TLC Discusses Brain Injury

Hi everybody, my name is Sandy Boucher and welcome back to the Learning Curve. If you've never tuned into the show before, this is a show that shares information. We have conversations with people that work and live in Thunder Bay. And our focus is trying to build understanding, especially between indigenous people and non indigenous people within the city. There's just so much misinformation out there or topics that we just don't have enough information about and you can only work with what you know. So this show is all about increasing your knowledge base so you can increase the content and the amount of conversations you have with your neighbor or, or that person you meet in the store. And as always, I just have to send a shout out to all those people that are walking up to me in the mall or wherever we happen to meet and mentioning that they've seen the show and they love it. So you're the reason I'm doing this. And if it's helping you to understand, then that just makes me happy. And on that note, I have to give a special shout out today to Megan Kurt. And I probably just totally messed up your name and I apologize for that for everyone else. I was on my computer this morning working away in my office and suddenly I received a notification from Facebook and someone had written on my timeline and it was Megan Kurt. And all he wrote was thanks for the Learning Curve show on Shaw tv. Thanks again, Sandy. So I promised him I was going to give him a shout out and I will happily do that now. Today's show, as always, I have an amazing guest for you. And this show may be quite surprising for you because the information we're going to share, I know, really surprised me when I heard it. As you know, as I mentioned on previous episodes, I talk a lot about oppression when I'm working in indigenous communities. And as Martin Luther King used to always say, there's three ways that a human being naturally reacts to long term oppression. The first one is acquiescence. That just giving up, it's never going to change. Why bother going to school? Why bother getting up to send the kids to school? Why bother getting a job? I might as well go out drinking. That is so common and it's a natural reaction until we train ourselves to get out of that cycle. The second way is violence in all of its forms. Whether it's hurting ourselves, hurting people like us, or hurting the people that we've decided are the oppressor. And that's the tie in for today's show because my guest today is Alice Belavance and She's the CEO of Bizno. Now, if you don't know what that is, you're about to find out. And you're going to hear some information that may be shocking but is incredibly valuable. So, as always, go get that coffee or water or whatever your drink is going to be and settle into that comfy chair. And we'll be back in a few minutes as together we walk through the learning curve. Hi, everybody, and welcome back once again, it's Sandy Boucher, and we're here on the learning curve with Alice Bellavance of Bizno. Thank you so much for coming out today.

Oh, thank you for having me.

I love this show because I get to invite my friends and I don't even know, I was thinking about it, preparing for the show today, and I don't know how long we've known each other, but it's quite a while.

Oh, yeah, at least 10 years.

Right? It's one of those. I swear, the older I get, I don't want to do the math anymore. It's like, it's just been a while, let's not count. Yeah. So that's awesome. So. But you know what? The other thing I've discovered is I invite people I know on the show and I always end up learning something about them I didn't know because we talk about work. Right. Like, we don't talk about a lot of other stuff. So I'm not sure. Are you from Thunder Bay?

Born and raised.

Ah, okay.

Grew up on a farm in Morello.

Are you serious? Okay, see, I didn't know that. So. Okay, awesome.

And oldest of eight. I have seven brothers.

Wow. Okay. That's the farm.

Yeah.

Okay. Yeah, exactly. So stayed here. Where'd you go to school?

I went to the Thunder Bay Christian School. I went to a one room school in Miller, Northwestern Merrillo for a period of time and went to Churchill High School when it first opened back in the day.

Wow.

Yeah. And then I did the nursing assistant training program through the Ministry of Health. Now it's part of the college, but back then it was the Ministry of Health and.

Yeah. Wow. Now we're going to talk about Bisno today, which is the Brain Injury Services of Northern Ontario.

That's correct.

Right. Okay, you've been there for, like, ever.

Yes, I've been there for 26 and a half years.

Okay.

And prior to being gainfully employed with them, I served on their board of directors and also the. I was on the founding board of directors of the organization for the Multidisabled, which actually Owns the nonprofit housing building that we have in the Castle Green area.

Okay.

Yeah. So I've been involved since 1983.

Wow. So how long has Bizno been around?

Bizno was formed as a Corporation in 1996. So we started as an organization for the multi disabled in 1991 with the building. So that's when I was gainfully employed, you know, discounting all the years prior to that. And then the way the ministry had things set up, they decided that the service provider couldn't own the housing that people lived in that they received the services from. So we had to delink. So OMD continues to own the building, and we had to form a new corporation that then hired the staff that looked after the people that lived in that building. So that's how it was formed.

Separation. Yeah.

And the reason it's northern Ontario is because the way the funding flowed, the Northwest usually gets about one third of what the Northeast gets. But because we got a big chunk of it to facilitate the development of our transitional learning center, the Northeast didn't get as much. And they thought, well, what are we going to do with that amount? It's not worth our while. And they said, we'll give it to you as long as you agree to take people from northeastern Ontario.

Wow.

So in the first five years that we were open, sometimes it was a 10 bed facility, sometimes half of the beds would be occupied by people from like, Sudbury, Sault Ste. Marie, Timmons, Kapaskay saying, Kirkland Lake. And, you know, people would come get their rehab, and then they'd go back to their home community. Some people permanently relocated to the city of Thunder Bay and moved to homes in the community, but stayed because they needed the outreach services. But.

Exactly.

Yeah. So that's why it's northern Ontario.

Yeah. Wow. I had no idea. And you mentioned Castle Green. You have another tie to Castle Green?

Yes, I do.

So what's the story on that?

Well, my husband, who's now deceased and has been for almost 20 years, was very much involved in the cooperative housing movement as well as other nonprofit housing initiatives, whether it was the HANDICAP Action Group, but he was a founding member of the Castle Green Housing Cooperative. And as it expanded through the various phases, they were going to go to castle Green Phase 5. But then the members decided they didn't want to get any bigger. So then they formed a new housing cooperative because there were still lots of people that wanted to be in a cooperative housing situation. So they formed Superior View Housing Cooperative. And my husband was the development coordinator for that. Aha.

And I know, ages ago, in another lifetime. I worked at Superior View.

Right.

And so I heard Terry's name long, I think, before I met you.

Absolutely.

You were there. Yeah. And then when I. I heard your last name, I was like, wait a minute. I've been reading this in founding documents for quite a while, so. Yeah. Wow. You were definitely homegrown, right?

Yep.

I can't even imagine the changes you've seen in Thunder Bay over the years.

There's been a lot. There's been a lot. You know, both from a healthcare perspective and social services, housing, just, you know, even the amalgamation of port Arthur and Fort William. I mean, you know, the 1970s. So. Yeah. Watched a lot of that.

I never even thought of that. Yeah, you would have been here for that. Because I remember watching and I remember the voting.

Oh, yeah.

What the name was going to be. Right.

Lakehead. And the Lakehead and Thunder Bay. Like, whoa, Split the vote.

Yeah. Oh, I remember that. So, brain. No, I actually, I googled you. I had to get some facts here. So the mission of Bizno is to assist individuals and living with the effects of an acquired brain injury and attaining their maximum potential as they continue living, loving, and doing so. Acquired brain injury. What is that?

So an acquired brain injury is anything that happens after birth that is not progressive or degenerative in nature. So if you look at American healthcare models, they tend to develop services by body systems. So. So the neurology system then would include not only things like brain injury, but it would include Alzheimer's, Parkinson's, Ms. autism, anything that has anything to do with the brain. But because they have so much population, they have scale, then they can specialize within their neurology program and have separate programs. In fact, they will have separate programs for people with traumatic brain injury versus somebody who has an acquired brain injury. So an acquired brain injury is. Is a sentinel medical event. So it could be an aneurysm, it could be a stroke. That's not related to the aging process. It could be a brain tumor. It could be a brain infection such as encephalitis or meningitis. It could also include toxic poisonings such as mercury. So some of the things that happen to indigenous people in the Wabagoon area. Yeah, that is a form of neurological disability because of the mercury that happened, because it gets stuck in the brain and causes significant memory impairments. And it also created some motor impairments for people. Another one is solvent abuse. So when we start thinking about isolated, remote communities where gas sniffing of solvent Use is very popular. I mean, we have seen individuals who've been so compromised from solvent abuse that they end up in a wheelchair because they damage their brain to the point that the motor functions of their brain no longer work.

And that damage is permanent. Right. Once it's done, it's done.

Yeah.

Wow.

Unfortunate. And then on the other side, in terms of traumatic. So that's. Anything that happens, that's an external force. So motor vehicle collision, ATVs, snowmobiles, falls, interpersonal crime, like assaults. And one of the big things my provincial association is involved with, and I'm on the Ontario Brain Injury Association Board, is for the last two years, we've been launching a campaign called Concussion Hits Home. And it's really focusing on domestic violence and some scary numbers related to domestic violence. I'm just going to look at this to make sure I get it right.

Go for it.

So this is based on an American research that was done in US shelters for women escaping violence. 92% of the women reported that they were hit in the head more than once by their partner. 83% reported that they were both hit in the head as well as being severely shaken. And 8% reported being hit on the head more than 20 times in the past year. And that was based on a very specific center in the US and so some of the other causes are asphyxiation. So that's, you know, if you're being strangled or you're near drowning or you have a cardiac arrest or respiratory arrest and you're no longer breathing, that's asphyxiation. Right.

Okay.

So that's lack of oxygen to the brain. And then once it's for a period of time, the brain cells start to die off. And that's how you get an anoxic brain injury due to asphyxiation.

Wow.

Yeah. Okay.

Has your head exploded? My head just exploded. Like, oh, my God. So this has. You must have a lot of indigenous people.

It's about one third of our business. And so we were involved a number of years ago with the Ontario neurotrauma Foundation, the Health Access Centre in Kenora, the Health Access center here in Thunder Bay. May Cat, who is well known in the field of healthcare here. Yes. She was involved in the research project as well. Well, we tried to take a look at what was the transition like for indigenous people who came to Thunder Bay because they needed the acute care at Thunder Bay regional, go to St. Joe's for rehab. But then how did they get to go home? So we did a participatory research project around that and interviewed people and we did a session here in Thunder Bay and we did a session in Kenora. But in preparation for that work, some of the other things that we had done was we found is that very little research is being done around the impact of brain injury in the indigenous population. And yet, knowing what we know now about colonization and the impact of intergenerational trauma and colonialism and residential schools, we know that there's all kinds of implications for why the numbers would be bigger. We just haven't studied how big is it. And so certainly they're at greater risk. And so I do know that the Calgary Health region in Alberta has done some studies and they say that the incidence and prevalence is four times greater in the indigenous population than in mainstream.

Wow.

And just based on our numbers, anecdotally, if one third of my business at Bizno is people with an indigenous history and a high number are due to interpersonal crime due to assaults.

Okay, that's what I was going to ask you. What's, what's. And that's what you see.

Yeah. And certainly motor vehicle collisions, ATVs, snowmobiles, like people engaging in high risk behaviors, you know, falls, you know, so certainly the biggest number still is motor vehicles. I mean, that is the big ticket item no matter what the population is.

Yep.

But in the indigenous population, the issue of assaults is greater there than it is in mainstream.

Okay, just out of curiosity, because I don't know my age, whatever it is, when I think assault, I think young men, but I'd be willing to bet you're seeing young women too. Right.

And we have had women referred to us from, you know, Faye Peterson and Bean, again, some of the shelters that support women escaping violence. Yeah, it's a real sad. And so we're doing some work provincially around with women's shelters to help them identify when. Because with a mild traumatic brain injury, 96% of people do make a good recovery. I mean, you take a look at concussion in hockey. I mean, look at Sidney Crosby. He was out for a long time, but with appropriate. And of course he had access to the best. Right?

Yeah.

But I mean, if you take the time to allow your brain to heal, people do recover. It's a small percentage who will have long term impact. We see the same with concussive injuries related to, you know, the blast injuries that happen in warfare. You know, all these young vets that are, that are getting blown up with this IUDs and so on and so forth. I mean, it's very significant. And there's still a lot of research being done around concussion, and we don't know why, for some people with repeated concussions, where they develop that cerebral atrophy, the cte.

Yeah, we're gonna have to hang on.

To that for a second.

Sorry. This is so amazing, so much information. But we gotta take a little break, and we'll be back in a few minutes to give you even more information on Viscount. Thanks. Hello. Hey, everybody, and welcome back to the Learning Curve. And we're here with Alice Bellevance from Bizno. And you know what? Every single time I do this show, and you think I would have learned by now, but it always goes in a direction I didn't think it was going to go. I think I know what our conversation is going to be, but I didn't. I never tied domestic violence to the work you do, which now, in retrospect, seems ridiculous. But you said something that I need to ask about, because we all know Shaken Baby Syndrome, and that's a horrible thing to discuss, but we know about that. I honestly thought shaking was only a risk for infants. Are you saying it's a risk for adults as well?

Yes, it is. Not to the same level as it would be with children. I mean, you have to think about a baby. The head is disproportionately larger than the rest of their body, and their neck strength isn't the same. Right. But when you think about the brain, the brain is the consistency of jello. And if you've ever made a jellied salad and it's on a plate and you shake it, it changes shape. And that's exactly what happens to the brain inside the head. It changes shape as you're being shaken or beat about. That's why they have this thing called pugilistic syndrome with boxers. You can't keep punching somebody up the side of the head and not expect that that brain is sloshing around inside your cranium. It does, and it bounces off. And the outside of our skull is smooth. But the inside of our skull, particularly at the back, it's like the Rocky Mountains back there. You know, there's lots of ridges and, you know, bony prominences that the brain tissue then shears on and then gets damaged. And you get these small hemorrhagic kinds of events happening, and that's why they have hematomas or these big blood clots and bruises that happen on the brain that then creates swelling and then that suffocates the brain cells. It causes that intracranial pressure. And so they need to relieve that.

Blown. My head just exploded. Well, I'm just thinking back to my own past. So I'm indigenous, and I come from, I mean, pretty common situations. I mean, there was violence in my family history. There's definitely alcohol in my family history. And I'm thinking, and I grew up in a small northern community. I mean, drinking in Northern Ontario is. That's not new, right? Exactly. But I can think of so many. And I'm going to talk about young men again. But I can think of so many young men that it was just everyone knew they were going to drink and they were going to fight and they're hitting each other on a regular basis.

And because it might be a minor concussion, they may have a good recovery. That's why I was starting to say before the break, we don't know why some NFL football players or some NHL hockey players, why, after repeated concussions, some of them develop this cte, that degenerative brain disease, and others might have had the same kinds of numbers of concussions, but they don't develop CTE because the only way they can confirm that is when they do an autopsy and they take a look at the brain once the person has died. And so, you know, there's a number of other things that I think we need to consider in terms of genetic predisposition and, you know, you know, some of the hereditary kinds of things, some environmental things. You know, do you have a history of, you know, earlier childhood kinds of concussions or falls, such as from Shaken Baby Syndrome or, you know, falling off the swing set or, you know, those. Like the number one cause of brain injury in children under the age of 10 is falling out of shopping carts.

Are you serious?

You know, I'm serious.

So that's why they have seat belts.

That's why they've got those seat belts and baby holders and things. Because I remember when my kids were little, you know, like, you turn yourself to get something out of the meat.

Pool for a half second, they're, you.

Know, they're practically out of the cart, right? They want to get out and explore. And so, you know, as we learn what the causes are, we're developing things to prevent. I mean, that's the whole point. It's really about prevention. And that's why we need to do so much more around injury prevention. Because many of the people that I work with, when I take a look at the cause of their brain injury, if they hadn't been driving in those weather conditions or if the driver that hit them wasn't drunk or impaired, that wouldn't happen. Or if that bear wasn't crossing the road or the moose. We have a lot of wildlife collisions here in the Northwest. Like, we have very high incidence and prevalence in northwest Ontario. We're about five times higher in terms of incidence and prevalence than other parts of the province. And it's because of our geography, the climate, that we have to drive in, the distances we have to drive, the conditions of the roads that we drive in, wildlife collisions. We also have higher incidence and prevalence of mental health and addiction. So if you have someone who's mentally ill and they're self medicating with alcohol and or other drugs and then they get behind the wheel of the car and they engage in high risk behaviors because they think they're invincible, that's how this stuff happens. All of those things are preventable. Technically, right?

Technically, right. So let's talk about service now. So Bizno has these services, but how, like you talked earlier that people from Sudbury and Sault Ste. Marie came here. Does Sudbury and Sault Ste. Marie have their own services now?

They do have. Now the March Dimes Canada does have some assisted living in Sudbury and they do have some outreach services now. So just to put it in perspective, we haven't had somebody from northeastern Ontario come to our center now for probably 20, close to 20 years. Like I think the first five years we had a lot. And I've been at this for 26 and a half, so. But what we do have is we have like 83 people on our wait list for assisted living.

But wow.

Yeah, okay, wow. And of those 83, four of them are still from the northeast. And that's because their care needs are beyond what March of Dimes Canada can deliver. And these four individuals are kind of doing revolving door with. They live with their family and when their family gets burnt out, they end up in the hospital and they go to the hospital for a while and then the hospital needs to get them out because they're alternate level of care. And they'll move them into the community and they'll pile in a lot of supports and services to help that person stabilize. And then as they stabilize, they start pulling the services away and then the family then ends up with the burden of caregiving until the wheels fall off that bus and then back to the hospital. Or maybe they do something stupid and get involved in the criminal justice system. And so then they might go into the corrections facility for a period of time and then they come out. So they do this cycling through the system.

So that's what's happening with the 83 people now. They're just physically.

No, of the 83 people, just over half are living at home with family. And of those I think there's about 12 or 13 where it's just the one parent, one caregiver left. So if something happens to them, they're going to end up in hospital. The other about one third are people that are currently living in the community and they might even be on our caseload through our outreach program. And they're getting by with the support from us through outreach through home and community care. Maybe they're getting some attendant care services through Hagie or they might be getting some mental health services through AlphaCord or CMHA. But it's a very fragile house of cards.

Right.

You pull that one card out, the whole thing could collapse. So we have a large number, about one third, like I said, of the 83 that are like that. We have the four people in the northeast that do this revolving door and we have similar number here that sort of do this secludous kind of thing. And then we also have people who are actually in hospital alc waiting for a space or people who are inappropriately placed in long term care. So we'll have like a 26 year old who's in a long term care facility in Sulacaut or in a long term care facility here in Thunder Bay, or you know, we have a couple people in Rainy river in long term care, you know, things like that. So people that are in their 20s, 30s, 40s, living in a place with 80 and 90 year olds.

Yeah. So these people that end up in the housing units, is that, are they there healing or is this a. This is where they're spending the rest of their day.

This is lifelong living. So we have 12 spaces on the old six south at McKellar Hospital, the old McKellar Hospital, which interestingly enough when that hospital was originally built, six south was originally the neurosurgical unit.

Oh wow.

Isn't that what goes around comes around? Now people are living there. So we have 12 spaces there, we have five spaces at Andrus Court and then we have our nine spaces in Castle Green which is supposed to be rehab, but eight of the nine beds are occupied by people who we haven't been able to transition to something else. In fact, seven of those nine people have been there since 2002 and their level of care is increasing exponentially as they age because they develop other co occurring chronic illnesses, whether it's diabetes. We have two of our folks are on dialysis, one is on home oxygen therapy. So their levels of care change as they get older. And it's the same for the people that we support through our community rehab and outreach. Their level of care is increasing. So we've had a number of individuals in the last year or so who are in their 40s or 50s, but they're ending up in long term care because there's just not enough community support to allow them to stay at home. And that's really sad.

We're down to the last couple minutes. Can you believe it? What needs to change? What do you need? What's going to make this better?

Well, I mean, clearly we need more assisted living and we need to work with the existing system in terms of if we have to use long term care. Can we take a look at developing some capacity within a resident care unit that specializes specifically in providing support to younger people with neurological impairments, not just people with brain injury, people with Ms. Who decompensate over time and need more care, or people with Huntington's or some of the other neurological disorders because they basically need the same kind of service. But we've compartmentalized it in terms of our definitions within the ministry. I mean, the other group that I get asked about all the time is fasd and it's a form of brain injury, but it happens before birth. But a lot of the people we support had fasd but now they got a brain injury on top of it because they've gotten involved in a fight or they've had a fall. We've had one young man who got hit in the head with a hockey puck. You know, so I mean, there's other reasons for why people get a brain injury.

How much information was that in one short half hour? I mean, the reality, the numbers are staggering. All I can say today is please take care of yourself. Think twice before you decide to get in that argument or hang around with that person or drink to that level. I mean, I'm not judging, been there, done that. But please take care of yourself. You don't want you or a loved one ending up in this situation. Thank you. And I hope to see you next time on the learning curve.