When we first created https://waiting.com in 1997, we were working with a trauma nurse from Froedtert Hospital in Milwaukee, Wisconsin in organizing and fact checking the page. At the time, I had asked her what the biggest break through which had occurred over the years in saving lives for severe brain injury. I had expected her to say the CT Scan which allows doctors to see the killer of increased intracranial pressure before it kills, or some other imaging or pressure related device. She surprised me with her answer: Flight for Life helicopters.
It was her belief that it was the Flight for Life Helicopters that rushed severely brain injured persons to the regional trauma center where she worked, that enabled all of the rest of modern medical science to intervene before death, or before more brain damage occurred. As being old enough to have watched every episode of MASH, it was easy for me to grasp the importance of what she was saying.
Ironically, I didn’t appreciate until I started doing death and brain injury cases from the aviation liability end, just how much those doctors and nurses who staffed those Flight for Life helicopters, risked their life to save the brain injured. Saturday night, three more died in this valiant cause in a helicopter crash near LaCrosse, Wisconsin. Dead are Dr. Darren Bean, nurse Mark Coyne, both of University of Wisconsin Hospitals and the helicopter pilot, Steve Lipperer. For more details, click here.
Today, all of those in the brain injury community should have a day of remembrance for the brave medical personnel and pilots who risk their life to save so many from death and further disability. Each time you see a Flight for Life, say a salute or a prayer for those who serve on board. Perhaps we can all plant a tree or a flower in honor.
Brain Injury Association Urges Support for Wounded Warriors Act
From the Brain Injury Association of Wisconsin:
Dear Friends:For those not in Wisconsin, your Senators and Congressmen can be found at http://www.senate.gov/ and http://www.house.gov/
Take Action!
Urge Your Senator to Cosponsor The Caring for Wounded Warriors Act of 2008
BIAA (Brain Injury Association of America) has endorsed The Caring for Wounded Warriors Act of 2008 (S. 2921), legislation introduced on Monday, April 28 by Senator Hillary Rodham Clinton which would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.
BIAA encourages you to urge your Senator to sign on as a cosponsor of this important legislation.
The bill would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning service members with TBI.
The first pilot program, which would provide for training, certification, and compensation for family caregiver personal attendants for veterans and members of the Armed Forces with TBI, is very similar to a provision in last year’s Heroes At Home Act of 2007, which BIAA also strongly endorsed.
The second pilot program would leverage existing partnerships between Veterans Affairs facilities and the nation’s premier universities, training graduate students to provide respite care for families caring for wounded warriors suffering from TBI.
To urge your Senator to become a cosponsor of S. 2921, click on the ‘Take Action’ link in the upper right corner of this email.
The Brain Injury Association of Wisconsin and the Brain Injury Association of America support this legislation.
If you have trouble with the “Take Action” button at the top, please let BIAW know. To “Take Action” visit www.biausa.org. Click on Policy & Legislation, then Legislative Action Center, and then Take Action.
Sincerely yours,
Pat David
Brain Injury Association of WI
Brain Injury Association to Hold Caregivers’ Conference
Caregivers’ Conference
The National Brain Injury Caregivers’ conference will be held in Dallas, TX on June 6-8, 2008 at the Westin Dallas Fort Worth Airport Hotel. The conference provides, caregivers of a person with a brain injury, support and guidance.
The conference will feature numerous medical professionals, over 25 experts and Lee Woodruff, special guest and best selling author. Lee Woodruff is the wife of Bob Woodruff, who suffered a brain injury in the Iraq War. His story is well chronicled, see for example: http://abcnews.go.com/WNT/Story?id=2904214
The conference is presented by The Brain Injury Association of America (BIAA). BIAA was founded in 1980, as an organization that supports individuals that are affected or individuals that have someone close that has been affected by a traumatic brain injury, by providing information and education.
Other speakers:
For further information:
http://biausa.org/livingwithbi.htm
The National Brain Injury Caregivers’ conference will be held in Dallas, TX on June 6-8, 2008 at the Westin Dallas Fort Worth Airport Hotel. The conference provides, caregivers of a person with a brain injury, support and guidance.
The conference will feature numerous medical professionals, over 25 experts and Lee Woodruff, special guest and best selling author. Lee Woodruff is the wife of Bob Woodruff, who suffered a brain injury in the Iraq War. His story is well chronicled, see for example: http://abcnews.go.com/WNT/Story?id=2904214
The conference is presented by The Brain Injury Association of America (BIAA). BIAA was founded in 1980, as an organization that supports individuals that are affected or individuals that have someone close that has been affected by a traumatic brain injury, by providing information and education.
Other speakers:
Joseph C. Richert
Chair, Brain Injury Association of America
President & CEO, Special Tree Rehabilitation System
Gregory J. O’Shanick, MD
President/Medical Director, Center for Neurorehabilitation and
National Medical Director, Brain Injury Association of America
Thomas Kay, PhD
Director Neuropsychology, Carmel and Associatates
Sarah Wade
Spouse of Injured Veteran
John Corrigan, PhD
Director, Ohio Valley Center for Brain Injury Prevention and Rehabilitation
Michael Howard, PhD
Clinical and Rehabilitation Psychologist, Lecturer
Biomed General Corporation
Janet Tyler, PhD
Director, Kansas TBI Project
Julie Peterson-Shea
Parent of child with brain injury
Lisa Silver
Transition Assistance Advisor, West Virginia National Guard
Peggy Keener
Parent of Person with Brain Injury
Faye Eichholzer
Spouse of Person with Brain Injury
Cheryl Amoruso
Sibling of Person with Brain Injury
Richard P. Bonfiglio, MD
Medical Director, HealthSouth Harmarville
Mike Davis, CBIS-CE
Neurological Case Management Associates
James Mikula, PhD
Neuropsychologist, Private Practice
Carolyn Rocchio
Caregiver of Person with brain injury
Laura Schiebelhut
Director of Public Policy, Brain Injury Association of America
Tim Feeney PhD
Executive Director, School and Community Support Services
Planning for the Transition from School Services to Adulthood
Linda Wilkerson, MSEd
President, Minds Matter LLC
Janet Tyler, PhD
Director, Kansas TBI Project
Visual Changes after Brain Injury
William Padula, OD
Director, Padula Institute of Vision Rehabilitation
Vocational Options After Brain Injury
Brandy Reid
Team Leader/Vocational Evaluator, Pate Rehab Dallas, TX
Kellie Manderfeld
Clinical Manager, Pate Rehab Dallas TX
Bill Ditto
Director, New Jersey Division of Disability Services
Tina Trudel, PhD
President/COO, Lakeview Healthcare Systems, Inc.
Susan H. Connors
President & CEO, Brain Injury Association of America
For further information:
http://biausa.org/livingwithbi.htm
TBI Act Signed into Law
From the Brain Injury Association:
Brain Injury Association of America
Policy Corner E-Newsletter – May 2, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
This week marked a major legislative victory for the brain injury community, as President Bush officially signed into law legislation reauthorizing the TBI Act (S. 793) on Monday, April 28! Congratulations to all BIAA state affiliates, advocates, and national stakeholders who helped make TBI Act reauthorization a reality. To view a copy of BIAA’s official press release applauding this major accomplishment, please visit our website at http://www.biausa.org/policyissues.htm.
In other exciting news, BIAA proudly endorsed The Caring for Wounded Warriors Act of 2008 (S. 2921), legislation introduced on Monday, April 28 by Senator Hillary Rodham Clinton which would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill. A copy of BIAA’s Letter of Endorsement for S. 2921 will be available shortly on our website at http://www.biausa.org/policyissues.htm.
Also this week, a report was released by the Department of Veterans Affairs Inspector General which found that the VA is not providing the necessary standard of support and long-term follow-up assistance needed by veterans with TBI and their families.
In addition, after the House of Representatives passed by a veto-proof margin last week important legislation which would place a moratorium until March 2009 on several harmful Medicaid regulations (H.R. 5613), the fate of the bill was left up to the Senate. Earlier this week, Senate Majority Leader Harry Reid (D-NV) attempted to bring the bill up on the Unanimous Consent Calendar, but this attempt was blocked by Senator Coburn (R-OK). Now there is an effort to get the bill included in the FY 2008 Supplemental Appropriations bill. BIAA continues to strongly endorse H.R. 5613 and supports efforts to include the bill in the FY 2008 Supplemental Appropriations bill.
As a final note, BIAA is waiting to see if Congress will be able to establish a budget this year before sending out its Legislative Action Alert on FY 2009 TBI Appropriations. There is speculation that Congress may indeed be able to achieve a budget agreement in the upcoming next few weeks, and BIAA’s Appropriations Action Alert will be sent out shortly thereafter.
*Distributed by Laura Schiebelhut, BIAA Public Affairs Manager, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
The Policy Corner is made possible by the Adam Williams Initiative, Centre for Neuro Skills, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
President Bush Signs TBI Act Reauthorization Bill Into Law
This week marked a major legislative victory for the brain injury community, as President Bush officially signed into law legislation reauthorizing the TBI Act (S. 793) on Monday, April 28! Congratulations to all BIAA state affiliates, advocates, and national stakeholders who helped make TBI Act reauthorization a reality.
BIAA issued a press release applauding this major accomplishment, noting that achieving successful reauthorization of the TBI Act has been BIAA’s biggest federal legislative priority this year.
BIAA President and CEO Susan Connors said, “TBI is recognized as a signature injury of the conflicts in Iraq and Afghanistan. The programs authorized by the TBI Act play a critical role in improving the nation’s ability to meet the needs of individuals with brain injury, military and civilian alike.”
This major policy accomplishment simply would not have been possible without the tremendous efforts of BIAA state affiliates, advocates, and collaboration among national stakeholders, as well as the leadership of numerous Members of Congress and the dedicated efforts of their staff members.
In particular, BIAA expresses profound appreciation for the leadership efforts of Senator Edward Kennedy, Senator Orrin Hatch, Representative Bill Pascrell, Representative Todd Platts, Representative John Dingell, and Representative Frank Pallone, all of whom played critical roles in ensuring the progress of this bill.
To view a copy of BIAA’s press release, please visit our website at http://www.biausa.org/policyissues.htm.
BIAA Strongly Endorses The Caring for Wounded Warriors Act of 2008
In other exciting news, BIAA proudly endorsed The Caring for Wounded Warriors Act of 2008 (S. 2921), legislation introduced on Monday, April 28 by Senator Hillary Rodham Clinton which would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.
The bill 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.
The first pilot program, which would provide for training, certification and compensation for family caregiver personal attendants for veterans and members of the Armed Forces with TBI, is very similar to a provision in last year’s Heroes At Home Act of 2007 (S. 1065/H.R. 3051), which BIAA also strongly endorsed.
The second pilot program would leverage existing partnerships between Veterans Affairs facilities and the nation’s premier universities, training graduate students to provide respite care for families caring for wounded warriors suffering from TBI.
Note: The legislation specifies that the curricula for the TBI Family Caregiver Personal Care Attendant Training and Certification Program “shall incorporate applicable standards and protocols utilized by certification programs of national brain injury care specialist organizations.” The legislation further specifies that the VA should also use such applicable standards and protocols in providing training for graduate student respite care providers.
A copy of BIAA’s Letter of Endorsement for S. 2921 will be available shortly on our website at http://www.biausa.org/policyissues.htm.
VA Inspector General Releases Report Criticizing TBI Care for Veterans
Also this week, a report was released by the Department of Veterans Affairs Inspector General which found that the VA is not providing the necessary standard of support and long-term follow-up assistance needed by veterans with TBI and their families.
The report, which was conducted at Senate Veterans Affairs Committee Chairman Daniel Akaka’s (D-HI) request, found specifically; “While case management has improved, long-term case management is not uniformly provided for these patients, and significant needs remain unmet.”
A copy of the report can be found at http://www.va.gov/oig/54/reports/VAOIG-08-01023-119.pdf.
TBI Support Group – Mint Julip
From one of our favorite former clients:
Thanks Cindy.
I had a good time at our TBI support group meeting today. It was a small group with only about 6 of us. Drake has changed their rules and does not allow us to serve or bring refreshments. We are only allowed to have them if we order them from Drake directly, which our TBI group can’t do since it does not have any funds.And the recipe:
So, I told our local TBI contact person that I would like to share with the group, the therapeutic value of growing mint. I brought several plastic baggies with mint plants along with the directions on How to Grow Mint in a Container Garden. I also shared with them the therapeutic value of making something with the mint….like Non-Alcoholic Mint Juleps. Pulling out all of the necessary items and the directions, I asked the group to help me figure out what we needed to do.We worked on a variety of skills at the beginning of our meeting. Cognitive skills like gathering together necessary materials, figuring out what materials we should distribute to everyone first, reading and following directions, sequencing. Physical skills and coordination involved in scooping ice out of a container with a ladle and placing it into a cup, using tongs to grab the mint sprigs and place in their cups. One member new to the group said the mint sprig should be placed in the top of the straw…so we had the added challenge of using very fine motor skills! Social skills like enjoying each other’s company, “clinking” our plastic cups together and sharing our hopes for this year. Another member came in late, so we re-tested our memory as we worked together to make a Mint Julep for her.
Today’s group was a rewarding experience for me. I was able to do a skill I used to do prior to my TBI on a smaller scale. It was fun and I felt great! And now I have to take a nap and recover.
Cindy
TBI (ALCOHOL-FREE) MINT JULEP
IngredientsDirections
- 1 cup water
- 1 cup white sugar
- _ cup (or more) fresh mint leaves, chopped
- Crushed ice
- Prepared lemonade
- Fresh mint sprigs, for garnish
To Make Mint Syrup:
- 1. Combine water, sugar and chopped mint in a pan. Bring to a boil and stir until sugar has dissolved.
- 2. Turn off burner and set pan aside for about an hour to cool down.
- 3. Strain out mint leaves by placing strainer over the container you are using for your mint syrup. (If the holes in your strainer are large enough to allow some of the leaves to go through, place a paper towel or coffee filter inside your strainer.)
- 4. Refrigerate mint syrup.
To Make Drink:–Cindy Schneider
- 1. Fill cup with ice. (Crushed ice works best)
- 2. Fill cup about _ full with prepared lemonade.
- 3. Pour a small amount of the mint syrup into your cup of lemonade. Taste and adjust according to your preference, adding more lemonade or more mint syrup if desired.
- 4. Garnish with a sprig of mint and a straw. Sip slowly and enjoy. (Especially good on a hot summer’s day.)
- 5. Optional: Make some sun tea and use in place of lemonade.
Thanks Cindy.
Herschel Walker, Brain Damage and Football
Too many hits? It is an old sports term, used to describe the running back who suddenly went from a Hall of Fame credentials, to ordinary, to out of football. It seems like half of the greatest running backs of all time went thru it.
If you are old enough to remember Earl Campbell, you would argue that no modern running back could carry his helmet. Yet, he went from absolutely amazing to positively mediocre, almost overnight. In 1983, he gained 1301 yards. In 1984, he had only 468. Even playing for his beloved coach Bum Phillips in New Orleans in 1985, he could only muster 643 yards, and then he was gone. http://www.profootballhof.com/hof/member.jsp?player_id=40
The younger readers may have only heard of Earl because of his relationship to the scandal of the way the NFL treats its veterans and their medical needs. http://www.cyclonefanatic.com/forum/pro-sports/18098-earl-campell-texas-legend.html
Others have their explanations for his disability. Mine: It all starts in the brain. We know that boxers ultimately become demented because of too many hits, but think of the force that a running back absorbs on nearly every carry. Is it a surprise that the cumulative impact of that force on the microscopic connective wires within the brain – the axons, ultimately effects thought, the nervous system and the way in which the brain and nervous system control the body?
There are three incomparable running backs in my adult years: Earl Campbell, Walter Payton and Emmitt Smith. Payton is the exception, I have no head injury theories with respect to him. But I remember the Cowboy Emmitt Smith in a way that only a Packer fan can. He just found a way to beat you. Not the fastest, not the biggest, not perhaps even the most elusive. He just had a knack. Big difference between Emmitt and Earl was that while Emmitt could run over people, he preferred to make them miss. Earl just ran over you for the sport of it. Well, Emmitt didn’t have that sudden career collapse that Earl did. He played successfully his last years in the game although the Cowboys did give up on him.
In my theories, the big change in Emmitt wasn’t because of the cumulative total of a lot of hits. His change seemed to occur all at once. On a Monday night game, against the Bears, Emmitt jumped over a pile and landed straight on his head. The way I remember it, it was a touchdown. It was the neck injury that got everyone excited. But I don’t believe Emmitt ever had quite the same knack after that play. His Cowboys never knocked the Packers out of the Playoffs again.
Why is Subtle Brain Injury© so disabling to a running back? A Subtle Brain Injury first effects the processing speed potentials of the brain because it disrupts white matter, the axons. While men in general are not as white matter dependent as women (a topic for another blog) athletes, especially those who must have instantaneous responses, are.
Assume that a running back needs 2 billion axons (to pick an entirely artificial number) to be able to react quickly enough to all of the different stimuli, applied memory and decision making of carrying the football. This pre-injury capacity gives the great runner the ability to know to cut left instead of right, situationally depending on whether it is All Pro Jimmy Linebacker who is trying to crush him versus Johnny Lineman. For more on diffuse axonal injury, click here.
Well, let’s also assume that our hypothetical running back started his career with 2.5 billion axons, but every hit robs him of a few and all of the blindsided ones, millions. Well when suddenly his reserves drop below 2 billion, he can’t react quickly enough to avoid the All Pros, but can still make the average defensive player miss. But now when Mr. All Pro hits him hundreds of millions of axons are lost, and it only takes a few more games until he can’t avoid even Mr. Average anymore. His strength is the same, his speed is the same, but his instincts are gone. Pretty soon the speed will go too because of the cumulative total of all those hits on his muscles and joints.
Well, this week’s news has another story of a legendary running back who went from All World, to worst trade in history in a short span, Herschel Walker. Walker went from 1514 yards in 1988 to 915 yards in 1989. While there are those who will say that this had to do with the way in which he was used after he left the Cowboys for Minnesota, true football fans will know that he just never had the same special quality after leaving the Cowboys. Like Earl Campbell, Walker used his amazing strength and power to punish defenders.
Now, Herschel Walker is newsworthy because of mental illness. See http://www.philly.com/philly/sports/eagles/20080415_NFL___Herschel_Walker_talks_of_mental_illness.html OK, that is possibly the explanation, but I am not convinced. Too many hits equals too much brain damage, which adds up to potential for serious neurobehavioral disorders.
If you think I am seeing brain injury under every rock, perhaps I am. But would someone please explain to me why the Poster Child for brain injury in sport – Mike Tyson, was never disqualified from boxing because of brain injury? If his complete inability to not bite Evander Holyfield’s ears is not a symptom of brain injury, then the world is flat. (For someone who shares my belief about Mike Tyson and brain injury, click here.)
I am not an expert in football or boxing although my first career was as a sport writer. I am not a medical doctor, so technically I am not an expert in brain injury either. But I do know both sports and brain injury and I know enough to recognize the patterns that point to brain damage. Is there enough force, is there evidence of injury and is there a change in the person? Emmitt I am suspicious about, especially the short term effect of the season he landed on his head. Of Earl, Herschel and Mike Tyson, I have no doubt.
If you are old enough to remember Earl Campbell, you would argue that no modern running back could carry his helmet. Yet, he went from absolutely amazing to positively mediocre, almost overnight. In 1983, he gained 1301 yards. In 1984, he had only 468. Even playing for his beloved coach Bum Phillips in New Orleans in 1985, he could only muster 643 yards, and then he was gone. http://www.profootballhof.com/hof/member.jsp?player_id=40
The younger readers may have only heard of Earl because of his relationship to the scandal of the way the NFL treats its veterans and their medical needs. http://www.cyclonefanatic.com/forum/pro-sports/18098-earl-campell-texas-legend.html
Others have their explanations for his disability. Mine: It all starts in the brain. We know that boxers ultimately become demented because of too many hits, but think of the force that a running back absorbs on nearly every carry. Is it a surprise that the cumulative impact of that force on the microscopic connective wires within the brain – the axons, ultimately effects thought, the nervous system and the way in which the brain and nervous system control the body?
There are three incomparable running backs in my adult years: Earl Campbell, Walter Payton and Emmitt Smith. Payton is the exception, I have no head injury theories with respect to him. But I remember the Cowboy Emmitt Smith in a way that only a Packer fan can. He just found a way to beat you. Not the fastest, not the biggest, not perhaps even the most elusive. He just had a knack. Big difference between Emmitt and Earl was that while Emmitt could run over people, he preferred to make them miss. Earl just ran over you for the sport of it. Well, Emmitt didn’t have that sudden career collapse that Earl did. He played successfully his last years in the game although the Cowboys did give up on him.
In my theories, the big change in Emmitt wasn’t because of the cumulative total of a lot of hits. His change seemed to occur all at once. On a Monday night game, against the Bears, Emmitt jumped over a pile and landed straight on his head. The way I remember it, it was a touchdown. It was the neck injury that got everyone excited. But I don’t believe Emmitt ever had quite the same knack after that play. His Cowboys never knocked the Packers out of the Playoffs again.
Why is Subtle Brain Injury© so disabling to a running back? A Subtle Brain Injury first effects the processing speed potentials of the brain because it disrupts white matter, the axons. While men in general are not as white matter dependent as women (a topic for another blog) athletes, especially those who must have instantaneous responses, are.
Assume that a running back needs 2 billion axons (to pick an entirely artificial number) to be able to react quickly enough to all of the different stimuli, applied memory and decision making of carrying the football. This pre-injury capacity gives the great runner the ability to know to cut left instead of right, situationally depending on whether it is All Pro Jimmy Linebacker who is trying to crush him versus Johnny Lineman. For more on diffuse axonal injury, click here.
Well, let’s also assume that our hypothetical running back started his career with 2.5 billion axons, but every hit robs him of a few and all of the blindsided ones, millions. Well when suddenly his reserves drop below 2 billion, he can’t react quickly enough to avoid the All Pros, but can still make the average defensive player miss. But now when Mr. All Pro hits him hundreds of millions of axons are lost, and it only takes a few more games until he can’t avoid even Mr. Average anymore. His strength is the same, his speed is the same, but his instincts are gone. Pretty soon the speed will go too because of the cumulative total of all those hits on his muscles and joints.
Well, this week’s news has another story of a legendary running back who went from All World, to worst trade in history in a short span, Herschel Walker. Walker went from 1514 yards in 1988 to 915 yards in 1989. While there are those who will say that this had to do with the way in which he was used after he left the Cowboys for Minnesota, true football fans will know that he just never had the same special quality after leaving the Cowboys. Like Earl Campbell, Walker used his amazing strength and power to punish defenders.
Now, Herschel Walker is newsworthy because of mental illness. See http://www.philly.com/philly/sports/eagles/20080415_NFL___Herschel_Walker_talks_of_mental_illness.html OK, that is possibly the explanation, but I am not convinced. Too many hits equals too much brain damage, which adds up to potential for serious neurobehavioral disorders.
If you think I am seeing brain injury under every rock, perhaps I am. But would someone please explain to me why the Poster Child for brain injury in sport – Mike Tyson, was never disqualified from boxing because of brain injury? If his complete inability to not bite Evander Holyfield’s ears is not a symptom of brain injury, then the world is flat. (For someone who shares my belief about Mike Tyson and brain injury, click here.)
I am not an expert in football or boxing although my first career was as a sport writer. I am not a medical doctor, so technically I am not an expert in brain injury either. But I do know both sports and brain injury and I know enough to recognize the patterns that point to brain damage. Is there enough force, is there evidence of injury and is there a change in the person? Emmitt I am suspicious about, especially the short term effect of the season he landed on his head. Of Earl, Herschel and Mike Tyson, I have no doubt.
TBI Act Reauthorization
From the Brain Injury Association of Wisconsin
But how come the tail of the brain injury animal, war injuries, gets all of the research and attention? There are a million Subtle Brain Injuries© a year in the U.S. and perhaps, a few thousand in Iraq. What about all the civilians who have brain injuries? Isn’t it time we did some major research on those most likely to be disabled by brain injuries, those over 40 – especially women over 40, those with prior head injuries and those with co-morbid issues such as other neurologic or emotional disorders?
A Subtle Brain Injury is a complicated synergistic maze. Limiting our research to young jocks and war casualties is not going to enlighten us as to why some people have apparent full recoveries and others never get better. It is not an accident that there is consistently 10-15% of those with concussions who wind up with persistant post concussion syndrome. Let us start screaming louder so that the real pathology in those cases is understood, and treated.
- TBI Act Reauthorization Update: Last week the US Congress passed legislation to reauthorize the Traumatic Brain Injury Act! The bill appears ready to be sent on to President Bush for his signature. In addition to authorizing ongoing CDC, NIH and HRSA TBI programs, the bill also authorizes a new study by the CDC and NIH in collaboration with the Dept. of Defense and the Dept. of Veterans Affairs to identify the incidence of brain injury among our veterans, especially veterans of Iraq and Afghanistan. Again, THANK YOU to all who took time to share their opinions with Congress regarding this legislation during the past year.
But how come the tail of the brain injury animal, war injuries, gets all of the research and attention? There are a million Subtle Brain Injuries© a year in the U.S. and perhaps, a few thousand in Iraq. What about all the civilians who have brain injuries? Isn’t it time we did some major research on those most likely to be disabled by brain injuries, those over 40 – especially women over 40, those with prior head injuries and those with co-morbid issues such as other neurologic or emotional disorders?
A Subtle Brain Injury is a complicated synergistic maze. Limiting our research to young jocks and war casualties is not going to enlighten us as to why some people have apparent full recoveries and others never get better. It is not an accident that there is consistently 10-15% of those with concussions who wind up with persistant post concussion syndrome. Let us start screaming louder so that the real pathology in those cases is understood, and treated.
Another Brain Injury Goodbye
Yesterday I dedicated this blog to the death of a great pioneer in the field of brain injury, Bryan Jennett, M.D. of the GCS scale. Today, I would like to give best wishes to a former advocacy colleague of mine, Pat David, of the Brain Injury Association of Wisconsin. I joined this organization in 1994 and became a member of its board for several years thereafter. Pat was the rock of that organization since that time and today announced her retirement. It comes with some good news, the passing in the House of Representatives of the TBI Act.
Here is the BIAW’s press release relative to Pat:
Dear Members & Donors:
I wanted to inform you of my pending retirement from the Brain Injury Association in June of 2008. I am so grateful for the past fifteen years and the opportunity to serve individuals with brain injury and their families in Wisconsin. I want to thank you, our members and donors, because it is your support that is the foundation upon which this organization was built and will grow. It has been a true privilege for which I am grateful.
Our Board of Directors is currently in the process of screening applicants for the Executive Director position and establishing a process for interviewing. We are also receiving input from our collaborative partners from the Dept. of Health and Family Services and the WI Brain Injury Advisory Council. Our plan is to have an individual in place before my departure to facilitate a smooth transition. I will keep you informed as that process further evolves.
I also need to share some breaking news….Yesterday, the US House of Representatives passed legislation to reauthorize the TBI Act (S. 793), by a vote of 392-1. The bill authorizes programs over the period of FY 2009 through FY 2012. Thanks to all who made their opinions known by contacting their Representative! The bill will next go to the US Senate once again, where approval is expected. Pending passage in the Senate, it would then be sent on to the President for his signature.
Thank you and do not hesitate to contact us at admin@biaw.org or 1-800-882-9282 with questions.
Sincerely yours,
Pat David
Director of Operations
Pat, your absence will be felt and I trust that your successor will do his or her best to carry on your mission.
Here is the BIAW’s press release relative to Pat:
Dear Members & Donors:
I wanted to inform you of my pending retirement from the Brain Injury Association in June of 2008. I am so grateful for the past fifteen years and the opportunity to serve individuals with brain injury and their families in Wisconsin. I want to thank you, our members and donors, because it is your support that is the foundation upon which this organization was built and will grow. It has been a true privilege for which I am grateful.
Our Board of Directors is currently in the process of screening applicants for the Executive Director position and establishing a process for interviewing. We are also receiving input from our collaborative partners from the Dept. of Health and Family Services and the WI Brain Injury Advisory Council. Our plan is to have an individual in place before my departure to facilitate a smooth transition. I will keep you informed as that process further evolves.
I also need to share some breaking news….Yesterday, the US House of Representatives passed legislation to reauthorize the TBI Act (S. 793), by a vote of 392-1. The bill authorizes programs over the period of FY 2009 through FY 2012. Thanks to all who made their opinions known by contacting their Representative! The bill will next go to the US Senate once again, where approval is expected. Pending passage in the Senate, it would then be sent on to the President for his signature.
Thank you and do not hesitate to contact us at admin@biaw.org or 1-800-882-9282 with questions.
Sincerely yours,
Pat David
Director of Operations
Pat, your absence will be felt and I trust that your successor will do his or her best to carry on your mission.
In Memoriam Bryant Jennett – Glasgow Coma Scale Author
In general, brain injury research and work is a pretty anonymous field. I can rattle off a bunch of names of researchers, but even most defense experts have never heard of many of these people. One of the names that almost everyone in the brain injury field has heard is Bryan Jennett. If they haven’t heard of him, they have heard of his most famous work: the Glasgow Coma Scale, commonly referred to as the GCS. The GCS score is the most single common denominator in all of head injury diagnosis, and any cursory review of a brain injury medical record will have a GCS score on it.
Bryan Jennett, CBE, M.D., the brain injury expert of Glasgow, Scotland, died on 16 February 2008. For a nice treatment on Dr. Jennett click here. The North East Center also includes a nice comment on his work on such link by Nathan Zasler, M.D. that is worth reading – Reflections on the Life and Work of William Bryan Jennett, CBE, M.D., FRCS. Dr. Zasler had this to say about Dr. Jennett:
“During his career, Dr. Jennett not only distinguished himself as a clinician and scholar but lectured and wrote extensively on issues relating to brain injury.
“He remained one of the driving forces behind some of the more recent international work in the area of disorders of consciousness over the last 15 years. What was most amazing was Dr. Jennett’s ability to look back on his own work and be constructively critical of it, including acknowledging some of the limitations of his own thinking. He continued to provide encouragement to other clinicians to pursue further honing of our collective understanding of the complexities of both assessment and management of this special population of persons with acquired brain injury.”
Only if this generation of doctors, scholars and researchers can share Dr. Jennett’s passion and vision for the future of brain injury research, will the advocacy that propelled Dr. Jennett’s career, be fulfilled. I hope his death reminds the medical community of that what we don’t know about brain injury is infinitely greater than what we know. Research on…
Next: the GCS score. What it tells us and what it does not.
Bryan Jennett, CBE, M.D., the brain injury expert of Glasgow, Scotland, died on 16 February 2008. For a nice treatment on Dr. Jennett click here. The North East Center also includes a nice comment on his work on such link by Nathan Zasler, M.D. that is worth reading – Reflections on the Life and Work of William Bryan Jennett, CBE, M.D., FRCS. Dr. Zasler had this to say about Dr. Jennett:
“During his career, Dr. Jennett not only distinguished himself as a clinician and scholar but lectured and wrote extensively on issues relating to brain injury.
“He remained one of the driving forces behind some of the more recent international work in the area of disorders of consciousness over the last 15 years. What was most amazing was Dr. Jennett’s ability to look back on his own work and be constructively critical of it, including acknowledging some of the limitations of his own thinking. He continued to provide encouragement to other clinicians to pursue further honing of our collective understanding of the complexities of both assessment and management of this special population of persons with acquired brain injury.”
Only if this generation of doctors, scholars and researchers can share Dr. Jennett’s passion and vision for the future of brain injury research, will the advocacy that propelled Dr. Jennett’s career, be fulfilled. I hope his death reminds the medical community of that what we don’t know about brain injury is infinitely greater than what we know. Research on…
Next: the GCS score. What it tells us and what it does not.
EDITORS NOTE: 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 – April 4, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education, urging an increase in Fiscal Year 2009 funding for TBI programs.
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues, which highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI.
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
Unfortunately, no activity occurred this week on H.R. 1418, the House version of legislation to reauthorize the TBI Act, which was passed by the House Energy and Commerce Act on March 13, 2008. BIAA will continue to advocate strongly for floor consideration of the bill by the entire House of Representatives and full passage by Congress into law as quickly as possible.
*Distributed by Laura Schiebelhut, BIAA Public Affairs Manager, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
The Policy Corner is made possible by the Adam Williams Initiative, Centre for Neuro Skills, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
BIAA Submits Testimony to House Labor-HHS-Education Appropriations Subcommittee
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education. BIAA’s testimony urges an increase in Fiscal Year 2009 funding for programs authorized through the TBI Act, as well as for TBI research programs conducted within the National Institute on Disability and Rehabilitation Research (NIDRR).
In the testimony, BIAA’s President and CEO Susan H. Connors states, “BIAA was gravely disappointed that last year, even as Congress had the good judgment to add hundreds of millions dollars to the budgets of the Department of Defense and the Department of Veterans Affairs to help address the problem of TBI among returning servicemembers, funding for the HRSA Federal TBI Program was reduced from $8.91 million to $8.754 million.”
Within the testimony, BIAA requests $30 million in funding for programs authorized through the TBI Act, as well as sufficient funding to sustain and increase medical rehabilitation research within NIDRR. The testimony also urges an allocation of at least $8.3 million to allow NIDRR to continue to fund 16 TBI Model Systems research centers.A copy of the testimony can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.
House VA Subcommittee Holds Hearing on TBI And Vision Problems
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues.
Testimony highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI, and the need for a seamless system of care within the Department of Defense and Department of Veterans Affairs to address these eye injuries, including greater use of specialized vision screening.
In the hearing, the Blinded Veterans Association (BVA) noted research showing that 75 percent of servicemembers with documented TBI injuries also have complaints about vision problems, and that approximately 60 percent of those injured have associated neurological visual disorders. A study conducted by one of the panelists, Gregory L. Goodrich, who is a research psychologist at the VA Palo Alto Health Care System, found that both Polytrauma Level I and Level II patients had high rates of visual impairment and/or visual dysfunction, and that injuries caused by a blast event were associated with more vision related loss and/or deficits than other causes.
In his testimony, Tom Zampieri, Director of Government Relations at BVA, asserted, “At present the current system of screening, treatment, tracking, and follow-up care for TBI vision dysfunction is inadequate. Adding visual dysfunction to this complex mix, especially if undiagnosed, makes attempts at rehabilitation even more daunting and potentially disastrous unless there are significant improvements soon.”
Mr. Zampieri urged the Subcommittee to request that DoD/VA provide for the full implementation of the “Military Eye Trauma Center of Excellence and Eye Trauma Registry,” which was recently authorized as one of the Wounded Warrior provisions in last year’s defense authorization bill (H.R. 4986). BIAA has officially endorsed legislation (S. 1999) to create such a Center.
BIAA Supports Bill to Enact Moratorium on Harmful Medicaid Regulations
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
The legislation, which was introduced by Representatives John D. Dingell (D-MI) and Tim Murphy (R-PA) on March 13, 2008, would delay the implementation of seven harmful Medicaid regulations through March 2009, including several rules which would be especially deleterious to individuals with traumatic brain injury.
One of these rules would limit rehabilitation services for Medicaid beneficiaries, severely curtailing the ability of people with disabilities – including TBI – to receive rehabilitation services now covered under Medicaid. Access to these rehabilitative services is essential, as in many cases, these services play a vital role in allowing people with TBI to live independently in the community.
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 – April 4, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education, urging an increase in Fiscal Year 2009 funding for TBI programs.
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues, which highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI.
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
Unfortunately, no activity occurred this week on H.R. 1418, the House version of legislation to reauthorize the TBI Act, which was passed by the House Energy and Commerce Act on March 13, 2008. BIAA will continue to advocate strongly for floor consideration of the bill by the entire House of Representatives and full passage by Congress into law as quickly as possible.
*Distributed by Laura Schiebelhut, BIAA Public Affairs Manager, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
The Policy Corner is made possible by the Adam Williams Initiative, Centre for Neuro Skills, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
BIAA Submits Testimony to House Labor-HHS-Education Appropriations Subcommittee
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education. BIAA’s testimony urges an increase in Fiscal Year 2009 funding for programs authorized through the TBI Act, as well as for TBI research programs conducted within the National Institute on Disability and Rehabilitation Research (NIDRR).
In the testimony, BIAA’s President and CEO Susan H. Connors states, “BIAA was gravely disappointed that last year, even as Congress had the good judgment to add hundreds of millions dollars to the budgets of the Department of Defense and the Department of Veterans Affairs to help address the problem of TBI among returning servicemembers, funding for the HRSA Federal TBI Program was reduced from $8.91 million to $8.754 million.”
Within the testimony, BIAA requests $30 million in funding for programs authorized through the TBI Act, as well as sufficient funding to sustain and increase medical rehabilitation research within NIDRR. The testimony also urges an allocation of at least $8.3 million to allow NIDRR to continue to fund 16 TBI Model Systems research centers.A copy of the testimony can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.
House VA Subcommittee Holds Hearing on TBI And Vision Problems
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues.
Testimony highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI, and the need for a seamless system of care within the Department of Defense and Department of Veterans Affairs to address these eye injuries, including greater use of specialized vision screening.
In the hearing, the Blinded Veterans Association (BVA) noted research showing that 75 percent of servicemembers with documented TBI injuries also have complaints about vision problems, and that approximately 60 percent of those injured have associated neurological visual disorders. A study conducted by one of the panelists, Gregory L. Goodrich, who is a research psychologist at the VA Palo Alto Health Care System, found that both Polytrauma Level I and Level II patients had high rates of visual impairment and/or visual dysfunction, and that injuries caused by a blast event were associated with more vision related loss and/or deficits than other causes.
In his testimony, Tom Zampieri, Director of Government Relations at BVA, asserted, “At present the current system of screening, treatment, tracking, and follow-up care for TBI vision dysfunction is inadequate. Adding visual dysfunction to this complex mix, especially if undiagnosed, makes attempts at rehabilitation even more daunting and potentially disastrous unless there are significant improvements soon.”
Mr. Zampieri urged the Subcommittee to request that DoD/VA provide for the full implementation of the “Military Eye Trauma Center of Excellence and Eye Trauma Registry,” which was recently authorized as one of the Wounded Warrior provisions in last year’s defense authorization bill (H.R. 4986). BIAA has officially endorsed legislation (S. 1999) to create such a Center.
BIAA Supports Bill to Enact Moratorium on Harmful Medicaid Regulations
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
The legislation, which was introduced by Representatives John D. Dingell (D-MI) and Tim Murphy (R-PA) on March 13, 2008, would delay the implementation of seven harmful Medicaid regulations through March 2009, including several rules which would be especially deleterious to individuals with traumatic brain injury.
One of these rules would limit rehabilitation services for Medicaid beneficiaries, severely curtailing the ability of people with disabilities – including TBI – to receive rehabilitation services now covered under Medicaid. Access to these rehabilitative services is essential, as in many cases, these services play a vital role in allowing people with TBI to live independently in the community.