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

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