John
A couple of issues that you mentioned which I want to add a bit about ¡V
Naltrexone & Brain Injury
Sorry to go on at such length below, but I feel that I have something to
contribute (in a positive manner) and felt it important enough to spend
time doing so

First of all ¡V Naltrexone.
Jen started Naltrexone approx 12 weeks ago and the immediate effect was
fantastic ¡V for the first time in years, she did not have any cravings
for a lot of the time. We have found, however, that when she has a
¡¥social drink¡¦ (eg. at the Theatre the other night she had a couple of
Spritzers ¡V white wine & lemonade ¡V the cravings returned the next day!)
So the message is ¡V Naltrexone helps her, but only if alcohol intake is
restricted or completely nullified. But Jen has to learn that for herself.
Only she can ¡¥control¡¦ the drinking ¡V she has to continue to have her
freedom to do what she wants (her self worth) but the message whenever she
craves for alcohol is ¡§if I have a drink, the cravings (which I hate)
will come back ¡V IS IT WORTH IT?¡¨ Jenny still has some way to go re the
alcohol but at least I think that there is light at the end of the tunnel.
It is a very slow process to change the habits of a lifetime. ¡V I reckon
that it will take at least another couple of years.
But at least Naltroxone has let Jen for the first time have some of her
life without the ¡¥cravings¡¦. The bottles are not talking to her all the
time now ¡V saying ¡§drink me, one or two will not hurt ¡V go on, have a
drink, you are a ¡¥free¡¦ person!! I help reinforce the 'learning' by
using the 'Errorless Learning' technique, which is described below

BRAIN INJURY
John, I was not saying that there was a separate Brain Injury (like the
accident you mentioned)

THE POINT THAT I WAS MAKING IS THAT WKS HAS DIRECTLY CAUSED A BRAIN INJURY!

During an episode of Wernickes, it is the leaking into the Brain (as a
result of lack on Thiamine) that directly destroys the brain cells. Jen¡¦s
Hippocampus (the part of the Brain where memories are formed) is
completely f***ked!! - as a direct result of Wernickes. She cannot form
any new memories at all. But ¡V another person could have a very similar
brain injury because of a stroke, or a bang to the head!! That other
person would also very likely have a complete lack of insight (or
awareness).
Cognitive Rehabilitation treats the awareness ¡V (lack of insight) as the
¡¥golden key¡¦. If the brain injured person can gain true awareness, then
they can gain true independence!
The first stage of awareness is learning about the Brain Injury (gaining
intellectual awareness) before then accepting and then acting on the
awareness. It will take around 7 years to go through the process (and in
the end may never work ¡V depending on the capacity of the damaged brain
to respond to the Cognitive Rehabilitation treatment). Very simply put,
cognitive abilities can be ¡¥grouped¡¦ into five Areas ¡V Attention,
Memory, Visual Processing, Information Processing & Executive Functions.
Rehabilitation consists of assessing each Area and undertaking exercises
as appropriate to help build up strategies. I am already seeing an
increase in Jen¡¦s ability to ¡¥learn¡¦ through routine and ¡¥errorless
learning¡¦ (*see below). Therefore, although Jen cannot remember things
that happened a minute or so ago, with repeating and being frequently what
happened, she can ¡¥learn¡¦ to recall the event!
So - to reiterate ¡V I took the view that WKS „³ Brain Injury „³ therefore
provide treatment that any other brain injured person (for whatever reason
that brain injury was caused) would have. That is the basis on which I am
trying to help Jen.

In other words, Jen has two illnesses. Alcoholism (which is slowly being
treated) and the Brain Injury caused by the lack of Thiamine.

I get very frustrated that a person with a Brain Injury caused by a
stroke, accident, bang on the head (for example mugging, fight etc) or
sport can receive Cognitive Rehab but that option is not provided to
people who suffer a brain injury resulting from lack of thiamine! Perhaps
the drinks industry should help here. Any other industry that causes so
much damage would have to ¡¥clear up¡¦ the mess that they caused! Why not
the drinks industry? (sorry, this last para is a soapbox ¡V I will get off
the soapbox now!)
Anyway, wish you all well. Lets all keep positive
Regards
Trevor

*Errorless Learning (extract from ¡§How to do Cognitive Rehabilitation¡¨
¡V Kit Malia & Anne Brannagan)
¡§ This feels very strange to apply at first.
Essentially you tell the person the answer before you ask them the
question. Research has consistently demonstrated that minimisation of
possible answers through this approach leads to faster learning of new
information.. As an example of this, take the following common scenario:
¡Kyou want the patient (the Brain Injured person) to remember your name.
The normal way of doing this is to ask ¡Kevery time you meet him/her,
¡¥What is my name?¡¦ This will result in the patient having to guess, and
often it is wrong. Each error confuses the new learning. The errorless
learning approach requires that you say the following to the patient: ¡¥My
name is Kit, What is my name?¡¦ This is much less likely to result in an
incorrect guess and therefore the patient learns this information much
faster. People who have problems with new learning enjoy this approach and
do not find it odd. In fact quite the contary, it makes the world a much
less confusing and more manageable place if they don¡¦t have to keep
guessing at things.¡¨

In my own experience, I have successfully used this strategy for Jen. We
went away for Jen¡¦s birthday last weekend (to a place called Abingdon).
Jen cannot remember things, but through using the Errorless Learning
technique and me saying ¡§we are going to Abingdon for your Birthday,
where are we going?¡¨ she learnt, and told others what she was going to do
for her birthday.
A second example ¡V The Cognitive Rehab workshop that we went on was run
by Kit Malia. When we saw him before the course he said to Jen ¡§My name
is Kit Malia, what is my name?¡¨ ¡V I repeated the name a few times
throughout the day ¡V now Jen has learnt his name and can recall it
without difficulty!
Food for thought ¡V a technique well worth trying?