketing firm that OBIA is currently working with, is developing a new ‘symbol’ to represent the Community Support Network. OBIA may or The Monarch may not incorporate this new symbol as their logo but local associations could keep their own logo and brand identity. Another idea that generated support was the option for local associations to ‘grandfather’ in the new symbol /logo and over time all associations could assume one consistent logo across the province. OBIA will be sending out a survey link for stakeholder feedback about OBIA’s current brand. The Brain Injury Association of Waterloo Wellington and Four Counties Brain Injury Association received their OBIA affiliation certificates. During Show and Tell we learned that Four Counties BIA has the LHIN’s new ABI Navigator working out of their office. This close working relationship has provided opportunities for FCBIA to educate the LHIN about ABI and the services the association provides. Cheryl also reported that FCBIA has been able to significantly increase the number of employment positions at the agency through job sharing. Additionally, the Brain Injury Society of Toronto is now running a family support group; the Brain Injury Association of Waterloo Wellington will be hosting a fundraiser “Brilliance in Music”, they now have an eight month Caregiver Support Group, they received a Trillium Grant for $120,000 over two years to hire a fundraiser and their glass program has raised over $ 15,000! The next OAC meeting has been scheduled for March 26, 2011. Location TBD. Page 3 Page 4 The Monarch The Monarch Page 5 Peer Support Mentoring Program for People Living with ABI By Jamie Fairles Peer Support Coordinator This month’s theme is brain injury in the military. When I first sustained my own brain injury over a decade ago I remember my mother commenting, “Well if the world ever goes to war and there is a draft, one good thing about you losing half your vision from the brain surgery, is that you won’t be called upon!” As true as this may be, it’s also sadly ironic that so many soldiers in the Iraq and Afghanistan wars are returning home with their own brain injuries from road side blasts and other war-related incidents. Just as there is certain camaraderie in the military, there is a common bond shared by anyone who has experienced living with a brain injury – either personally, or secondarily. The Peer Support Mentoring Program recognizes and capitalizes on this special bond and that’s what makes the program so very helpful and unique. If you feel your experience living with a brain injury can be useful to somebody else, or if you’re in need of support from somebody who has faced similar challenges, please call the office to inquire about the program! Phone: 519 642-4539 Toll Free: 1-888-642-4539 Page 6 The Monarch Thank you to sponsors, silent auction donors, attendees & volunteers who made Mac to the Future a tremendously successful evening! DIAMOND SPONSOR PLATINUM SPONSOR GOLD SPONSOR Siskinds the law firm Lerners Astral Media Media Sponsorship M&T Printing Group (Diamond in-Kind sponsorship) PricewaterhouseCoopers Davis Martindale The Robert Nash Wealth Management Group Matson Driscoll & Damico Ltd Continuum a division of Community Rehab King-Reed & Associates Rehab First Inc. Intact Insurance Legate Personal Injury Lawyers Hoare-Dalton BridgePoint Financial Services WINE SPONSORS DMA Wine Sponsor Rein Lomax MEDIA SPONSOR Astral Media TRANSPORTATION SPONSOR Keyz Thankz Reath's Tilt & Load Towing (min $5000) 3M Active Wellness Massage Therapy Astral Media Bartimaeus Bayshore Home Health Black Dog Village Pub & Bistro Blackfly Beverages Blackfriars Salon & Spa Boston Pizza Braywick Bistro Campbell Complete Chiropractic Channers Mens Wear Chris Country Meats Christie & Scott MacGregor Cinnabon Crabby Joe- Wellington Location Dan Carr Shell D'Arcy Lane Institute David McCagherty & Susan Skelton Davis Martindale Deacon Flooring Delta London Armouries East Park Golf Edmond & Amanda LeCouteur Ermo Hair Studio Evolve Assessments The Monarch (min $2500) SILENT AUCTION DONORS Fanshawe Pioneer Village Featherfields the Bird & Garden Store Flamenco Dance London Foster Townsend Graham & Associates Gift of Art Incare Inclusive Health Management Island Style Joanne Ruediger Keyz Thankz Kingsmill's Dept. Store Llyndinshire Golf & Country Club London Crochet Club London Knights London Orchestra London Regional Childrens Museum Lorianne's Dance Studio Lorrinda Mabee Maia Bent, Lerners Marble Slab Creamery McLarens Canada MDM Reporting Milestones Restaurant Moksha Yoga Moving Towards Wellness NeuroTrauma Rehab at Parkwood Hospital (min $1000) OIHJE Salon and Spa Proviva Wellness Strategies Pursuit Health Management Quantum Quantum Education and Cognitive Services Reflections Rheo Thompson Candies Robert Q Travel Rundles Restaurant Shantz Orthotic Solutions Shauna Powell, Lerners Southwestern Ontario Home Inspections TC Adjusters Tetherwood Spa The Athletic Club The Grand Theatre The Little Inn in Bayfield Tina's Jewellery Tony LeCouteur Van Horik's Greenhouses Wabi Sabi Hair Artistry Westhaven Golf and Country Club Wortley Roadhouse Page 7 The Ontario Brain Injury Association & Brain Injury Association of London & Region You Can Now Belong to Both Associations for One Low Fee!! Program Highlights Membership in both the Ontario Brain Injury Association (OBIA) and the Brain Injury Association of London and Region (BIALR). Individual members shall be entitled to one vote at both BIALR and OBIA’s Annual General Meeting. Family members shall be entitled to no more than two at both BIALR and OBIA’s Annual General Meeting. Membership in Community Support Network/Reseau De Soutien Communautaire (CSN/RSC) is available to individuals and families who support the aims and objectives of participating community associations and OBIA. Corporations, associations, partnerships, or other types of organizations are welcome to support participating community associations and OBIA by listing or advertising in the online ABI Directory of Services, but may not hold CSN/RSC membership. Members will receive a one-year subscription to OBIA Review and The Monarch newsletter. Members may participate in the Peer Support Mentoring Program for People Living with ABI. Members will have free access to OBIA’s resource library and be eligible for a $25.00 discount on most of OBIA’s training programs. All membership fees are equally divided between OBIA and BIALR OBIA & BIALR Dual Membership Application Form Name: Address 1 Address 2 City: Postal Code Home Phone: Work Phone: Email: Yes! I wish to purchase a Dual Membership and I understand that I will hold membership to both Ontario Brain Injury Association and the Brain Injury Association of London & Region. Annual Membership Fees: Individual $30 Family $50 Subsidized $5 Please make cheque payable to Ontario Brain Injury Association or pay using: Visa MasterCard Card Number: American Express Expiry / Ontario Brain Injury Association PO Box 2338 St. Catharines, ON L2R 7R9 [email protected] Registered as a Canadian Charitable Organization, Registration #10779 7904RR0001 Page 8 The Monarch The Monarch Page 9 Chroni ic posttrau m aticpainand th e sequelae ofa TBI m ay chall e lnge our abi ilt iy t distin guish betw een the w t o .A s a re sul lt appropria te patie nttrea tm ent s ofte n com prom ised.Ho w do w e bette r d eli n ne i ate th e ph ysicalfrom th e psychologi icaleff f ects oftrau m a? Thisexcitin g hal l day work kshop will provide e att at end e t ees wit t h: x x x an update on the h ro oe of ndi ividualhealh t providersinvol lved w ithmul lti t -di iscipli inary pain manage em entprogram s efe f cts of on ich are oft t en poorl l y understo od and m anaged review th e spectrum of f c cussion (m TBI and TBI)w hi the n nte i gr ratio n of p hysicalw ithpsychologi icalgoals of teatment acknow ledgin ng th e possible cogni it tie as w ell las ph ysicalbalance and postur ralissues affe cti n re i ng habi ili lt ta i tio n G loriaGilb ert, PT , M.Sc.is h te owne rofthe i frstprivately owne d physiotherapy clinic in London,The Downt town Cl inic,Physiotherapy & Healt th Counselling (1 982).Throughout h te years,G lori a i has developed aspecial niterestin r teati nig m / anaging h te pati eint wit t h persistentpain and other nocicepti vie sy ym m pto om s. The possible eff e fctofm ild tra um ati ci brain n ijuries,oft e tn overlooked in h tese individuals has been shown toim pacton h teir ehabilita t ti oin.G lori a i si a Fellow of both h te Can adian and Ameri c ian Academ ies ofPain M anagem ent. Sarah Vernon-S cott t ,Ph.D. D ,C.Psych has significantexperience working wi i t th h tose who are i lving wi i th t the eff e fcts s ofbrain n ijuryand chronic pain.This includes ex xp peri e ince in h te area ofchronic pain managem ent Sarah si e rgistered wi i th t the College ofP sycho logists of O ntari o i and her Pro fessionalm em berships niclude London Reg ional Psychological Associati o in and Ont t ari o i Psychological Association. Dat te e: ri iday A pril i 9, 2 2011 Time: : :00 am: : Re egi i s strat t on & Conti inenta alBr rea e kf fast 8:30 m ± 12:00pm: W ork kshop W ork kshop f e ee:$100 Locati ion: Four Point t s S her rato a n Hote el1150 Weli ing l ton Road South, Lo ndon, ON S ponsored B y: To Regis se er rf or t hisW orkshop: Use our ocnvenien e t online reg istr a ati o on i at w w w .bra aninju rylondon.on.ca Or m ai il tis com pl lete et e d reg istr a ati ti on o o orm f al on o g wi ith your paym ent to : Brain In jury A ssociatio n of London & Region 560 Wel llin l ton Street, oLw er r Level London, ON, N6A 3R4 Nam e A ddre ess: _ Ci ity: P hone: Prov: P.C. __ W ould you i lke to re ceive em ail updates on u fture events? Yes No mEai il For u urther rn nf form o ati ti on o contac a t 19 5 642-4539 orsupport t@ bra ani niin nj ju ur rylo ondon. .on o .ca A ll proeeds go di rec e tl y l t supporttheprogr a rms ofh te B ra ai in n Ijury u y Associati o in ofLondon & Regio on. **R Regi is st stratio n deadlin e isA pri il 5,2011** Page 10 The Monarch SAVE THE DATE! What makes June 17, 2011 so special? It is the date of The Brain Injury Association of London and Region's Annual Conference……. Mark that down on your calendar, enter it in your day timer, text it to a friend, do whatever it takes to BE THERE! WE CAN HELP If you or a family member are suffering the effects of a brain injury or other serious injury, contact us for advice. You or your loved ones may be entitled to benefits and compensation. FREE INITIAL CONSULTATION Telephone: (519) 679-0400 Fax: (519) 679-6350 Email: [email protected] Website: www.bbo.on.ca 1600-380 Wellington Street London, ON N6A 5B5 The Monarch Page 11 Ask a Lawyer Stephanie Ouelette Seeking Compensation for Soldiers A limitation period is a time limit imposed by statute in which a lawsuit can be brought. In Ontario there is a general two-year limitation period in which to bring most actions, however there are several exceptions to this rule. Knowing which limitation period applies is important because if a claim is not brought in time, the court may not allow the claim to be heard. In the case of actions against the Department of National Defense for personal injuries, the limitation period is only six months from the date the incident occurred. This shortened limitation period is intended to allow the Department of National Defense to carry on its work without the threat of impending law suits. However, for the claimant, this Page 12 limited time frame means that he or she must act quickly to initiate a suit. A tort action may only be brought against the Department of National Defense if the injury sustained is of a kind found within National Defense Act. This generally includes all military activity at home and abroad by all branches of the military. Interestingly, the Crown Liability and Proceedings Act states that no claim can be brought against the Department of National Defence if the injured person receives a military pension or compensation has been paid or is payable to the injured person from the Consolidated Revenue Fund. These provisions essentially preclude tort claims for personal injuries by those in the armed The Monarch forces since they will likely qualify for a disability pension or receive some compensation from the Fund. However, if the injured member of the armed forces applies for a pension and is denied, if the lawsuit was not initiated within the six month period he or she will be statute barred from bringing a claim because the limitation period had expired. It is therefore important to initiate an action within the six month period, even if the injured person intends to seek alternate compensation. Since 2006, injured soldiers have been compensated through the Canadian Forces Members and Veterans Reimbursement and Compensation Act, for injury or disease sustained while in service, or for non-service related injury or disease that was aggravated by service. This Act replaces compensation under the Pension Act and provides services, assistance and compensation to Canadian forces members and veterans. If the injured soldier qualifies, there may be money available to assist with transition to the civilian labour force, a clothing allowance, rehabilitation services, vocational assistance and loss income benefits. Applications for benefits are made through the Minister of Veterans Affairs and appeals are heard by the Veterans Review and Appeal Board. If you or a loved one has been injured and the military is potentially involved, you should contact a lawyer immediately to protect your rights. Personal Rehabilitation Counselling Services Inc. E. “Ike” Lindenburger Helena Wood M. Div., M.S.W., C.C.R.C., C.Ht. M.S.W., (R.S.W.) Psychosocial Rehabilitation Individual, Couples and Family Therapy Independent Medical Assessment Catastrophic Injuries Stress and Anger Management Grief and Loss, Bereavement Cognitive/Behavioural Therapy Capacity Assessment Hypnotherapy Pain Management Fear of Driving and PTSD Relationship Management Appointments at office or in clients’ home Mailing Address 900 Adelaide St. South P.O. Box 37088 London, ON N6E 3T3 Phone: Ike: 519-645-7393 Fax: 519-645-6195 Email: (Ike) [email protected] Counselling Office 190 Wortley Road London, ON (Lower Level) Helena: 519-280-5196 Email: (Helena) [email protected] Supporting people to gain healthy functioning The Monarch Page 13 Unique Fundraiser It all started at the Casino night back in November when Susan Skelton told Eric Lindros that she would donate $1,000 to the Association if he would agree to play in a pickup hockey game with her husband . Eric immediately agreed & joined Dave McCagherty along with his hockey team on February 20, 2011 at Medway Arena for an action packed game! Eric was on hand before the game to meet the team, their spouses, Donna Thomson and family. Many of the team members joined Susan in making a donation to the Association. We are so happy to have Eric visit London again in support of our organization! Thanks to Susan and Dave over $1,500 was raised! Picture above: Donna Thomson, Executive Director accepting donation from Susan Skelton. Picture to immediate left: Susan Skelton & husband Dave McCagherty all ready for the big game! Picture top left: Eric signing a Toronto Maple Leaf Jersey donated for the gala by Susan & Dave Page 14 The Monarch ABOUT THIS CONFERENCE The Brain Injury Association of London & Region is holding its Fourteenth Annual Conference on June 17th, 2011. Tech Talk: Technological Supports for Brain Injury Challenges will provide service providers, survivors, and family members with information on a variety of innovative technological supports available to assist those living with a brain injury. As always, this conference will provide an excellent opportunity to explore informative exhibits and network with industry professionals. SCHEDULE 7:30am: Set up Exhibits, Registration, Continental Breakfast 8:25am: Welcome & Opening Remarks by Maia Bent, Conference Chair 8:30am: Leaving the State of Stuck: How Technologies Can Better Serve Individuals with Brain Injuries – Dr. Marcia Scherer 10:30am: Break and Visit Exhibits 10:45am: Technologies in the Home-John Rosenberg 11:30 am: elearning… Helping people change their lives through distance education! Trish Trenter & Luc Comeau 12:15pm: Lunch, Networking and Visit Exhibits 1:15 pm: Compensatory Strategies of the 21st Century - Deidre Sperry and Nick Dertinger, Partners in Rehabilitation 2:45 pm: Break & Visit Exhibits 3:00 pm: “Necessary for some, good for all”- Translating Augmentative Communication and Assistive Technology into Universal Design Don Carlson, Margo Clinker, Mireille Testa and Megan Wass 4:00 pm: Closing Remarks by Donna Thomson, Executive Director, Brain Injury Association of London & Region FEATURED SPEAKERS Marcia J. Scherer, Ph.D., MPH Dr. Scherer has advocated consumer-focused service delivery for the length of her career. She developed the consumer-focused model and assessments, Matching Person & Technology and the most current version focuses on persons with cognitive disabilities. Dr. Scherer is President of the Institute for Matching Person & Technology. She is also Professor of Physical Medicine and Rehabilitation, University of Rochester Medical Center. Dr. Scherer has also authored several books, and is a past member of the National Advisory Board on Medical Rehabilitation Research, U.S. National Institutes of Health. John Rosenberg, Silvercross®. John is a graduate of The University of Western Ontario and Queens University, and has been a Silvercross® franchise holder for 15 years. He resides in Middlesex County with his wife and 5 children, and they raise Beef Cattle. John has 15 years experience in dealing with home mobility, stair lifts, and elevating and bathing devices, and he trains and supports new franchise holders as well. Luc Comeau Executive Director - elearnnetwork.ca Luc is passionate about e-learning. He is the founding executive director of elearnnetwork.ca, an initiative aimed at using e-learning to bring quality college and university opportunities to Ontario residents no matter where they live. Luc is a graduate of Laurentian University; his career has spanned the private, government and non-profit sectors. His management and partnership work have always contributed to generating real results for real people. Trish Trenter, eLearning Coordinator - elearnnetwork.ca Trish is a graduate of the University of Western Ontario; she has worked in the private and non-profit sector in the areas of marketing and client relations. She works with a team approach because knowing you have someone in your corner, even from a distance, can help you get to that goal! We provide many services for people seeking to further their education and training, including research, student support, registration support, technical support exam invigilation for distance education. The best part of my job is helping people and presenting options. Deidre Sperry M.Sc., S-LP(C) is a registered Speech Language Pathologist and has been practicing for nearly 20 years. She has her own community based private practice, and works primarily with people who have sustained an Acquired Brain Injury. Deidre has participated in various research projects, authored several innovative community based assessment and treatment programs, and was a member of the Expert Panel for the development of her college’s Preferred Practice Guidelines for Cognitive Communication Disorders. Recently she has joined with other colleagues to develop a service designed to provide support over the internet to people with impaired executive functioning. Nick is currently a student at Brock University in St. Catharines Ontario. He is in his fourth year of study in the honours Physical Education program. He plans to finish his degree by the summer of next year. In 2006, Nick was involved in a severe accident and sustained catastrophic injuries including a brain injury. He had to delay the start of his university program, but he never lost sight of his goals and was able to start his program in 2007. Don Carlson, PEng, Rehabilitation Engineer, Parkwood Hospital Don works on practical, client-based Assistive Technology (AT) implementation in collaboration with Speech Language Pathologists and Occupational Therapists . He works with integrating AT controls onto wheelchairs, computer access (special access software applications, voice recognition, adapted key boards and mouse controls) as well as home controls for access, security and safety, home automation and recreational assistive technologies. Margo Clinker, M.Cl.Sc., MBA, Reg CASLPO, Speech Language Pathologist, NeuroTrauma Rehab, Parkwood Hospital. Margo has a special interest and actively investigates and implements applications of new technology to assist her clients rebuild communication skills, facilitate compensatory strategies, return to school and to work. Mireille Testa, M.Sc.OT, Occupational Therapist, NeuroTrauma Rehab, Parkwood Hospital. Mireille works with the Rehabilitation Engineer to link both the technical and clinical aspects of assistive technology in order assess client's needs, create practical solutions and ensure clients are able to use these solutions in their daily lives. Megan Wass is a Learning Disability Specialist with ATN Access Inc. She received her degree from the University of Western Ontario in Religious Studies and Psychology, with course work also completed in the Social Work field. I have been working with ATN Access Inc. to assist individuals with learning and cognitive challenges to achieve their educational and vocational goals. Monthly Support Groups After taking a break over the summer, the Support Groups will resume meeting in September. The following is a list of the current groups, their time & place of meetings. Information is also available on our www.braininjurylondon.on.ca website at or by contacting Becky at (519) either642-4539 or by [email protected] email . London/Middlesex First Baptist Church 568 Richmond Street London, ON Last Thursday of Each Month April 28, May 26, June 30, 2011 Perth County Zehrs Markets nd 2 Floor Community Room 865 Ontario Street Stratford ON Oxford County Last Tuesday of Each Month Woodstock Public Library 445 Hunter Street Woodstock. ON April 26, May 31 June 28, 2011 Third Thursday of Each Month from 6:30 to 8:30 p.m. April 21, May 19, June 16 Oxford County Perth Social Leisure Gr CMHA Oxford Branch 522 Peel Street Woodstock, ON Third Tuesday of Each Month 6:30 to 8:30 pm Central United Church 194 Avondale Ave. Stratford, Ontario Every Wednesday 1:0-4:00 pm Social Group for Age3018Cornerstone Clubhouse 781 Richmond St N London, Ontario First Thursday of each month April 7, May 5, June 2, 2011 Elgin & Huron Counties Dates/times yet to be determined. The Monarch Page 19 Knowledge gained from Treating Canadian Military Personnel - Implications for a team approach to helping those with mild traumatic brain injury. Dr. Charles Nelson Although mild traumatic brain injury (mTBI) is not a new concept, assessment and treatment of persistent symptoms can be challenging and require a coordinated approach. Clinical evidence suggests cases may best be handled by a primary care provider working in collaboration with an array of health care professionals familiar with the military and capable of managing all symptoms associated with the condition. Furthermore, early identification of traumatic injury may assist in identifying effective treatment modalities for this clinical population which is already vulnerable to multiple risk factors that can impede progress. Regrettably, no single diagnostic test is able to confirm the presence of mTBI. Diagnosis relies on several pertinent criteria: characteristic symptoms, neurocognitive findings, a plausible timeline from the occurrence of the suspected contributory injury, and exclusion of all other alternatives. Page 20 Recently, a study was conducted to examine how military personnel with mTBI respond to their recovery. The objective of this study was to compare several physical and mental health outcomes of veterans with possible mTBI with outcomes of those for whom such an injury was not identified during screening, and to subsequently develop a practical framework for coordinating the special assessment and treatment needs of military personnel with mTBI. Despite a complicated and often comorbid clinical landscape among operational stress injuries, this study provides several implications for treatment. The associations between mTBI, PTSD, and physical health symptoms suggest that individuals with suspected mTBI would benefit from the use of an integrated rehabilitation team. The involvement of physiotherapists and chronic pain specialists is recommended, as they may be able to offer treatment to The Monarch help relieve the burden of physical pain and improve health-related quality of life outcomes negatively impacted by physical limitations. It is also suggested that dealing concurrently with physical complaints may be necessary to facilitate improved mental health outcomes. It is well-known that somatic complaints contribute to the psychiatric sequelae of depression and anxiety. Deployment-related stress and unresolved somatization may interfere with the individual’s ability to cope with psychological distress and consequently impede the realization of therapeutic goals. Social workers and occupational therapists should also be included in the circle of care, as many individuals with mTBI indicated experiencing difficulties with social role functioning. Previous research on members of the general population who experience an mTBI have demonstrated that impaired psychosocial functioning resulting from mTBI can act as a greater barrier to rehabilitation than cognitive deficits. Aspects of social functioning that have been shown to deteriorate as a result of mTBI in general populations include loss of gainful employment, interference with interpersonal relationships, limited social support and self-isolation, reduced emotional perception, and reduced social competence. While these studies are limited to the general population, clinical observation suggests similar problems are faced by clients of the Parkwood Hospital OSI Clinic. In fact, one might expect to see these psychosocial barriers to rehabilitation manifest with greater severity in military personnel who are struggling to reintegrate into civilian society after leaving the Canadian Forces. Hosted by Donna Thomson Occupational therapists Tune in to AM980 every Sunday at :30 p.m. for a half hour of information about the hidden and social workers may be disability that is brain injury. Host, Donna Thomson will be joined by experts to discuss various issues able to assist military persurrounding brain injury. The show is also available on podcast on the www.am980.ca website under sonnel with impaired psy‘Hosts and Shows’. chosocial functioning resulting from mTBI by offering Thank you to the following sponsors for their generous support of the show over the past year: supportive therapy, assistBayshore Home Health ing with vocational skillsBrown Beattie O’Donovan building and providing Foster Townsend Graham & Associates strategies for improving Legate & Associates interpersonal relationships Lerners London Speech & Language Centre and building social connecM. D. M Reporting Services tions. “The Brainwaves Show” Siskinds the Law Firm The Monarch Page 21 Speech language pathologists, optometrists, and ophthalmologists may also be useful in the rehabilitation process, given that the neurological consequences that follow a head/brain injury may include sensory disorders, motor disorders, and speech motor control disorders, though the latter is more likely to be restricted to individuals with moderate to severe TBI. Previously reported research from Weichel and colleagues found that 21% of individuals with combat-related TBI also experienced ocular trauma. The authors of this study also noted that the impact of sensory dysfunction, such as vision loss, on the treatment of PTSD and other co-morbid psychiatric disorders, as well as other TBI-related outcomes, is unknown. Improving access to optometrists and ophthalmologists could increase our understanding of these effects. Psychologists and psychiatrists should continue to act as integral members of the collaborative team, focusing their efforts on improving mental health outcomes and reducing the severity of mental health complaints. Psychiatrists can assist in the rehabilitation process by making certain that individuals with mTBI fully understand and comply with their medication regimen, as mTBI has been shown to impair memory function, and may impact medication adherence. Other studies have shown that psychologists can contribute to the rehabilitation of individuals with mTBI by providing psychoeducation about mTBI and comorbid conditions. Additionally, therapy focused on building resilience and positive coping mechanisms in conjunction with traditional cognitive rehabilitation therapies may prove beneficial for individuals with cognitive deficits resulting from mTBI. It is also imperative to consider all possible opportunities for rehabilitation such as encouraging involvement in peer groups (such as the Operational Stress Injury Social Support Program), providing referrals to appropriate associations and networks, and arranging for acute care or post-acute care when necessary. Clinicians should take military culture into consideration when treating soldiers with mTBI, as military personnel may respond more positively to therapy when they feel their health concerns are being addressed in the context of their military career and culture. The wide range of symptoms experienced by military personnel with indicators of mTBI necessitates an integrated array of specialized health care professionals. Integrated treatment of mTBI, though not yet widely studied, offers a promising approach to treating the multifaceted symptoms of mTBI and accelerating recovery. ST. MARYS COMMUNITY REHABILITATION !"" # $ !""% # &'()*+( Page 22 The Monarch TOWARDS AN UNDERSTANDING OF ACQUIRED TRAUMATIC BRAIN INJURY IN SOLDIERS Dr. Jacques Gouws Over the past years there have been an increasing number of Canadian Forces (CF) members who return from the deployment to Afghanistan complaining of symptoms indicative of conditions such as Posttraumatic Stress Disorder, Depression and Anxiety. However, when a soldier is screened for mental health concerns, it is important to also keep in mind that the nature of this combat deployment is such that it is not uncommon for soldiers to be at risk of also sustaining a concussion or more severe closed head injury. This can be caused by falls, blunt trauma to the head in the heat of battle, training accidents, and of course vehicle accidents, which happen quite frequently as well. That said, in the present deployment situation CF members are most likely to sustain a traumatic brain injury (TBI), from exposure to Improvised Explosive Devices (IED’s). The reader is referred to the following excellent web resource, hosted by the Defense and Veterans Brain Injury Center (DVBIC) of the USA Department of Defense military, on TBI from explosive devices: http://www.dvbic.org/TBI---The-Military/BlastInjuries.aspx The following text is quite informative and is therefore quoted directly from this website: A TBI is caused by a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Exposure to blast events can affect the body in a number of ways; in addition, these different injuries mechanisms can interact and result in more impairments or prolonged periods of recovery. - Primary blast injury is the result of exposure to the over pressurization wave or the complex pressure wave that is generated by the blast itself. This blast over-pressurization wave travels at a high velocity and is affected by the surrounding environ- The Monarch ment; for example, the effects of the blast wave may be increased in a closed environment such as a vehicle. Air-filled organs such as the ear, lung, and gastrointestinal tract and organs surrounded by fluid-filled cavities such as the brain and spinal cord are especially susceptible to primary blast injury (Elsayed, 1997; Mayorga, 1997). The over pressurization wave dissipates quickly, causing the greatest risk of injury to those closest to the explosion. - Secondary blast injury is the result of energized fragments flying through the air; these fragments may cause penetrating brain injury. - Tertiary blast injury may occur when the individual is thrown from the blast into a solid object such as a adjacent wall or even a steering wheel. These types of injuries are associated with acceleration/deceleration forces and blunt force trauma to the brain similar to that observed following high speed motor vehicle accidents. - Finally, quaternary blast injury can occur in the presence of severe blast related trauma resulting from significant blood loss associated with traumatic amputations or even from inhalation of toxic gases resulting from the explosion. As can be seen from the above information, a multitude of factors come into play when a soldier is involved in an IED event. Therefore, it is important to carefully review the history of such an event and then assess whether there is a likelihood of a TBI as a consequence of the IED explosion. Also, this may be complicated by the psychological sequelae of the event itself, in that there is possibility of psychological trauma that may manifest as, amongst others, PTSD. Finally, PTSD and TBI symptoms overlap to a great extent, thus it is quite easy to diagnose one and miss the other! Page 23 Brain Injury & and the Military Fact Sheet • Traumatic Brain injury is a significant health issue that affects service members and veterans during times of both peace and war. • The leading causes of brain injury in the military are: bullets, shrapnel, blasts, falls, motor vehicle crashes and assaults. • The high rate of traumatic brain injury and blast-related concussion events resulting from current combat operations directly impacts the health and safety of individual service members and subsequently the level of unit readiness and troop retention. • The impact of traumatic brain injury is felt within each branch of service and throughout both the Department of Defense and the Department of Veterans Affairs health care systems. • Active duty and reserve service members are at an increased risk of sustaining a traumatic brain injury compared to their civilian peers • Some of the TBI and concussive injuries associated with a significant blast may not be identified acutely because they often occur simultaneously with life-threatening injuries which take precedence to save the wounded soldier’s life and service members may be reluctant to endorse acute symptoms because they do not want to be evacuated and separated from their unit • Because blast exposure is so common in combat zones and almost everyone has had some of the acute symptoms of concussion, it may not be identified as problematic until the service member returns home from deployment • Brain injury has been called a signature injury of the conflicts of the wars in Iraq and Afghanistan due to the high rate of exposure to roadside bombs that can jar the brain and cause longterm health problems • Traumatic Brain Injuries and Post Traumatic Stress Disorder share common symptoms such as difficulty concentrating, memory problems, and irritability. • It is difficult to ascertain whether a soldier’s symptoms are from a brain injury or psychological issues such as post traumatic stress disorder Page 24 The Monarch More Answers on Head Injury Diagnostic Imaging at Southlake Regional Health Centre Dr. Norman Just, Dr. Yin-Hui Siow, Jean-Marie Fiala “Good diagnosis is essential to good treatment.” A combination of new technology and incredible dedication from the staff in the Diagnostic Imaging department at Southlake Regional Health Centre in Newmarket provides answers to patients with traumatic brain injury. Computed tomography (CT) is the standard imaging modality for patients with an acute head injury, whether mild, moderate or severe. CT scanning is a fast scan modality that quickly answers critical care issues concerning contusions, hemorrhages and skull fractures. Patients with a mild to moderate head injury may have a normal CT scan, but continue to experience symptoms that include headaches and cognitive changes. Very small and very deep micro-hemorrhages are not routinely visible on a standard CT scan, or, for that matter, on routine Magnetic Resonance Imaging (MRI) scans. New developments in MRI are providing increasingly detailed neuropathological information that helps clinicians understand neurocognitive and neurobehavioural changes in patients following a head injury. This detailed knowledge of the injury severity (type, size and location of lesions) inevitably helps to better predict patient outcomes. The Monarch A recently introduced scanning application for neurological MRI exploits magnetic susceptibility differences between tissues by amplifying the magnitude of the signal given by injured areas containing any blood breakdown products (ferritin, deoxyhemoglobin, methemoglobin and hemosiderin). The new application is called Susceptibility Weighted Imaging (SWI). It is 3-6 times more sensitive than traditional MRI methods for detecting small hemorrhages resulting from trauma to the brain, as in, for example, cases of diffuse axonal injuries (DAI). DAI is a common pathology found after a traumatic brain injury and is a major cause of prolonged functional deficits. DAI lesions reflect an injury to the continuity of the white matter in the brain. SWI is sensitive to DAI by detecting micro-hemorrhages that would otherwise go unnoticed. SWI makes it possible for the radiologist to see the size and number of very small areas of injury. Additionally the sequence is sensitive for examining small veins and any bleeding occurring in the white/grey matter boundaries. Brain microstructure is evaluated using another technique at Southlake MRI called Diffusion Weighted Imaging (DWI). This technique provides information on cell health by sensing disturbances in the diffusion of water in the extracellular space and across cell membranes. The application of this technique focuses on the assessment of cerebral ischemia (lack of blood flow) and infarction (tissue death due to the lack of oxygen). Abnormal diffusion appears as a result of a stroke, tumour, brain abscess or a traumatic event. DWI can detect cytotoxic edema (a fluid shift first into the intracellular space and then to the extracellular space of brain tissue) and therefore demonstrates hyperacute/acute (6 to 24 hours post injury) and acute/subacute (24 hours to 1 week post injury) cerebral infarctions. Thus DWI can identify acute infarctions and differentite them from other chronic diseases including old chronic infarctions. continued on page 26 Page 25 continued from page 25 The examination also includes a look at the health of the vessels in the brain. Called Magnetic Resonance Angiography (MRA), this sequence produces a three-dimensional image of the vessels, enabling the radiologist to view the vessels from several different directions and check for aneurysms, blockages or any other disruptions. While MRI examines the disruption of normal anatomy by traumatic brain injury, Single Photon Emission Computed Tomography (SPECT) imaging examines the disruption of normal brain function. SPECT is complementary to MRI because each can expose abnormalities that are not apparent on the other study. When taken together, they are a powerful tool for assessing traumatic brain injury. SPECT provides insight into the function of the brain based on the uptake of an isotope tracer. A number of studies have been performed on patients with mild traumatic brain injury using technetium99m labeled hexamethypropyleneamine oxime (99mTC-HMPAO) for SPECT imaging. Whether the injury is acute or chronic, SPECT examines patterns of cerebral blood flow and identifies areas of hypoperfusion. The areas of hypo-perfusion (low blood flow) are associated with injury. Depending on the location, the identified hypo-perfused areas can help explain loss of consciousness, cognitive difficulties and cerebral atrophy. From a patient’s perspective, a deficiency in the amount of blood within the injured area signals a poorly functioning area and a generally unfavourable outcome. Suggested Further Reading: Bigler, E. Neuroimaging in Mild Traumatic Brain Injury. Psychological Injury and Law 2010; 3:36-49 Neil, J. Diffusion Imaging Concepts for Clinicians. The Journal of Magnetic Resonance Imaging 2008; 27(1):1-7 Mittal S., Wu Z., Neelavalli J., Haacke E.M. SusceptibilityWeighted Imaging: Technical Aspects and Clinical Applications. American Journal of Neuroradiology 2009; 30:232-52 Mosely M. Diffusion and Perfusion Weighted MRI. SMRT Education Seminars 2007; 10(4);11-22 Prayer, L., Wimbeger, D., Oder W. Kramer, J. et al. Cranial MR Imaging and cerebral 99mTc HM-PAO-SPECT in Patients With Subacute or Chronic Severe Closed Head Injury and Normal CT Examinations. ACTA Radiologica 1993; 34:593-99 Runge, V. Clinical MRI, 2002, W.B. Saunders Company, Pennsylvania Schonberger, M., Ponsford, J. Reutens, D., Beare, R., et al. The Relationship between Age, Injury Severity and MRI Findings after Traumatic Brain Injury. Journal of Neurotrauma 2009; 26:2157-2167 Page 26 At Southlake, patients benefit from both an MRI using the advanced techniques described above and a SPECT scan. The exams are done on the same day and interpreted together by one or two radiologists. The synthesis of MR (morphology) and SPECT (functional) information provides the clinician with a unique combination of information that has valuable prognostic implications. Moving Towards Wellness Ltd. P.O. Box 1055 Clinton, ON N0M 1L0 Tel: 519 482-7181 Fax: 519 482-3799 E-mail: [email protected] Website: www.movingtowardswellness.ca Mary Hansen, RRP, CCRC Director and Senior Consultant Dorothy Ditner, Office Manager/Intake Coordinator Services Offered by Moving Towards Wellness Ltd: Catastrophic Case Management Disability & Medical Case Management (NonCatastrophic & Personal Injury) Discharge Planning to Rural & Urban Communities Life Care Plan (Future Care Cost Analysis) Social Work (Adjustment Counselling) In Home Assessments: Activities of Daily Living, Attendant Care, Housekeeping Home Maintenance Rehabilitation & Recreation Therapy Vocational Consulting and Assessments Return to Work Planning & Facilitation Ergonomic Assessments and Implementation Job Site Assessments with Physical Demands Analysis Functional Capacity Evaluations Home Exercise, Community Based Programs, Aquatic Rehabilitation Servicing the urban and rural areas of MIDWESTERN AND SOUTHWESTERN ONTARIO The Monarch Enhancing Community Inclusion and Participation TheInCareteam’sexperienceandtraining: x x x x x x x x x x x x ǡ ǡ ǡ MAUREENNAGLE,DSW,RRP,B.A.inDisabilityStudies(2011),SeniorCaseManagerǦ ͳͻ JOEZABLOCKI,CaseManagementCertificate(2011),CaseManagerǡǦ ǡ ǡ Ǥ LAURIEVANEINDHOVEN,MSW,RSW,SocialWorkerǦ Ǧ Ǥ DEBORAHCRUNICAN,B.Sc.OT,OccupationalTherapistǦͳ Ǥ MELISSAVANSAS,HSF,DSW,B.A.(Psych),B.Ed,RehabilitationTherapistǦ Ǥ Ǥ CAROLINACOHOON,B.A(English),RehabilitationTherapistǦ Ǥ Ǥ KEVINSILVA,RehabilitationTherapistǦ Ǥ Ǥ LISASANS,RehabilitationTherapistȂ Ǥ Mission Statement Focusing on specific and identified individual needs, InCare aims to improve the quality of life of persons with a disability For further information on our services please visit our website at www.incarehealth.com. or contact us at InCare PO Box 309 Grand Bend, Ontario N0M 1T0 Phone 519 238-2021 Fax 519 238-2047 Where you there? Excellent turnout and fablous, funky music made for a for great night at our 11th Annual Dinner and Dance. We caught some attendees as they joined “Doc’ in the countdown before takeoff back to the future. To the far right, Mac Graham and his band The Outfit entertained with music from the 70’s and 80’s. Page 28 The Monarch Thank you to sponsors, silent auction donors, attendees & volunteers who made Mac to the Future a tremendously successful evening! See our full list of sponsors on page 7. Legal minds. Caring hearts. If you or someone you love has suffered serious injury, our experienced lawyers will listen to your problems and help you get the best possible results. The Monarch • Car accidents Free initial consultation. London • Motorcycle accidents Hospital or home visits. 519.672.4510 • ATV and snowmobile accidents Free second opinions. Toronto • Brain injury claims • Spinal cord injury claims Free parking. 416.867.3076 Injury Help Line www.lerners.ca/personalinjurylawyers 1.800.263.5583 • Fatality claims • Slip and fall claims • Insurance disputes • Other injury claims Page 29 A MESSAGE TO FAMILY MEMBERS AND FRIENDS … by Janne Brown * I am still Janne … but I am different in many ways than before the accident. * Please remember that not every disability is the same. Your experience with someone with a disability may not be the same as mine. * Large gatherings are difficult for me. I feel very isolated. When there is a lot of conversation around me, it is easy for me to get lost in the conversation.. This is because of my brain injury. * I enjoy listening to conversations and I also enjoy contributing to conversations. It is helpful when someone asks me a question directly in these situations as it is often difficult for me to interject comments appropriately. * New information can be difficult for me. I can become confused if I don’t have all the facts of what is being said. Some people can ‘read between the lines’ during a conversation and just naturally know what people are talking about. I cannot do that because of the injury to my brain. * I don’t catch on to body language and subtle cues very well. I usually take things very literally. * Using public transportation usually works out well. However, the winter and inclement weather is often difficult for me. It would be helpful if someone would check on me to see if I need any thing. * My tiredness may be different than yours and this is because my body has to work harder than others to function as they do. Crowds and situations where there is a lot of physical and/or mental activity cause fatigue. I need fairly frequent breaks. * I have short term memory loss since the accident. I will often not recall conversations from the day before and may need more frequent reminders. * It would mean the world to me to receive a quick call or a note from time to time just to say hello. I spend a lot of my time alone and I get lonely sometimes. * If I have hurt anyone or if you have any concerns about me, please speak to me about it first. Please know that I really love my family and friends and you are what is most important in my life. Page 30 The Monarch Upcoming Conferences and Events What: All This and a Brain Injury, Too! Brain Injury Association of Sarnia Lambton 7th Annual Conference Where: Lambton Inn Conference Facility 1485 London Road, Sarnia, Ontario When: April 7, 2011 Website: [email protected] What: “Mild Traumatic Brain Injury: Advances in Research and Practice” Hamilton Health Sciences 18th Annual Conference Where: Hamilton Convention Centre When: April 28 & 29, 2011 Website: www.hamiltonhealthsciences.ca What: Chronic Pain & Brain Injury Workshop Sponsored by Legate & Associates, Siskinds & Lerners Where: Four Points Sheraton, London When: April 29, 2011. 8:00a.m.-12:00p.m. Website: www.braininjurylondon.on.ca What: Where: When: Children’s Safety Village Birthday Party Helmet Exchange Fanshawe Park London June 5th, 2011 What: Helmets on Kids 10th Annual Campaign Kick Off Where: Lord Elgin School 1100 Victoria Drive, London When: June 16, 2011 Website: www.braininjurylondon.on.ca. Bartimaeus Rehabilitation Services Because Experience Matters Bartimaeus provides rehabilitation services for people with an acquired brain injury and people who have suffered from serious trauma. For more information, please call or email Tish Byrne at 519-575-2002 , [email protected] or visit our website www.bartimaeus.com SINCE 1988 Knowledge Ɣ Experience Ɣ Choice The Monarch Page 31 Upcoming Conferences and Events What: Tech Talk…Technological Support for Brain Injury Challenges Brain Injury Association of London & Region 14th Annual Conference Where: Four Points Sheraton London, When: June 17th, 2011 Website: www.braininjurylondon.on.ca What: Annual General Meeting Brain Injury Association of London & Region Where: Four Points Sheraton London When: June 17th, 2011 4:30 pm Website: www.braininjurylondon.on.ca What: Camp Dawn 2011 Where: Rainbow Lake, Waterford Ontario When: September 15th – 18th, 2011 Website: www.campdawn.ca Page 32 Continued What: 10th Annual London Brain Injury Golf Classic Where: Greenhills Golf Club When: September 22nd, 2011 Website: www.braininjurylondon.on.ca What: M.D.M. Reporting Services 4th Annual Charity Casino Night Where: West Haven Golf Club When: November 19th, 2011 Website: www.braininjurylondon.on.ca With every dawn a new path is found. The Monarch REHAB FIRST Building futures. Brain Injury Association of London & Region 560 Wellington Street, Lower Level London, ON N6A 3R4