San Francisco Giants Fan Sustains Brain Damage After Beating By Dodgers Boosters


Posted on 9th April 2011 by Gordon Johnson in Uncategorized

, , ,

Modern sports tap into our tribal instincts. When your hometown team wins, your clan has won, has survived. Sports access deep, primitive, powerful emotions.

But that is no excuse to beat up a fan of a rival team.

Yet that is exacty what happened March 31 in a horrendous incident at Dodger Stadium in Los Angeles. During the season opener between the Dodgers and their archrivals, the San Francisco Giants, a Giants  fan dressed in that team’s “regalia” was attacked by two animalistic Dodgers’ fans.

The victim, 42-year-old Bryan Stow of Santa Cruz, Calif., sustained serious brain damage and was put in a medically induced coma by doctors. Published reports said doctors had performed surgery to remove part of Stow’s skull to relieve the pressure on his brain, which had swollen from his injuries.

The two sports savages that attacked Stow, a father of two, escaped. Authorities are offering a $100,000 award for any information about the attackers.

Let’s hope these two cowards, who reportedly attacked Stow from behind, are identified, apprehended, charged and convicted. 

And while they are in prison, we hope they are surrounded by Giants fans.   

Sports Writer Frank Deford Offers His Analysis Of Cincinnati Bengal Chris Henry’s Brain Damage


Posted on 7th July 2010 by Gordon Johnson in Uncategorized

, , , , , , , ,

Veteran sports writer Frank Deford takes up the story of Chris Henry, the deceased Cincinnati Bengal player who was found to have sustained brain damage, in a story for NPR Wednesday.

Deford poses an interesting question: Are some athletes more susceptible to brain damage than others?

And he talks about efforts to find a way to determine if someone has a predisposition to brain damage.

I’ve written in-depth about the significance of Henry’s case, and Deford goes over it as well. Henry died several months ago after falling off the back of a pick-up truck. Apart from the injury from his fall, an autopsy determined that Henry  had CTE, chronic traumatic encephalopathy, which is essentially brain trauma.

Right now CTE can only be positively diagnosed by an autopsy, “in the brain tissue of cadavers,” as Deford puts it. So far 22 deceased ex-National Football League players have been found to have suffered from CTE,  he notes.

Henry’s case is a landmark because his death occurred while he was still in the prime of his career (had he not had all of the behavioral issues) and he never even sustained any documented concussions.

Deford writes about efforts to find a test that will detect CTE in the brains of the living. Lisa McHale, the widow of deceased NFL player Tom McHale, and McHale’s friend Jim Joyce are pushing for that.

McHale, suffering from depression and self-medicating with drugs, died of an overdose when he was just 45. His widow  Lisa blames his problems on brain damage he sustained while playing pro ball.

Joyce, himself an ex-player, is chairman of Aethlon Medical in San Diego. Joyce is doing research to determine if there are biomarkers that could be used to find those with a predisposition to CTE, according to Deford.

The question is asked could such a test convince parents to steer their kids away from sports like football and soccer if in fact they do have a predisposition to CTE.

The concern I have as I hear the chorus about CTE from more and more voices is that they seem to confuse the issue.  The issue is not whether there is an after death marker of brain injury, CTE, but whether there has been brain injury.  We can’t find a test for CTE because it is a particular thing that is only found on autopsy.  While we can’t find a litmus test for brain injury, experienced doctors can make the diagnosis with the proper consideration of all of the medical evidence, including the story of the life of the injured person.

Chris Henry’s life told such a story.  The tragedy is that no one ever listened to it in context that he was an athlete, playing a violent game.



More Than 1,000 Disabled in N.J. Could Lose Benefits From Cash-Strapped Traumatic Brain Injury Fund


Posted on 20th February 2010 by Gordon Johnson in Uncategorized

, , , ,

Roughly 1,300 disabled people in New Jersey could lose treatment and services because of budget cuts impacting the state’s Traumatic Brain Injury Fund.

A New Jersey Assembly committee met Thursday to talk about possible ways to raise more money for the fund. In order to keep within the fund’s yearly $3.4 million budget, some officials have recommended that the fund only serve those who sustained a blow to the head, not those who suffered brain injury from a stroke, tumor or other type of trauma.

If that change were made, 60 percent of the 2,000 people who now get services from the program would be ineligible for it.

One of the solutions being considered is raising the 50-cent surcharge on car registrations that funds the program now.

Recipients who would be cut off from the Traumatic Brain Injury Fund are understandingly upset, as described in this well-done human interest story by The Star-Ledger of Newark, N.J.

The story talks about the case of Michael Jankowsky of Toms River, who got stabbed in the heart trying to protect a friend 25 years ago. His brain didn’t get oxygen, and he suffered brain damage. He needs constant care, at age 45.

“He uses a wheelchair, slurs his speech, and struggles to concentrate,” The Ledger writes. “He has made progress over the past few years, his mother says, thanks to New Jersey’s Traumatic Brain Injury Fund, which paid for speech therapy and other treatments not covered by insurance.”

The story goes on, “That could end soon. The Brain Injury Fund is going broke, and the state wants to limit whom it helps to people whose brain damage came from a direct blow to the head.”

This is absurd. The issue is whether the brain is injured, not what mechanism of injury caused it. Some of the most serious of brain injuries don’t involve any blow to the head and as high as 50% of concussions do as well. See for more on the mechanical forces which cause brain injury.

Vegetative Patients Display Consciousness, Ability To Communicate, New Study Finds


Posted on 4th February 2010 by Gordon Johnson in Uncategorized

, , , ,

A groundbreaking study, raising troubling medical ethics issues, has found that patients in a vegetative state showed signs of brain activity, indicating not only consciousness but even the ability to communicate.

The study, published online Wednesday by The New England Journal of Medicine,, created an immediate debate about how serious head injuries should be treated, as well as the ethical issue of whether attempts should be made to ask comatose patients what kind of care they want.

In other words, should vegetative patients, once considered unresponsive, now be asked whether they want to live or die?

In the study, 54 patients with vegetative brain injury in England and Belgium were assessed with functional magnetic resonance imaging (MRI), to determine if they could respond to two established imagery tasks. And an additional technique was developed to determine “whether such tasks could be used to communicate yes-or-no answers to simple questions,” according to The New England Journal.

Five patients (five of whom were diagnosed with traumatic brain injury, and four diagnosed as being in a vegetative state) were “willfully able to modulate their brain activity,” the Journal said, “In three of these patients, additional bedside testing revealed some signs of awareness, but in the other two patients, no voluntary behavior could be detected by means of clinical assessment.”

Imaging tests involving one woman showed she had brain activity, in her motor cortex, when she was asked to think about playing tennis, the study found.

One patient was able to answer yes or no questions during the MRI, “however, it remained impossible to establish any form or communications at bedside,” according to the New England Journal article.

The study’s conclusion was that “these results show that a small proportion of patients in a vegetative or minimally conscious state have brain activation reflecting some awareness and cognition. Careful clinical examination will result in reclassification of the state of consciousness in some of these patients. This technique may be useful in establishing basic communication with patients who appear to be unresponsive.”

The study had two goals: The first was to determine whether patients in a vegetative or minimally conscious state retain the capacity for a purposeful response to stimulation, however inconsistent. “Such a capacity, which suggests at least partial awareness, distinguishes minimally conscious patients from those in a vegetative state and therefore has implications for subsequent care and rehabilitation, as well as for legal and ethical decision making,” the New England Journal article said.
The second goal of the study was “to harness and nurture any available response, through intervention, into a form of reproducible communication, however rudimentary. The acquisition of any interactive and functional verbal or nonverbal method of communication is an important milestone. Clinically, consistent and repeatable communication demarcates the upper boundary of a minimally conscious state.”

In introducing the study’s findings, the New England Journal said, “ In recent years, improvements in intensive care have led to an increase in the number of patients who survive severe brain injury. Although some of these patients go on to have a good recovery, others awaken from the acute comatose state but do not show any signs of awareness. If repeated examinations yield no evidence of a sustained, reproducible, purposeful, or voluntary behavioral response to visual, auditory, tactile, or noxious stimuli, a diagnosis of a vegetative state — or “wakefulness without awareness” — is made. Some patients remain in a vegetative state permanently. Others eventually show inconsistent but reproducible signs of awareness, including the ability to follow commands, but they remain unable to communicate interactively.”

That term “minimally conscious state” was used in 2002 by the Aspen Neurobehavioral Conference Work Group to describe the condition of these kinds of patients, “thereby adding a new clinical entity to the spectrum of disorders of consciousness,” the article says.

One of the five patients that showed brain activity, the study found “had the ability to apply the imagery technique in order to answer simple yes-or-no questions accurately. Before the scanning was performed, the patient had undergone repeated evaluations indicating that he was in a vegetative state…the functional MRI approach allowed the patient to establish functional and interactive communication.”

The article went on, “Indeed, for five of the six questions, the patient had a reliable neural response and was able to provide the correct answer with 100% accuracy. For the remaining question — the last question of the imaging session — the lack of activity within the regions of interest precluded any analysis of the results. Whether the patient fell asleep during this question, did not hear it, simply elected not to answer it, or lost consciousness cannot be determined. Although the functional MRI data provided clear evidence that the patient was aware and able to communicate, it is not known whether either ability was available during earlier evaluations.”

The study received wide coverage in the press, with a Page One story in The New York Times
and The Star-Ledger of Newark, which ran The Washington Post’s story on the surprising study results,

The Wall Street Journal, Los Angeles Times,0,4078396.story
and the Associated Press also did coverage of the study.

The New York Times wrote, “The experts agreed that the new study exposed the limits of the current bedside test for diagnosing mental state: checking whether patients’ eyes can track objects, and carefully looking for any signs – eye blinks, finger twitches – in response to questions or commands.”

Veterans With PTSD Win Review of Their Rejected Benefit Claims


Posted on 31st January 2010 by Gordon Johnson in Uncategorized

, , , , ,

Veterans of the wars in Iraq and Afghanistan, whose claims for benefits based on post-traumatic stress disorder (PTSD) were rejected, will have another chance to get relief. For the full story, see

The military has agreed to do an expedited review of the claims due to a judge’s order, which stemmed from a class-action lawsuit filed by seven combat veterans who were discharged for PTSD. Those vets claim they were illegally denied health care and other benefits that they were entitled to with their disability.

One of the original plaintiffs was ex-Army Sgt. Juan Perez, who suffers from PTSD and has problems with migraines and his eye resulting from a head injury he sustained during two tours in Iraq.

The Pentagon mandates that soldiers who leave the military due at least in part to PTSD must receive a disability rating of at least 50 percent to get full benefits, according to the National Veteran Legal Services Group.

But roughly 4,300 former soldiers earned ratings of less than 50 percent, so they were denied benefits. Those veterans will soon receive legal notice that they will be able to have an expedited review of their cases by the military, and that they can “opt in” to a class action lawsuit involving the matter.

The seven ex-soldiers who started the class action suit had disability ratings of 10 percent or less.

After the new review, former soldiers who get ratings of 30 percent or more will become eligible for benefits, according to The New York Times.
Those applications can be found at

Lawyers for the veterans expect that the reviews will result in ex-soldiers getting millions of dollars.

The higher disability rating will translate to lifelong monthly disability payments, and free health care for the veteran, his or her spouse and their minor children.

Post Concussion Syndrome – Diagnosing and Treating for All Risk Factors

1 comment

Posted on 4th January 2010 by Gordon Johnson in Uncategorized

, , , , , , , ,

I said this last week on my Justice and American Politics blog,
In the days after a concussion, the brain is trying mightily to rewire itself to deal with the new challenges. That rewiring is not always positive. Add panic or emotional distress and the plasticity that we all hope will avoid negative consequences, can rewire the brain in the wrong ways. I call this “negative plasticity” and I believe it is one of the strongest arguments for better and more thorough diagnosis and follow-up for concussion.
To answer that question one must first define the term “plasticity.” I found a great definition of it at:

Brain plasticity refers to the brain’s lifelong capacity for physical and functional change; it is this capacity that enables experience to induce learning throughout life. Research in this field has demonstrated that the adult brain continuously adapts to disproportionately represent relevant sensory stimuli and behavioral outputs with well coordinated populations of neurons. This adaptation is achieved by engaging competitive processes in brain networks that refine the selective representations of sensory inputs or motor actions, typically resulting in increased strengths of cortical resources devoted to, and enhanced representational fidelity of, the learned stimulus or behavior.

In severe brain injury lingo, plasticity is the capacity of one part of brain to take on the function of a part of the brain which is damaged. But as the brain has the capacity to rewire itself in positive ways, so can it in negative ways.

As long as I have been doing Post Concussion Syndrome cases, I have been asking myself this question: Why is there this significant subset of people who have such bad results from an injury that the majority of people have apparent full recoveries, within days if not hours? This small minority of people that fall into the symptomatic category have been referred to most often as either the “miserable minority” (Ron Ruff, neuropsychologist) or as suffering from the Persistent Post Concussive Syndrome. “PPCS” (Michael Alexander, M.D. , Neurology, 1995). That “miserable minority” of people consistently make up between 5 and 15% of those who suffer a concussion or mild traumatic brain injury. What explains this divergent outcome for this PPCS group?

I believe there are a number of issues. First, some of them have far more than a “simple concussion.” This portion have fairly serious brain injuries but because the symptoms of those concussions occurred when they were not being monitored by medical professionals, the severity of the brain injury is grossly underrated.

Second, some of them have other neurological injuries, which again, went misdiagnosed. The most common among this group are those with vestibular disorders. See Symptoms of dizziness, balance and vertigo can put significant demands upon the brains attentional resources and account for many of the cognitive and emotional complaints associated with the post concussion syndrome. In my career, I have found nearly a 50% incidence of vestibular disorder among my clients.

Third, there may be an artery dissection that happened contemporaneously with the head injury or as a result of treatment for the head injury, particularly from a chiropractor. Artery dissections can cause a stroke, with resultant moderate to severe brain damage.

Fourth, the brain injured person may be emotionally more vulnerable than the 85 to 90% of those who have good recoveries. This is likely the most significant factor and is the area where my term of “negative plasticity” comes into play. While the evidence of this particular component of concussion pathology is incomplete, I believe that as we learn more about the limbic system and the axonal connections between it and the lower frontal lobes, the emotional component of concussion recovery will become a huge field of discovery and potentially treatment.

What is the reason this is important in a week when a football coach gets fired for locking an athlete with a concussion up in a dark place? There is a major overlap between PTSD and the post concussion syndrome. After all, both are “all in the head”. “All in the head” means it is in the brain. There is not a bright line of demarcation between emotional injury and organic or “hard wire” injury in the brain. In all likelihood, there is no line at all. If you damage a person’s emotional center, regardless of whether you do so by direct trauma or via emotional rewiring, the hard wiring change is the same.

Concussion survivors need the best treatment, not just to protect them from repeat trauma’s, but also to protect the vulnerable brain from negative rewiring. A concussion in its infancy can become a life long disability if the vulnerable brain is neglected or abused. We worry about “shaken baby syndrome”. We should also worry about the neglected emotional state of all brains that are injured.

Health Care Reform Now Awaits Reconciliation


Posted on 27th December 2009 by Gordon Johnson in Uncategorized

, , , , , ,

The New York Times is the world’s best newspaper. I learned that in Journalism school almost 40 years ago. It is still true today. Like all newspapers, it is at risk of failure because of the revolutionary shift in advertising revenues caused by the rise in the internet. I never subscribed to the New York Times, because I was a Midwesterner and it just didn’t seem practical. Well the NY Times is now part of my daily reading, because they have perhaps the best online newspaper: I sure hopes the webpage helps the newspaper survive.

I was newly impressed with the NY Times this morning when I read their analysis of the two health care proposals in our Congress, the House version and the Senate version. I think it is a must read for anyone concerned about the health care debate, or about the health of brain injured people. That article is here: If you are required to register to get to this page, by all means, register. In fact, make the your home page, I did.

This article has the most comprehensive explanation of the two bills in Congress and a simple and reasoned explanation of which aspects of each bill should be retained. We hope that our Senators are capable of seeing the big picture and allowing small compromises to get this historic legislation passed. We hope our progressive colleagues in the House don’t blow up the coalition on Health Care Reform over a liberal agenda that can wait for another day.

Read the details. This comes under the category of things you need to know as a citizen.

White House putting off budget update


Posted on 20th July 2009 by Gordon Johnson in Uncategorized

, , , , ,

Healthcare reform, Wallstreet’s collapse and rebirth, unemployment and huge deficits. A hell of a time to finally get the kind of leader this country has needed for a decade. Money and American politics, money in American politics should be on center stage this summer. But it has been a big news cycle of deaths and so far from any upcoming election that only the wonks really seem to notice.

Here are the facts: our economy is in decline and unless we can find ways in which to generate greater economic activity at home, we are going to continue to fall further and further behind. 10% unemployment isn’t a surprise, unless you really believed what the politicians were saying (even Obama) when things looked the darkest. Wall Street can recover, but that doesn’t mean the American economy will recovery. Most of Wall Street’s numbers are based on trading, not production and what production these American companies are doing is overseas.

Regardless of how deep of a hole it seems to put us in we must have economic stimulus from the Federal Government. The complex issue is how we turn that stimulus not only into short term American jobs, but into making the American economy stronger, more competitive, greener. It seems such a logical thing to combine Obama’s idealism on these green issues with the economic needs of our country. But economic planning is complex and thwarted at every turn by special interests.

Time for true leadership in Washington and lets start by telling the truth.

Attorney Gordon Johnson

Date: 7/20/2009 10:08 AM

TOM RAUM,Associated Press Writer

WASHINGTON (AP) — The White House is being forced to acknowledge the wide gap between its once-upbeat predictions about the economy and today’s bleak landscape.

The administration’s annual midsummer budget update is sure to show higher deficits and unemployment and slower growth than projected in President Barack Obama’s budget in February and update in May, and that could complicate his efforts to get his signature health care and global-warming proposals through Congress.

The release of the update — usually scheduled for mid-July — has been put off until the middle of next month, giving rise to speculation the White House is delaying the bad news at least until Congress leaves town on its August 7 summer recess.

The administration is pressing for votes before then on its $1 trillion health care initiative, which lawmakers are arguing over how to finance.

The White House budget director, Peter Orszag, said on Sunday that the administration believes the “chances are high” of getting a health care bill by then. But new analyses showing runaway costs are jeopardizing Senate passage.

“Instead of a dream, this routine report could be a nightmare,” Tony Fratto, a former Treasury Department official and White House spokesman under President George W. Bush, said of the delayed budget update. “There are some things that can’t be escaped.”

The administration earlier this year predicted that unemployment would peak at about 9 percent without a big stimulus package and 8 percent with one. Congress did pass a $787 billion two-year stimulus measure, yet unemployment soared to 9.5 percent in June and appears headed for double digits.

Obama’s current forecast anticipates 3.2 percent growth next year, then 4 percent or higher growth from 2011 to 2013. Private forecasts are less optimistic, especially for next year.

Any downward revision in growth or revenue projections would mean that budget deficits would be far higher than the administration is now suggesting.

Setting the stage for bleaker projections, Vice President Joe Biden recently conceded, “We misread how bad the economy was” in January. Obama modified that by suggesting the White House had “incomplete” information.

The new budget update comes as the public and members of Congress are becoming increasingly anxious over Obama’s economic policies.

A Washington Post-ABC News survey released Monday shows approval of Obama’s handling of health-care reform slipping below 50 percent for the first time. The poll also found support eroding on how Obama is dealing with other issues that are important to Americans right now — the economy, unemployment and the swelling budget deficit.

The Democratic-controlled Congress is reeling from last week’s testimony by the head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, that the main health care proposals Congress is considering would not reduce costs — as Obama has insisted — but “significantly expand” the federal financial responsibility for health care.

That gave ammunition to Republican critics of the bill.

Citing the CBO testimony, House Minority Leader John Boehner, R-Ohio, on Monday accused Democrats of “burying this budget update until after Congress leaves town next month.” He called the budget-update postponment “an attempt to hide a record-breaking deficit as Democratic leaders break arms to rush through a government takeover of health care.”

Late last week, Obama vowed anew that “health insurance reform cannot add to our deficit over the next decade and I mean it.”

The nation’s debt — the total of accumulated annual budget deficits — now stands at $11.6 trillion. In the scheme of things, that’s more important than talking about the “deficit,” which only looks at a one-year slice of bookkeeping and totally ignores previous indebtedness that is still outstanding.

Even so, the administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may actually top $2 trillion.

The administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may top $2 trillion.

If a higher deficit and lower growth numbers are not part of the administration’s budget update, that will lead to charges that the White House is manipulating its figures to offer too rosy an outlook — the same criticism leveled at previous administrations.

The midsession review by the White House’s Office of Management and Budget will likely reflect weaker numbers. But where is it?

White House officials say it is now expected in mid-August. They blame the delay on the fact that this is a transition year between presidencies and note that Obama didn’t release his full budget until early May — instead of the first week in February, when he put out just an outline.

Still, the update mainly involves plugging in changes in economic indicators, not revising program-by-program details. And indicators such as unemployment and gross domestic product changes have been public knowledge for some time.

Standard & Poor’s chief economist David Wyss said part of the problem with the administration’s earlier numbers is that “they were just stale,” essentially put together by budget number-crunchers at the end of last year, before the sharp drop in the economy.

Wyss, like many other economists, says he expects the recession to last at least until September or October. “We’re looking for basically a zero second half (of 2009). And then sluggish recovery,” he said.

Orszag, making the rounds of Sunday talk shows, insisted the economy at the end of last year, which the White House used for its optimistic budget forecasts, “was weaker at that time than anyone anticipated.” He cited a “sense of free fall” not fully recognized at the time.

“It’s going to take time to work our way out of it,” the White House budget director told “Fox News Sunday.”

Even as it prepares to put larger deficit and smaller growth figures into its official forecast, the administration is looking for signs of improvement.

“If we were at the brink of catastrophe at the beginning of the year, we have walked some substantial distance back from the abyss,” said Lawrence Summers, Obama’s chief economic adviser.

Copyright 2009 The Associated Press.

Move to child’s home major adjustment for senior


Posted on 3rd July 2009 by Gordon Johnson in Uncategorized

, , , , ,

Date: 7/3/2009 8:14 AM

ADRIAN SAINZ,AP Real Estate Writer

From deciding where grandma will sleep to knowing her preferred bed time, turning a home into three-generation household takes plenty of planning and frank discussions that can be difficult.

Family psychologists, social workers and relocation specialists are seeing more seniors moving in with their grown children due to financial concerns. The recession has led to increasing job losses and shrinking savings accounts, forcing many seniors to change their retirement plans and consider moving in with their grown children temporarily, or permanently.

Multigenerational households made up 5.3 percent of all households last year, up from 4.8 percent in 2000, AARP reports.

In many cases, such a move is difficult and painful, in others it’s a relatively seamless transition. To make it as easy as possible, grown children and their parents, and often grandchildren as well, need to work out details of the transition.

“It’s an incredibly complicated situation,” says Marsha Frankel, a social worker with Jewish Family & Children’s Service of Greater Boston.

Changes in a senior’s living arrangement — whether living independently or in an assisted living facility — can come suddenly, especially if eroded investments or job loss makes their current situation unaffordable. The unemployment rate for workers aged 55 and older hit 7 percent last month, almost double the rate a year ago, data released Thursday showed.

In fact, about one in 10 people aged 50 and older live either with their grandchildren or their parents, according an AARP survey of more than 1,000 respondents 18 and older released in March.

Sixteen percent of respondents 55 and over reported that moving with their family or a friend was necessary in the past six months. Among those 18 and over who say they are likely to make such a move, 34 percent cited a loss of income as a reason for the move, 19 percent cited a change in job status and 8 percent blamed home foreclosure.

When considering a move, seniors should honestly asses their relationship with their child and his or her spouse. A strained relationship could lead to conflict.

For many seniors, the last time they lived with their children was when they were teenagers whose lives needed direction and discipline, said Nancy Wesson, author of “Moving Your Aging Parents.” It’s the same for the adult child, who may have resented being told what to do all the time and rebelled against mom or dad as a teen.

“A lot of those dynamics are hiding in wait” and surface when the senior parent moves in, Wesson says.

But the relationship has now changed — both parties are adults and will need to adjust their approach to a more patient, communicative partnership.

If a senior decides to make the move, the first step is obvious but absolutely necessary: Have a family conference to discuss how everyone’s life is going to change. AARP suggests the household should also have regular conferences, perhaps once a week after dinner or on a weekend afternoon, to discuss the next week’s schedule.

Families can set up a three-month trial period and should have a backup plan in case the move just does not work.

“The key issue is everybody communicating and things being spelled out in advance,” Frankel says.

A key point of discussion is realizing how much care the senior requires in their daily lives, and how the younger family members are going to help.

It’s important for the senior to retain some control of their lives to keep from feeling isolated. A grown child should refrain from taking over every little aspect of the parent’s life and micromanaging their parents to the point of frustration.

“That’s offensive and they don’t appreciate it,” said Wesson, a senior relocation specialist. “It hurts their feelings. Involve them as much in the process as they are willing to handle.”

Preparing the home for the move is a big step. Homeowners should know if the house can accommodate someone who has trouble climbing stairs. Clutter should be removed from walking areas, and lighting can be improved to deal with any vision loss by the senior.

A grandchild who is being displaced from their usual bedroom should know ahead of time. Bed times might have to be adjusted. Times for having friends over should be established in advance.

The living space in the home should accommodate for Dad’s Favorite Chair, and everyone should have their own designated places, whether it’s to read or watch TV or do homework, AARP suggests.

Homeowners should review their insurance documents or make sure the senior is added to coverage in case there’s a household injury.

Also, the entire household should talk about finances. Seniors with a job, leftover savings or monthly Social Security checks can contribute some money for groceries, utilities or even the mortgage.

However, money doesn’t have to change hands. A more active senior could drive the grandkids to school, baby-sit twice a week or do the grocery shopping. Such routines provide consistency and help life go more smoothly.

But, as the senior gets older, he or she may not be able to drive any more and can’t help out in the household anymore. Adult children and their parents should look down the road and determine what the next step should be if the level of required care becomes too time-consuming.

“People often just think in the moment, that they’re in a financial crunch,” Frankel says. “What happens when mom has been putting her money into the household and suddenly needs more care? Those are the kinds of things that really get to be looked at and create all kinds of problems.”

These and other issues can be obstacles, but a situation in which a senior moves in with their children and grandchildren also can be a blessing: It can bring families closer together.

Multigenerational households should take advantage and try to eat meals together, look at family photos, and plan outings in which everyone participates. A grandmother’s or grandfather’s experience can be invaluable to a younger person who is willing to listen.

“It brings cross generational closeness that you can’t achieve when you are not living together,” said Elinor Ginzler, AARP’s housing expert.

Copyright 2009 The Associated Press.

FDA backs drug that treats diabetes via the brain


Posted on 8th May 2009 by Gordon Johnson in Uncategorized

, , , , , ,

Date: 5/6/2009 1:08 PM

AP Medical Writer

WASHINGTON (AP) — People with Type 2 diabetes may soon get a very different treatment approach: A drug that helps control blood sugar via the brain — an idea sparked, surprisingly, by the metabolism of migrating birds.

The Food and Drug Administration approved Cycloset, maker VeroScience Inc. announced Wednesday. It’s a new version of an old drug called bromocriptine, used in higher doses to treat Parkinson’s disease and a few other conditions. But unlike its older parent, Cycloset is formulated to require a low, quick-acting dose taken just in the morning — no other time of day.

That timing provides a bump of activity in a brain chemical that seems to reset a body clock that in turn helps control metabolism in Type 2 diabetes, said VeroScience’s Anthony Cincotta, who led the drug’s development.

Company studies suggest that one morning dose helped lower the usual post-meal blood sugar rise at breakfast, lunch and dinner. Over six months, 35 percent of Cycloset users reached recommended average blood sugar levels, compared with 10 percent of diabetics given a dummy drug, Cincotta said.

Cycloset is the first drug to win FDA approval under new guidelines that require better evidence that diabetes treatments are heart-safe. Diabetics are at increased risk of heart disease. In a yearlong safety study involving 3,000 diabetics, those given Cycloset had 42 percent fewer heart attacks and other cardiovascular complications than those given a dummy drug.

Where do the birds come in? Years ago, Louisiana State University researchers were studying how migrating birds arrived at their destinations without being emaciated. They develop seasonal insulin resistance, the very condition that in people leads to Type 2 diabetes.

People don’t have those seasonal variations but the theory is the dopamine plays a role anyway.

The researchers discovered a biological clock — in the brain’s hypothalamus — that controlled when the metabolism change kicked in for the birds, and also in hibernating mammals. Different concentrations of certain brain chemicals, including dopamine, at different times of day dictated whether the bird metabolized like a fall bird or a summer bird, said Cincotta.

People don’t have those seasonal variations but the theory is the dopamine plays a role anyway in sensitivity to insulin, although Cycloset apparently did not affect weight.

Bromocriptine mimics dopamine: “We’re regulating the regulator,” Cincotta said.

Side effects include nausea and dizziness, sometimes because of blood pressure dips upon standing. Nursing women shouldn’t use it. Bromocriptine inhibits lactation, and although no link is proven, there have been reports of strokes in postpartum women using higher doses. The FDA said it also should be used cautiously with people taking blood pressuring-lowering medication.

It’s uncertain how soon sales can begin, or the drug’s cost: VeroScience, of Tiverton, R.I., is in negotiations with larger drug companies to find a distributor.

Copyright 2009 The Associated Press.