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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

 
From the Navy Times, Kelly Kennedy - Staff writer, Friday Feb 22, 2008:
After months of military officials and medical personnel lamenting the lack of an immediate, unequivocal, physical proof of mild traumatic brain injury, an anesthesiologist thinks he has found a solution.

And it may be as simple as two sensors and a BlackBerry.

Dr. Richard Dutton heads up trauma anesthesiology at the R. Adams Cowley Shock Trauma Center at the University of Maryland and sees about 4,000 people a year who doctors believe have a brain injury. But without a CT scan or an MRI, it’s hard to immediately tell for sure — especially if, as is the case in most trauma situations, doctors are also worried about broken bones, ruptured organs or heavy bleeding. And about 3,000 of those cases are mild TBI, which doesn’t show up on a scan.

So Dutton and a team of engineers decided to see if they could use sonar to “listen” for differences in healthy brains and injured brains. They used a headband with sensors to pick up the sound transmitted through the brain with sonar and then analyzed the data fed back into a computer. The Air Force paid for the research.

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Doctors typically can’t see mild TBI, even with a scan. But they know it’s important not to send a service member back out on patrol with a mild TBI because injuries caused by mild TBI are cumulative; even a slight second head injury can cause death for someone with an already damaged brain, and no one wants to go on patrol with someone whose vision is blurry or who has short-term memory loss.

When Dutton and the engineers tried out their equipment on people they believed to have mild TBIs, they found turbulent blood flow — or irregular bandwidths — on the Brain Acoustic Monitor.

“You hit your head, your BAM becomes abnormal,” Dutton said. “We think we may have an objective marker for brain injury. This is pretty exciting stuff.”

And it’s completely portable, which could be good news for troops in Iraq and Afghanistan. In Iraq, there’s one CT scan — in Balad — and no MRI machine. Medics don’t have access to the heavy, expensive equipment.

Read the entire article. This could be a huge diagnostic breakthrough for TBI's.

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Years ago, I remember, I read some quotation to the effect that "just because somebody's handicapped doesn't mean he can't be a jerk."

I myself am hearing-impaired, and understood exactly what the quotation meant: the handicapped, or the disabled, or the special-needs individual, or whatever polite term you want to use -- all such people are people first, and handicapped second. They have the same kinds of neuroses that other people have; the same things (plus a whole lot more) make them angry; and so on. They can be just really difficult to live with.

Ditto, those who live with them. Being a caretaker doesn't somehow magically endow you with superhuman powers of forgiveness, patience, generosity. It doesn't require you to be a saint, and it won't make you one.

Graphic evidence of the clash of human failings -- exaggerated by a disability -- comes from Jacqueline L'Heureux's article, "Do We Have to Crash Our Marriage, Too?" from the Fall 2007 issue of The Challenge, a print publication of the Brain Injury Association of America (BIAA). BIA has graciously permitted us to post a copy of that article (599KB PDF) here on sossisson.com. The article begins:
I never saw the truck coming, stopped on a freeway under a knock-your-eye-out blue sky. My back would freeze for months from the monster grille I never felt mount our car.

I want that day back, to live repeatedly, like the characters in "Our Town" -- every part of it right until the crash. Not because it was special, but because it was so ordinary, effortless -- as no day has been since. I want to start with rising early, clear-minded and happy to make breakfast for my son, who hardly ever touches it, then joke quietly, scruff his hair and send him off to school. I want to say the same thing I have said as he leaves every day since preschool (and his three brothers before him). "Remember, no matter what happens out there, you are loved." He waves me off, smiling at the silly ritual that he is too old for on this day his mother changes forever.

After that day, I was in rehab most of the rest of his high school in another city. His father swung from being angry to coldly withdrawn in response to my traumatic brain injury (TBI), seizure disorder, and chronic pain from my injuries. Rubble continued to rise under the truck long after that Indian summer evening. The debris eventually included my clinical practice as a Ph.D. family therapist, my life's work treating post-traumatic stress disorder (PTSD) patients and their families, a center I founded and directed, my university teaching, and the necessary, but wrenching dissolution of my 33-year marriage.
Think non-TBI'd family relationships are harrowing? Wait till you read the rest of L'Heureux's story.

Note, though, that the piece is not unrelievedly grim. L'Heureux concludes with some helpful tips, among them these:
If You Have a TBI and Your Marriage Is in Trouble:
  • Find a therapist -- it's okay if it takes several tries before you find a fit.
  • In the first 24 months post-injury, advocating for yourself in your marriage, or even using sessions well in therapy, is difficult. You will have problems processing and retrieving information, assessing your own experience, using judgment and finding energy. If your spouse is angry, and the therapist does not monitor the stimulation in the room, you can be "cooked" easily. The most important thing is to ask for help from others. Ask for help in all tasks. Things will get better.
  • Many changes happen in the first two years after the injury and sometimes after that. Don't try to judge how things will be in your marriage by how things are now. Your brain is still healing (and body, if physical injuries are present). You may not be stable on medications due to the changes. If you have PTSD symptoms, get help. It is highly treatable. Look up EMDR [certified clinicians] on the web. Ask if they work in stages, starting with grounding and stabilization.
  • If you are working with a couples' therapist who has no brain injury experience and your therapy is not progressing, call your state brain injury association for mental health providers who work with brain-injured patients.
  • When you call, ask the therapist to send intake forms before the visit. Write things down between sessions as you think of them. Speak up as soon as you get lost in the processing part of couples' sessions -- it's too important. If you need a short break, that's okay, too.

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This morning I found an interesting site, Spot-On.com, which is, according to the site's About Us page, "a web-based syndication service offering a range of independent, intelligent and insightful looks at politics and current events." One post, by admitted liberal writer Christopher Brauchli, definitely merits sharing with our readers:
In his last State of the Union message, Mr. Bush received great applause when he said: "Our military families also sacrifice for America. . . . We have a responsibility to provide for them. So I ask you to join me in expanding their access to child care. . . and allowing our troops to transfer their unused education benefits to their spouses or children. Our military families serve our nation, they inspire our nation, and tonight our nation honors them." One week later he submitted his 2009 budget and dissed the veterans. No funds were included for transferring education benefits.

In submitting his $1.3 trillion budget he forgot to include the benefit that would cost between $1 billion and $2 billion dollars. That was not the end of ignoring the needs of veterans. According to a release from the Brain Injury Association of America, for the third year in a row, Mr. Bush has proposed the complete elimination of the Federal traumatic Brain Injury Program. The program "provides grants to state agencies and [other organizations] to improve access to health and other services for individuals with traumatic brain injury and their families." Susan Connors, president and CEO of the Brain Injury Association of America described the omission as "deeply disappointing" and went on to say that "President Bush just doesn't get it." Those two examples are not the only ones in which veterans who have withstood the onslaught from the enemy in Iraq have to defend themselves from the onslaught of the wolf in the White House parading in sheep's clothing.
Visit Spot-On.com to read the complete post.

Just the kind of duplicitous doublespeak we've come to associate with this administration, but it's especially troubling when those being hurt by it are our returning military, for heaven's sake, as well as some of our most vulnerable citizens. It's a disgraceful situation that should get tons of press, but I wonder how many of the Republican Party's faithful are even aware that the country's vets are being treated this way. My guess is not many. As I've said before, "Support our Troops" takes more than a magnet slapped on the rear of your SUV.

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St. Petersburg Times, By William R. Levesque, Times Staff Writer, February 12, 2008 --

TAMPA - The James A. Haley VA Medical Center and the University of South Florida Photo credit: U.S. Dept. of Veterans Affairsannounced on Monday that they are entering into a partnership to research traumatic brain injury.

Traumatic brain injury is considered the signature wound of soldiers serving in Iraq who are often exposed to explosions. Up to 20 percent of all returning troops exhibited symptoms of the injury.

Congress last year set aside $450-million for research on the condition, which is still poorly understood by the medical community. [This is something Jack has complained about for years. The extremely poor care he received immediately following his own injury inspired a lifelong crusade to have doctors better informed about brain injury. He believes even psychologists, although they are not medical doctors, would benefit from learning more about brain injury. And he's convinced their patients would. How can they expect therapy to be successful if part of the patient's problem is a brain injury that the therapist either doesn't recognize or knows little about?]

At a news conference outside Haley, Rep. Kathy Castor, D-Tampa, said she recently inserted language in the National Defense Authorization Act that gives the Haley-USF partnership "a leg up" in getting some of that $450-million.

How soon or how much of the money will come to Tampa is not immediately clear.

"We have unique assets here," Castor said. "So we're going to use all that leverage to draw down as much of those research dollars that we can."

She said it was unique set of circumstances having a major veterans hospital sitting side by side with a major research university like USF. And both are a short drive from MacDill Air Force Base.

Also, Haley is home to a polytrauma center, one of just four in the nation where physicians treat some of the most severely wounded veterans.

Haley doctors said the partnership contains an education component that allows researchers to "export" their knowledge on treating traumatic brain injury to hospitals around the nation.

Continue reading.

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We've posted a lot about TBI injuries in the military over the past year or so, sadly because it's the sheer number of TBIs suffered in the Iraq War that has drawn so much needed attention to this once silent epidemic.

Well, it's silent no more. Congress and the military have gotten heavily involved. The Centers for Disease Control in Atlanta are sponsoring studies of TBI in prisons. Others are beefing up studies of TBI in homeless populations. In fact, Jack is meeting this month with a representative from Harvard to discuss studying TBI's impact on the homeless. The NFL has completed intensive studies on TBI in professional football. For a topic that rarely saw the light of day, it would now be hard to find someone who had NOT heard about TBI in the past year.

And speaking of the past year, the Surgeon General has just praised the improvements in the way Army medicine assists and transitions its wounded and ill. If you'll remember, it was not so long ago that the Army was on the receiving end of a lot of criticism in this very area.

Coupled with those improvements,
Col. Loree Sutton, head of the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, spoke at the [same] media roundtable about improvements in mental health and brain injury research and treatment.

"There have been numerous advancements in the last few months with respect to mild traumatic brain injuries, Post Traumatic Stress Disorder, depression and anxiety," she said. Mental health professionals, both Army and civilian, will continue to cooperate and share information regarding mental health and brain injuries and the risks associated with them.

Sutton added that a scientific working group would convene later this month to review all areas and discuss ways to better serve affected Soldiers and their families.

"We are looking to take a holistic approach (when dealing with) injury and trauma," she said.
Read more about the roundtable here.

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From Injuryboard.com:

Researchers studying brain injury believe that people with unrelated social or cognitive problems may have something in common: a long-forgotten blow to the head. It is widely accepted that severe head injuries can lead to cognitive and behavioral problems. What is new, according to brain researchers Wayne A. Gordan, M.D. and Mary Hibbard, Ph.D., is the contention that there are many other cases where a past blow to the head resulting in unconsciousness or confusion is the unrecognized source of such problems. These problems include learning disabilities, alcoholism, drug abuse, and depression.
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Dr Gordon, director of Brain Injury Research Center at Mount Sinaii School of Medicine in New York, says, "[unidentified traumatic brain injury is an unrecognized major source of social and vocational failure." According to one researcher, "[when you look at children with learning disabilities or behavior problems, there's often an underlying high percentage of children with traumatic brain injury. We're looking at about 20%."

Continue reading.

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