November 29, 2005, 8:42 am

NPR Tackles TBI During Wartime

National Public Radio (NPR) had an excellent piece today called “Helping Troops Recover from Brain Injuries,” which recounted the story of Steve Cobbs, an army sargeant who sustained a TBI when his vehicle plummeted into a crater.

You can listen to the NPR story HERE.

Currently, 67% of soldiers severely injured in Iraq are being diagnosed with a traumatic brain injury–that amounts to ten a day. This is a terrifying statistic because it means that while many of them are surviving wounds that would have killed them, they are also entering a society terribly unprepared to offer them the lifetime support they will need for their injuries.

Read more about the quiet crisis of brain injury and the Iraq war here.

Link to this post

November 28, 2005, 10:18 am

Link Between TBI and Aging

As part of our continuing exploration into the issue of aging and brain injury, I thought it might be helpful to refer to a study conducted a few years ago by researchers at Duke University. Twenty-five percent of the general population carries variation of the apolipoprotein gene known as apolipoprotein E4 (APOE4):

“Thus, the researchers concluded that the brains of those who carry the APOE4 gene show greater deterioration than those who do not. “This is an important finding in the study of aging. I believe it will lead to a greater understanding of age-related memory loss and hopefully, one day, to ways of keeping our brains sharper, longer,” noted Doraiswamy.”

It appears that this gene leads to the increased risk of Alzheimer’s, but it also turns up as a contributing factor to memory problems in a person with traumatic brain injury!

What are the implications? Obviously, this is good news for people suffering from Alzheimer’s-related dementia. For people with TBI, however, it suggests an unconventional form of treatment for brain injury–gene therapy.

Click here to read “Gene Linked to Accelerated Brain Aging in Healthy Adults“

Link to this post

November 23, 2005, 9:25 am

Thanksgiving in a Brain Injury Rehab

What do the holidays look like for a person recuperating from a traumatic brain injury? This year, many of our brain-injured patients will be going to a local mall to use a portion of their income to buy toys for disadvantaged kids.

Some of our patients struggle with severe injuries that have altered their control of speech, memory, and movement. To see them fully engaged in the holiday spirit, to see them give with abandon, and to see them delight in their humanity is more than just humbling–it’s inspiring.

Even in the midst of a terrible impairment, TBI survivors move past the pitfall of viewing themselves as a victim, and instead view themselves as wholly capable persons who can make contributions that matter. Neglecting the inherent human dignity of the TBI survivor–whether they are minimally conscious or fully responsive–is to neglect our own humanity.

Link to this post

November 21, 2005, 10:00 am

Olympic Skier's Life Story After TBI

There’s a new book out about the Olympic gold-medalist Bill Johnson, who survived a traumatic brain injury in 2001. Here’s a brief description about his story:

“Bill Johnson was known for his aggressive skiing style and bravado, a man who taunted his competitors and predicted his own victories. At the 1984 Winter Olympics, he caught the media’s attention when he declared, “Everyone else is here to fight for second place.” True to his word, Johnson set the world on fire when he achieved what no other American skier had ever done and won the gold medal in the men’s downhill… In 2001, trying to mount the comeback that kept eluding him, Johnson skied face first into a mountain at 70 mph, leaving him broken and comatose.

Johnson lives every day with the effects of the brain damage he suffered—his speech is slurred and he has forgotten sizable portions of his former life. He has made tremendous progress physically and was actually back on skis eight months after the accident that almost killed him. In 2002, Johnson jogged in to the opening ceremonies of the Winter Olympics in Salt Lake City, one of the final torch bearers. SKI TO DIE is his amazing, compelling story of triumph and tragedy.”

Click this link for more about Ski to Die: The Bill Johnson Story

Link to this post

November 17, 2005, 11:00 am

The Meditated Brain

The November issue of Neuroreport is getting widespread press coverage for its report on newly-discovered effects of meditation on the brain:

“Brain imaging of regular working folks who meditate regularly revealed increased thickness in cortical regions related to sensory, auditory and visual perception, as well as internal perception — the automatic monitoring of heart rate or breathing, for example.”

The effects of meditation on the brain have been a subject of increased study in the past decade, and research seems to indicate that the practice offers significant merit for brain health.

To find out more about the brain and meditation, here are a few helpful links:
“Meditate on This: Buddhist Tradition Thickens Part of Brain”
NPR’s “Science Explores Meditation’s Effect on the Brain”
“Meditation Gives Brain a Charge”

Link to this post

November 16, 2005, 9:36 am

What's Going On In Your State?

Yesterday I had the opportunity to chat with a social worker at Mid Missouri Mental Health Center in Columbia, Missouri about the state of brain injury in his area. Pretty grim picture, to say the least. Missouri recently cut Medicaid funding to brain injury patients, making it even more difficult for them to find care in and out of state. Add to that complication that most brain injury rehabs throughout the midwest are at capacity, the treatment options for TBI are dwindling.

So what happens to TBI patients needing services? They do the familiar mental health facility shuffle. States seem more than happy to pay for inappropriate treatment! How would you like it if you went to the doctor for a broken leg and he sent you to a chiropractor to get your back adjusted? Sure, the chiropractor might help your back feel better, but you’ve got a more serious condition that needs attention. It’s the same situation with brain injury survivors in the mental health system.

Get involved with your local brain injury association and learn how you can help drive legislation that actually acts on behalf of TBI survivors, not against them.

Link to this post

November 11, 2005, 9:23 am

Arkansas CMSA Conference

This week found me at the Arkansas Case Management Society of America’s annual shindig for providers–the theme, as you may guess from the Pink Panther pic below, was Crime Scene Investigations. According to the national CMSA, “case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes.” Put in laymen’s terms, we case managers try to find services for people who need them, and we try to find ways to pay for the treatment.

Very few case managers work with problems above the neck, and even fewer work with brain injuries. Like every other resource for the brain-injured, there simply aren’t enough TBI case managers to go around. I spend the bulk of my office days responding to hordes of emails requesting help, but often begin with two recommendations:

–Go to the Brain Injury Association website and get informed.
–Go to nashia.org and find the Head Injury Administrator in your state.

When you start looking for help for brain injury treatment, it’s always a good idea to be as informed as possible to avoid running into dead ends and getting burned out. If you have any other good preliminary recommendations, feel free to email me and I’ll post your input here on the blog.

Link to this post

November 8, 2005, 12:12 pm

Going Backwards in TBI

Every so often, I come across news clips like the following:

” A provider of brain injury rehabilitation services is closing its South Portland center, blaming reductions in the state’s Medicaid program. The Maine Center for Integrated Rehabilitation said its clinic on John Roberts Road will shut its doors Friday. About 38 clients will be affected, said Scott Mayo, the company’s clinical director.”

One of the Gordian knots of brain injury funding involves Medicaid bureaucracy, and the news excerpt above hints at the kind of heartbreak millions of TBI survivors across the country must endure. Medicaid exists to provide services. If it doesn’t pay for services, then service providers dwindle and die. But if services are required, then Medicaid will send TBI survivors to another state to find healthcare–provided the TBI survivor has a) a serious advocate b)plenty of time and c)the right criteria to qualify for a nearby rehab. Medicaid is counting on the fact that TBI survivors aren’t able to make it through the process, so Medicaid ends up saving more dollars while removing services from some of the medically neediest people in our country.

I could rant for days about this, but you can take action. Go to www.nashia.org and find your state’s head injury administrator. Write or call to ask them how you can get involved in brain injury advocacy today.

Link to this post