Maximizing Quality of Life After a Car Accident: Tips from Legal and Medical Experts

0:00:09 - Shane Smith
Hey, this is Shane Smith, with Mind Matters: Navigating Head Injuries and Concussions. I'm here today with our guest, John Mobley, from the Concussion and Brain Injury Group at Shane Smith Law. Today, we're going to be talking about some of the things you can do, or have others do, to assist you after you've been permanently injured in a car accident. Usually, these are-- we're focusing on serious life changing impacts and things you can do to try to make life a little more enjoyable, a little more livable. Thanks for being with us, John, and I'll let you start off.

0:00:35 - John Mobley
The real goal with our conversation here today is just looking at clients and victims of motor vehicle accidents. Once they have, you know, at some point your treatment is going to conclude. And the doctors are going to say you know, we've done everything that we can do for you. What do you do after that? You know that's kind of the question is, what do you do after the doctor has said you've reached either maximum medical improvement, you're going to have some level of what they call impairment, or you know things like this. We see this a lot with our brain injury department because you know, brain injuries are typically, to some degree, permanent.

There's not necessarily a cure. There's things you can do to make them better, but not a cure. And so what we try and do is arm our clients with this, with good information, so that they can take positive life steps to improve, you know, their quality of life and long-term outlooks.

0:01:28 - Shane Smith
When you said a lot of times you have some type of impairment, what's that mean?

0:01:32 - John Mobley
So sometimes when either a client has received surgery and then post-surgery they still have some degree of pain, or maybe they had shoulder surgeries they still don't have full use of their arm back. A lot of times we will see specialists give them an impairment rating. Basically it says look, you've lost 20% of the use of your arm or 50% of the use of your back or you know, due to your head injury you're just not going to be functioning with the same level of productivity and decision making and focus and attention that you had before your brain injury. We see that a lot with clients involved in- usually are more serious accidents that have to do a lot of medical treatment or surgeries, or are told, you know, they can't get surgery because there's just nothing that the surgery could fix or it's too risky, then they're impaired or receive an impairment rating.

0:02:24 - Shane Smith
Now I'll also say, I tell my clients this when they've got it, if they get something like this early on or it feels like the doctor hasn't done everything he could do or exhaust it. There's nothing wrong with going to seek a second opinion before you reach that point right?

0:02:39 - John Mobley
100%. I mean, if you have the time and the patience and the want-to to do it. A second, even a third opinion cannot hurt, right? You know? At least you're getting multiple eyes on it, on your situation. Sometimes that involves, you know, multiple doctors within the same specialty, just to make sure, like a big decision like surgery.

Maybe you want three orthopedic surgeons to make sure they say that, you know, this is something I need to get done. Or you might want to get the second opinion of a doctor in like an adjacent area. So an orthopedic, a neurologist or a pain management doctor.

0:03:12 - Shane Smith
I mean, yeah, when you talk about specialists, we see that a lot with like ankle and foot and hand things. So let's say general orthopedist, and then they'll narrow it down to a podiatrist or, you know, an orthopedist that just concentrates on the extremities or something like that. So if you've got a permanent injury, nothing at all wrong with seeking a second opinion, certainly if it's in the first six months of the case. You know, we generally recommend it if somebody says you're at maximum medical improvement. But once we're past that point, what are some of the things people should look at where they can make the most impact in their life?

0:03:41 - John Mobley
Yeah. So we have a bunch of different categories that we like to go through with our clients sometimes. One of the first ones, surprisingly enough, is just diet. A lot of the times when we're seeing some of the feedback we get in medical records that we review for our clients, a lot of times we'll see specialists tell our car crash or slip and fall clients, you know, eating better and losing weight will give you better medical outcomes on just a whole variety of things, number one being surgery success and safety. If you are too overweight, sometimes surgery is unsafe to proceed with. We'll see some of our specialists tell certain clients that they need to get their weight down through diet to be a safe candidate for surgery.

And also having a lower body mass index will improve the outcome and the success rate of your surgery.

0:04:28 - Shane Smith
I was going to say, I know anesthesiologists, the folks who put you to sleep, are always very concerned about weight. Once you cross a certain BMI, I guess the risks just go up exponentially, right? Alright. So diet's the first thing. What's another area they can focus on?

0:04:50 - John Mobley
You know, just sticking with kind of the diet. It also helps with the overall amount of stress on your joints. If you've sustained some sort of injury, especially to like an extremity, it doesn't have to be an extremity but like, think about, like knees, the small little you know, joints around your ankle and your foot, also your back. Having, you know, lower weight, better diet is going to improve your long-term outcomes. If you do have like an impaired knee or an impaired ankle, it's just less weight on that area.

0:05:20 - Shane Smith
And we've seen cases before where we've had surgeons say, hey, I can do this, but you need to hit certain criteria before I can go do it, and that's usually focused right on weight.

0:05:29 - John Mobley
Yeah, see it all the time. Another thing that we're surprisingly seeing now is with our brain injury clients, having a specialized diet can actually improve some of the bad symptoms of a brain injury. So we're seeing some of our clients be recommended the keto diet. You got to cross-reference this with your general practitioner and make sure it works for your diet, you know, long term. But we're definitely seeing some neurologists and brain doctors recommend like the keto or certain high protein diets, maybe low in carbs, because they're finding that people that have brain injuries, their symptoms aren't as severe and dramatic with certain dietary changes.

0:06:12 - Shane Smith
Okay, so that's definitely something to talk to your doctor about. If you had a brain injury, would this be appropriate, or even, is it safe for me to try?

0:06:19 - John Mobley
Exactly. Okay, all right. The next one would be exercise. The key walk away here is that more muscle bulk and more muscle mass reduces the risk of potential fractures during falls or trauma. And you may think well, what does this have to do with brain injuries? Well, with brain injuries, you know, we have a lot of clients, one of the key symptoms of brain injury is vertigo, dizziness, trouble with vision. You know, when you think of those three things, you also equate that with all of a sudden, you have more falls, you slip more often. Maybe navigating the shower in the morning when you're half asleep with a brain injury is a little bit tougher.

So being in the healthiest possible state possible from like a muscle mass and working out and exercise and strengthen your body will in fact actually protect you from certain falls that could otherwise break bones when you have more things surrounding that bone.

0:07:19 - Shane Smith
So John, we talked a little bit about exercise. The best types of exercise for this activity would be generally resistance type exercise, right, some kind of physical resistance movement with weights or bands or something right?

0:07:33 - John Mobley
Absolutely. Things that would, you know, hopefully grow, improve muscle.

0:07:37 - Shane Smith
Okay, all right. Sleep, exercise. What's the third one?

0:07:43 - John Mobley
With exercise too, you know another thing just to point out is that weaker muscles can also equate to less agility, which can increase risk for further injury as well. For injured people that have sustained neck whiplash injuries, strengthening the neck safely with neck exercises can be crucial to pain reduction and further injury. And these are usually pretty simple exercises you can do at home that involve, you know, light resistance with bands, like you mentioned earlier, to strengthen that neck area.

0:08:17 - Shane Smith
I think that's, we can dig deep into that in another podcast episode. All the exercises people can do just for neck rehab almost basically? Right. After exercise, what's the next easy one to hit?

0:08:28 - John Mobley
Another one that is, you know, a little bit under the radar is just basic posture, and what I mean by posture I'll have to explain that a little bit is, you know, car accident victims, especially ones that experience whiplash, they may need to make certain lifestyle posture adjustments. That could be things from changing your, you know, your, the pillow that you use, or your sleeping position. More often than not, we're getting feedback- one of the big things that, when we're doing our client interviews to check in with them on their treatment paths and treatment levels is they'll say you know, my sleeping is just so messed up because it's hard to get to sleep, or it's hard to get to sleep and stay asleep. Because you think about it. It's like you know, if your pillow is not at the right height or your sleeping position has changed because of the pain that you're experiencing, then it can truly impact your ability to get a good night's sleep, and that's unfortunately a great foundation for getting better for most people.

0:09:30 - Shane Smith
Yeah that's what I was gonna say is I know, even when I've got a virus, you know, if I can't sleep I'm not gonna get better. And a lot of times, as soon as I can sleep through the night, I start to feel a whole lot better.

0:09:40 - John Mobley
Right, absolutely. I mean, it really all starts with that, and we just hear this from our clients all the time that you know, my sleep has been ruined since the car accident. So sometimes it's as simple as a matter of making adjustments to what you once used. You may now need a thicker pillow, or more pillow support, more head support, so that whatever symptoms you now are, you know, permanently impacted by don't bother you as bad.

0:10:12 - Shane Smith
And I know a lot of chiropractors or orthopedists will have pillows in their office you can actually just buy. You know before I knew any of this, I'm always sort of like eh, what are they doing? Are they just trying to make quick 50 bucks? But the more research you do, the more you look at it, there's actually some justification that it can really help a lot of folks.

0:10:25 - John Mobley
Yeah, definitely in this case.

0:10:27 - Shane Smith
All right sleeping. That's a main area for posture and position. What else along posture?

0:10:32 - John Mobley
So, with posture, another big thing is well, we spend a lot of our life sleeping. What else do we do? We spend a lot of our time at a work desk. So basically making sure you have a great posture at your work desk, and this includes a lot of things. Having a sit-stand desk.

You know a lot of people are saying well, I don't know if I want to stand all day at a work desk, but the other added benefit of that is that it's adjustable, so you don't necessarily have to be standing, but at least you can adjust the sit-stand desk to get that proper alignment where you're not straining your body. You know, if we're straining to look at our dual monitors or we're straining our neck, you might not even realize you have that tension, but if you have sustained a permanent injury to your cervical spine and your neck, that can really compound your symptoms. So it's good to be in a nice aligned position with the monitors at a proper height so that you're not constantly looking up or constantly looking down, and that your elbows are basically aligned with your desk so that your shoulders aren't shrugged, creating additional strain in your neck. It's worth the time for our car accident victims to do that, so that their long-term injuries aren't compounded.

0:11:46 - Shane Smith
And I know standing desks have- the ones that go up and down have really dropped in price over the last two, three years as they become much more popular. Years ago it seemed like they were crazy high and now they're much more reasonable and I don't want to say commonplace, but a lot of employers have them.

0:12:02 - John Mobley
Very affordable now, you're absolutely right. I mean the price has gone down significantly where you can get them under $100, which is nice for people looking to improve kind of their work, alignment and posture. Another area too that I almost forgot about is, for brain injury clients another recommendation that we are seeing from a lot of neurologists across the board is for people with brain injuries to really be aware about limiting their screen time. It's literally usually listed as one of the treatment paths, which is to- that goes for phones, but it can also go for work monitors when you're at work. So it's really important for some of our clients who have experienced brain injury to be aware of the fact that, hey, I've been working for hour and a half, two hours. I need to take a screen break because otherwise it can, it can and does trigger some of those brain injury symptoms like the inability to focus, headaches, sensitivity to light, just because your ability to not get fatigued with a brain injury goes way down.

0:13:08 - Shane Smith
It gets decreased. So even normal stuff like just working all day and then going home and playing on your phone is gonna exacerbate all those brain injury symptoms.

0:13:18 - John Mobley
That's correct. And another thing too, if you have a neck injury, you may really wanna look into also investing into a hands-free headset, because doing this motion all day with a phone pinned between your shoulder is not gonna make your neck better. Yeah, and it's another small purchase that you can make that will really improve your quality of life if you are- you know, do have a neck impairment.

0:13:43 - Shane Smith
I can totally agree with that one, because there've been many days when I spent too much time with my head sideways, and I felt it and I don't have a neck injury. We covered everything with posture, or is there any other areas related to posture?

0:13:55 - John Mobley
Really the only the final thing is just being aware of your posture. Like you said, we've talked about sleep and then at work, but just around the house too, a lot of times people will, you know, melt into the couch after a long day of work. Then you have to ask yourself is the couch giving you proper alignment and posture when you're sitting with your head on the arm of the couch and it's kind of cranked up which I'm sure we've all done once or twice after a long day of work. But where you know that comfy lazy boy chair that is putting you at an angle might not be the best chair for you if you have a- lumbar herniations all up and down your spine that you may need to have a little bit more structured sitting when you're sitting at home.

0:14:37 - Shane Smith
Okay, wow, yeah, and that's something definitely to take a look at, because I know lots of people have lazy boys, or those recliners, and then they get hurt and that's where they still want to go rest and it's just making things worse. Right, we talked about a diet. We talked about exercise. We talked about posture. I mean, everybody spends a bunch of time at work. We talked a little bit about screen breaks. Is there anything else at the work environment that can help out?

0:14:58 - John Mobley
You know we really covered a lot of the main things with work. The only other thing that I could think about with brain injury clients is that you really want to just be cognizant and aware of your break time and taking the adequate kind of steps to maybe walk away from work just a little bit throughout the day, come back, take smaller breaks so that the brain and the body have time to recharge. Because the typical just you know, work all morning, take a lunch break, work the rest of the day. That style of you know time division of your work day does not work for people once they are diagnosed with a brain injury. So sometimes that may involve, you know, speaking with management or your boss to be like, hey, here's my, you know, new reality, new situation, would you be willing to accommodate me?

0:15:48 - Shane Smith
And it's something that it's a legitimate conversation with your boss basically right? Like I've got a brain injury, my doctor says x, y and z. Can we make some arrangements so I can keep working and being productive? But if you force me into this, I'm going to not be productive by the end of the day.

0:16:05 - John Mobley
That's right and you know, I'm sure that can probably- people watching this might be like that'd be a tough or awkward conversation to have with my employer. But you know, bringing you know a doctor's note or an impairment letter from your brain doctor or your brain surgeon explaining, hey, here's what would really benefit, you know, the client and my patient, probably would help facilitate that conversation a little bit so that you can get the accommodations you need to be successful in the workplace.

0:16:32 - Shane Smith
John, I think those are the main areas we discussed about you know, just small lifestyle changes that kind of have a big impact on our clients, certainly the ones after a brain injury, but also after a cervical injury or a lumbar injury as well.

If you're interested in things related to concussions and head injuries, hit like and subscribe down below to see future episodes and hit the bell so you get that notification. If you got questions for John, just email us info, i-n-f-o, at shanesmithlaw.com. And I always remember. If you're in pain, call Shane. 980-999-9999