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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

 

From Austin News KXAN.com:

AUSTIN (KXAN) - Traumatic brain injuries are debilitating to individuals who suffer from them - not only physically and emotionally - but economically as well.

A study commissioned by the CORE Health Foundation , a local advocacy group, found that each year in Texas, brain injuries cause an estimated $6.8 billion worth of economic trauma in terms of deaths, emergency room visits, hospitalizations and disability.

With that, the Dripping Springs based organization conducted an MRI scan on its first participant in a program researching brain plasticity - or how the brain can repair itself. The plan is to help individuals with TBI to improve their lives through learning and rehabilitative therapy.

Read more.

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>From England's NHS Choices:
“Caffeine helps cut brain cancer risk,” said the Daily Express, reporting that a daily cup of tea or coffee can stop tumours growing by restricting blood flow to the brain.

The large study behind this story followed 410,000 men and women across 10 European countries for 8.5 years and looked at the development of two forms of brain tumour. Brain tumours are rare, and during follow-up there were only 588 new cases in total. The researchers found no meaningful associations when they looked at each country separately, although combining all the national results showed a trend between greater caffeine consumption and lower cancer risk.

The results echo those of a previous study and are likely to lead to further research into how caffeine may affect the working processes in the brain. However, the research has numerous important limitations, including the fact that variable methods were used for measuring caffeine intake across countries. Overall, while this research is of scientific interest, it has limited implications for current medical treatment.

Read more.

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From Helium:
For those who have suffered a traumatic brain injury the long term affects on cognitive abilities can prove to be the most difficult part and the hardest thing to live with. While the visible signs of the trauma have healed the damage that occurred within might very well affect the rest of their lives. There are many ways that this type of injury can have an impact on the individual's cognitive abilities and behavior.

Being unable to concentrate is one of the more common symptoms mentioned. When there are distractions it becomes even more difficult for the injured person to stay focused. The ability to block out background noise while they are having a conversation may be impossible. Instead their thoughts bounce around catching snippets of the noise going on around them and this distracts them from what they were doing. This in turn results in them forgetting and having to start from square one.
Read more.

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From Asheville Citizen-Times:
NEWTON — Edwardo “Eddie” Wong Jr. shot a state trooper during a traffic stop two years ago because he feared for his life, said a neuropsychologist who believes Wong has a traumatic brain injury.

“He explained he had an experience of being robbed before and the circumstance didn't make sense to him,” said Shawn Acheson, who testified for the defense in Wong's murder trial on Tuesday. “It didn't make sense to him that he should be frisked or handcuffed over a license tag violation, and that scared him.”

The jury, for now, won't hear about that because the defense team broke a rule of evidence, and the judge ruled the testimony was “a self-serving, last-minute statement that (Wong) thinks will help his case.”

Wong is charged with first-degree murder in the slaying of Trooper David Shawn Blanton Jr. He could face the death penalty if convicted.

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Acheson said he believes Wong suffers from traumatic brain injury that prevents him from having impulse control, foresight or an appreciation of consequences for his actions.

Wong's attorneys have said he fell from a five-story apartment building in Brooklyn, N.Y., as a child and suffered a brain injury though prosecutors have said tests showed no lesions or scarring on his brain.

Acheson is not a medical doctor. He holds a Ph.D.

Poovey limited Acheson to testifying about evidence of “diminished capacity,” which is one of the defenses Wong's attorneys have said they will use.

The term is a legal description that means a person's mental functions are impaired.

Acheson said some brain injuries aren't visible on MRI scans.

A scan of Wong's brain found no evidence of injury, according to prosecutors.

“Traumatic brain injury is not a simple thing,” he said. “It's a very complex injury process.”
Read more.

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From U.S. Department of Defense, American Forces Press Service:
BETHESDA, Md., Sept. 27, 2010 – Valerie Wallace was at her wits’ end when she first heard about a novel traumatic brain injury treatment program under way here at the National Naval Medical Center.

Her 22-year-old son, Army Sgt. John Barnes, was wounded in southwestern Iraq in 2006 during a mortar attack while he was deployed with the 101st Infantry Division.

He had slipped into a coma for 12 days, remembering nothing of the attack when he regained consciousness with a severe traumatic brain injury. He recognized his family members’ faces, but had lost much of his verbal and motor skills as well as his short-term memory.

After two months at Walter Reed Army Medical Center in Washington, followed by treatment at the Department of Veteran Affairs’ Tampa Polytrauma Rehabilitation Center, in Tampa, Fla., Barnes seemed on the road to recovery, his mother recalled.

But a fluid buildup within his brain stopped that progress cold, requiring an emergency craniectomy to relieve swelling. From there, as Barnes began his rehabilitation almost from square one, he fluctuated between extremes. At one point, his recovery was so successful that he’d started living independently and enrolled in college, but at other times, his condition was so dire that his mother feared he was spiraling out of control.

“Then the [post-traumatic stress disorder] set in and he began self medicating with whatever he could get his hands on,” his mother recalled. “It was just a disaster.”

It was only by chance that Wallace learned through a friend about the National Naval Medical Center’s psychological health and traumatic brain injury team. The little-known team was stood up here about two years ago to address the complexities of brain and mental-health injuries.

Dr. David Williamson, the team leader, admitted Barnes for about a month of close observation in the six-bed TBI unit known as “7 East.”

We have a whole portfolio of brain injury specialists, treating clinicians who look at all the basic aspects of brain function, like movement, balance and vision, up through the higher brain functions like memory and personality and emotional regulation,” Williamson said. “And the [patient’s] time here allows us to put together a very sophisticated assessment of all these different areas of brain function, and to identify what the needs will be downstream.”
Read more.

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From The Denver Post:
For 10 weeks, Matthew Keenan lay in a coma, the victim of a hospital error that plunged him into respiratory arrest and cut off oxygen to his brain. A judge appointed his mother to serve as guardian and conservator for her comatose 37-year-old son. Twice, his father called a priest to perform last rites. Then he awoke.

He had no idea where he was. He could move nothing but his eyelids. Then his fingers.

It was the start of a long, remarkable, some might say miraculous recovery. He learned to use his arms again, to sit up, to feed himself, to use a wheelchair, to regain a brain that survived a nearly fatal injury.

Yet when he rolled into a Boulder courthouse three years ago and petitioned to be free of his guardian, he ignited a legal battle that persists to this day.

The bank chosen to manage his money jumped into the case, allying itself with his guardian. Both billed him for the time they spent challenging him in court.

Although Keenan's guardian resigned months later, his conservator — Colorado State Bank and Trust — has charged almost $300,000 for litigation costs before and after a judge summarily replaced it.

Keenan, now 45 years old, came away from a crippling hospital experience with a settlement that provided about $2.6 million, money intended to last a lifetime. Now he is risking yet more of that estate in case he loses another round in court.

"I'm grieved," he said. "It's left my soul and my heart hardened to the process. I just can't believe I'm having to pay them to fight me."

Read more to see how Colorado State Bank and Trust's lawyers blame Keenan's brain-injured behavior, coupled with his lawyer's misunderstanding of probate law.

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This story highlights just how much information on TBI is available these days, as well as how much research is focusing on brain injuries and their repercussions. When we started this blog not that many years ago, it was hard to find substantive information about TBI, and practically no one had even heard the term. Now, after two wars and an NFL study, the topic is everywhere, from medical journals and health blogs to daily newspapers and magazines. It's what we wanted, I know, but sometimes it almost feels trendy, like traumatic brain injury has become the "in" medical issue, the "condition du jour." I'm not complaining, mind you. I did that for the years when no one was talking about it. No, I'm just reflecting on this incredible turnaround that is more than we ever hoped for... and remembering its cost.

From The Wall Street Journal:

Concussions are a hot topic in sports these days as evidence of their long-term consequences piles up. A study published last month, for example, suggests a link between repeated head blows sustained in sports and a brain condition similar to Lou Gehrig’s disease. A piece in this week’s New England Journal of Medicine sums up what we know about the long-term effects of traumatic brain injury.

Youth sports are of particular concern — just last week, statistics on basketball injuries showed the number of traumatic head injuries rose 70% even as the overall injury rate dropped. Yesterday a House committee hearing focused on proposed legislation to establish a national standard for how schools deal with students who sustain concussions. (Here’s the Washington Post story on the hearing, and here’s a story from the New York Times.)

Read more.

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This is a tragedy and at the same time just another example of how contemporary American society's answer to so many problems is to criminalize them. Should Ryan Crofutt be arrested for behavior caused by his traumatic brain injury (TBI)? He himself was the victim of a horrendous crime that left him with a TBI, his parents could not find the help he needed, and now is it right to victimize him again for actions he could not help?

From the Palm Beach Post:

— For years, Vicki Crofutt has fought to find residential treatment for her brain-damaged son, worrying that eventually something bad would happen.

On Thursday morning, her fears were realized.

An early morning scuffle between Ryan and his father, left Frank Crofutt, 55, with two broken legs and Ryan, 25, on the run from Boynton Beach police.

"It hasn't been the best day in my life," Vicki Crofutt said Thursday evening while waiting for her husband to be taken into surgery at JFK Medical Center.

Perry Borman, head of the county office of the Florida Department of Children and Families, called the situation a tragedy.

Borman was among a cadre of county and state leaders who earlier this year tried to find some way to help Ryan, who sustained a traumatic brain injury in 2004 when drunken thugs beat him and then ran him over with their car. While effects vary, people with traumatic brain injuries often have difficulty keeping their emotions in check.

Florida doesn't adequately fund programs for people with traumatic brain injuries, Borman said. Because treatment is expensive, insurance companies, including Crofutt's, won't cover it.

After watching doors shut on Ryan, Florida Rep. Joe Abruzzo, D-Wellington, pledged to file legislation during the upcoming session.

"While it might not help Ryan and his family in the short term, we need to work with Rep. Abruzzo to close this loophole to better assist TBI patients in our community," Borman said. "We can't let them fall through the cracks.

Read more.

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From UPI.com:
A study of U.S., Canadian and European patients with a form of dementia suggests one's career may influence where the disease begins in the brain.

Dr. Nathan Spreng, who conducted the study while a psychology graduate student at Baycrest and is now a postdoctoral fellow at Harvard University, says... "The disease appeared to attack the side of the brain that was the least used in the patient's professional life."

Patients who had jobs rated highly for verbal skills, such as a school principal or chief executive, showed greater tissue loss on the right side of the brain -- which is not specialized for language or verbal skills. Patients with jobs rated lower for verbal skills, such as art director or flight engineer, showed greater atrophy on the left side of the brain.
Read more.

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From Wired:
The Navy SEALs’ much-hyped online test to detect traumatic brain injuries churns out a disconcertingly high rate of false positives, according to university researchers who’ve studied the test in healthy college students.

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From CBS 7, Odessa, Texas:
For years football players have taken pride in toughness, choosing to keep playing no matter what injury they face.

But as the NFL changes its tune by tightening up treatment of concussions, the move is having a ripple effect down to the lower levels.

Whether it's Jason Witten's head hitting the ground or a gridiron star from Odessa, Midland, or Monahans, the danger of sustaining a concussion is a common thread.

So the NFL is tightening its treatment of concussions and so is the YMCA, making sure everyone sees the signs of a brain injury.

"Signs of a concussion would include memory loss, loss of consciousness, even if they act normal, but the fact that they had loss of consciousness means they at least have a concussion", says Dr. Richard Bartlett, of Odessa’s Permian Prompt Care.

Concussions occur when the head is jarred so hard, that the brain moves around inside the skull.

While helmet technology has improved over the years, the risk of a concussion is still there. That's why the YMCA requires that all of the coaches on their fields be certified in concussion detection and management.

"We've had to go through comprehensive video training and then we also have to pass a test when it comes to identifying and knowing what to do", says youth coach Jose Gaona.

Gaona says the National organization, USA Football, is doing a lot. Through PSAs, posters and symptom charts they're pushing awareness and action.
Read the rest of the article.

For a wealth of information on concussions in football visit the USA Football website by following this link:

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From the Pittsburgh Post-Gazette:
Fourteen 10- and 11-year-olds from the Peters Township Indians White team gathered under cover for their final practice last week, chased indoors Thursday by rain and sodden football fields.

The youngsters were practicing plays and more for about an hour before finishing with a routine one-on-one drill on tackling fundamentals. Routine as long as no one got a concussion during the final drill again.

One player from the White team -- the Peters Township Junior Football Association's age-group squads are named after the Washington County school district's colors -- has been sidelined for the season's opening three games because of a concussion.

Another, 10-year-old Nick Young, has missed five consecutive games: Three already this year because of a sprained medial collateral ligament in his left knee, and the final two last season because of a concussion.

Rick Young watched Nick, his son, miss those final two games of 2009 -- amid e-mails from the coach pleading, "Can he play this weekend?" -- and then endure two months of concussion-induced emotional and academic turbulence in the fourth grade. That experience motivated Dr. Young, a podiatrist, to become an at-large board member and safeguard the association's 225 young brains.

Parents, players, organizers and regulators are becoming aware of a widespread problem that doesn't belong solely to NFL Sundays. Concussions happen during youth football and college Saturdays, high school Friday nights, and practices all days, down to tykes of 6.

Read more.

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I just came across this and think it sounds like a wonderful program, combining aid for TBI survivors and wildlife conservation. It's in New York state, but there might be similar programs elsewhere. Anyone know?

From The Daily News:

NAPLES, NY -- Headquartered in Canandaigua, NY, Bridges for Brain Injury, Inc. is a not-for-profit organization that provides services for adults with acquired and traumatic brain injury. Their mission is "to aid individuals with a traumatic brain injury in bridging the gap between surviving and living lives of independence with dignity and hope." Their program helps members rebuild necessary skills while enhancing their quality of life through creative approaches, education, responsibility, and fun.

"Wildlife Defenders" is a wildlife conservation outreach effort conducted by Bridges For Brain Injury, Inc.'s program members. Bringing live native and exotic species, the Defenders visit schools, senior facilities, and community events to introduce audiences to their animal ambassadors and encourage awareness about environmental and wildlife conservation. Members also discuss brain injury issues and the importance of safety and prevention practices. The program allows members to work on personal goals such as socialization, organization, communication, memory retention, planning, and pre-employment skills. Wildlife Defenders is a fully operational, licensed and USDA approved wildlife conservation outreach program, certified to handle and house more than 37 species of exotic and native wildlife.

Regular admission ot Cumming Nature Center is a requested donation of $3 per person or $10 per family. Admission is free for RMSC members.

For information and directions, go to www.rmsc.org or call (585) 374-6160.

Meet wildlife ambassadors and their friends at special programs this fall at Cumming Nature Center, 6472 Gulick Rd., Naples.

"Wildlife Defenders," a program of Bridges for Brain Injury, Inc., will give presentations at 11 a.m. on Sept. 12 and 25, Oct. 14 and 23 and Nov. 4. Admission is $2 per person in addition the nature center admission.

See the original article at The Daily News Online, serving Genesee, Wyoming, and Orleans (NY) counties.

If you live anywhere near Naples, NY, you might want to look into this program. Also, to find out more about Bridges for Brain Injury, visit their web site.

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From Bloomberg Business Week:
Obesity caused by heavy drinking can add to brain damage caused by drinking itself, says a new study.

Researchers examined the findings of different types of brain scans conducted on 54 men in an alcohol treatment program and compared them with each man's body mass index (BMI). BMI is a measurement that takes into account a person's height and weight. The study findings appear online and in the December print issue of Alcoholism: Clinical & Experimental Research.

"It is commonly believed that it is the large amount of consumed alcohol by itself that leads to brain injury in alcoholics," principal investigator Dieter J. Meyerhoff, a professor of radiology at the University of California, San Francisco and San Francisco VA Medical Center, said in a journal news release.

"This is only partly correct. In previous studies, we have shown that alcoholics who smoke cigarettes have greater brain injury than nonsmoking alcoholics. This new study suggests that a high BMI, independent of drinking and smoking, is also associated with brain injury," Meyerhoff said.

Read the rest of the article.

Read more about alcohol and health at The U.S. Centers for Disease Control and Prevention web site.

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From HS Game Time:

RIVERSIDE - More and more, people have concussions on the brain these days.

There's been a surge in new literature on the topic as well as added media exposure, helping improve the public consciousness about how scary serious head injuries can be.

The National Federation of State High School Associations has taken heed, introducing a rule this year that requires game officials to remove an athlete who appears concussed from play for the day.

The California Interscholastic Federation took it a step further, implementing guidelines that forbid an athlete from returning to play without clearance from a licensed health care provider trained in the evaluation and management of concussions. Ideally, athletes will work their way back slowly only after first proving asymptomatic.

With studies having shown the adolescent brain to be three times more susceptible to catastrophic harm than those that are fully developed, the new protocols aim to do more to protect kids.

"A lot of coaches and families aren't understanding what's actually going on within the brain, and they're putting the kids out there too soon and they're getting a second concussion before the brain actually heals," said Dr. Chris Marker, the director of the new SPORT Concussion Clinic in Riverside.

Second-impact syndrome makes that dangerous. It is the term used to describe what happens if the brain swells rapidly after a person suffers a second concussion -- even a mild one -- before symptoms from an earlier one have subsided. The result can be traumatic brain injury or death.

With that in mind, increased vigilance and precaution are good things, mostly, according to those involved with high school athletics.

Read the entire article here.

 
The 2nd post on caregivers from our guest blogger, Viki Kind:
As caregivers, we do our best to make good decisions for our loved ones and to keep them included as much as possible in their own lives. But to really understand how our choices are experienced by the person in our care, it is time for you to trade places with the person you are caring for and to consider the world from his or her perspective. If you can, have someone else read this to you slowly, so you can close your eyes and truly put yourself in your loved one’s shoes.

Imagine what it would feel like to have someone else be in charge of your life. You don’t get to decide where you are going, how you will get there or what will happen when you arrive. You have to do things on someone else’s schedule now. How would it feel to know that you are have lost control of your life?

You are still the same person, but somehow different. You try to remember things, but you know you keep forgetting. You try to speak but the words aren’t there. You can’t do the things you used to do and you feel helpless all the time.

Without your voice, you feel as though you no longer exist. You are at the mercy of others whether you like it or not. People treat you differently. They treat you like a child and don’t take you seriously. They speak in a sing-song voice as they would with a baby. When you do talk, people don’t listen or respect what you say. People talk as if you are not even in the room. You feel invisible. Just once, you would like to be you again.

Maybe you are in the midst of terrible grief. All of these losses are overwhelming, but nobody is willing to talk to you about your sadness. You wish that someone would listen to your complaints and let you cry about what you are going through.

You are no longer able to do things physically; you need help with the simplest of tasks. You have to wait until someone comes to help you to the bathroom, and sometimes while you are waiting, you can’t hold it any longer and you have to use your diaper. Oh my goodness. You are wearing diapers. And perhaps you can’t even feed yourself without someone’s help. Or maybe you can’t swallow and now you are fed through a tube. What would it be like to never taste food again?

Write down how you would feel if you had to cope with what your loved one is experiencing. Then write down what you think it is like for your loved one to be in this situation. If you can, ask the person directly what is the most difficult part of his or her experience. When you take the time to listen to and understand another person’s experience, it is an act of healing. Have a kind and respectful day.
Viki Kind is a clinical bioethicist, medical educator and hospice volunteer. Her book, “The Caregiver’s Path to Compassionate Decision Making: Making Choices for Those Who Can't,” guides families and healthcare professionals through the difficult process of making decisions for those who are losing or have lost the ability to think. She has also been a caregiver for many years for four members of her family.

You can visit Viki at her web site KindEthics.com.

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From FoodConsumer:

What is a Concussion?

A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head. Concussions can also occur from a fall or blow to the body that causes the head and brain to move rapidly back and forth. Even what seems to be a mild bump to the head can be serious.

How Can Concussions Happen in Schools?

Photo: Children in a swing.Children and adolescents are among those at greatest risk for concussion. Concussions can result from a fall, or any time a student’s head comes into contact with a hard object, such as a floor, desk, or another student’s head or body. The potential for a concussion is greatest during activities where collisions can occur, such as during physical education (PE) class,playground time, or school-based sports activities.

Students may also get a concussion when doing activities outside of school, but then come to school when symptoms of the concussion are presenting. For example, adolescent drivers are at increased risk for concussion from motor vehicle crashes.

Concussions can have a more serious effect on a young, developing brain and need to be addressed correctly. Proper recognition and response to concussion symptoms in the school environment can prevent further injury and can help with recovery.

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Visit the FoodConsumer site to finish reading this article and to learn more about this and many other interesting topics.

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August 26th Press Release from EurekAlert:

GALVESTON – Traumatic brain injury, currently considered a singular event by the insurance industry and many health care providers, is instead the beginning of an ongoing process that impacts multiple organ systems and may cause or accelerate other diseases and disorders that can reduce life expectancy, according to research from the University of Texas Medical Branch at Galveston.

As such, traumatic brain injury should be defined and managed as a chronic disease to ensure that patients receive appropriate care and that future research is directed at discovering therapies that may interrupt the disease processes months or even years after the initiating injury, say co-authors Dr. Brent Masel, a clinical associate professor in UTMB's department of neurology and Dr. Douglas DeWitt, director of the Moody Center for Traumatic Brain & Spinal Cord Injury Research/Mission Connect and professor in the department of anesthesiology. Masel also serves as president and director of the Transitional Learning Center in Galveston, which for more than 25 years has provided survivors of brain injury with the special rehabilitation services they need to re-enter the community.

The literature review, which appears in the current issue of The Journal of Neurotrauma, examines 25 years of research on the effects of brain injury, including its impact on the central nervous system and on cognitive and motor functions.

Traumatic brain injury occurs when a sudden trauma causes damage to the brain and can be classified as mild, moderate or severe, depending on the extent of the damage. While many patients recover completely, more than 90,000 become disabled each year in the U.S. alone. It is estimated that more than 3.5 million Americans are presently disabled by brain injuries – suffering lifelong conditions as a result.

"Traumatic brain injury fits the World Health Organization's definition of a chronic disease, yet the U.S. health care system generally views it as a one-time injury that heals the way a broken bone does," says Masel. "Only by reimbursing and managing brain injuries on par with other chronic diseases will patients get the long-term treatment and support they need and deserve."

The researchers add that re-classifying traumatic brain injury as a chronic disease may help to provide brain injury researchers with the additional funding required to investigate a potential cure.

Read the whole press release.

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