BISCUSSIONS

BIS Services

Bringing honest conversations from the voices behind neurorehabilitation. Each episode will feature a BIScussion with someone new; clients, CRAs, case managers, families, psychologists, OTs, solicitors and anyone else in the neurorehab sphere. In each episode we will dive into a different topic, be it lived experience, culture, boundaries, fatigue, research, or the realities, challenges and insights that shape the work we do at BIS Services and beyond. Real conversations, real experiences, and real opportunities to connect and learn from each other. Have something to say? Come and have a BIScussion with us.

  1. Aug 27

    The Big F-Word: Why Fatigue Has to Come First in Brain Injury Rehab

    In this episode of BIScussions the format flips and Eky Popat interviews Natalie Mackenzie, founder and cognitive rehabilitation therapist at BIS Services, about the subject she is best known for pushing to the front of every rehab conversation: brain injury fatigue. Natalie makes the case that fatigue belongs beneath attention at the base of the cognitive hierarchy, and that when it goes unmanaged it gets mistaken for something else. Clients described as disengaged, lacking initiation or non-compliant are very often clients whose fatigue nobody has assessed properly. What Natalie and Eky cover: Why fatigue is spoken about far more often than it is measured, and what a proper assessment looks like Two to four weeks of structured logging, why it stops there, and the risk of clients hyper-focusing on fatigue Triggers and vulnerabilities: light, noise, children, vestibular dysfunction, emotional load, medication, hydration, missed meals Distinguishing brain injury fatigue from vestibular symptoms, migraine and pre-existing conditions , and what gets missed when a post-injury ME diagnosis leaves the brain injury out of the picture The education piece, including motorways becoming B roads, and why analogy and storytelling do the heavy lifting Scheduling therapy around cognitively optimal windows, getting fatigue evidence into the rehab plan, and why inconsistent MDT practice makes client consistency impossible Reading fatigue in a session: fidgeting, hair twisting, face scratching, and clients who report being fine until they are not Recharge that is not sleep, the points system, and why crochet is restorative for one person and cognitively expensive for another Why improving fatigue scores can dip as clients do more, and why that is progress Fatigue in the workforce, and CRAs using the same tools they deliver Natalie also announces the digital version of the Fatigue Management Journal for the first time, with clinician and CRA logging being built in, and confirms a paediatric edition in development. Resources The Fatigue Management Journal, digital: The Fatigue Management Journal, pace your day, notice your patterns The Fatigue Management Journal, print edition: available on Amazon Fatigue courses for case managers and MDT members, and the brain injury membership: Home - BIS Services Cognitive Rehabilitation Contact Natalie: natalie.mackenzie@thebiss.co.uk Instagram: @thebraininjurytherapist Have something to say? Come and have a BIScussion with us.

    The Big F-Word: Why Fatigue Has to Come First in Brain Injury Rehab

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Bringing honest conversations from the voices behind neurorehabilitation. Each episode will feature a BIScussion with someone new; clients, CRAs, case managers, families, psychologists, OTs, solicitors and anyone else in the neurorehab sphere. In each episode we will dive into a different topic, be it lived experience, culture, boundaries, fatigue, research, or the realities, challenges and insights that shape the work we do at BIS Services and beyond. Real conversations, real experiences, and real opportunities to connect and learn from each other. Have something to say? Come and have a BIScussion with us.