New Jersey Youth Sustains Brain Injury From Fall At Rutgers Game

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Posted on 15th November 2010 by Gordon Johnson in Uncategorized

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Stunts that just seem to be playful can often turn dangerous, as a 20-year-old New Jersey man found out Saturday. 

Nicholas Amabile of Florham Park. N.J., remained in critical condition Sunday from head injuries he sustained when he fell down a flight of stairs at Rutgers Stadium in Piscataway, according to The Star-Ledge of Newark Monday.  

Amabile isn’t a Rutgers student, but he attended the Scarlet Knight’s game against Syracuse University on Saturday. According to Amabile’s friend and witness, Anthony Pryer, they were leaving the game in the second quarter when Amabile suddenly decided to slide down the staircase railing. 

Amabile fell about 30 feet and was knocked unconscious. He was taken to Robert Wood Johnson University Medical Center in New Brunswick, N.J., where he remained.

Authorities wouldn’t comment on the extent of his head injuries.                                      

http://www.nj.com/news/index.ssf/2010/11/florham_park_20-year-old_man_i.html

 

In A Case Worthy Of ‘House,’ Mom Was Put In Coma Five Months Until Diagnosis

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Posted on 8th November 2010 by Gordon Johnson in Uncategorized

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Doctors put Donna Landrigan in a coma for five months as they struggled to find out what was wrong with her.

Landrigan’s tale was chronicled by AOL Health, kicking off with the painful headaches that the mother of three, then 35, was suffering from for almost a month until she finally collapsed on her kitchen floor.

http://www.aolhealth.com/2010/11/04/doctors-induce-5-month-coma-to-save-womans-life/?ncid=webmail

But as Landrigan’s case demonstrated, diagnosing a brain malady can play out like an episode of “House.” Physicians for months were stymied and couldn’t determine exactly what was wrong with Landrigan’s brain. Ultimately, she received treatments at four hospitals in several different states.

Doctors initially thought that Landrigan has encephalitis, or swelling of the brain due to infection. But tests came back negative. Then physicians believed that the young mother had nonconvulsive status epilepticus, which entails seizures and kills more than half the people who have it. But that diagnosis didn’t pan out.

At that point, doctors put Landrigan into a coma using propofol, the powerful anesthetic that killed pop superstar Michael Jackson. They did it because they feared that her brain could not continue to withstand the seizures she was having. Later, doctors put Landrigan into an even deeper coma using pentobarbital.

 The woman’s condition worsened, and doctors then went on to a new diagnosis: That one of Landrigan’s own antibodies was injuring her brain. 

That, it turns out, was the answer. Landrigan had anti-NMDA receptor antibodies, which can attack brain nerve cells, according to AOL Health. These antibodies typically appear when someone has a teratoma, which is a kind of tumor that people get in the ovaries or testes. 

Doctors removed Landrigan’s ovaries and fallopians tubes, and discovered that she did in fact have a benign teratoma. Her diagnosis was anti-NMDA receptor encephalitis. Landrigan was then slowly brought out of her induced coma.

Although her seizures ended once her tumor was removed, Landrigan is not back to her old self. A year after being taken out of her coma, the mother, now 36, remains in a wheelchair and has nerve damage, according to AOL Health. She still expects to walk one day.       

 

    

 

 

NFL Considers Socking Players With Suspensions For Helmet Hits

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Posted on 19th October 2010 by Gordon Johnson in Uncategorized

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After a spate of player concussions and injuries this past weekend, it looks like the National Football League is poised to crack down on players who made hard head hits during games.

Several press accounts, including one in The New York Times Tuesday, reported that the NFL would mete out tough penalties and possibly even suspend players who inflicted dangerous blows to the heads of other players. NFL executive vice president of operations Ray Anderson warned of the coming actions Monday. 

http://www.nytimes.com/2010/10/19/sports/football/19hits.html?_r=1&ref=sports

 The NFL should take action after the long list of shenanigans last Sunday. After being hit in the helmet Detroit Lions linebacker Zack Follett was hosptialized overnight. Pittsburgh Steelers player James Harrison “knocked two Cleveland Brown players out of the game with head injuries,” according to The Times.

And the topper seems to have been New England’s Brandon Meriweather, who was penalized for his hit on Baltimore’s Todd Heap.

The Times quoted Anderson as saying that the league didn’t want another Darryl Stingley incident on its watch, referring to the New England Patriots player who was paralyzed in a 1978 hit and died in 2007. 

There is even talk of suspensions for helmet-to-helmet hits, a suggestion made on-air Sunday by former NFL player Rodney Harrison, who had a reputation as a hard-hitting — even dirty– player during his career. According to The Times,  Harrison said that that suspensions, not fines, “got his attention” when he was playing.

 The NFL competition committee might even consider barring all hits that invovle using a helmet, The Times reported.

Family Of Marine Coma Victim Help Canine ‘Marine’ Overcome PTSD

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Posted on 8th October 2010 by Gordon Johnson in Uncategorized

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 The family of a hero Marine, who was died after being in a coma, is  now trying to help another “Marine” get over his post-traumatic stress disorder from combat in Afghanistan. The Marine with the PTSD is Gunner, a bomb-sniffing dog. 

http://online.wsj.com/article/SB10001424052748703859204575525991305561822.html?mod=ITP_TEST

The Wall Street Journal this week wrote the story about Deb and Dan Dunham, who have adopted the Labrador retriever and are trying to help him recover from the trauma of combat.  

The Dunhams, who live in Scio, N.Y., are getting over their own emotional heartache, according to The Journal. In 2004 their 22-year-old Marine son, Corporal Jason Dunham, during combat in Iraq threw his helmet over a live granade to protect two of his men. They walked away with wounds, but Jason took a piece of scrapnel in his brain. He went into a coma, The Journal reported.   

Jason stayed alive and was brought to a naval hospital in Maryland, but the Durhams were told that their son would not regain consciousness. The family had him taken off life support, as per the wishes he expressed before he went overseas. Jason won a Medal of Honor for his heroism.

Gunner, in turn, was trained to find explosives and was deployed to Afghanistan. But combat duty eventualy proved too much for the dog, and it was decided he needed to be shipped back to the states.

The Journal did separate stories about the Dunhams and Gunner, and family was among those that told the Marines they wanted to adopt the dog. The Dunhams got Gunner, and The Journal story describes how the family is helping him get over his PTSD, just as he is helping them deal with the loss of their son. 

Post Coma, Two Brain Injury Victims Succeed With Their Recoveries

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Posted on 5th October 2010 by Gordon Johnson in Uncategorized

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I’ve dedicated my life to being an advocate for brain injury victims, and it’s been a rewarding calling. And it also has its challenges.

While medicine has made strides in the treatment of Traumatic Brain Injury patients, brain injury is not like breaking a bone. Making a full recovery, to return to your prior level of function, is not easy and is not often typical. The refrain I and my associates hear from TBI victims is often the same: “I want my life back.”

Unfortunately, no one can give them their lives back. But in some cases, they can grab back their lives themselves. 

It’s always heartening when I get a case where a TBI victim make a remarkable recovery, and when I hear about other upbeat stories, I like to share them. And here are two.

The first case is that of Bryan Steinhauer, who sustained severe brain injuries when he was beat up near Binghamton University in 2008. The New York Daily News did a profile of Steinhauer Sunday, which was headlined “How He Beat The Serb Monster: Survives Coma & Heads For Dream Job.”

   http://www.nydailynews.com/ny_local/2010/10/03/2010-10-03_its_the_biggest_thing_for_me__to_reclaim_my_life.html

Steinhauer two years ago was assaulted by three men, including Miladin Kovacevic, for dancing with one of their girlfriends. “Doctors didn’t know if he would be able to speak again, let alone if he would live,” according to the News.

Steinhauer was in a coma for three months, and has “undergone thousands of hours of speech and physical therapy,”  the News reported. It paid off, because Steinhauer is about to start work at KPMG, the accounting firm. Kovacevic, in turn, is about to start a prison sentence for assault.

Steinhauer’s mentor at the Greater New York Hospital Association, Lee Perlman, had this to say about the 24-year-old TBI survivor’s recovery.

“It’s mind-boggling,” Perlman told the News. “It is arguably one if the most inspiring, resilient shows of force that I could ever imagine.”

Steinhauer, who walks with a limp and talks slowly since his assault, goes to Mount Sinai Medical Center in Manhattan once a month to speak with brain trauma patients and offer them encouragement. 

The second inspiring case is that of Jenna Philips, a Carmel, Calif., teen who fell 14 feet through a barn ceiling and landed on her head, knocked unconscious. She came out of her coma a day later, according to AOL, and had two brain contusions and a rightside skull fracture.

http://www.lemondrop.com/2010/09/29/how-i-recovered-from-brain-damage/?icid=main%7Cmain%7Cdl3%7Csec1_lnk3%7C174444

Against the advice of her doctors, Jenna returned to high school three weeks after her fall. In addition to her regular lessons, she was also undergoing cognitive therapy for her brain injury.

In “How I Recovered From Brain Damage,” Jenna is very articulate, and does a good job describing the successes, and failures, of her recovery. It was not easy.

But Jenna did go on to college, majoring in nutrition, and now has her own business, Mission Possible, an outdoor fitness program.

“I learned how to listen to my body, and understand what it needs,” Jenna told AOL. “I also learned how to persevere, and that with perseverance, anything is possible.”

 

New York Good Samaritan Dies Of Brain Aneurysm After Failed Rescue Attempt

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Posted on 22nd September 2010 by Gordon Johnson in Uncategorized

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When Kitty Genovese was stabbed to death despite her cries for help, it added to the perception of New Yorkers as being heartless and cold. But Richard Bermudez was anything but that: The bus driver’s Good Samaritan efforts last Thursday to help a woman have led to his death.

Bermudez, just days before he was set to get married and a month before his retirement, suffered a brain aneurysm after the strain of trying to rescue a woman after a tornado swept through Queens last week. He had been put on a ventilator, and his family had him taken off it three days later, becaue he had told them he never wanted to live on a machine, according to the New York Post.

http://www.nypost.com/p/news/local/queens/storm_tragic_hero_inbNBz4NowHbonA3H2abuO

Bermudez desperately tried to help a woman, Aline Levakis, who was trapped in her car after a tree fell and crushed it during the tornado. She died at the scene.

Bermudez was distraught when he failed to rescue Levakis, and began to complain of headaches and of feeling ill. He was riding in a co-worker’s car when he slumped down, according to The Post, and was brought to Queens General Hospital.  

Bermudez, who had high blood pressure, had an aneurysm, a blood vessel in his brain has burst. He was placed on the ventilator, and had been deemed brain dead.  

 

Good Samaritan Suffers Brain Aneurysm After Helping Woman During Queens Tornado

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Posted on 19th September 2010 by Gordon Johnson in Uncategorized

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In this sad case, the adage “no good deed goes unpunished” was true.

When a tornado passed through Queens, N.Y., Thursday a Good Samaritan tried to help a woman when a tree crushed  her car. The woman died and Richard Bermudez, 57, of St. Albans, Queens, suffered a brain aneurysm Friday, apparently from the stress of his efforts to rescue the woman, the New York Post reported Sunday. 

http://www.nypost.com/p/news/local/queens/brain_death_hits_storm_hero_xY9A7sgYk6A9bLAjubIv3K

Bermudez, who was slated to be married this week, was diagnosed as brain dead Saturday, and was given last rites by a priest.

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.

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.    

Chris Henry and TBI: Would Dr. House have Diagnosed Brain Injury in Time?

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Posted on 29th June 2010 by Gordon Johnson in Uncategorized

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Brain injury is a condition that involves microscopic damage to brain tissue that can only be seen in life through the lens of the patterns of the injured person’s life.  Chris Henry, the former NFL wide receiver whose autopsy results confirmed he was living with brain damage, may have finally made that clear.  See yesterday’s bloghttps://waiting.com/blog/2010/06/former-nfl-player-henrys-autopsy-reveals-evidence-of-brain-damage.html Mike Wilbon of Espn’s PTI (http://espn.go.com/espnradio/show?showId=pti) called the Henry story the most important sports story of the day and even went so far as to say that because of this story, his two year old child would never play football.  This story is important not just because it warns us of the dangers of playing football, but because it tells us we must think “brain injury” when looking at the patterns of troubled people’s lives.  This story also tells us that it is time that autopsy returned to head of the research class in understanding about all pathology, but especially that in the brain.

Since I posted yesterday’s blog, I have done some research on Chris Henry’s life, not just to see the pattern of behavior issues, but also to see if anyone had ever considered a diagnosis of “brain damage” at any time prior to his death. I could find no references to any physician, trainer, NFL official or commentator (including myself)  ever suggesting that Henry was suffering from Post Concussion Syndrome.  When doctors make a diagnosis, they should engage in something called a differential diagnosis, which involves a consideration of all the possible diseases.  I always think of this as a Doctor House (from the TV series) process of putting diseases on a whiteboard, then crossing out the ones that don’t fit.  I strongly suspect that no doctor had ever put TBI on Chris Henry’s whiteboard, or if they ever did, quickly dismissed it because there was no single concussion that he was treated for.

Here (with the easy job of Monday morning quarterbacking the diagnosis) is how I picture Dr. House and his cast approaching the problem.  It is the fall of 2009 and Henry is again asking Commissioner Goodell for reinstatement and Goodell orders a full assessment on Henry.  Because Henry is such a special case, Goodell enlists the services of Dr. House. (If you are not familiar with the show, the cast and plot is explained here: http://en.wikipedia.org/wiki/House_%28TV_series%29 ) House pulls his team together and starts writing on the whiteboard the following potential conditions:

  • Nutcase;
  • Jerk;
  • Spoiled jock; and
  • Bi-polar.

Dr.  “Thirteen” Hadley throws out “brain injury.”  He is a football player she says, a wide receiver, he does get hit often.  Dr. Chase states “it can’t be brain damage, the CT was clean.”  (He actually did say that in an episode in Season 6http://www.tv.com/house/moving-the-chains/episode/1320924/summary.html?tag=ep_guide;summary ).  Dr. Foreman, a neurologist, puzzled  by Thirteen’s suggestion, argues that Henry was never knocked out. Dr. Taub points out that according to the CDC you can have brain injury without ever losing consciousness and that CT’s show virtually no evidence of brain damage when done post-acutely.  House steps in and orders an MRI.

After the commercial, our cast reassembles, normal MRI in hand and now Dr. Foreman derisively dismisses the TBI theory, stating that this is all psychiatric and Henry should be shipped off for an inpatient evaluation at a psychiatric hospital.  House who has some experience with such places says to hold off on that until they have ruled out all “organic causes.”

Taub raises the possibility of Carbon Monoxide poisoning or toxins and House dispatches Chase and Foreman to search Henry’s apartment, where they find nothing.   Meanwhile, Thirteen has not abandoned her initial theory of TBI and pours over the history of Henry’s on the field and off the field problems in his NFL file (for a detailed history seehttp://en.wikipedia.org/wiki/Chris_Henry_%28wide_receiver%29 ).  Here is what she finds:

  • During Henry’s sophomore season in college at West Virginia , he was ejected from a game at Rutgers University due to multiple unsportsmanlike conduct penalties and was suspended for the season finale against the University of Pittsburgh. His former Mountaineers coach, Rich Rodriguez, stated that he was “an embarrassment to himself and the program” for his conduct.[6]
  • On December 15, 2005, Henry was pulled over in northern Kentucky for speeding. During a search, marijuana was found in his shoes. He was also driving without a valid driver’s license or valid insurance.[19] He pleaded guilty and avoided a jail sentence.
  • One month later, on January 30, 2006 he was arrested in Orlando, Florida for multiple gun charges including concealment and aggravated assault with a firearm.[20] He was reported to have been wearing his #15 Bengals jersey at the time of his arrest. He pleaded guilty to this charge and avoided jail time.
  • On April 29, Henry allowed three underage females (ages 18, 16 and 15) to consume alcohol at a hotel in Covington, Kentucky.[21] One of the three, an 18-year-old woman, accused Henry of sexually assaulting her; she later retracted her story and was charged with filing a false police report.[22] On January 25, 2007, Henry pleaded guilty to a misdemeanor violation of a city ordinance commonly referred to as a “keg law.” He was sentenced to 90 days in jail, with all but two of those days being suspended.[21]
  • He was pulled over on Interstate 275 in Ohio on June 3 at 1:18 A.M. by Ohio Highway Patrol trooper Michael Shimko for surmised drunk driving. He voluntarily submitted to a breathalyzer test at 2:06 A.M. at the Milford Police Department and registered a .092 blood-alcohol level, .012 above the level permitted in the state of Ohio.[23]
  • Henry allegedly assaulted a valet attendant at Newport on the Levee in Newport, Kentucky on November 6, 2007.[26] He was arrested for a second time in Orlando on December 3 for violating his probation he was on from a January 30, 2006 arrest. On February 21, 2008, he was found not guilty.
  • On March 31, 2008, Henry punched a man named Gregory Meyer, 18, and threw a beer bottle through the window of his car. Henry claimed it was a case of mistaken identity and also that he thought it was somebody else that owed him money. Henry was waived by the Bengals a day after this arrest and was then served a house arrest sentence.

What Thirteen concludes from this conduct history is that Henry never seems to grasp that there are rules or that there will be consequences to  his actions.  Even if he does, he doesn’t seem to be able to conform his actions.  The multiple unsportsmanlike conduct penalties in one game in college stands out as a precursor of all that followed.

Thirteen Googles “criminal behavior and tbi”.  What she finds is the articleAcquired Brain Injury and Criminal Behavior by Inés Monguió, Ph.D http://www.uninet.edu/union99/congress/confs/hi/03Monguio.html and our bloghttp://www.subtlebraininjury.com/blog/2010/04/more-on-roethlisberger-tbi-and-the-criminal-law.html

What she finds in Dr. Monguió’s paper:

Brain injury, particularly to the frontal lobes or to the connecting circuits of frontal areas to other brain centers, can affect the ability to form criminal intent. Deficits in executive function result in poor self monitoring, planning, judgment, and forethought. The rigidity or impulsivity often seen in traumatic brain injuries make the formation of criminal intent quite a challenge for the individual. Following are general areas to consider when evaluating a criminal defendant to provide information during the trial. The question of legal insanity will be explored in more detail as neuropsychological data may provide information to the courts regarding a defendant’s state of mind at the time of the commission of the crime.

She compares the paper to Henry’s behavior and finds poor self-monitoring, judgment, forethought, as well as impulsivity.   Thirteen renews her argument for TBI.  House points out that you need a traumatic event for a Traumatic Brain Injury.  Where was the event?  Thirteen, argues back that repeated sub-clinical blows, like boxers receive, can cause long term encephalopathy, without a specific concussion – Muhammad Ali was never knocked out.  She argues for a neuropsychological assessment.

This of course would be one of those episodes where House couldn’t walk in at the last instant with the miracle cure.  In the “fact is stranger than fiction” category, Henry actually dies of a traumatic brain injury when he falls from the back of his fiancé’s truck after another neurobehavioral event, a domestic squabble.  All of the circumstances leading up to his death point to brain injury – temper control, violence and judgment in getting into the back of the pickup.  We would hope that this would be one of those cases where House, haunted by the death he couldn’t solve. would order the autopsy.

Fortunately for the future of TBI research, the autopsy was ordered here.  The best thing that has come out of the NFL head injury awareness program is the move to enlist current and former players in this autopsy project.  What we don’t yet have and maybe never will is the answer as to what to do when the in vivo (during life) half of the diagnostic tree points to TBI in someone who makes his living getting hit.  Would treatment for TBI have saved Chris Henry’s career, his life?  Probably not the first, potentially the second.