In August 2011, I decided to leave a very stressful job. I took some time off and to relax before working my next step. I had a few days of temp work lined up in the mean time.

On 12th September, I got out of bed, went to the bathroom and washed my hands. I wasn’t able to dry them properly and thought I must have been tired. I leaned over to start making the bed and noticed drops landing on the sheets. I realized that I was dribbling. It was a bit odd so I went down stairs to talk to my husband.

I tried to speak but my words were jumbled. I tried to write down what I wanted to say but wasn’t able to write any words. The right side of my body had stopped working and I couldn’t communicate at all. The strange thing was that I could visualize the words written in my head. Each time I would try to say them, something different would come out. Within minutes, I was not able to stand and my husband sat me down.

At this point my face dropped and my husband realized what was wrong. He carried me to the couch and lay me down. I heard him call for an ambulance straight away. While we waited, he dressed me. It wasn’t easy for him to do, as I couldn’t really move very much.

The ambulance arrived ten minutes later and the ambulance ladies were great. They reassured both my husband and I that it was going to be okay. I remember being in the ambulance and watching the traffic part behind us as we sped through. It was pretty fast for peak hour in Melbourne. A short time later at the hospital, I had a second stroke. I was admitted for five days and underwent many tests. Doctors were unable to determine why I had experienced the stroke. I was 39 years old.

I returned home and went through daily fatigue and the world seemed very big outside. I lost a lot of confidence; even walking to the shop was a planned outing. I became very shy and concerned about strangers. I was overwhelmed easily with too much information. I wasn’t able to drive for a while and always had my phone with me just in case it happened again. I would sometimes dream I was having another stroke. It was a really difficult time for me.

I began researching health and looked for foods that would help with cognitive repair and energy. I wanted to make sure I was making healthy lifestyle changes. This became my number one purpose, as I never wanted to go through that experience again or see the worry on my husband’s face.

I had just started drinking green smoothies in the weeks prior to my stroke. I found that from drinking green smoothies, my energy gradually increased and my fatigue became less of a problem. I also added around 70% raw food to my diet. This made a noticeable difference to my health. My purpose has to been to share healthy living strategies with as many people as possible to avoid or lower the risk of serious illness. I started my smoothie business in January 2012.

It has been seven months since my stroke and I have never been fitter, healthier or more relaxed in my life. I have no fatigue or energy problems and my life is much better for it. I have completed three fun runs since my stroke and have managed to shave 7mins off my time. I am really proud of this achievement. I also recently went fire walking which was amazing. Changing my lifestyle became very easy when I had a big enough reason to do it. Having a stroke was a big wake-up call and it made me re-evaluate what’s important in my life.

Following a brain injury many people report that their senses of taste and/or smell have been affected. This may be as a consequence of injury to the nasal passages, damage to the nerves in the nose and mouth, or to areas of the brain itself loss or changes to smell and taste are particularly common after severe brain injury or stroke and, if the effects are due to damage to the brain itself, recovery is rare. The effects are also often reported after minor head injuries and recovery does occur, it is usually within a few months of the injury and recovery after more than two years is rare.

The two senses can both be affected in a number of different ways and some definitions of the terms for the different conditions are provided below. The two senses are connected and much of the sensation of taste is due to smell, so if the sense of smell is lost than the ability to detect flavour will be greatly affected. Therefore, a disorder of smell will usually occur together with a disorder of taste.

Sadly, there are no treatments available for loss of taste and smell, so this information is designed to provide practical suggestions on how you can compensate.

Disorders of smell

Anosmia: total loss of sense of smell
Hyposmia: partial loss of sense of smell
Hyperosmia: enhanced sensitivity to odours
Phantosmia:/parosmia: false smells
Dysosmia: distortion of odour perception

Disorder of taste

Ageusia: total loss of sense of taste
Dysgeusia: distortion or decrease in taste
Parageusia: perceiving a bad taste in the mouth
Dysgensia: persistent abnormal taste
Loss of taste and smell after brain injury

Health, safety and hygiene issues

Fire/smoke: fit a smoke alarm, have electrical regularly serviced, remove plugs when not in use and use an alarm to remind you of food cooking in the oven.

Gas leaks: have gas appliances regularly serviced and fit a gas detector. You might want to consider an electric cooker and fire.

Out-of-date food: always eat or throw our food by it’s used by date. If in doubt, throw it out! Clear out the fridge and cupboards regularly.

Identifying products: try to keep products such as drinks, bleach, cleaning products and solvents in their original containers. Make sure they are clearly labelled.

Home hygiene: ask friends/family/carers to help empty rubbish bins and keep toilets and kitchen clean to avoid health risks.

Personal hygiene: be aware of the need to wash yourself, your clothes and bed linen regularly. Use an antiperspirant deodorant and perhaps a shoe deodorant too. Ask a close friend of family member to advice in this area.

Mouth care: it is important to keep your mouth clean and to brush teeth regularly and thoroughly, including brushing your tongue as well. Using mouthwash and dental floss helps. Visit dentist regularly.

Toxic fumes: take precautions and follow manufacturer’s advice when using products such as paint, cleaning products and solvents. Wear protective mask, ensure rooms are well ventilated and don’t smoke.

Tips for a healthy, balanced diet

Changes to taste and smell can affect appetite and eating in a number of ways:

The smell of food stimulates the appetite, so loss of smell can lead to a reduced appetite and lack of interest in food. Loss of smell can also lead to a reduction in saliva production, therefore dry foods, such as biscuits and crackers, may be more difficult to eat.

The choice of foods may be limited to those with provide flavour, which can lead to a diet that doesn’t provide a balanced variety of nutrients.

Making meals more interesting

Be imaginative. Use varied colours and textures.

Under cook vegetables so that they are crunchy, have a crunchy base and smooth topping.

Try using seeds, nuts, wholegrain cereals, fresh fruit and vegetables, beans and pulses to add texture.

Adding bacon bits or grated strong cheese, such as parmesan, can add flavour to a meal.

Experiment with using different herbs and spices.

Grate onions, carrots, apples or other suitable fruits and vegetables to add texture.

Serve hot and cold foods together. Try ice-cream with hot sauce/stewed fruit or lasagne with salad.

Make meals a social time with friends and family.

Establish a regular routine for times to eat breakfast, lunch, evening meals and snacks each day.

Use a cookbook and try new and interesting recipes.

It is important to note that some of these suggestions may not be suitable if you are experiencing difficulty with chewing, swallowing or choking and have been advised to eat a softer diet. Consult your GP, dietician or speech therapist for further advice.

Loss of enjoyment of food can lead to avoiding eating altogether

Altered taste can make certain foods, such as meat, taste unpleasant and lead to those foods being avoided. Any of these problems may affect your choice of food and lead to an inadequate diet. It is very important to maintain a healthy, balanced diet and below is some suggestions to help you do this.

A balanced diet

This is essential for good health. All that is really required is to eat sensibly, choosing a range of foods in the correct proportions. Below are some suggestions to help you do this:

Try to base your meals on starchy foods such as bread, cereals, potatoes, rice or pasta. Aim to include at least one food from this group in each meal.

Try to eat as great a variety of foods as you can, have at least five portions of fruit and vegetables a day. Try to drink the equivalent of about a pint of milk a day. This includes milk used in tea and coffee. Try to use reduced fat milk and be very careful that the milk hasn’t gone off, especially in hot weather.

Limit foods containing a lot of fat and sugar

If you avoid certain foods because they taste unpleasant look for alternative sources of protein and nutrients. For example, if you cannot eat meat replace it with fish, beans, eggs or milk.

If you continue to experience difficulty adjusting your diet or have any other dietary concern, such as diabetes or Coeliac disease, that make it difficult to vary foods that you eat, discuss with your GP.

Avoiding too much salt

Loss of sense of taste may make people likely to add too much salt or other flavouring, such as garlic or chillies. Avoid too much salt by:

Following a recipe or routine to avoid oversalting foods during cooking.

Trying to add less salt in cooking and not to add salt to the table.

Vegetables that are steamed, baked, roasted or cooked in the microwave retain their natural flavour better than when they are boiled. This reduces the need to add extra salt in cooking.

To add flavour to foods try different herbs and spices, mustards, lemon juice, vinegar, pickles and success – follow directions for using additional flavourings and try not to add extra, as over-seasoning foods can cause indigestion.

Drinking and alcohol

Loss of taste and smell can also affect the amount of fluids you drink, which may result in dehydration. It is also possible to have too much caffeine or sugar in hot drinks to try to make up for an impaired sense of taste.

Try to drink eight glasses (totalling about 1.5-2.5 litres) of fluid a day. This includes all drinks such as water, juice, tea, coffee etc, but not alcoholic drinks, as alcohol dehydrates the body. If exercising heavily you will need to drink more than this.

Avoid very strong tea and coffee or try decaffeinated varieties.

Avoid excess sugar to tea and coffee.

Energy drinks often contain a large amount of caffeine and should be drunk in moderation.

Drinking plenty of liquid can help remove unpleasant tastes from the mouth.

Alcohol

You may have been advised to avoid alcohol because of your brain injury or any medications you are taking. If you are unsure, ask your GP. Tolerance to alcohol can be reduced following brain injury and stroke. Try to drink in moderation or not at all. Remember that alcohol will have the same effect on you even if you can’t taste it, and make sure that you know what is in the drinks bought for you. Try drinking low alcohol or alcohol free beers as an alternative.

This story was first seen in the Synapse bridge magazine, and was reproduced with the permission of Headway.org.uk.

Paul Gianni recounts the things that motivated his remarkable recovery after his brain injury

While in hospital, I carried a three-ring binder that held all my notes, appointments and saved as a diary so I could track my progress. In the beginning, all my progress notes had to be written by the doctors and therapists since my strength and coordination (and thus my ability) to write were all impaired or non-existent. In it I also have my first attempts at writing my name after regaining semiconsciousness. Those scribbles looked like something a child might do. The letters were large, ill formed and basically readable. This binder also held my daily schedule so I would know which area and therapist to see next. I would have to say that of all therapies, my two favourites were physical therapy and speech/memory therapy.

In hindsight

Looking back, I can probably explain the reason for those two being my favourites – I was driven by immediate results and I could see advances made daily. I would attend those therapy sessions twice a day, and would notice daily that I could remember a little more, speak a little more clearly, walk a little further, and lift a little more weight. These advances seem trivial to some, but they meant the world to me as I slowly recovered.

I need more

In the evenings, other patients would gather in what was called ‘The Great Room’ to converse and relax after the day’s therapies. During these periods, I would hear the focus of discussion generally turn towards negative topics. Since I was already depressed enough with partial paralysis, memory problems and disfigurement, I did not want to partake in their little talks. Instead I sat in my room and thought (or dreamt) of what I would do if I was not in hospital but employed.

What a shock

Then it struck me one afternoon as if somebody had slapped me with a board; suddenly I looked up at the clock and noticed it was half past twelve. I thought to myself, “What am I doing here? I should be running to meetings, having a terrible lunch and getting some work done, not sitting in some hospital.” At that point, my stay at the hospital’s rehabilitation wing was completely different. I had a purpose….a mission!

Motivation

With my shocking new knowledge, I attacked my therapies with new vigour and an absolute need to recover quickly. In the evenings while the other patients sat about in the great room, ate ice cream and drank soda, I returned to the physical therapy room to exercise. I lifted weights, walked on the balance beam, stretched, rode the exercises bike; everything I thought would help me get there faster. My knee kept aching painfully, but the doctor insisted I was fixating on an imaginary problem, which is common.

Nevertheless, with a new urgency, I pressed onward. Nightly I would sneak back into the physical therapy room, turn on a few lights so I wouldn’t draw attention to myself and then exercise on whatever equipment was available. Some of it was locked away, so my regime was limited. Also, I was unable to access all of the different therapy facilities, and some of the equipment for other things needed guidance, so I stuck with what I could do alone.

All that time I had been wearing hospital garments and slippers. I had relatives bring things I used to do so I could reacquaint myself with them, things such as a neck tie and calculator. I didn’t want to be obsolete or useless when the time came for me to get out of hospital. You cannot imagine the tears that poured into my eyes as I recalled how to tie a necktie and my shoes! I had done it! This was my first bit of proof; I thought that I do NOT belong here!

Results differ

Since the outcome of each acquired brain injury is unique, not all readers can expect the same things I have, for I have been lucky.

If survivors’ families and caregivers are considerate, encouraging, patient and understanding, progress can be recognised. However, since not all survivors are able to recover to the same level of functioning, pressure and anger should be avoided.

This story was first seen in the Synapse bridge magazine, and was reproduced with the permission of Lash and Associates Publishing/Training Inc.

Possible motivators during rehabilitation

Post pictures in various areas of favourite pastimes*
Encourage them to push themselves a little more each day
Post awards, photos, certificates etc. That were earned in prior activities*
Discuss both past and future plans
Always congratulate the survivor on each accomplishment, no matter how minor it may seem to you
Avoid pessimism to the absolute greatest of your ability

*Caution Do this only if the survivor will be able to do those things again

We are thrilled to have had Mathew Hart, Executive Chef at Balgownie Estate on board for Food for Thought Melbourne. The event was held last night at Central Pier Docklands. As part of the six course degustation guests were treated to a ‘smoking hot’ dish of smoked spiced spring chicken, sticky apricot chutney and sage thyme jus created by Mathew.

Prior to the event Mathew kindly took some time to chat with us about; his support of the Foundation, relationship with stroke, the Yarra Valley and his cooking style.

In February 2012, Mathew joined the dynamic team at Balgownie Estate Vineyard Resort & Spa as Rae’s Executive Chef. He has worked in kitchens in South Australia, Melbourne and the United Kingdom. He has professional experience in some the valley’s more notable restaurants including The Vines, Chateau Yering and Tokar Estate. It is certainly safe to say that Mathew is somewhat of a Yarra Valley connoisseur!

Why did you decide to support the National Stroke Foundation at Food for Thought?

There are a lot of the charities that I would like to get involved in. I think it’s important to do what you can to support research and other families who might be struggling. It sounds like such a great event; not only is it for a good cause but it also a night of reflection and celebration.

Do you have any personal connection with stroke?

My friend’s wife had a stroke last year. She was in here early thirties. Fortunately she is okay now.

You are a specialist in Yarra Valley produce. What do you consider signature produce that represents the valley?

I am very keen to use lots of local growers and suppliers. Brads zucchini flowers are quite big and everyone is getting them in the city now, which is great. There are also lots of fruits and berries out and about. We have our own veggie patch at Balgownie Estate and use a lot of those vegetables in our recipes.

The dish you have chosen to cook at Food for Thought is very interesting. Is there a particular reason that you chose it?

One of our signature dishes is wine smoked beef. We are on a vineyard so when all of the grapes are off we can take the clippings and use them for smoking. It’s a new concept that we brought in since I have been there. If you choose the beef it comes out smoking on the table!

A song that you like to listen to when you are preparing food?

Warren G, Regulate

Balgownie Estate
Melba Highway
Yarra Glen VIC 3775
www.balgownieestate.com.au
+61 3 97300774

If you have taken time to explore Melbourne’s lovely laneways you most likely would have stumbled upon the iconic Gingerboy sign nestled in Crossley Street. Behind the vibrant, fluoro sign is the renowned restaurant of the same name.

Food for Thought chef Leigh Power is Head Chef at Gingerboy. His professional experience is diverse and whilst he has a background in classic European cooking (he worked at The Treasury, Melbourne) he has always had a passion for Asian flavours. Fittingly Leigh worked for two years as Sous Chef at Gingerboy and in 2011 was promoted to Head Chef.

Leigh took a moment to chat with us about why he has chosen to support the Foundation and the foods that he loves. He has even shared a handy cooking tip and recipe. Thanks Leigh!

Is there a particular reason you are drawn to the National Stroke Foundation?

Yes, my Grandfather had a stroke a far while ago. Fortunately he is okay and still alive but I have certainly seen the negative effects of stroke. It has been very hard for my Grandfather. I hope that I never have to live through anything like that.

What inspires you when you are developing recipes?

Well the food here at Gingerboy is based on hawker markets and hawker stalls throughout Thailand, Singapore and Vietnam. I have always had a passion for Asian flavours (even though my background is in European cooking). Most recently I spent time in Spain. The food there was amazing so I have tried to draw a lot from the Spanish food. It’s the freshness of their food that I love, especially the seaside restaurants in San Sebastian. I found the pinchos and tapas to be so colourful and I think that the Gingerboy food is certainly like that.

A food that inspires you is… soy.

What dishes get your top recommendation on the Gingerboy menu?

There are a few things on here that I really love. I love slow cooked food, so the duck leg is slow braised. The ox cheek that is on now is really beautiful too, it’s marinated for 24 hours.

Where do you source your products?

We try and source most of our produce locally as we want to promote the sustainability of Victorian farmers. We aim for mostly Australian produce and we are trying to implement that with our wine list. We even have a Gingerboy Pinot from a maker in Geelong.

Do you have a handy cooking tip for our readers?

Yes I have an easy one for avocados: If you want to cut your avocado before it is time to serve keep the stone and put it back in the avocado. This will stop the avocado from oxidising because the stone takes on the air in the actual avocado.

A song that you like to prepare food to is… Foo Fighters Generator

Gingerboy
27/29 Crossley Street Melbourne VIC 3000
www.gingerboy.com.au
(03) 9662 4200

Soy cured ocean trout, tumeric, coconut caramel and pickled daikon

This dish has become a bit of a gingerboy signature, the soy cures the trout nicely over night. The trout melts in your mouth as the fat makes it nice and creamy to eat. The dressing uses fresh tumeric which adds a great colour and flavour to this dish.

Serves 4 as a banquet

Ocean trout
600 g ocean trout filet, skin of and deboned
600 ml light soy sauce
4 star anise, lightly toasted
3 lemons, zested and juiced
4 spring onions, white end only washed and roughly chopped
3 cloves garlic, peeled and roughly chopped
30 g ginger, peeled and roughly chopped
1 tablespoon castor sugar
Tumeric, coconut caramel
150 g palm sugar, grated
80 ml water
60 ml shiso vinegar
150 ml coconut cream
10 g tumeric, peeled and finely chopped
6 spring onions, white end only and finely sliced
3 large green chillis, finely sliced
80 ml lime juice
2 pinch’s sea salt
Pickled chinese radish
1 small white radish, peeled
1 cup coriander leaves, picked and washed
250 ml sichuan pepper pickle

Ocean trout

Place the ocean trout into a small deep tray, then in a mixing bowl place the rest of the ingredients and let it sit for 10 minutes so the flavours can infuse.

The ocean trout will take 20 – 24 hours to cure, so pour the liquid over the top. It should be covered with the curing liquid if so cover with cling film and place in the fridge, if it is not covered completely with liquid you will need to pull it out after 10 hours and flip the trout over. Once cured take the trout out of the marinade and let it sit on a clean tray ready to be sliced. Set up a chopping board and place the trout down and using a very sharp knife, slice gently about 1 - 2mm in thickness then lay it down on the tray. Once sliced cover with glad wrap and reserve on the fridge until needed.

Tumeric coconut caramel

Place the palm sugar in a pot with the water and put it on to the stove on a medium heat. The sugar will turn to a nice golden caramel which takes about 6 – 8 minutes, then add the turmeric and chillis and wait for 30 seconds before adding the coconut cream and shiso vinegar. Bring back to a gentle simmer then turn it off as you need to melt the caramel back down, take of the heat and reserve on the side. Once cool add the lime juice, salt and spring onions.
Pickled chinese radish

Peel the outside skin of the radish and discard, then using the peeler peel the radish from top to bottom in to a bowl, you should end up with ribbon looking pieces of radish. Place them into a bowl and then pour the pickle liquid over the top, and let it sit on the side for about 20 minutes.

To serve

Place 8 -10 slices of ocean trout on the plate in a neat circle, then 2 tablespoons of tumeric, coconut caramel over the top and around the trout. Mix the coriander through the radish then place neatly in the middle of the trout.

Look at the symptoms and triggers of fatigue, and some strategies to minimise and manage it

Fatigue is a common and very disabling symptom experienced by people with Acquired Brain Injury (ABI) or neurological conditions. Some people describe an overwhelming sense of general fatigue that can occur at any time of the day. It happens without warning, and the person needs to rest immediately before the symptoms get worse.

Fatigue is also a problem among carers as they find themselves managing increased workloads and greater responsibilities. Members of the rehabilitation team understand our position and can recommend coping strategies and support services such as respite care. Consult with your GP or a trusted team member before your own health is affected.

What is fatigue?

The fatigue associated with brain injury or neuromuscular damage often appears more suddenly, lasts longer, and takes longer to recover from than ordinary fatigue. Make no mistake; it is real and not a case of mind over matter.

What causes fatigue?

Fatigue can occur for no apparent reason or after relatively mild exertion. It may be caused by physical activity, but is just as likely to occur as a result of mental activity.

Planning the week’s errands, organising a work schedule, calculating a weekly budget or simply reading, can be very draining. We all experience this to some extent, but for the person with a brain injury, it happens more easily and much more frequently.

Fatigue can be managed with good planning and rest periods, but first carers and the family member affected need to acknowledge that it is real.

Symptoms

The following symptoms may all suggest fatigue:

• Withdrawal
• Loss of appetite
• Shortness of breath
• Slower movement and speech
• Short answers, quieter voice, dull tone of voice
• Irritability, anxiety, crying episodes
• Increased forgetfulness
• Lack of motivation to plan for each day
• Lack of interest in things the person normally considers important (e.g. appearance, grooming)

Fatigue also intensifies symptoms experienced because of ABI or neurological condition, such as

• Poor vision
• Slurred speech
• Difficulty finding words
• Poor concentration
• Cramps or weak muscles
• Poor coordination or balance

The next step is to work out what triggers it and what factors make the symptoms worse, such as holding a demanding conversation for more than 10 minutes or watching a film with a complicated plot. You can then work together to develop strategies to conserve energy.

Managing fatigue

Contingency plans: Fatigue may occur at the least convenient times – on public transport or during a meeting. You need to negotiate ways of coping when this happens. You can use specific strategies or call in extra support. Work out contingency plans with your family member. Your physiotherapist can help with suggestions.
Assess your environment: Provide an environment that is easy to move around and work in. Think about how and where things are stored; bench heights, entrances, types of furnishing and lighting. For example some people may find fluorescent lighting or dim lighting more tiring.
Assess best hour: Some people function best in the mornings, so complete demanding tasks then. Others function better in the afternoon or the evening. Organise your routine accordingly.
Schedule rest periods: make a daily or weekly schedule, and include regular rest periods. “Rest” means do nothing at all.
Use aids: Use mechanical aids to conserve energy for when it really counts. One man spared his legs extra effort by using his wheelchair to get from his house to the car, then from the car to the church, before walking his daughter, the bride, down the aisle.
Break it down: Break down activities into a series of smaller tasks. This provides opportunities to rest while allowing the person to complete the task. Encourage sensible shortcuts.
Set priorities: Focus on things that must be done and let others go.
Medication highs and lows: Be aware of changes throughout the day that relate to medication. Is the person better or worse immediately after taking heir tablets? Plan their activities around those times.
Sleep: Encourage a regular sleeping pattern. Some people may also need a regular nap – or two – during the day.
Fitness: Your family member should maintain fitness within their individual ability, that is, enough exercise to stay fit, but never to the point of causing tension, overtiredness or cramps.
Weight: Maintaining a healthy weight helps. If your family member’s condition affects their ability to eat, consult a dietician and speech pathologist to ensure they have a nutritious diet that is easy to manage.
Weather: Hot weather can also increase fatigue. Plan around this.
Seek support: Ask for advice. In particular, an occupational therapist can visit your home and advise on an energy – conserving plan.

For more information, talk to your doctor or condition – specific support organisation.

Thank you to The Brain Injury Association of Queensland for the article in Synapse Bridge Magazine the official journal of BIAQ. This article was first reproduced with the permission of BrainLink, from their excellent brain injury resource available for free download www.brainlink.org.au.

Brain injury can change parts of the brain that regulate or control emotional behaviour and feelings

Emotional lability refers to rapid, often exaggerated changes in mood, where strong emotions or feelings (uncontrollable laughing or crying, or heightened irritability or temper) occur. These very strong emotions are sometimes expressed in a way that is not related to the person’s emotional state.

What causes emotional lability?

Emotional lability occurs because of damage to parts of the brain that control:

• Awareness of emotions (ours and others)
• Ability to control how emotions are expressed, so ability to inhibit or stop emotions emerging

When a person is emotionally labile emotions can be out of proportion to the situation or environment the person is in. For example, a person may cry, even when they are not unhappy – they may cry just in response to strong emotions or feelings, or it may happen “out of the blue” without warning.

A person may have little control over the expression of these strong emotions, and they may not be connected to any specific event or person.

Following a brain injury an individual may also lose emotional awareness and sensitivity to their own and others emotions, and therefore their capacity to control their emotional behaviour may also be reduced.

They may overreact to people or events around them – conversations about particular topics, sad or funny movies or stories. Weaker emotional control and lower frustration tolerance, particularly with fatigue and stress can also result in more extreme changes in emotional responses.

The person may express their emotions in situations where previously they would have been able to control (in quiet situations, in church, listening to a concert).

These behaviours can be confusing, embarrassing, and difficult to understand for the person with brain injury and for others.

Emotional responses after Acquired Brain Injury - become aware of triggers

• Be aware of triggers for emotional lability and try to avoid these when you can. Triggers can include: excessive fatigue or tiredness
• Stress, worry or anxiety
• High stimulation (too demanding, too noisy, too many people) and too much pressure
• Strong emotions and demands from others
• Very sad or funny situation (such as jokes, movies, certain stories or books)
• Discussing certain topics (e.g. driving, loss of job, relationships, death of a family member)
• Speaking on the telephone or in front of a group or where a person feels under pressure.

Have a break

Have a short break away from the situation so the person can regain control of emotions, and to give the opportunity for emotions to settle.

Sometimes a break for a few minutes or longer period is enough to regain control of emotions – taking a short walk, doing a different activity all can help to cope with these strong emotions.

Ignore the behaviour

Try to ignore the emotional lability as much as possible. Try to get others to ignore it too and continue on with the conversation or task.

Focussing on the lability, or giving the person too much attention when it is happening, can reinforce the problem. It is important that other people don’t laugh too, as this will also reinforce and increase the behaviour.

Change the topic or task

Changing the topic or activity (redirection and distraction) can reduce stimulation or stress (particularly if the topic was a trigger). Try to distract or divert the person’s attention by engaging them in a different activity or task.

Provide information and education

Uncontrolled crying or laughing can be upsetting frightening or confusing for other people if they don’t understand so:

Provide simple explanations of information to other people about the lability e.g. “I cry a lot since I had my stroke….don’t worry about it” or “Sometimes when I am nervous I get the giggles”.

Tell people what they should do e.g. just ignore me and it will stop”.

Plan ahead

When there is severe emotional lability, one-to-one, brief and fun activities in a quiet environment will be better. Try to avoid putting the person in stressful situations or environments e.g. noisy, busy, high levels of activity or a too demanding.

Plan activities that are within the person’s ability, and plan more demanding activities or appointments after rests, or when the person has the most energy. Plan for rests between activities.

Use cognitive techniques

Some simple cognitive strategies can also assist in managing emotional lability:

• Relaxation and breathing exercises to reduce tension and stress
• Use distraction e.g. thinking of something else, imagining a peaceful image or picture, counting
• Do an activity (going for a walk)
• Discuss cognitive and behavioural strategies (e.g. ‘thought stopping’|) with a psychologist.

Counselling and support

Sometimes a person has had many losses and changes to cope with after the brain injury – loss of work, ability to drive, independence, changes in relationships or finances, and lower quality of life. These changes can happen suddenly with little chance to prepare for them.

These feelings of sadness, grief, anger, frustration, disappointment, jealousy or depression after an injury are common and may be difficult to cope with.

If there are other emotional adjustment and coping issues, referral to a councillor such as a psychologist, social worker or psychiatrist may be helpful. Families (parents, siblings, partners, children), friends and carers may also benefit from support and care to help them understand and to cope with these changes.

Thank you to The Brain Injury Association of Queensland for the article in Synapse Bridge Magazine the official journal of BIAQ. This article was first printed from the ABIOS fact sheets available at www.health.qld.gov.au/abios.

We are currently looking for StrokeSafe Ambassadors in the Sydney area to apply StrokeSafe Ambassador.

The StrokeSafe Ambassador program is a Stroke Foundation initiative where stroke survivors, carers and health professionals spare their time to participate in community-based stroke awareness and education talks.

Our volunteer speakers, who are trained by stroke foundation staff to deliver their message, speak to a variety of people in a broad range of community settings.

We have found this program to be extremely well-received and participants have passed on feedback that shows the stroke prevention messages are being heard. Here is some recent feedback sent to us after StrokeSafe Ambassador, stroke survivor and Stroke Foundation supporter Karen Bayly volunteered her time to speak at the Melbourne War Widows’ guild:

“Last year I organised for Karen Bayly, StrokeSafe Ambassador, to address a meeting of members from the Melbourne War Widows’ Guild. Karen’s talk was educational, informative and inspiring but most importantly it was effective.

One of the attendees was at home late in December when she experienced the signs of stroke. Because she was aware of the FAST message she acted quickly and this in turn minimised the impact of her stroke. The member regained speech within days and had one month of rehabilitation to restore muscle strength before returning home.

We live in a world full of acronyms and abbreviations however not many of them can be accredited with preventing the severity of a stroke or indeed perhaps the saving of a life. I congratulate the National Stroke Foundation, its ambassadors and all connected with the FAST campaign.”

Jill Wilmott, War Widows’ Guild of Australia – Victoria. Karen says: “We all like to think that every time we speak we might save a life or assist in preventing dependent disability.

“I spoke to a community group of about 20 women in their 70s and 80s. The organiser of this talk contacted the NSF to let us know that a lady who heard me talk had a stroke a few months after hearing my presentation.

“The good news is, because of the strokesafe Ambassador presentation, she recognised the signs of stroke, called 000 and has made a strong recovery.

“The key thing I’ve been reminded of is that every life is important. The quality of life of every stroke survivor matters. Stroke recovery is a difficult and lonely journey for all stroke survivors and those close to them, regardless of age”.

“I have had so much help from so many people I want to give back to others.”

If you take the 86 tram out of Melbourne CBD you will soon find yourself in the eclectic area of Northcote. Think cute little coffee shops, artisan bakeries, crafty boutiques, a bar named after a shoe store and you have painted the charming picture. You would be amiss however not to include Scott Pickett and Ryan Flaherty’s latest venture in this vision. We are talking about their beautiful Art Deco designed restaurant aptly named the Estelle Bar & Kitchen that is comfortably nestled in the hub of High Street. Their delectable degustation menu at the restaurant matches the delicate décor. It is a space that cultivates Scott’s food philosophy of creating simple dishes that are executed exquisitely.

This is the second year that Scott has brought his exceptional international experience to the Food for Thought table and we are very excited to taste the delights he will dish up this year.

To give you some idea of Scott’s extraordinary experience he was Executive Chef at Albert Park’s The Point, when the restaurant was awarded Two Chef Hats. Prior to this he worked at leading restaurants around Melbourne (Brasserie by Phillipe Mouchel, Ondine, and Matteo’s to name a few) and spent three years at The Square in Mayfair London.

Scott took some time to chat with us about; why he supports the National Stroke Foundation, the Estelle Bar & Kitchen, the produce he likes to cook with and the song he loves to cook to. He has also kindly shared his delicious sounding recipe for Tomahawk of Cape Grim, Gratin Potatoes & Pine Mushrooms.

How did you become involved in the National Stroke Foundation?

My Grandfather had a stroke and I found him when I was about four or five. I support the National Stroke Foundation because of my Grandfather and what he has personally lived through. It really affected my family and I suppose it still does in a way. For twenty years it was there, it was tangible and we dealt with it; Mum, my sisters and I. It is important to educate others about what stroke actually is and how to recognise the signs of stroke. I feel this mainly because it was only a couple of years ago that I realised how people can suffer strokes across the board, from children and teenagers and all the way through to the elderly. Actually, where it hits in the community is so vast. It’s just a randomness of things that is just so unfortunate.

Northcote is such a great spot for a restaurant…

It’s booming! I have always liked this area and I was living in Collingwood and Fitzroy in my early twenties. It seems that everyone who was living in those areas in the ‘90’s have moved up a couple of postcodes to Northcote. The area on the whole a bit alternative and hip but with people who have set themselves up a bit more. I am at that stage in my life. So it’s a really good fit and gel for our restaurant. Plus it is really close to town.

You have a lovely outdoor area (think beautiful light-filled brick courtyard with lots of herbs)…

I built this outdoor area myself and this is where I spend my Monday and Tuesday mornings. Gardening, building and painting, it’s great. I wanted to make are area where we can all go for inspiration. Plus we have herbs and that fits in with what we do with our whole organic thing. It’s a lovely place to hang out. These wooden tables are only three weeks old. We got them built by a local guy that lives in the back alley. Since these have arrived it has lifted the whole garden to the next level.

Type of food you like to cook with?

I am a meat man more than anything else. Sauces, meat, game birds, beef. You know game bird season has started now, so guinea fouls, pheasants, venison….

Anything you would like to add about the Food for Thought event?

I just think it is brilliant that we can get such a great group of boys in Melbourne together and have a sell-out event where we all have a bit of fun and enjoy the night. Helping to improve the exposure of stroke is great. It is a big and important thing.

A song that inspires your cooking…

Best of You by the Foo Fighters

Estelle Bar & Kitchen
243 High Street, Northcote
(03) 9489 4609
enquiries@estellebarkitchen.com.au
www.estellebarkitchen.com.au

Tomahawk of Cape Grim, Gratin Potatoes & Pine Mushrooms

1 Tomahawk steak, approx 1 Kilo
Olive oil
Sea salt
Butter
1 kilo of potatoes
250 ml cream
1 head of garlic
Thyme
Bay leaf
1 kilo of pine mushrooms
Parsley
Chervil
White wine

For steak:
Season tomahawk with sea salt & pepper. Seal steak in a hot pan until golden on both sides. Cook in a pre heated oven at 160 C for approx 30-45min. Remove from oven and rest for half the cooking time.

For gratin potatoes:
Peel and slice your potatoes. In a heavy based pan sweat off garlic in a little butter
add cream and sliced potatoes. Cook For 4-5mins. Season with salt and pepper.
Add some thyme, bay leaf and transfer to a heavy oven baking tray. Cook for 45-60 mins or until golden brown.

For pine mushrooms:
Brush pine mushrooms with a pastry brush to clean and remove needles. Slice into nice large pieces. Sauté in a hot pan with olive oil, garlic and butter. Season with salt and pepper. Add a splash of white wine. Finish with freshly chopped herbs.

To Serve:
Slice tomahawk in 8/9 pieces, arrange on platter, garnish with pine mushrooms,
gratin potatoes on the side. Eat with mustard, béarnaise or peppercorn sauce.

Equipment List:
Choping board
Nice heavy large pan to seal steak
Platter to serve meat and mushrooms on
Oven baking dish for potatoes
Nice plates/bowls for herbs, pots etc
Second pan to cook mushrooms (like a heavy based skillet)
Med/large double handled pot to cook gratin
Cream jug
Pastry brush

Think that’s about it…Scotty

Boroondara Stroke Support Group founding member Jenny Cheng started her group in October 2002 with five members. In 2012, as they get ready to celebrate their 10th anniversary, Jenny’s members number 80. The group draws its members from 11 suburbs in the inner-eastern suburbs of Melbourne.

The group meets twice a month and Jenny says key to its success has been the many and varied activities on offer. Year-round programs include lawn bowls, woodwork, gardening, singing, art and gym. This year they are introducing a Mahjong program.

All activities are offered once or twice a month and encourage exercise and socialising, as well as learning new skills. The programs are catered to the particular needs of the members where they need to be. For example, Jenny says it is very hard for stroke survivors to manage a gym, for fear, for example, of falling off a treadmill.

To overcome this, Jenny managed the local YMCA gym to make its facilities available to the group exclusively an hour every month.

“The recreational program really encourages people to get out and get involved,” Jenny says.