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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

 

We've been writing about the potential for TBI's in high school sports and the very real dangers of concussions, which are now considered mild TBI's. This topic hit home recently when a local baseball player was struck in the head with a ball. The Tallahassee Democrat reported:

Miller Joyner fired a strike Tuesday night, much to the delight of his Robert F. Munroe teammates surrounding him on the mound. The cheers and applause were a far cry from five days earlier, when the senior shortstop was drilled in the head on a botched pickoff play at second base in the Bobcats' game at Maclay.

A hush went over the crowd as Miller dropped to his knees. The sound of it, his father Bradley Joyner said, was unbearable.

"I was in shock at the time," Bradley Joyner said.

Miller, who has played baseball since he was 6 years old, sat in the dugout for a few innings before going home and sleeping off his headache.

It wasn't until the next day that Miller was admitted to the Intensive Care Unit at Tallahassee Memorial Hospital when a CAT Scan revealed he not only suffered a fractured skull, but there was internal bleeding.

"I was scared," Miller said. "I never thought something like that would happen."

Miraculously, the bleeding stopped and Miller was released from the hospital Saturday.

But his baseball career is over.
According to a study by NeurosurgeryToday.org, 26,964 baseball and softball players were treated in emergency rooms for head injuries in 2008.

Keep reading the article.

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We just blogged about concussions in young athletes a few days ago. Thankfully it continues to receive increasing attention as more well-known athletes speak out. The following is by Rich Tenorio of The Daily Item.

BOSTON -- North Shore sports fans would have recognized many of the former professional athletes who gathered at the State House on Tuesday, from ex-New England Patriot Ted Johnson to boxing legend Micky Ward. Yet the cause that brought them together was related to high school sports: to urge passage of a bill aimed at minimizing the effects of concussions on high school players in Massachusetts.

"Our society tells us athletes are warriors," said State Sen. Steven A. Baddour of Methuen, a sponsor of the bill who spoke at Tuesday's conference. "But there's no way to shake off a brain injury. Young athletes especially need time to heal."

Senate Bill 796 impacts all schools subject to the rules of the Massachusetts Interscholastic Athletic Association. The bill would increase awareness of concussions through training for school personnel and students, written information provided to student-athletes, and documentation of student-athletes' history of head injuries.

It would also set guidelines for when players can return from a concussion: Players who suffer from one cannot return the same day, and a player who suffers a concussion needs medical clearance before playing again.


Keep reading the article.

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This was interesting to me because my personal physician has me on prescription-strength Vitamin D for the next six months. Apparently they're finding that Vitamin D deficiencies can cause numerous problems, and my level was quite low. This past year was the first year a doctor mentioned Vitamin D to me, except in conjunction with taking Calcium for bone density. Now they're finding a link to fatigue after brain injuries. Bears watching.

From medpageToday:

PRAGUE -- Among patients who have suffered a traumatic brain injury, vitamin D deficiency is associated with an increased likelihood of having chronic fatigue, Dutch researchers found.

Of 90 such patients, 80% who were fatigued had the vitamin deficiency, compared with 40% of those who were not fatigued.

Having a sleep disorder strengthened the association between vitamin D deficiency -- defined as a level less than 50 nmol/L -- and fatigue, Schnieders said in an interview.

"I think it's important to get knowledge to the patients, the rehabilitation doctors, and the family doctors that they should look at vitamin D and sleep in these patients," she said.

Keep reading the article.

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Bret Michaels, front man for the rock band Poison, star of reality show Rock of Love, and a contestant on this season's Celebrity Apprentice, was rushed to the hospital late Thursday night with a severe headache. It turned out that Michaels had suffered a subarachnoid hemorrhage. Bret Michaels is 47 years old and was diagnosed with diabetes when he was a child.

According to the Health and Beauty News blog,
a subarachnoid hemorrhage is bleeding in the subarachnoid space. The subarachnoid space lies between the pia matter of the brain and the arachnoid membrane. It is often seen following a head injury or when there is a cerebral aneurysm. Subarachnoid Hemorrhages may also occur spontaneously.


Symptoms of a subarachnoid hemorrhage include severe headaches, confusion or decreased sense of alertness, difficulty moving, and loss of feeling, becoming extremely irritable or having sudden mood swings, stiff neck, and trouble with vision, vomiting, and seizures. The headaches may come on quickly and intensely and are described as excruciatingly painful. Sometimes there is a sudden pop or snap that is felt before the onset of the headache.
An update was posted on his web site and Facebook pages today (Sunday, April 25) stating that doctors are still looking for the source of the bleeding, and Michaels remains in intensive care. The update went on to say, "As we all know Bret is a fighter and we are hopeful that once all is complete the slurred speech, blurred vision and dizziness, etc. will be eliminated and all functions will return to normal." We'll try to post an update on this as more information is released.

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The AP reports that military veterans and their caregivers got help from Congress this past week.
The Caregivers and Veterans Omnibus Health Services Act attempts to address the struggles of caregivers who are forced to quit their jobs and often lose their health insurance to care for wounded family members.

Caregivers of veterans from all eras would receive training, counseling, mental health services and 30 days a year of in-home replacement care. Health insurance would be available if they have none.

Besides the stipend, which would be based on hours and the degree of care provided, caregivers for some wounded Iraq and Afghanistan vets would be eligible for lodging and assistance when accompanying them on medical visits.

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Warning: this is a tragic story. But it does raise questions that might eventually affect the legal rights of mentally incapacitated individuals.
(CNN) -- Abbie Dorn always wanted children, and in June 2006 she got her wish -- triplets. But during a difficult birth she suffered severe brain damage that took away her chance to raise them.

Now, her parents and former husband are locked in a legal battle over whether Dorn is capable of interacting with her children, and whether they should visit her.

Abbie and Dan Dorn, both devout Orthodox Jews, were in their early 20s when they met in Atlanta, Georgia, and embarked on a whirlwind romance. They married in August 2002 after dating for six months. Dan Dorn took a job with his father in Los Angeles, and his wife moved to Southern California with him.

Three years later, in the fall of 2005, Abbie became pregnant.

"They were very much in love," recalled her mother. But what happened to Abbie when her triplets were born would tear the young family apart.

According to her parents and their lawyers, during the delivery Abbie began bleeding severely and went into cardiac arrest, which deprived her brain of oxygen. Medical personnel were not able to resuscitate her for nearly 20 minutes, according to the Cohens (Abbie's parents) and their lawyers.
Abbie's parents took over her care while Dan took the triplets and began raising them in California. One year after their birth, Dan contacted Abbie's parents to tell them he was ready to move on and wanted a divorce. The Cohens filed for divorce on Abbie's behalf, and in 2008 the divorce was finalized.

What happened next isn't very pretty. The Cohens and Dan can't agree on whether Abbie is making progress. Dan believes that she remains in a vegetative state while her parents contend that she has made dramatic progress since 2008. Whatever the truth, what's at stake is whether she has the right to have visits from her children. Dan doesn't want the children to see their mother; the Cohens believe she has a right to a relationship with them, whatever that relationship might be.

Complicating this case further is the fact that Dan has sued Abbie's estate for child support. (The estate received a medical malpractice settlement of $7.8 million which pays for Abbie's care.) This seemed to be the last straw for a lot of people commenting on the news story. Let me just say that they were not lobbying to form a fan club for Dan Dorn.

What do our readers think? Read the whole story here, and then let us know. Or, if you want to read even more about Abbie's situation, the Los Angeles Times ran a lengthy story on April 11th that goes into more detail about what happened and the ongoing court arguments.

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Jack has spoken out about concussion (now recognized as a type of traumatic brain injury) in high school sports for years. Long before concussions were taken as seriously as they are today, Jack worried about the risk to young athletes, who are also vulnerable to multiple concussions. Jack initiated and has for years supported neuropsychological evaluations for football players at his prep school, Episcopal High School in Alexandria, VA. (The school has since started scanning athletes in all sports.) He believes that having a baseline evaluation is important for more readily diagnosing brain injury after sports-related accidents.

According to The Brain Injury Resource Center
the risk for catastrophic effects from successive seemingly mild concussions sustained within a short period is not yet widely recognized. Second Impact Syndrome results from acute, usually fatal, brain swelling that occurs when a second concussion is sustained before complete recovery from a previous concussion that causes vascular congestion and increased intracranial pressure, which may be difficult or impossible to control.
Neurologists say once a person suffers a concussion, he is as much as four times more likely to sustain a second one. Moreover, after several concussions, it takes less of a blow to cause the injury and requires more time to recover.

The Centers for Disease Control and Prevention (CDC)has developed a tool kit called Heads Up: Concussion in High School Sports.
The kit contains information for coaches, athletes and parents. Definitely worth checking out if you have a teen involved in contact sports. (Sports-related concussions can occur before you child reaches high school. The CDC also has a kit geared toward youth sports called Heads Up: Concussion in Youth Sports).

But as informative as these kits are, you should always heed this advice from the CDC: If you think your athlete has sustained a concussion…don’t assess it yourself. Take him/her out of play, and seek the advice of a health care professional.

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Because of some changes required by Blogger, which hosts this blog at sossisson.com, we will be making numerous changes in coming weeks. These will almost certainly involve:
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In the meantime, if you have been visiting the blog at this address:
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Thank you!

 
We all know by now that Traumatic Brain Injury is the signature wound of the Iraq War. Explosions that would have killed soldiers in previous wars are now less often fatal, due to the improved protective qualities of military helmets. So there are less fatalities, but more brain injuries. According to the Defense Department, more than 134,000 service men and women suffered traumatic brain injuries from 2003 through 2009. The military has planned clinical trials using pure oxygen in a pressurized chamber to determine if the technique can help brain-injury sufferers heal.

From The Associated Press:
The U.S. military plans clinical trials next year to see whether breathing pure oxygen in a pressurized chamber might help thousands of Iraq and Afghanistan war veterans suffering from traumatic brain injuries.

About 300 service members with mild to moderate damage will participate in the trials of hyperbaric oxygen therapy to help determine whether it can help them heal, or at least ease the headaches, mood swings or other symptoms linked to brain injury.

Some will spend a total of 40 hours over 10 weeks breathing pure oxygen in a hyperbaric chamber, where the atmospheric pressure is increased to a level similar to what they would experience about 20 feet under water.


Read the story here.

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One of Jack's concerns is the frequency of traumatic brain injuries in prisons and their affect on inmates in a prison environment. A few years ago, it would be almost impossible to find literature on this topic, but thanks to the growing body of knowledge about TBI, and its movement into the public consciousness (primarily due to the Iraq War), information on TBI is easier to find than ever before. To be sure, TBI and the Criminal Justice System is lagging somewhat behind other areas in terms of information available, but the field is steadily growing (as is TBI and the Homeless population).

The following is from the National Disability Rights Network:

Increasingly, large numbers of persons with mental illness, cognitive disabilities and/or physical disabilities are coming into contact with the adult correctional system. It is estimated that as many as 50 percent of prisoners have a mental illness or other type of disability. Jails and prisons have become the “new asylums” -- a costly response to mental health care.

From arrest through every phase of the criminal justice system, persons with disabilities encounter a system not designed to handle large numbers of persons with disabilities. Lack of access to community mental health treatment and other public services often results in people with disabilities being arrested and booked in jails where adequate treatment is unlikely. When competency is an issue, delays in transporting such individuals for treatment are commonplace. Those who are convicted and confined in penal facilities tend to serve longer sentences than others convicted of similar crimes, and prison conditions are harsher due to their disabilities.

Persons with disabilities often encounter an absence of justice in a system not designed to handle a large number of persons with disabilities.

Why are inmates with TBI or some form of mental illness not hospitalized in a state hospital? Why are they going to prison in ever increasing numbers?

A few years ago, Frontline produced an in-depth look at Ohio's prison system, and why it houses so many mentally ill individuals. Although this program focuses on mental illness, who's to say whether some of the prisoners filmed had also suffered a TBI. But mental illness or TBI, the sheer wrongness of incarcerating sufferers with either condition is obvious.

The opening sentences of the Frontline introduction:
Fewer than 55,000 Americans currently receive treatment in psychiatric hospitals. Meanwhile, almost 10 times that number -- nearly 500,000 -- mentally ill men and women are serving time in U.S. jails and prisons. As sheriffs and prison wardens become the unexpected and often ill-equipped caretakers of this burgeoning population, they raise a troubling new concern: Have America's jails and prisons become its new asylums?
You can watch the entire show here. Please let us know what you think. We'll be writing more about TBI and prisons this year.

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