April 26, 2007, 9:28 am

I Know You Won't Forget

Every so often, someone provides a resource in short supply. Square Circle Press has a forthcoming title called "I Know You Won't Forget," a children's book that deals with the difficult issue of a brain injured parent.

From the website:

The book was written by a group of TBI survivors from the Crotched Mountain Community Partnership Structured Day Program in Albany, NY. Conceived as part of a group therapy project, the book has given the clients a sense of pride and accomplishment which many mundane activities do not provide. The book's illustrator is also a TBI survivor, professional artist Carol Jordan.

Click here to read more.

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April 23, 2007, 2:05 pm

Military Still Unsure About Blast Effects

Today I received yet another call from a VA social worker looking for services in Oklahoma. She was complaining that a veteran in Oklahoma shouldn't be going all the way to Dallas for outpatient brain injury rehabilitation, but that the military offered no other solutions for her case. It's another sad demonstration of the complex social issues that arise from TBI.

In other recent news, a military doctor readily admits the cognitive complexities resulting from blast-related brain injuries:

Symptoms include short-term memory loss, faulty concentration, irritability, changed vision and headaches, among others. And problems vary from person to person. On top of that, brain injuries can be mistaken for other disorders such as post-traumatic stress disorder or substance abuse.

Technology can't yet clarify matters. Mild brain injuries rarely get detected on MRIs and other imaging tools."

Click here to read the full article.

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April 19, 2007, 8:07 am

Education and Prevetion

In 2006 a study regarding alcohol and marijuana use among 49,000 high school age young adults revealed that of the 12th grade group, 13% smoked marijuana in automobiles and 10% drank alcohol in automobiles. The results were similar for grades 11 and 10. Studies regarding marijuana demonstrate that the impairment from smoking marijuana is equivalent to the level of impairment associated with blood alcohol levels of 0.007% to 0.10%. At that level coordination, judgment and motor control will be very impaired. The effects of marijuana last up to 24 hours with the euphoric stage lasting 6 hours. This is longer than the alcohol high. The individuals in the study could not identify impairment associated with marijuana use beyond the euphoric state, however, they continued to have problems with coordination, judgment and motor control. In other words, they remained impaired long beyond the initial high. If they were drivers, they would be at a high risk for causing a motor vehicle accident and possibly causing a brain injury for themselves or others.

Brain injury prevention requires that we educate young adults about the effects of substance abuse. This study tells us that substance abuse occurs in motor vehicles where the risk for injury can be very high. We know that brain injury is highest among young adults, 16-24 years old. Why not be clear with our older adolescent and young adult children about the risks they face when they use drugs and alcohol. The place they choose to get high may be an additional risk factor which elevates their chance for a brain injury.

Source: Joffe, A, Journal Watch Pediatrics and Adolescent Medicine, April 11, 2007

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April 17, 2007, 7:02 am

Protect Your Brain, It's the Only One You'll Get

Children with a brain injury are at a greater risk of having a second brain injury. In a study from the University of Montreal, Dr. Bonnie Swaine followed 3599 young patients seen in emergency departments of two Montreal pediatric hospitals.Within six months, 2.4% of the children suffered a second brain injury and at twelve months 4.1% had a subsequent brain injury. The risk of a subsequent injury was 1.7 times higher for children who had a brain injury than children who had other injuries which brought them into the hospital for emergency care. As brain injury can produce a wide range of changes, even a mild injury can produce subtle deficits in coordination, balance or judgment which can increase the risk of a second injury.

Brain injury prevention cannot be overlooked for children. Appropriate safety restraints in cars, helmets for bike riding and skateboarding and parental care to reduce other risk factors are crucial to prevent the first injury and certainly reduce the odds for the second. With the Spring activities and return to active outdoor play, let's make it safe for our children.

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April 12, 2007, 1:50 pm

Vonnegut Dies of Brain Injury

During my recent trip to Iraq, I chose to bring along Kurt Vonnegut's Slaughterhouse Five as company through the endless airport terminal waits. I've read it periodically throughout my life, but it never seemed a more appropriate time than then. I was heading into a war zone, and about to witness a level of suffering I'd never imagined. While standing in the Balad Hospital hallways, watching dismembered bodies float between tents, I couldn't help but hear echoes of Vonnegut's tender and sharp prose in my head. Now, during a time when we need strong voices, one of our best has been silenced–and by TBI.

Vonnegut was 84, and recently took a fall that caused the brain injury that killed him. It's a story I hear several times a week, from family members of the elderly, and my line is always the same: there aren't any geriatric brain injury rehabs out there. Medicare won't cover your mother, and Medicaid won't find a place for your father. Your only option may be an Alzheimer's unit. It's become a regular problem in American healthcare, that we seem willing to put a tremendous amount of funding into emergency and trauma care, but we won't support the lives we fight so hard to sustain. Nobody knows this more than the brain injured elderly. So it goes.

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April 6, 2007, 2:10 pm

Problems Persist for Returning Vets

Last week, the New York Times reported that the military's medical tracking system, known as the Joint Patient Tracking Application, is replete with shortcomings:

"The Defense Department's inability to get all hospitals to use the system has routinely forced thousands of wounded soldiers to endure long waits for treatment, the officials said, and exposed others to needless testing."

Although the military's medical system of care is one of the most sophisticated systems, its own complexity may be complicating life for vets. There are reports of soldiers not receiving paychecks and receiving lab tests that may be more destructive than helpful. The military's difficult in treating brain injured troops should only serve to underscore the complexity of this injury, and the challenges that it poses for society.

Click here to read the NY Times article.

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April 4, 2007, 8:00 am

New Medications Trials for TBI related Seizures

Two drug trials offer promise in controlling seizures which occur in 25% of moderate and severe brain injuries with even higher numbers, approaching 50%, for war related injuries. Topamax and Keppra are being used as  prophylactic measures in these two studies to prevent  seizure disorders from developing.  Seizures can appear as cognitive or behavioral events in addition to what we commonly regard as a seizure involving the loss of consciousness and motor control. There are over 1.4 million people in the U.S. who experience a brain injury which creates a large number of people who are at risk for developing seizures. A seizure disorder may take months or sometimes years to develop, however the consequences for the person are significant and may be the cause of further disability which prevents a return to independence and work. The studies involving Topamax and Keppra offer hope to combating the inflammation which is caused by the release of cell harm chemicals and neurotoxic substances following the initial injury. The inflammatory process is believed to be the cause of seizures following a traumatic brain injury.  Emergency room procedures for traumatic brain injury can be expanded to include these medications if the studies support their effectiveness in preventing and reducing seizures. The drug trials involving these two drugs are taking place at the Children's National Medical Center, the Washington Hospital Center and at the University of Washington.

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