Why did I Fall?

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Posted on 9th August 2010 by Gordon Johnson in Uncategorized

From a reader:

Hi

I have read and enjoyed greatly the work on your website.

After suffering a TBI last year, I spent 5 months in a coma and the rest of the year in Addenbrookes hospital.

I have had a long and painful journey of recovery and still attend the hospital twice  a week now.

I have always loved poetry and now I really feel as though I have got something to share.

I don’t expect you will want my work for your site, but wonder if you know of any online groups where I can share my poems?

I attach one for you.

Many Thanks,

Scott

Scott Crawford

Market Manager – Parts and Accessories

Indesit Company UK Ltd

Morley Way, Peterborough, PE2 9JB

Mob. +44 (0) 7801 724315

E-mail: scott.crawford@indesit.com

Mob. +44 (0) 7801 724315

E-mail: scott.crawford@indesit.com

 

 

Why did I fall?

 

Why did I fall down the stairs that night?

Why did I never see heaven or a light?

Why did this have to happen at all to me?

Why could’nt fate lust leave me be?

 

After all the treatment and rehab and stuff

Why do I fell lucky and happy and tough?

How have I found peace in this hell of a mess?

Why do I fell lighter and suffer less stress?

 

I think I fell from more than the stairs that night.

I think I fell from blindness and now have sight.

I worry not about the stuff I left behind.

I worry not because I can be good and kind.

 

So despite of all the agony and pain I feel.

I savour every moment, for my life is real.

I long to find a friend that really understands.

I’d love to stop and talk a while, but I have plans…

Scott Crawford

Is There Nothing We Can Do for TBI Treatment?

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Posted on 6th August 2010 by Gordon Johnson in Uncategorized

Gordon Johnson,

In searching for information regarding concussion and head trauma, I found your site. You have a great deal of information on your site related to the subject which is why I decided to contact you. My brother spent several years boxing and was also a professional bull rider in the Southwest. He suffered several concussions from both sports and is suffering because of those injuries. While doctors tell him there is nothing they can do, we are hoping to find either a legitimate clinical trial he can participate in or the latest solutions to those suffering from the side effects of brain trauma. I’m not sure who would offer trustworthy and reliable information, but somehow I just felt that might be you and you might know of someone we can contact about a clinical trial or solution.

If you could put me in the right direction, I would greatly appreciate it. I thought a person of your caliber would have many resources. I appreciate your time and thank you in advance.

Name Withheld

 

On Tue, Aug 3, 2010 at 10:27 AM, Gordon Johnson <gordon@gordonjohnson.com> wrote:

I understand your frustration, feeling as if you have asked the most simple of questions yet no one is even acknowledging that a question was asked, moreover offering an answer.

While we  have a long successful history of treating the most severe symptoms of brain injury,  we have virtually no tract record with treating the more “mild” aspects.  Neurorehabilitation is aimed at returning the ability to speak, to walk, to remember on a very rudimentary level.  But to take the injured mind from a 75% recovery (what is called a satisfactory recovery) to a that of a fully functioning adult, we have no clue how to do that.  Almost all mild brain injury treatment programs fail and the more intensive they are, the more likely they are to fail.

We can improve memory skills, we can teach memory aids.  But we don’t seem to have any idea how to go from improving memory in the laboratory/classroom where there is only one task to do at a time, to materially improving memory in the real world, where distractions are the norm.  Our brains start with a substantial but finite ability to multi-task, much like your computer has a certain about of RAM, that allows it to multi-task. When the white matter of the brain is injured (and the amount of white matter injury is always exponentially greater than what can be seen on an MRI) this finite amount of capacity to multi-task is dramatically reduced.  Thoughts, impulses, nerve impulses are no longer able to take the efficient pathway through the brain and must find a work around.  That work around is slower and when little else is going on it may still work.  But when the brain is asked to do two or more things at once, it isn’t just that the work around isn’t keeping up with real time, it seems to be that the signals just can’t get through at all.  Hence, the mind crashes.

Likewise, we learn to become adults in our frontal lobes  through a generation long process of growing from childhood through adolescence into adulthood.  Trial and error, correction, rewards, punishments and the blooming of self actualization, all done upon an ever increasingly capable and developed brain.  Add damage to the frontal lobes to the white matter communication inefficiency in multi-tasking and suddenly mature, subtle and nuanced behavior is completely thrown out of balance.  It took a generation to create the wonderful mix of traits that become our personality – no neurorehabilitation training program is patient enough to rebuild that network.  And sadly, no adult regardless of how aware they may be of the injury they have suffered is willing to take even months of being corrected like a child.  To stay with the computer analogy, even if there was no hard wire damage, the rewriting the code of that adult behavior program takes too long, both for the resources society is willing to devote to the struggle and now hugely inpatient mind that needs to be rebuilt.

Clinical trials?  Keep searching, let me know what you find.  I know there are those working with neurofeedback who are claiming remarkable success, but I am concerned they are near chiropractor-like charlatans.  Some drugs do help with concentration, but I suspect there are aspects of those drugs that make other neurobehavioral issues more fragile.

The best advice is to start with the most thorough diagnostic tools and then understand that your brother must very cautiously step forward into a multi-tasking world that will demand more than he is prepared to give.  Speech and occupational therapy may help with the work arounds, the accomodations.  There are support groups through the Brain Injury Association, which can help him and you realize that he and you are not alone.  The goal for now has to be find accomodations for his disability and be cognizant of the long struggle ahead.

Attorney Gordon Johnson

PS. I would like your permission to post your question and my answer to a blog, with your name removed if you choose.

Gordon,

I really appreciate your timely and lengthy response. It really shows you read your emails and take each of them seriously. I would believe most attorneys have much time involved in their clients and would ignore such an email. Thank you so much for taking the time to read and respond to mine.

Can you remove the state as well as our names? If so, sure you can post my question.

I’d like more information about the support groups through the BIA. My brother has tried different avenues including drugs, doctors and even no drugs at all. He suffers from depression and sleep apnea, which in my research I have found those are possible symptoms of brain injuries. It has effected his life with his family as well as work. He had his hopes set on a clinical trial but I have been warned those can be very dangerous (he is married with children). He was hoping considering his level of injuries, a doctor would be interested in studying him or doing an MRI to help diagnose/treat his condition. I don’t know that such an option exists but we are praying it does.

I appreciate your help and concern of our situation.

Sincerely,

Name Withheld

Editor’s Note:

Information on the BIA support groups can be found at http://biausa.org and specific to each state at http://www.biausa.org/stateoffices.htm

My New York Colleague Says NFL Is ‘Disenguous” On Ex-Player Brain Injury And Disability Payments

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Posted on 1st August 2010 by Gordon Johnson in Uncategorized

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One of my traumatic brain injury colleagues in New York, attorney Michael Kaplen, called the National Football League to task for merely paying “lip service” to concerns about the long-term damage of concussions. 

http://www.nytimes.com/2010/08/01/sports/01inbox.html?_r=2

In a letter published July 31 by The New York Times, Kaplen cited a July 26 story that I blogged about, “NFL Asserts Greater Risk of Head Injury.” That was a story about the NFL getting to put up locker room signs warning players about the effects of concussions, one of the league’s first major admissions of the link between injuries on the field and dementia in later years.

 http://www.tbilaw.com/blog/2010/07/nfl-owns-up-to-long-term-dangers-of-concussions-in-new-locker-room-poster.html

Kaplen, chairman of the New York State Traumatic Brain Injury Services Coordinating Council, thinks the NFL is being “disengenous” by, on the one hand drafting the new warning poster, but still refusing to grant full disability to retired players who now have early-onset dementia, memory loss and cognitive problems. 

“The continuous refusal by the lawyers retained by the N.F.L. to accept the association between long-term disability and concussions exemplifies their disingenuous position when confronting the issue of brain damage,” Kaplen wrote to The Times’s sports editor. “It is implausible that these lawyers are acting without the full knowledge and approval of their client.”

Here is the rest of Kaplen’s letter:

“The league is now doing a better job of paying lip service to acknowledging the long-term disability associated with concussions. But it remains steadfast in its refusal to fulfill its fiduciary obligations under the disability retirement plan and adequately compensate those players who have sacrificed their brains and lives while the league owners have continued to reap the financial benefits.

It would be interesting to know what initiatives the league was undertaking to review the disability files of all those players who have been wrongfully denied brain-injury-associated disability payments, with their purported better understanding of traumatic brain injury.

It may be that the only way to obtain justice for these players is to require a truly independent review of these files or surrender the cloak of immunity behind which the league hides and consent to a full and fair court hearing.”

I couldn’t have said it better myself, Michael.

 

New York Met Jason Bay’s ‘Delayed’ Concussion Likely To Put Him On The DL

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Posted on 29th July 2010 by Gordon Johnson in Uncategorized

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The New York Mets aren’t taking any chances with the health of Jason Bay, who sustained a concussion — without knowing it — after running into an outfield wall trying to make a catch. It looks like Bay is going to wind up on the disabled list, the New York Post reported Thursday.

 http://www.nypost.com/p/blogs/metsblog/mets_bay_rests_again_with_concussion_OAqLV4OOypHUe2ihokZk2O

Update: Bay was in fact put on the DL Friday, for 15 days.

http://www.nj.com/mets/index.ssf/2010/07/mets_outfielder_jason_bay_land.html

The left fielder’s case is a good example of why thorough testing and examinations — such as are available now — should be performed to determine the severity of a head injury. That’s a lesson all should have learned from the death last year of actress Natasha Richardson.

Bay ran into the wall last Friday night while playing in Los Angeles, catching a fly ball and holding onto it. But he didn’t start getting any of the symptoms of a concussion, namely a dull headache, until Sunday night, when he was flying home from the road trip to the City of Angels, according to The New York Times.

http://www.nytimes.com/2010/07/28/sports/baseball/28citifield.html?_r=1&ref=sports

Bay apparently mentioned his headaches to his trainers on the plane, but that bit of important news didn’t make its way to Mets manager Jerry Manuel until Tuesday. That was after Bay had gone to a doctor, right before the Mets were ready to play the St. Louis Cardinals at Citi Field.

Manuel pulled Bay out of Tuesday’s lineup, and the $66 million-contract player had not been feeling much better the past few days.

Bay said that this was his first concussion, and that his doctor suggested he might actually have “more of a whiplash,” according to The Times. 

“He said the doctor told him it was uncommon for someone to have delayed symptoms with a concussion,” The Times wrote. 

This is yet another case that doctors need to do a careful evaluation of those who suffer brain injury, particualry those involving symptoms such as amnesia and neurobehaviorial changes.

Ohio Boy Hit In Head By Line Drive Continues To Make Progress

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Posted on 28th July 2010 by Gordon Johnson in Uncategorized

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Many people who sustain traumatic brain injury make tremendous strides. The human spirit can defy expectations, or the lack of them, as has been the case with young Luke Holko.

On Sept. 2, 2009 Luke was being held by his dad, Chad Holko, watching a minor league baseball game in Niles, Ohio. The Mahoning Valley Scrappers were playing, and 5-year-old Luke and his father were in the front row, by first base, according to a moving story by Fanhouse.com.

http://www.fanhouse.com/2010/07/26/major-gains-for-boy-hit-by-ball-at-minor-league-game/?ncid=webmail

You probably have already figured out what I’m about to tell you. Luke got hit full force in the back of his head by a line drive off the bat of player Ben Carlson. According to Fanhouse, Luke’s cerebellum hit his brain stem from the force of the blow. Doctors put Luke in an induced coma for two days.

He was treated at Akron Children’s Hospital for about a month, and then was transferred to the Cleveland Clinic’s children’s rehab center. He was sent back to the Akron hospital Oct. 30 and finally came home, in a small wheelchair, on Nov. 5, according to Fanhouse.

Physicians didn’t want to give Luke’s father and mother Nicole any long-term prognosis for him. Like many traumatic brain injury patients, Luke had to relearn many tasks, such as how to talk again and how to swallow. His hearing may be returning. He has made a lot of progress since being near-death. 

He went from a wheelchair to a walker in mid-January, and starting walking on his own in May.

Luke’s walking is still not steady. He is off balance, because his brain isn’t sending the proper signals to the nerves in his right leg. He has to get four botox injections every few months in his calf-muscle, according to Fanhouse.  

Carlson, the player whose line drive smashed into Luke’s head, came to visit the boy. They spent about four hours playing together, and had a great time, Fanhouse said, adding that Luke cried when Carlson left.

Here’s wishing that Luke’s progress will continue.

New York Cop Survives,Tries To Move On After Brain Injury From Accident

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Posted on 24th July 2010 by Gordon Johnson in Uncategorized

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Carlos Olmedo, a police officer in Brooklyn, has had an almost miraculous recovery from a horrendous accident that left him with traumatic brain injury in May.

Olmedo, 31, was chasing down several suspected car thieves in Bensonhurst in the early morning May 16 when he was hit by a motorcycle, according to a profile of him Friday in the New York Daily News.

http://www.nydailynews.com/news/ny_crime/2010/07/23/2010-07-23_injured_hero_cop_is_welcomed_home.html

 The young cop says he was thrown 40 feet in the air and landed on his left side. He sustained severe brain injury and was in a coma for 11 days, clinging to life. When Almedo finally regained consciousness, he learned the seriousness of his injury and understood that his recovery would not be easy. At first, he didn’t even remember his infant son.

According to the News, Almedo prayed for a miracle. He was in the hospital for 2 1/2 months, and has made steady progress.

At this point the police officer has undergone brain surgery, and has a dent in the left side of his head “the size of a fist,” according to the News. Physicians have grafted part of his skull bone onto his stomach, and they will reattach that piece of bone to Omedo’s skull this month. 

The police officer, who also had his ankle crushed in the accident, isn’t back to his old self, but is happy to be alive. Olmedo has some memory loss and his speech is slurred a bit, The News reported.  

 The cop returned to his old stationhouse last Thursday, about two months after his near-fatal accident, where he was greeted by his collegues and New York City Police Commissioner Ray Kelly. It was a hero’s welcome. 

 

Actress Melissa Cunningham Sustains Brain Hemorrhage At VH1′s ‘Celebrity Rehab’

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Posted on 22nd July 2010 by Gordon Johnson in Uncategorized

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Actress Melissa Cunningham, who was seeking treatment from Dr. Drew Pinsky of VH1′s “Celebrity Rehab,” suffered a brain hemorrhage and was hospitalized this week. But she is now out of the hospital.

http://www.popeater.com/2010/07/22/melissa-cunningham-brain-hemorrhage-jeremy-london/?icid=main|main|dl2|link4|http%3A%2F%2Fwww.popeater.com%2F2010%2F07%2F22%2Fmelissa-cunningham-brain-hemorrhage-jeremy-london%2F

Cunningham is in the process of getting a divorce from troubled actor Jeremy London, and they are both appearing on Dr. Pinsky’s VH1 reality  TV show. 

Cunningham came to Dr. Pinsky’s Pasadena Recovery Center in California last Wednesday for help kicking a prescription pill addiction. London checked into the same rehab center on Sunday.

Cunningham, who was having a difficult time with drug withdrawal, got sick and was taken to the hospital Sunday, the day her husband arrived. She was diagnosed with a brain hemorrhage.

 Radar Online reported that Cunningham has already returned to rehab. She and London were married in 2006, and have a child together. But they are splitting up and getting  a divorce.

London, a substance abuser, has been in the news recently. Last month he alleged, rather conveniently, that he was kidnapped by men who at gunpoint  made  him take methamphetamine and esctasy for 12 hours.    

Baseball Player, Beaned By 93-MPH Ball, Sues MLB, Helmet Maker

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Posted on 21st July 2010 by Gordon Johnson in Uncategorized

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An up-and-coming baseball player who was hit in the head with a 93-mph fastball has filed suit against Major League Baseball and his helmet’s manufacturer, according to the New York Post. As in many traumatic brain injury cases, it’s a tragic story.  

http://www.nypost.com/p/news/national/player_beans_helmet_firm_with_lawsuit_8YjjJoLtJcAhAzFO1yNROP

Jordan Wolf , 25, was playing for the Baltimore Orioles Class A farm team when the accident took place. In 2008 Wolf was beaned in the head. He suffered a skull fracture that went from his ear to the top of his cranium, according to the Post. 

The young player with lots of promise got a brain hemorrhage. He can no longer speak and his has no feeling on the right side of his body. His baseball career is over.

In addition, Wolf has now been diagnosed with epilepsy and has had a number of seizures, the Post wrote.

In his suit, filed in federal court in Manhattan, Wolf is asking for unspecified damages from Rawlings sporting goods and MLB. He alleges that they failed to make sure he had enough protection while he was playing.

 

 

New Jersey Mother, Whose Veteran Son Killed Himself, Outlines What VA Must Do To End Suicides

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Posted on 18th July 2010 by Gordon Johnson in Uncategorized

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 Last week  a New Jersey woman named Linda Bean trekked to the nation’s capitol to testify about her son’s suicide two years ago. Army Sgt. Coleman Bean, 26, killed himself after coming back to the states following two tours of duty in Iraq.

 Bean puts the blame for her son’s death squarely on the Department of Veterans Affairs. The VA is not accommodating to vets, she charged, endlessly delaying appointments with her own son, for example. 

Bean was brief, but powerful, in her five minutes of testimony last Wednesday to the House Subcommittee on Oversight and Investigations, getting a standing ovation, according to The Star-Ledger of Newark.

http://www.nj.com/news/index.ssf/2010/07/nj_mother_of_veteran_who_kille.html

“There are veterans who will tell you that they have had to scrap and right for every VA service they’ve received,” Bean told the subcommittee, The Ledger reported.

She also spoke of the difficulties of using the VA’s website to garner information and get help.

 I’ve been following the topic of soldier suicides because of the enormous number of American troops who are coming home from Iraq and Afghanistan with brain injury, “shell shock”  if you will.  Our soldiers are not just suffering from post-traumatic stress disorder, they are suffering from brain injury — subtle or traumatic — and one of its typical after effects, depression. 

You might not think to link brain injury and depression, but I can tell you that many of my brain-injury clients become clinically depressed. So suicide is always a concern of mine. And the VA has been aware of the suicide issue with veterans of Iraq and Afghanistan, and been trying to address it, as long ago as 2007.

http://veterans.house.gov/Media/File/110/12-12-07fc/12-12-07fcqfrvaresponse.htm

Right now veterans and service members comprise about 20 percent of the 30,000 U.S. suicides each year, The Ledger reported, citing VA statistics. That translated to 334 active-duty service members killing themselves last year.  

Bean’s son committed suicide two years ago, and in all fairness to the VA , it really has stepped up its assistance to vets since then. As part of an improved outreach program, the VA established a suicide hotline for soldiers. That 800-number has fielded more than 300,000 phone calls and saved 10,000, The Ledger reported.

And the VA just last weak eased its requirements for veterans to received disability payments for PTSD. We will be blogging more about that topic soon.

 But even as the military has tried to help returning veterans, it seems that those efforts are failing. The suicides continue, and some of the Army programs meant to help veterans have come under fire.

 For example, The New York Times recently did an expose of the Army’s Warrior Transition Battalian units, which were set up stateside to help veterans who had suffered serious physical and psychological damage in combat.

http://waiting.com/blog/2010/04/army-trauma-units-are-%e2%80%98worse-than-iraq%e2%80%99-one-solider-charges.html?preview=true&preview_id=386&preview_nonce=2862b2d308

The Times reported that the veterans in these units are essentially being warehoused, not getting counseling and being tormented by those who watch over them. One vet called the transition units worse than Iraq. That doesn’t sound like a set-up that will make a veteran happy to be home. It sounds like a situation that might make a veteran put a gun to his or her head.

And the military appears to be putting its head in the sand in terms of determining which returning veterans sustained brain damage during their tours of duty. U.S. Today recently reported that the military has failed to comply with a directive that they test soldiers before and after they are in combat for brain injury.

http://waiting.com/blog/2010/06/611.html

If the military knows a soldier has brain injury, it can give him or her psychological help, or medications, to ensure he or she don’t get depressed and take their own lives. 

Bean made some sound recommendations to the VA, including suggesting that it establish a group of veterans within the agency to help those just coming home navigate the system’s bureaucracy and red tape. And these veterans can act as a support group for returning troops trying to acclimate themselves to life in the states again.

She also recommended that the VA work more closely with civilian counseling organizations. But the VA doesn’t seem very interested in working with people outside the agency.

For example, the new VA guidelines for PTSD disability mandate that a military doctor, not a civilan physician, certify that a veteran qualifies for benefits. Veterans’ group have criticized that provision in the new disability directive. 

http://waiting.com/blog/2010/07/veterans-not-satisfied-with-new-regulation-on-ptsd-and-collecting-disability-benefits.html?preview=true&preview_id=734&preview_nonce=4b79cc5dc8

Veterans Not Satisfied With New Regulation On PTSD And Collecting Disability Benefits

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Posted on 13th July 2010 by Gordon Johnson in Uncategorized

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The government’s new rule regarding disability benefits for veterans for post-traumatic stress disorder are an improvement but still don’t go far enough, according to veterans’ groups. 

http://www.nytimes.com/2010/07/13/us/13vets.html?scp=1&sq=veterans%20and%20mental%20health&st=cse

The new regulation says that veterans no longer have to document a specfice event, like a particular bomb blast, as the cause of them developing PTSD. Such evidence is often hard, if not impossible, to track down, according to The New York Times.

President Obama even referenced the new regulation on his radio show this weekend, saying, “I don’t think our troops on the battlefield should have to take notes to keep for a claims application.”

While veterans groups were happy about the change in the rule, they still voiced criticism about it. They are concerned about a clause that says the final say on whether a vet’s PTSD is a result of their military service can only be made by a doctor or psychologist that works for the Department of Veterans Affairs.

The veterans believe that private doctors should be allowed to make that determination, too. Such physicians have often been treating a vet and are familiary with his or her issues and background, the veterans groups argue.

The veterans affairs department argues that there will be more consistency in the exams if they are done by doctors working for the government, and that these physicians will be ablet to pick out “malingerers.”

Groups such as the National Organization of Veterans Advocates fear that government doctors will reject legitimate PTSD claims from veterans.

The veteran affairs department held a press conference on the new regulation regarding PTSD and disability payments on Monday. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1922

Officials denied that government doctors would be less likely to find that a veteran’s PTSD was due to their military service.