Attorney Gordon Johnson
On Jul 14, 2008, at 7:31 PM, Alina Higuera wrote:
Hello My name is Alina I come from a family of ten kids 7 girls and 3 boys It seems as if my family and I are reliving the devastation of my brothers ( 3rd born ) brain injury that occured on Dec 3, 1979. his injuries were caused by blunt force trauma to the head, he fell out of the back of a pick up truck. The part of the brain that was damaged was at the brain stem. After being in a coma for 3 mo. he returned to us, having to relearn how to do everything, unfortunatly my brother never did regain use of his legs and was able to move his right arm only. he remained very inteligent as he was before this happened. All of his sences were very much intact including pain. He could’nt move anything but he could feel everything, I remember so many many times he would yell for me to come and scratch his itch because he was unable to and we all know how irritating that is, pain was another thing that my brother could feel, it would break my heart to see the unbearable pain on his face when he would be getting therapy or just cleaning him up. My brother lived in that hell for 31 yrs and never one time did I ever hear him feeling sorry for himself, he was always smiling and without fail the first one to say “Good Morning” and nerver forgot a birthday and was the one always doing the cheering up. We lost my brother on Feb 15, 2008 although he is greatly missed I am happy that he is no longer suffering from the bondage that he lived with and through for so many years. On July 12, 2008 my older sister ( 5th born ) 51 years old went into cardiac arrest while visiting another sister over the weekend, after returning from a quick errond as she walked into the front door she found my sister face down on the ground not breathing and with no pulse, she began to administer CPR immediatly, as she called out for help a neighbor came running who happens to be a lifegaurd and assisted my sister with CPR paramedics finally arrived still with no pulse or breathing they began chest compressions and then the electric paddles to try and start the heart, finally after about 15 mins they were able to feel a faint pulse. My sister now lays in a coma on a breathing machine with no responsive reaction. She was having seizures that were coming between every 15 to 30 secs of eachother. because of the lack of oxygen to the brain they say that she does have significant brain damage now to what extent we are not at all sure. Seeing my sister hooked up to machines and just laying there is a de ja vu of 31 years ago. My heart is breaking for my mom because as before she sits along side of my sisters bed talking to her and insisting that she will be just fine as she did with my brother. I can only hope and pray that she comes out of this and returns back to normal ( as normal as possible ) for the sake of my sister she would never want to live as my brother did ( we have all discussed it many times ) and as for the sake of my mom I can only hope and pray and hope and pray that she is strong enough to handle whatever the outcome will be. Only time will tell the fate of my sister, I love her and I miss her sooo very much and God willing she will come back the way she was.
Thank You for reading my story and even more for allowing me to write about it and somewhat releasing it from inside of me.
Alina Higuera
Hello Gordon,
I was so hoping to get a reply back from you. I am very sad to say that after sending this email, we were informed that due to the lack of oxygen to the brain, that my sister was brain dead and that they could do no more for her. She was removed from the machines and to much surprize was breathing on her own for about 36 hrs. she passed away July 18. You absolutley have my permission to post this on your blog, I can only hope that it will bring some comfort to the surviving relatives that they are not alone. Thank You so much for your response.
Alina Higuera
Another Waiting.com Coma Tragedy
From another reader, who got solace from our advocacy on https://waiting.com:
Kudos for our Coma Advocacy
From a user of https://waiting.com:
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
I was thumbing through some old email and I ran across yours. I remember writing you when my mother fell into coma. I remember how helpful this website was to me. How you help me and my family to understand what my mother was going through. I especially like how this site explained all the many different tubes and meaning of words surrounding coma. It educated me, it made me apart of the process. I enjoyed that very much.
My mother was 68 years old and lost the battle of recovery, however, this site helped me to deal with that also. This site gave me hope and kept me inform of what could happen. This site helped prepared me for the future without my mom. I thank God for giving me the strength to go though this and I thank you for educating me on coma so that I know what to pray for. My mother was laid to rest April 5, 2008. Thank you for being there for me.
Sonia
Obama and McCain urged to Attend Military Head Injury Conference
From the Brain Injury Association of America:
We agree that one of the most pressing issues for the next administration, is better care for returning vets, and also for all brain injury survivors.
Dear Advocates:
BIAA issued a press release today urging both presidential candidates to attend the 2008 Fort Hood Presidential Town Hall and engage in an in-depth discussion of the increasingly complex issues facing America’s military and veterans community, including the rate of traumatic brain injury among returning service members. BIAA is a member of the 2008 Forth Hood Presidential Town Hall Consortium, and the event is tentatively scheduled to occur on August 11, 2008.
In other news, in a welcome and surprising turn of events this week, the Senate voted by a veto-proof margin to pass a key Medicare bill (H.R. 6311), which the House and Senate had previously been unable to agree on before the July Fourth congressional recess. The final Medicare package, which will prevent deep cuts in Medicare payment rates for physicians which had been scheduled to begin on July 1, was previously passed by the House on June 24.
The Medicare bill also contains important delays in the implementation of Medicare’s competitive bidding program for Durable Medical Equipment (DME), and an extension of the Medicare outpatient therapy cap exceptions process.
It is anticipated that President Bush will veto the bill, however, and although the Senate passed the bill with a veto-proof margin earlier this week, the White House needs only three Senators to switch their votes in order for a veto override to fail. Thus, it is extremely important that advocates visit BIAA’s Legislative Action Center to take action TODAY to urge their Senator to vote to override the President’s expected veto. To do so, please visit http://capwiz.com/bia/callalert/index.tt?alertid=11604356.
The Fiscal Year 2009 appropriations process to be stalled, as the House Appropriations Committee does not plan on marking up any more bills this summer after a partisan dispute erupted in recent weeks over amendments on energy policy. And while the Senate Appropriations Committee plans to have all 12 of its bills approved by the panel by the end of this month, Senate Majority Leader Harry Reid (D-Nev.) said this week that action on appropriations in his chamber will be very limited during the next few months.
*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
BIAA Urges Presidential Candidates to Participate in Fort Hood Town Hall Event
BIAA issued a press release today urging both presidential candidates to attend the 2008 Fort Hood Presidential Town Hall and engage in an in-depth discussion of the increasingly complex issues facing America’s military and veterans community, including the rate of traumatic brain injury among returning service members. BIAA is a member of the 2008 Fort Hood Presidential Town Hall Consortium, and the event is tentatively scheduled to occur on August 11, 2008.
The Consortium planning the event includes a diverse group of military, veterans and community-service organizations, including Disabled Veterans of America, the Brain Injury Association of America, and Sentinels of Freedom. These groups are working in partnership with the military, the Department of Veterans Affairs, state and local governments, and faith and community-based organizations to deliver services and support to our military, veterans and families.
In the press release, BIAA President and CEO Susan H. Connors states, “Traumatic brain injury (TBI) is a common consequence of any war. TBI is recognized as the ‘signature wound’ of the current conflict; yet, accessing the right treatment, right now remains a challenge for many wounded service members and veterans. Our troops and the millions of civilians who sustain TBIs here at home need proper screening and diagnosis, expert rehabilitation, and ongoing community-based services. Family caregivers need information, training and support, and voters everywhere need to let the presidential candidates know where we stand.”
To view BIAA’s press release in its entirety, please visit our website at http://www.biausa.org/policyissues.htm.
Surprise Appearance By Senator Kennedy Pushes Senate to Pass Medicare Bill
In a welcome and surprising turn of events this week, the Senate voted by a veto-proof margin of 69-30 to pass a key Medicare bill (H.R. 6311), after a unexpected, dramatic appearance and “aye” vote by Sen. Edward M. Kennedy (D-MA) on Wednesday. Sen. Kennedy had not been in the Capitol for six weeks, as he is recovering from surgery in early June to remove a malignant brain tumor.
The House and Senate had previously been unable to agree on a Medicare package before the July Fourth congressional recess. The final Medicare bill, which would prevent deep cuts in Medicare payment rates for physicians which had been scheduled to begin on July 1, was overwhelmingly passed by the House on June 24, but before Senator Kennedy’s appearance had been unable to gain Senate passage.
In addition to replacing a 10.6 percent cut to Medicare’s physician payment rates with 18 months of stable payments, the Medicare bill also contains an 18-month delay in implementation of Medicare’s competitive bidding program for Durable Medical Equipment (DME), as well as an 18-month extension of the Medicare outpatient therapy cap exceptions process.
It is anticipated that President Bush will veto the bill, however, and although the Senate passed the bill with a veto-proof margin earlier this week, the White House needs only three Senators to switch their votes in order for a veto override to fail. If the President delays acting on the bill, or Congress is unable to override an expected veto, the physician payment cuts and DME competitive bidding program will go into effect, and the outpatient therapy caps exceptions process will continue to be expired (as of June 30, 2008). Thus, it is extremely important that advocates visit BIAA’s Legislative Action Center to take action TODAY to urge their Senator to vote to override the President’s expected veto. To do so, please visit http://capwiz.com/bia/callalert/index.tt?alertid=11604356.
Fiscal 2009 Appropriations Process Still Stalled
The Fiscal Year 2009 appropriations process continues to be stalled, as the House Appropriations Committee does not plan on marking up any more bills this summer after a partisan dispute erupted in recent weeks over amendments on energy policy. And while the Senate Appropriations Committee plans to have all 12 of its bills approved by the panel by the end of this month, Senate Majority Leader Harry Reid (D-Nev.) said this week that action on appropriations in his chamber will be very limited in the next few months.
There continues to be widespread speculation that this year’s appropriations process will eventually become stagnant this fall, as Democrats may wait for the president to leave office before completing work on the funding bills in order to avert a promised veto.
CQ Today reported earlier this week, “Reid (D-Nev.) said his chamber will likely consider, at the most, two fiscal 2009 appropriations bills this year before passing a continuing resolution (CR) in September that would keep the government funded at current levels into early next calendar year, when a new president takes office. The new fiscal year begins Oct. 1” (CQ Today, David Clarke, 7/10/08).
The full Senate Appropriations Committee has approved the Labor, Health and Human Services (HHS), and Education funding bill, which provides the same funding amounts for several TBI programs as last year. This includes $5.7 million for TBI programming within the Centers for Disease Control and Prevention (CDC) and $8.754 million for the HRSA TBI State Grant Program.
The House Labor, Health and Human Services (HHS), and Education Appropriations funding bill has only been passed by the House Subcommittee and not the full House Appropriations Committee. The House Subcommittee markup contains increased funding for some federal TBI programs compared to last year. The bill includes $11 million for the HRSA TBI State Grant Program (+$2.246 million over last year) and $6.6 million for TBI programming within CDC (+$0.9 million over last year).
We agree that one of the most pressing issues for the next administration, is better care for returning vets, and also for all brain injury survivors.
Kind Words about http://tbilaw.com from New Zealand
Below is an email we received with respect to our websites and web advocacy.
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
To Gordon Johnson and team, I thank you so much for your site. My name is Wendy and I am a 44 year old woman from New Zealand. I am a victim of Multiple TBI’s. As a child I sustained many head injuries (alot was me being knocked out), and have recieved many since. Most of which I have been knocked out many times, some for long periods, but mainly having the back of my head hitting the ground before any other part of my body. The worst injury I sustained was in 2001 when I had a home invasion and was beaten by 2 people wearing work boots being knoked for 8 or 9 hours. That was the second time I had been knocked out for that long. Other instances were being unconcious for up to 2 hours.
I found your site very easy to understand and informative. All of the symptoms you described were me wrapped up into one big ball. A brain damaged mess with what as a future?!
I do wish so much that your firm was over here in New Zealand as I have had no help from our ‘system’ as one may put it.
Thanks so much for putting this information on the net. People need to understand more about becoming brain damaged and how it affects the victim and how it changes them. Its helped me with my youngest daughter (13), as she never really understood why Mum wasnt like she used to be. I really hope that someday in someway that there will be some miracle cure for thoses affected by TBI or Multiple TBI’s..
Kindest Regards, Wendy. :o)
Thoughts on Dog Breeders: Dog lovers or dog sickness?
My passion for brain injury began as a partnership with an exceptional advocate, Becca Martin. She continues to be propelled by advocacy, although of a different nature. But her advocacy is so genuine and passionate that sometimes I devote this blog to her passion for dogs.
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Gordon S. Johnson, Jr. 2008
I knew a dog breeder once. She was a friend I met through work. She bred collies and shelties out of her home. Back then I didn’t know this was called a backyard breeder. Her house had that overwhelming smell of dogs as the shelties lived indoors. The collies had kennels in the yard. The puppies were raised in a basement that made your eyes sting.
Now, this woman’s life orbited around her love for dogs. She lived, breathed and reveled in dogs. She showed dogs, trained dogs and sold dogs. But, she taught me that there is no such thing as a responsible breeder.
Being a lot more ignorant then, I thought the only problem she had was an overabundance of dogs and that a love for dogs could go too far. But I discovered there was a darker side to breeding pretty quickly. I would play with the cute litter of collie puppies and watch as their noses grew into the traditional collie nose. Round about the time the puppies were ready for sale, she would drive them to a vet an hour and a half away for a “vet check”. It seemed odd to me at the time as one of her best friends was a local vet.
Now being that kind of person, I always was drawn to the puppies that looked a bit off. You know what I mean, that look that you know something makes them a bit of an underdog in the world. I asked about these little guys and she told me that collie genetics sometimes resulted in abnormal skull development and the eye sockets didn’t expand for the growth of their eyes…a painful condition.
Anyway, she usually came from these “vet checks” missing a puppy or two. “Where is so and so” I would ask. And she would say “so and so was humanely euthanized”. So and so had the misfortune to be a victim of selective inbreeding. I suppose you have to travel a long way to find a vet willing to regularly euthanize otherwise healthy puppies.
There was always a kennel full of beautiful collies as well. During my acquaintance with this woman…I began to realize that none of her breeding dogs who became obsolete for breeding were ever rehomed. They were buried in her vet’s back field when they weren’t producing quality puppies.
It was then that I realized that there is a difference between dog lover and dog sickness. It wasn’t about the money. She couldn’t possibly have recouped her losses. Anyone who knows rescue knows there is probably not a high enough price to charge for a puppy that makes backyard breeding profitable. Not if you actually feed and vet the dogs. The only people who turn a profit are those who supply no care.
But, did she love dogs? Yes, she loved the perfect dogs. She loved the ones that brought adoration in the show ring. Everything else was just a means to get there. Love this week could mean euthanasia next week…based on a whim.
Maybe it’s the way she taped the ears to give them that perfect collie fold that just sort of raised the question in my mind of what is it with people? What drives people to breed for a certain look? They breed cattle for record breaking milk or meat production, chickens that mature in 6 weeks…but what is it that drives people to commit inhumane acts in order to achieve a breed standard?
Like a lot of people I used to let these backyard breeders slide under the radar compared to the disdain I felt for puppy mills. I have been guilty myself of obtaining a puppy from a breeder, but education is everything. I admit, during my life, I have always been younger and more ignorant.
I just want to finish with a thought that has bothered me this past year about my own rescue dogs. Because it illustrates the mentality which leads to this obsession with breeds.
It is an incident that occurred when I adopted Charm, my pit bull/border collie mix. Now most of us know it doesn’t really matter what the other part of the mix is…if it got labeled pit bull at the shelter…it’s a pit bull for life. No one looks at my dog and says is that part border collie? No one. But there was a certain rescuer that put in postings saying that what I had adopted wasn’t a real pit bull.
Which led me to the thought…so would I have to go to a breeder who gives out AKC papers to have a real pit bull? What does it mean to be a real pit bull? Cuz, gosh, the shelter wasn’t going to provide me with anything other than an adoption certificate for a pit bull mix. I didn’t even know it was a contest…my pit bull is more pit bull than your pit bull? All I know is there was a dog who needed a home and she was labeled pit bull and that meant no one wanted her.
It’s that sort of thinking that fuels breeders everywhere. Human ego gets catered to at the expense of the dogs. In the end, dogs are dogs are dogs. I don’t expect perfection, or conformation. My purebred chow is no more and no less than my shelter specials. No one is following me around with a score sheet that I can detect.
But to conclude my rant for the day….breeders cater to something in humans which is not pretty. Get a dog not a fashion accessory. You are not going to look cooler, your dick is not going to seem bigger, your place on the planet is not measured in your manipulation of genetics. And every shelter in America has something special waiting for you…a 100% dog waiting for a home. And each and everyone comes with an adoption certificate…what other papers could you possibly want???
Becca Martin
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Gordon S. Johnson, Jr. 2008
I knew a dog breeder once. She was a friend I met through work. She bred collies and shelties out of her home. Back then I didn’t know this was called a backyard breeder. Her house had that overwhelming smell of dogs as the shelties lived indoors. The collies had kennels in the yard. The puppies were raised in a basement that made your eyes sting.
Now, this woman’s life orbited around her love for dogs. She lived, breathed and reveled in dogs. She showed dogs, trained dogs and sold dogs. But, she taught me that there is no such thing as a responsible breeder.
Being a lot more ignorant then, I thought the only problem she had was an overabundance of dogs and that a love for dogs could go too far. But I discovered there was a darker side to breeding pretty quickly. I would play with the cute litter of collie puppies and watch as their noses grew into the traditional collie nose. Round about the time the puppies were ready for sale, she would drive them to a vet an hour and a half away for a “vet check”. It seemed odd to me at the time as one of her best friends was a local vet.
Now being that kind of person, I always was drawn to the puppies that looked a bit off. You know what I mean, that look that you know something makes them a bit of an underdog in the world. I asked about these little guys and she told me that collie genetics sometimes resulted in abnormal skull development and the eye sockets didn’t expand for the growth of their eyes…a painful condition.
Anyway, she usually came from these “vet checks” missing a puppy or two. “Where is so and so” I would ask. And she would say “so and so was humanely euthanized”. So and so had the misfortune to be a victim of selective inbreeding. I suppose you have to travel a long way to find a vet willing to regularly euthanize otherwise healthy puppies.
There was always a kennel full of beautiful collies as well. During my acquaintance with this woman…I began to realize that none of her breeding dogs who became obsolete for breeding were ever rehomed. They were buried in her vet’s back field when they weren’t producing quality puppies.
It was then that I realized that there is a difference between dog lover and dog sickness. It wasn’t about the money. She couldn’t possibly have recouped her losses. Anyone who knows rescue knows there is probably not a high enough price to charge for a puppy that makes backyard breeding profitable. Not if you actually feed and vet the dogs. The only people who turn a profit are those who supply no care.
But, did she love dogs? Yes, she loved the perfect dogs. She loved the ones that brought adoration in the show ring. Everything else was just a means to get there. Love this week could mean euthanasia next week…based on a whim.
Maybe it’s the way she taped the ears to give them that perfect collie fold that just sort of raised the question in my mind of what is it with people? What drives people to breed for a certain look? They breed cattle for record breaking milk or meat production, chickens that mature in 6 weeks…but what is it that drives people to commit inhumane acts in order to achieve a breed standard?
Like a lot of people I used to let these backyard breeders slide under the radar compared to the disdain I felt for puppy mills. I have been guilty myself of obtaining a puppy from a breeder, but education is everything. I admit, during my life, I have always been younger and more ignorant.
I just want to finish with a thought that has bothered me this past year about my own rescue dogs. Because it illustrates the mentality which leads to this obsession with breeds.
It is an incident that occurred when I adopted Charm, my pit bull/border collie mix. Now most of us know it doesn’t really matter what the other part of the mix is…if it got labeled pit bull at the shelter…it’s a pit bull for life. No one looks at my dog and says is that part border collie? No one. But there was a certain rescuer that put in postings saying that what I had adopted wasn’t a real pit bull.
Which led me to the thought…so would I have to go to a breeder who gives out AKC papers to have a real pit bull? What does it mean to be a real pit bull? Cuz, gosh, the shelter wasn’t going to provide me with anything other than an adoption certificate for a pit bull mix. I didn’t even know it was a contest…my pit bull is more pit bull than your pit bull? All I know is there was a dog who needed a home and she was labeled pit bull and that meant no one wanted her.
It’s that sort of thinking that fuels breeders everywhere. Human ego gets catered to at the expense of the dogs. In the end, dogs are dogs are dogs. I don’t expect perfection, or conformation. My purebred chow is no more and no less than my shelter specials. No one is following me around with a score sheet that I can detect.
But to conclude my rant for the day….breeders cater to something in humans which is not pretty. Get a dog not a fashion accessory. You are not going to look cooler, your dick is not going to seem bigger, your place on the planet is not measured in your manipulation of genetics. And every shelter in America has something special waiting for you…a 100% dog waiting for a home. And each and everyone comes with an adoption certificate…what other papers could you possibly want???
Becca Martin
A Weekly Update on Federal Policy Activity Related to Traumatic Brain Injury
From the Brain Injury Association of America:
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
Brain Injury Association of America
Policy Corner E-Newsletter – June 27, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
Legislative activity related to traumatic brain injury policy ensued on numerous fronts this week, as Congress made progress on several bills before leaving town for a week-long July 4 recess beginning on Monday.
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
Meanwhile – on the other side of the Capitol – as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs. Unfortunately, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. The fate of all House appropriations bills are now uncertain.
Progress on several important bills not related to appropriations also took place this week. On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act. BIAA has strongly supported and endorsed this legislation, which was recently introduced by Sen. Clinton (D-NY), and would strengthen supports for family caregivers of returning servicemembers with TBI.
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
Also this week, the Senate approved a compromise version of the war supplemental funding bill, readying the legislation for president’s expected signature. This legislation contained a moratorium – strongly supported by BIAA – on the implementation of several harmful Medicaid regulations.
Finally, the House and Senate were unable to agree on a final Medicare package, which would have prevented deep cuts beginning on July 1 in Medicare payment rates for physicians. Negotiations on such a package are expected to continue when Congress resumes session on Monday, July 7.
Please note that the next issue of Policy Corner will be published on Friday, July 11, as Congress is in recess next week.
*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
Labor-HHS-Education Appropriations Bill Advances in Senate; Stalls in House
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
The Senate’s markup provided the same funding amounts for several TBI programs as last year, including $5.7 million for TBI programming within the Centers for Disease Control and Prevention (CDC) and $8.754 million for the HRSA TBI State Grant Program.
Meanwhile, on the other side of the Capitol, as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs compared to last year. The House Subcommittee markup includes $11 million for the HRSA TBI State Grant Program (+$2.246 million over last year) and $6.6 million for TBI programming within CDC (+$0.9 million over last year).
Unfortunately, though, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. In fact, partisan vitriol reached such a high level during the attempted House markup of the Labor-HHS-Education funding bill that Rep. Obey (D-WI), Chairman of the House Appropriations Committee, threatened not to allow any further progress to occur this year on House appropriations bills. Stay tuned.
Senate Veterans Affairs Committee Approves Caring for Wounded Warrior Act Provisions
On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act, S. 2921. BIAA has strongly supported and endorsed this legislation, and several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.
Provisions in the legislation, which was recently introduced by Sen. Clinton (D-NY), would strengthen supports for family caregivers of returning servicemembers with TBI. Specifically, provisions would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.
A quote from BIAA President and CEO Susan H. Connors was included in Sen. Clinton’s press release announcing passage of the bill’s provisions:
“Traumatic brain injury not only affects individuals but entire families as well. The Brain Injury Association of America applauds Senator Clinton and Members of the Senate Veterans Affairs Committee for their leadership in passing this legislation, which compassionately and responsibly provides much-needed supports to family caregivers of servicemembers with TBI,” said Susan H. Connors, President and CEO of BIAA.
BIAA will continue to monitor the progress of this important bill, and thanks advocates for urging their Members of Congress to become cosponsors of this legislation.
House Passes ADA Amendments Act of 2008 By Wide Margin
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
The ADA Amendments Act of 2008 is the product of meaningful negotiations and discussions with experts in the disability community, business and employer groups, Members of Congress, and congressional staff. The measure prohibits consideration of mitigating measures in the determination of whether an individual has a disability, with the exception of ordinary eyeglasses and contact lenses. The bill also affords broad coverage for individuals “regarded as” having a disability under the ADA.
A copy of BIAA’s endorsement letter, which was circulated to all Members of the House of Representatives prior to the vote this week, is available at http://www.biausa.org/policyissues.htm.
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
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Brain Injury Association of America
Policy Corner E-Newsletter – June 27, 2008
A weekly update on federal policy activity related to traumatic brain injury
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Dear Advocates:
Legislative activity related to traumatic brain injury policy ensued on numerous fronts this week, as Congress made progress on several bills before leaving town for a week-long July 4 recess beginning on Monday.
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
Meanwhile – on the other side of the Capitol – as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs. Unfortunately, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. The fate of all House appropriations bills are now uncertain.
Progress on several important bills not related to appropriations also took place this week. On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act. BIAA has strongly supported and endorsed this legislation, which was recently introduced by Sen. Clinton (D-NY), and would strengthen supports for family caregivers of returning servicemembers with TBI.
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
Also this week, the Senate approved a compromise version of the war supplemental funding bill, readying the legislation for president’s expected signature. This legislation contained a moratorium – strongly supported by BIAA – on the implementation of several harmful Medicaid regulations.
Finally, the House and Senate were unable to agree on a final Medicare package, which would have prevented deep cuts beginning on July 1 in Medicare payment rates for physicians. Negotiations on such a package are expected to continue when Congress resumes session on Monday, July 7.
Please note that the next issue of Policy Corner will be published on Friday, July 11, as Congress is in recess next week.
*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
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Labor-HHS-Education Appropriations Bill Advances in Senate; Stalls in House
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
The Senate’s markup provided the same funding amounts for several TBI programs as last year, including $5.7 million for TBI programming within the Centers for Disease Control and Prevention (CDC) and $8.754 million for the HRSA TBI State Grant Program.
Meanwhile, on the other side of the Capitol, as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs compared to last year. The House Subcommittee markup includes $11 million for the HRSA TBI State Grant Program (+$2.246 million over last year) and $6.6 million for TBI programming within CDC (+$0.9 million over last year).
Unfortunately, though, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. In fact, partisan vitriol reached such a high level during the attempted House markup of the Labor-HHS-Education funding bill that Rep. Obey (D-WI), Chairman of the House Appropriations Committee, threatened not to allow any further progress to occur this year on House appropriations bills. Stay tuned.
Senate Veterans Affairs Committee Approves Caring for Wounded Warrior Act Provisions
On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act, S. 2921. BIAA has strongly supported and endorsed this legislation, and several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.
Provisions in the legislation, which was recently introduced by Sen. Clinton (D-NY), would strengthen supports for family caregivers of returning servicemembers with TBI. Specifically, provisions would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.
A quote from BIAA President and CEO Susan H. Connors was included in Sen. Clinton’s press release announcing passage of the bill’s provisions:
“Traumatic brain injury not only affects individuals but entire families as well. The Brain Injury Association of America applauds Senator Clinton and Members of the Senate Veterans Affairs Committee for their leadership in passing this legislation, which compassionately and responsibly provides much-needed supports to family caregivers of servicemembers with TBI,” said Susan H. Connors, President and CEO of BIAA.
BIAA will continue to monitor the progress of this important bill, and thanks advocates for urging their Members of Congress to become cosponsors of this legislation.
House Passes ADA Amendments Act of 2008 By Wide Margin
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
The ADA Amendments Act of 2008 is the product of meaningful negotiations and discussions with experts in the disability community, business and employer groups, Members of Congress, and congressional staff. The measure prohibits consideration of mitigating measures in the determination of whether an individual has a disability, with the exception of ordinary eyeglasses and contact lenses. The bill also affords broad coverage for individuals “regarded as” having a disability under the ADA.
A copy of BIAA’s endorsement letter, which was circulated to all Members of the House of Representatives prior to the vote this week, is available at http://www.biausa.org/policyissues.htm.
The Search for the Perfect Plaintiff
The technique almost all attorneys hired by insurance companies use to defend brain injury cases, is to blame all of the problems the injured person has after the accident on psychological problems the plaintiff had before the accident. The reason is that post concussional symptoms have much in common with the symptoms someone might have from depression. For that reason, defense attorneys and the doctors they hire will blame it on pre-morbid (pre-injury) factors, even if there is no documentation of such psychological issues beforehand.
Thus, experienced plaintiff attorneys become progressively more gun shy about representing someone who has had documented problems before they got hurt. History of migraine, don’t want the case; history of counseling, don’t want the case; prior accidents, don’t want the case. The list of reasons to not represent someone with a brain injury could go on for two pages, but suffice it to say I have heard lawyers I respect give entire lectures devoted to all the reasons not to represent someone.
To a degree, such caution is a self preservation instinct, because the amount of money and time a plaintiff attorney invests in a case. When a plaintiff attorney chooses the wrong brain injury case, not only do they risk not making any fee for his or her time (almost all of these cases are handled on a contingent fee basis) but the lawyer may lose tens of thousands of dollars in out-of-pocket costs, to get the case ready for trial. I confess to turning down cases that other lawyers are willing to take a chance on. My firm and our colleagues only have so much time and resources. Sometimes, there are just too many negatives to justify going forward.
Yet while I turn down many cases, I am turning down fewer cases because of concerns about a pre-morbid mental health issue. While such issues make a case more difficult, they also make it more significant. Concussion, quite simply, does not disable most people. But it does disable a significant minority, probably in the neighborhood of 15%. Pre-injury psychological problems might make a case more complicated, but to me, they also make it more credible. The “perfect plaintiff”, is considerably less likely to be the person disabled by a seemingly routine concussion. That person would likely have a steady improvement over the first few days after the concussion, and like young jocks, be back in the game a week or two later.
Yes, I suppose there are cases where a remarkable individual – with no clouds on their medical or emotional history – suffers a moderate to severe brain injury and becomes clearly disabled. But if you represent only the “perfect plaintiff” you will turn down far too many people whose cases merit representation. While I choose my challenges carefully, the challenge of connecting pre-morbid vulnerabilities to actual resulting pathology and disability, is one I am shying away from less and less.
Thus, experienced plaintiff attorneys become progressively more gun shy about representing someone who has had documented problems before they got hurt. History of migraine, don’t want the case; history of counseling, don’t want the case; prior accidents, don’t want the case. The list of reasons to not represent someone with a brain injury could go on for two pages, but suffice it to say I have heard lawyers I respect give entire lectures devoted to all the reasons not to represent someone.
To a degree, such caution is a self preservation instinct, because the amount of money and time a plaintiff attorney invests in a case. When a plaintiff attorney chooses the wrong brain injury case, not only do they risk not making any fee for his or her time (almost all of these cases are handled on a contingent fee basis) but the lawyer may lose tens of thousands of dollars in out-of-pocket costs, to get the case ready for trial. I confess to turning down cases that other lawyers are willing to take a chance on. My firm and our colleagues only have so much time and resources. Sometimes, there are just too many negatives to justify going forward.
Yet while I turn down many cases, I am turning down fewer cases because of concerns about a pre-morbid mental health issue. While such issues make a case more difficult, they also make it more significant. Concussion, quite simply, does not disable most people. But it does disable a significant minority, probably in the neighborhood of 15%. Pre-injury psychological problems might make a case more complicated, but to me, they also make it more credible. The “perfect plaintiff”, is considerably less likely to be the person disabled by a seemingly routine concussion. That person would likely have a steady improvement over the first few days after the concussion, and like young jocks, be back in the game a week or two later.
Yes, I suppose there are cases where a remarkable individual – with no clouds on their medical or emotional history – suffers a moderate to severe brain injury and becomes clearly disabled. But if you represent only the “perfect plaintiff” you will turn down far too many people whose cases merit representation. While I choose my challenges carefully, the challenge of connecting pre-morbid vulnerabilities to actual resulting pathology and disability, is one I am shying away from less and less.
Brain Injury and Clubs
Editor’s Note: On http://tbilaw.blogspot.com I am writing a very serious work on the Nightmare of Brain Injury. I thought these pics would be relevant and illustrative, but they disrupted the flow of what I was trying to say there, so I am posting them here.
And thank you Cindy for the images.
And thank you Cindy for the images.
Footnotes to the Nightmare of War Time Brain Injury
Editor’s Note: This week, I am engaged in an intense writing project on my other brain injury blog: http://tbilaw.blogspot.com on the Nightmare of Wartime Brain Injury. There are some footnotes and funnies that don’t really work as a direct part of that project, so I am posting them here. Later in the week, I will comment on Henry VIII’s brain injury here as it is quite pertinent to that topic as well. http://tbilaw.blogspot.com/2008/06/loss-of-smell-was-missed-sign-of-brain.html
Henry the VIII and Brain Injury Behavior Changes
From my co-author of https://waiting.com:
For those who watch the Showtime series, The Tudors, this season brought a lot of changes in the life of King Henry VIII. Although not happy with his new queen’s inability to deliver an heir, Anne’s prospects got a lot worse after the king suffered a fall from a horse in a jousting accident.One very believable theory as to why Henry VIII had such a dramatic change in weight was that he lost his sense of smell, which can dramatically change a person’s eating habits. See a related blog at http://tbilaw.blogspot.com/2008/06/loss-of-smell-was-missed-sign-of-brain.html
Some historians conjecture that Henry was severely affected by a leg injury he suffered at the time, but others further hypothesize that Henry, who is reported to have been unconscious for several hours, may have suffered a brain injury which led to the drastic change of behavior he exhibited towards Anne Boleyn after his fall.
When one considers the sort of activities the king engaged in prior to his fall -jousting tournaments and break neck hunting expeditions – it might be expected that the king most likely had a history of “knocks to the head”. Regardless, his perception of his wife, Anne, certainly became very distorted and in keeping with many of the symptoms of a brain injury.
Very suddenly, he became convinced that the woman he had risked a kingdom for, had seduced him with witchcraft and he became very susceptible to the reports of wrongdoings from her enemies at court. Eventually this led to several trials for infidelity and treason. Five men were accused on unconvincing evidence and sentenced to death, including her own brother, George Boleyn.
The signs are in the change of behavior in the king. When he had divorced Catherine of Aragon, although she was banished from the court, she was treated with some sort of compassion and her daughter Mary was given safe refuge. Not so, with Anne Boleyn. She was granted no mercy and the king was impatient for her execution and announced his betrothal to Jane Seymour 24 hours later, believing that he had a sign during his period of unconsciousness that she was his salvation.
It was a somewhat chilling reminder to me of the type of fill in memory that exists after a major brain injury, in which facts are easily distorted or replaced because the survivor must make sense out of the gaps which occur. I can easily imagine Thomas Cromwell’s whisperings to the king of Anne’s shortcomings suddenly becoming accepted as truth in an attempt by Henry to replace his own confusion.
Many of Henry’s behavioral changes are in keeping with the theory that he suffered a brain injury. Although his leg injury may have complicated his activities, his sudden disinterest in exercise and former activities certainly would help explain many of the medical symptoms he suffered from that point on, foremost being the obesity he suffered until the end of his life.
The reason I found this historical incident so intriguing is because it related to my own experience with a severe brain injury survivor in which confabulation played a key role. The survivor would fill in gaps with whatever information the people he had contact with gave him, true or false, he had no ability to discern reality himself. Thus, in a situation with hostile family members, this led to some very distorted views of his situation, despite proof to the contrary.
Not only did he fill in holes in his memory with random information, whatever information he was given was exaggerated with every telling. Given the facts of his accident, each time he repeated what he believed to have happened, it became more and more fantastic. This point struck me on The Tudors when Henry breaks down and cries that Anne had slept with hundreds of men when proof of her infidelity was sketchy at best.
It is no doubt, chilling, to realize that the 72,000 executions King Henry VIII ordered in his lifetime may have been perpetuated by an undiagnosed brain injury.
Regardless of the actual historical facts surrounding Henry’s injuries, the depiction that the writers for The Tudors chose to encompass was very true to the nature of brain injury. Henry had other injuries that the doctors were more concerned with and his head injury would have gone untreated. He was unable to discern that those around him had their own personal political agendas and became vulnerable to a desperation to fill in missing gaps in his own memory of the facts. He exaggerated fantastic gossip to mammoth proportions. His former grief and compassion for his enemies turned to an unemotional detachment towards those around him. And a former inclination for personal gratification escalated to a point that would make him an infamous character in history.
One can dispute the argument, but the change of person exhibited by Henry following his accident leaves many questions as to what damage actually occurred in his jousting accident.
Rebecca Martin