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Jack Sisson's TBI Blog

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From ScienceDaily (Apr. 2, 2009)
A blood test that can help predict the seriousness of a head injury and detect the status of the blood-brain barrier is a step closer to reality, according to two recently published studies involving University of Rochester Medical Center researchers.

News stories about tragic head injuries – from the death of actress Natasha Richardson to brain-injured Iraq war soldiers and young athletes – certainly underscore the need for a simpler, faster, accurate screening tool, said brain injury expert Jeffrey Bazarian, M.D., M.P.H., associate professor of Emergency Medicine, Neurology and Neurosurgery at URMC, and a co-author on both studies.

The S-100B blood test recently cleared a significant hurdle when a panel of national experts, including Bazarian, agreed for the first time that it could be a useful tool for patients with a mild injury, allowing them to safely avoid a CT scan.

Previous studies have shown the S-100B serum protein biomarker to increase rapidly after an injury. If measured within four hours of the injury, the S-100B test accurately predicts which head injury patients will have a traumatic abnormality such as hemorrhage or skull fracture on a head CT scan. It takes about 20 minutes to get results and could spare many patients unnecessary radiation exposure.

Physicians at six Emergency Departments in upstate New York, including the ED at Strong Memorial Hospital in Rochester, this year will continue to study the accuracy of the test among 1,500 patients. Scientists plan to use the data to apply for U.S. Food and Drug Administration approval.
Read article.

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This morning I found an interesting site, Spot-On.com, which is, according to the site's About Us page, "a web-based syndication service offering a range of independent, intelligent and insightful looks at politics and current events." One post, by admitted liberal writer Christopher Brauchli, definitely merits sharing with our readers:
In his last State of the Union message, Mr. Bush received great applause when he said: "Our military families also sacrifice for America. . . . We have a responsibility to provide for them. So I ask you to join me in expanding their access to child care. . . and allowing our troops to transfer their unused education benefits to their spouses or children. Our military families serve our nation, they inspire our nation, and tonight our nation honors them." One week later he submitted his 2009 budget and dissed the veterans. No funds were included for transferring education benefits.

In submitting his $1.3 trillion budget he forgot to include the benefit that would cost between $1 billion and $2 billion dollars. That was not the end of ignoring the needs of veterans. According to a release from the Brain Injury Association of America, for the third year in a row, Mr. Bush has proposed the complete elimination of the Federal traumatic Brain Injury Program. The program "provides grants to state agencies and [other organizations] to improve access to health and other services for individuals with traumatic brain injury and their families." Susan Connors, president and CEO of the Brain Injury Association of America described the omission as "deeply disappointing" and went on to say that "President Bush just doesn't get it." Those two examples are not the only ones in which veterans who have withstood the onslaught from the enemy in Iraq have to defend themselves from the onslaught of the wolf in the White House parading in sheep's clothing.
Visit Spot-On.com to read the complete post.

Just the kind of duplicitous doublespeak we've come to associate with this administration, but it's especially troubling when those being hurt by it are our returning military, for heaven's sake, as well as some of our most vulnerable citizens. It's a disgraceful situation that should get tons of press, but I wonder how many of the Republican Party's faithful are even aware that the country's vets are being treated this way. My guess is not many. As I've said before, "Support our Troops" takes more than a magnet slapped on the rear of your SUV.

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The Buffalo News, by Lou Michel, Wednesday, December 19, 2007 --

You can see the cost of the wars in Iraq and Afghanistan in their empty shirt sleeves, the scars on their heads, in their eyes so weary from sleepless nights.

They return to their homes, trying to fit in again. Most will. Too many will not.

At least 25 local soldiers, four Marines and one sailor have been killed overseas since the war on terror began. Less known are the local veterans returning home with broken bodies or troubled souls.

Some 30,434 men and women in uniform have been wounded in Iraq and Afghanistan, but the Pentagon does not say where they are from, so it’s unclear exactly how many of the wounded hail from Western New York.

Almost 1,700 of those veterans have sought medical treatment at the Veteran Affairs Medical Center in Buffalo since 2003, with a majority seeking help for war-related injuries.

There are probably many more local veterans seeking medical treatment who are not counted in VA enrollment figures because of their status as citizen soldiers. Reservists and National Guard members often have access to private health insurance provided by from their civilian employers, according to VA officials in Washington, D.C.

But for the veterans who are trying to adjust while under the care of the local VA, the navigation of a sometimes unresponsive bureaucracy adds to the pain of life beyond the combat zone.

More than 600 of the 1,659 veterans treated here sought assistance for posttraumatic stress and other psychological readjustment troubles, according to the Department of Veterans Affairs.

“It is a full-time job working on getting whole, getting medical treatment and benefits,” said Bill Biondolillo, who served two combat tours in Iraq for a total of 14 months.

“We go and do the dirty work and we have to carry that, while the rest of the country goes on with life,” said Biondolillo, a major in the Reserves.

The list of injuries local veterans seek treatment for is frightening:

• Exposure to Russian-made bullets with depleted uranium in the shell casings. This can cause tumors, skin ailments and respiratory problems.

• Traumatic brain injuries and concussions from blasts, as well as shrapnel from explosive devices.

• Damage to the neck, back and hips from carrying as much as 100 extra pounds of body armor, ammo and other equipment.

• Irritable bowel syndrome and gastric illnesses caused by stress and living in unsanitary conditions.

Continue reading the article.

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Kaiser Daily Health Policy Report Capitol Hill Watch --
Lawmakers Pass Measures To Improve Veterans' Health Care Services

Dec 12, 2007 -- House and Senate lawmakers recently passed measures addressing veterans' health. Summaries of news about the legislation appear below:

* Traumatic brain injury: The Senate on Tuesday by voice vote passed a bill (S 793) sponsored by Sen. Orrin Hatch (R-Utah) intended to improve treatment of traumatic brain injuries in veterans returning from Iraq and Afghanistan, CQ Today reports. The bill would require CDC and NIH to conduct research to improve treatment techniques for traumatic brain injuries and also would mandate that CDC monitor brain injury cases. In addition, the legislation would reauthorize and expand programs established by a 1996 law that permits CDC to grant states funds for brain injury patients to enter treatment and rehabilitation programs (Hunter, CQ Today, 12/11).

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NASHIA logoThere's almost too much to blog about here -- and there's certainly too much to blog about in detail -- at the page on NASHIA's recent 2007 State-of-the-States conference.

What is NASHIA? It's the National Association of State Head Injury Administrators (and I bet you didn't know there was even one state head injury administrator, let alone a whole national association):
TBI is a complex disability that challenges States’ ability to respond to the needs of persons with TBI and their families. These individuals need services that cross multiple programs including Medicaid, vocational rehabilitation, employment, education, home health care, mental health, substance abuse, and long-term care programs. Without coordinated systems of care, individuals are often placed inappropriately into nursing homes or left to the families to care for without much support or assistance. When families are no longer able to care for these individuals, the families turn to the State, which is generally the only resource for these crisis situations.

In 1990 NASHIA became the first and remains the only forum addressing State government’s significant role in brain injury. NASHIA is the premier source of information and education for State Agency employees who are responsible for public brain injury policies, programs, and services. NASHIA is also the voice of State government in Federal TBI policy issues.

NASHIA reaches out to all State Agency employees who interact with individuals with brain injury and welcomes membership by advocates, professionals, and organizations with an interest in State and local policy and service delivery.
(From the About NASHIA page)

The theme of the September conference this year was "Gateway to Solutions: Doing What Works." Many presentations from the conference are available as (often large) MS Powerpoint files and/or Adobe Acrobat (.pdf) documents.

The first day's presentations focused largely on TBI and the military (a subject which we've covered here regularly). Topics:
  • Veterans and TBI
  • Department of Veterans Affairs
  • The True Welcome Home (Missouri's State Veterans Ombudsman and "Operation Outreach" program)
  • Heart of a Hero
  • States Panel ("how four States have encountered challenges and opportunities in bridging the gap between current systems for veterans with TBI")
Day 2 moved on to some other topics:
  • CDC Update: TBI Resources from the CDC and How You Can Use Them
  • TBI in Jails and Prisons: Ethics and Implications of Screening
  • TBI and Aging
  • Behavioral Issues after Brain Injury: Where To From Here?
  • TBI and the Substance Abuse System
  • Domestic Violence and the Link to the World of TBI
  • Assistive Technology and Employment
  • Having Our Say: Consumer-Directed Services and People with Brain Injury
  • Mining the Online TBI Collaboration Space (TBICS) to Find Publication Gems
  • Homelessness and Acquired Brain Injury: Identification, Needs Assessment, and Case Management
  • TBI is a Community Health Issue
  • Protection and Advocacy Work with Veterans
  • Shaken Baby Prevention Initiatives
...and there were still Friday and Saturday to come!

Visit the NASHIA conference page for links to the presentations themselves. And while you're there, also see their page of information on yet more conferences which they sponsor. Excellent resource.

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In an article earlier this year, the magazine Discover asked, "What sort of future do brain-injured Iraq veterans face?" Read the following article to find out if they managed to answer that question:

Discover, 02.23.2007 -- In a flash, the blast incinerates air, sprays metal, burns flesh. Milliseconds after an improvised explosive device (IED) detonates, a blink after a mortar shell blows, an overpressurization wave engulfs the human body, and just as quickly, an underpressure wave follows and vanishes. Eardrums burst, bubbles appear in the bloodstream, the heart slows. A soldier—or a civilian—can survive the blast without a single penetrating wound and still receive the worst diagnosis: traumatic brain injury, or TBI, the signature injury of the Iraq War.

But in the same instant that the blast unleashes chaos, it also activates the most organized and sophisticated trauma care in history. Within a matter of hours, a soldier can be medevaced to a state-of-the-art field hospital, placed on a flying intensive care unit, and receive continuous critical care a sea away. (During Vietnam, it took an average of 15 days to receive that level of treatment. Today the military can deliver it in 13 hours.) Heroic measures may be yielding unprecedented survival rates, but they also carry a grim consequence: No other war has created so many seriously disabled veterans. Soldiers are surviving some brain injuries with only their brain stems unimpaired.

While the Pentagon has yet to release hard numbers on brain-injured troops, citing security issues, brain-injury professionals express concern about the range of numbers reported from other military-related sources like the Defense and Veterans Brain Injury Center, the Department of Defense, and the Department of Veterans Affairs (VA). One expert from the VA estimates the number of undiagnosed TBIs at over 7,500. Nearly 2,000 brain-injured soldiers have already received some level of care, but the TBIs—human beings reduced to an abbreviation—keep coming.

Keep reading this article.

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Washington Post

ROMNEY, W.VA., Sunday, October 14, 2007 -- Michelle Turner's husband sits in the recliner with the shades drawn. He washes down his Zoloft with Mountain Dew. On the phone in the other room, Michelle is pleading with the utility company to keep their power on.

"Can't you tell them I'm a veteran?" asks her husband, Troy, who served as an Army scout in Baghdad and came back with post-traumatic stress disorder.

"Troy, they don't care," Michelle says, her patience stretched.

The government's sweeping list of promises to make wounded Iraq war veterans whole, at least financially, has not reached this small house in the hills of rural West Virginia, where one vehicle has already been repossessed and the answering machine screens for bill collectors. The Turners have not been making it on an $860-a-month disability check from the Department of Veterans Affairs.

After revelations about the poor treatment of outpatient soldiers at Walter Reed Army Medical Center earlier this year, President Bush appointed a commission to study the care of the nation's war-wounded. The panel returned with bold recommendations, including the creation of a national cadre of caseworkers and a complete overhaul of the military's disability system that compensates wounded soldiers.

But so far, little has been done to sort out the mess of bureaucracy or put more money in the hands of newly disabled soldiers who are fending off evictions and foreclosures.

In the Turner house, that leaves an exhausted wife with chipped nail polish to hold up the family's collapsing world. "Stand Together," a banner at a local cafe reminds Michelle. But since Troy came back from Iraq in 2003, the burden of war is now hers.

Michelle has spent hundreds of hours at the library researching complicated VA policies and disability regulations. "You need two college degrees to understand any of it," she says, lacking both. She scavenges information where she can find it. A psychotic Vietnam vet she met in a VA hospital was the one who told her that Troy might be eligible for Social Security benefits.

Meanwhile, there are clothes to wash, meals to cook, kids to get ready for school and a husband who is placidly medicated or randomly explosive. Besides PTSD, Michelle suspects that Troy may have a brain injury, which could explain how a 38-year-old man who used to hunt and fish can lose himself in a three-day "Scooby-Doo" marathon on the Cartoon Network.

Keep reading this article.

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U.S. Army Sgt. Frank Sandoval
It's hard to believe that, at this late date, certain people still accuse those of us opposed to the Iraq War of not supporting our troops. How in the world can they construe supporting our troops to mean sending them back into that escalating quagmire for repeated (and extended) tours of duty where over 3,700 have died and approximately 1,800 have suffered traumatic brain injuries (TBIs)?

According to the Washington Post, "...neurologists worry that hundreds of thousands more -- at least 30 percent of the troops who've engaged in active combat for four months or longer in Iraq and Afghanistan -- are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch." A study by researchers at Harvard and Columbia predict that brain injuries from the Iraq war will cost the government at least $14 billion over the next 20 years.

Here's one more recent story:
CAMP WILLIAMS, Utah (ABC 4News)- A voluntary assignment to help the people of Afghanistan develop new agriculture skills turned into a life long sentence for a Utah man, who joins an increasing list of returning soldiers who suffer from traumatic brain injuries caused by roadside bombs.

"I remember leading up to it, the event, most of the explosion, no," said Highland resident Doyle Peterson.

A roadside bomb destroyed Peterson's vehicle in rural Afghanistan two years ago on August 21, 2006. He is recovering physically, but like many roadside bomb survivors Peterson sustained permanent damage to his brain.

"It's a blank spot. I do remember some of the things that happened when we were being evacuated to the field hospital," he said.

Brain injures are now the signature injury of the Iraq war according to former Secretary of Army, Martin R. Hoffman. Hoffman came to Utah to meet with members of the Community Based Health Organization (OBHCO) located at Camp Williams.
Continue reading.

The photo accompanying this post was honored in The Best of PhotoJournalism 2007. Go here to see this picture and other winners.

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The number of TBI's caused by injuries in the Iraq War continues to stretch the government's ability to treat them. As the following excellent article points out, no one was prepared for the high number of wounded, kept alive by improved body armor. And no one really knows exactly how many of those wounded are TBI survivors:
Only an estimated 2,000 cases of brain injury have been treated, but doctors think many less obvious cases have gone undetected. One small study found that more than half of one group of wounded troops arriving at Walter Reed Army Medical Center had brain injuries. Around the nation, a new effort is under way to check every returning man and woman for this possibility.
Even with the continuing media coverage of the war's injured, and the recent flurry of interest by Congress, I still don't think the average American's knowledge (or even awareness) of TBI has increased by much. I hope I'm wrong. I know that Bob Woodruff got a lot of press, and that he made the rounds of television talk shows. I suppose we just need to be patient. Change takes time, and it will be a while before people's understanding of TBI increases appreciably. Here's an excerpt from the article:
Orangeburg Times Democrat, June 23,2007 -- These are America's war wounded, a toll that has received less attention than the 3,500 troops killed in Iraq. Depending on how you count them, they number between 35,000 and 53,000.

More of them are coming home, with injuries of a scope and magnitude the government did not predict and is now struggling to treat.

"If we left Iraq tomorrow, we would have the legacy of all these people for many years to come," said Dr. Jeffrey Drazen, editor-in-chief of the New England Journal of Medicine and an adviser to the U.S. Department of Veterans Affairs. "The military simply wasn't prepared for its own success" at keeping severely wounded soldiers alive, he said.
Continue here to read the entire article.

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ABC30.com, 05/24/2007 - As many as 20% of service members returning from duty in Iraq and Afghanistan will have some level of traumatic brain injury.

This spring the Department of Defense acknowledged traumatic brain injury as a "significant health concern" and vowed to identify it among active duty troops. But many new cases are likely to emerge as troops transition to civilian life as veterans.

Military records show that 60% of the 25,000 war injuries to date resulted from explosive blasts like IED's or roadside bombs. And nearly 3,000 of the wounded are currently being treated for severe traumatic brain injury or TBI.

Fresno V.A. Hospital emergency room doctor James Lindsay says injuries in this war are different from other wars when bullets did the majority of the damage.

Dr. Lindsay, Fresno V.A. E.R. physician, says "there's less ballistic wounding from actual gunfire and more blast injuries and blast injuries typically produce traumatic brain injuries." And those blasts can leave an injury without ever breaking the skin.

Read the article here.

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News about brain injuries in Iraq doesn't stop:
Frontline combat troops in the Iraq war have at least a one in five chance of coming home with a brain injury, according to Chris Elia, a Veterans Affairs psychologist who spoke Friday about traumatic brain injuries in veterans at the second annual Black Hills Brain Injury Conference in Rapid City.

“And I suspect it’s a much higher chance than that,” Elia said, presenting an array of statistics about what has become the “signature wound” of the wars in Iraq and Afghanistan.

Of the 23,000 U.S. soldiers, marines and other military personnel who have been wounded in Iraq and Afghanistan since 2002, more than 6,500 have been diagnosed with traumatic brain injury, according to military figures. Elia said those numbers are probably low, given what today’s war is still teaching medical experts about blast injuries.
What a shame that it's literally taken a war to bring TBI front and center. Hardly a day goes by now that TBI is not in the news, and word of advances in TBI research hits the media with unusual frequency. Advocates for brain injury research have wanted this for a long time, but who could have forseen that a war would be necessary to accomplish it? The universe does indeed work in mysterious ways, but I can't imagine anyone who'd have chosen this route to brain-injury awareness.

Read the complete article here.

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'Red Tree Sky,' photo by Greg Olsen, copyright 2007
No matter your politics, I hope you'd agree that it's a strange world in which wars are said, dispassionately, to have "signature injuries." For the American Civil War, maybe this was battlefield amputations; for World War I, trench mouth or gas-attack symptoms; for Vietnam, I guess, post-traumatic stress; and for the original Gulf War, various Agent Orange-related afflictions.

Here at sossisson.com, we've noted before (recently, for example, here) that traumatic brain injury is widely regarded as the signature wound of the current war in Iraq. This sad state of affairs has at last received Federal attention, in the form of a Congressional ruling that soldiers must be tested for TBI before and after their Iraq deployments. This news came at the end of last week, in a report from USA Today. This comes roughly concurrently with a report from the Defense Department itself, per the Associated Press.

From USA Today:
The Pentagon must use computers to screen troops before and after they go to Iraq or Afghanistan to better determine whether they suffered traumatic brain damage in combat, according to a plan by a congressional brain-injury task force...

Congress has authorized a record $450 million for brain-injury treatment and research in the Iraq spending bill being negotiated by Congress and the White House. Legislators say the Pentagon acted slowly on this issue.

"The military was blindsided by the number of blast injury victims in Iraq and Afghanistan, and it is clear that the proper resources were never in place to care for them," says Rep. Bill Pascrell, D-N.J., co-chairman and founder of the 112-member Congressional Brain Injury Task Force.

And from the Associated Press:
Issuing an urgent warning, the Defense Department's Task Force on Mental Health chaired by Navy Surgeon General Donald Arthur said more than one-third of troops and veterans currently suffer from problems such as traumatic brain injury and post-traumatic stress disorder.

With an escalating Iraq war, those numbers are expected to worsen, and current staffing and money for military health care won't be able to meet the need, the group said in a preliminary report released Thursday.

"The system of care for psychological health that has evolved in recent decades is not sufficient to meet the needs of today's forces and their beneficiaries, and will not be sufficient to meet the needs in the future," the 14-member group says.
There have also been a couple of other recent news items on this issue:

As increasingly elaborate body armour protects the torso, and even the limbs, the brain is still vulnerable to shock waves that helmets cannot deter... And these "closed-head" injuries are harder to treat than even those commonly suffered by motorcyclists.
  • From the San Antonio Express-News, "Troops living with brain injury":
    ...untold thousands of U.S. troops [are] returning from the Middle East with a brain injury, the signature wound of the war in Iraq and a rising challenge stateside for everyone from doctors to lawmakers.

    Overtaxed military medical facilities have farmed out many cases [...] to private rehabilitation centers at an unprecedented pace, raising questions about oversight and quality of care and forcing the military to rethink preventing and screening for such injuries, many of which are hidden...

    In Iraq, modern body armor protects troops from bullets and shrapnel. Not even a padded helmet can keep a riveting blast from pounding the brain against the ridges inside the skull, causing bruising or swelling or stretching its nerve fibers. The injuries often aren't seen on CT scans or MRIs.

    But they can cause a loss of balance, memory or cognitive skills that might not appear until a year after deployment. Even civilians who don't live by the tough-and-ready ethos of the military are hesitant to seek help.

  • From Army Times, "Soldier says he was deployed with head injury":
An MRI later showed that Thurman had lesions on the right parietal lobe of his brain, a condition that led to a “don’t deploy” order — which the Army violated, according to Thurman. Worse, rather than providing compassionate understanding of the symptoms associated with traumatic brain injury, he said leaders at Fort Carson, Colo., have harassed him, refused him medication and pushed for an Article 15.

Thurman stepped forward Friday as one of the 18 soldiers whose cases were cited by six senators in a letter to the Government Accountability Office requesting a review of alleged improper handling of traumatic brain injuries, post-traumatic stress disorder and ungrounded personality disorder discharges.

The letter was sent after an Army surgeon general investigation into the cases said the soldiers were handled properly — but the soldiers involved said no one from the surgeon general’s office ever talked to them in the course of that investigation.
As an aside, if you -- like I -- were previously unfamiliar with the term "Article 15": It refers to a section of the Universal Code of Military Justice, or UCMJ. Generally, it's one of the UCMJ's "punitive articles." According to Rod Powers, about.com's "Guide to the US Military," Article 15 is one of several procedures
whereby the commanding officer or officer in charge may:
  • Make inquiry into the facts surrounding minor offenses allegedly committed by a member of his command;
  • afford the accused a hearing as to such offenses; and
  • dispose of such charges by dismissing the charges, imposing punishment under the provisions of Art. 15, UCMJ, or referring the case to a court-martial.
To initiate Article 15 action, a commander must have reason to believe that a member of his/her command committed an offense under the UCMJ. Article 15 gives a commanding officer power to punish individuals for minor offenses... The term "minor offense" ordinarily does not include misconduct which, if tried by general court-martial, could be punished by a dishonorable discharge or confinement for more than one year. The military services, however, have taken the position that the final determination as to whether an offense is "minor" is within the sound discretion of the commanding officer.
Note that the soldier whose case is covered in the Army Times piece claims about his post-TBI treatment that his superiors have "pushed for an Article 15." I understand that the military code of justice must be different than the civilian. But if this claim is at all true, I hope the military at least stops to reflect on ways in which Article 15 can be abused -- if not outright criminalizes the abuse.

[Updated 2007-05-09 7:56 pm]

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FORT CARSON, Colo. — The Army, faced with thousands of cases of brain injury from the Iraq war, will soon begin testing brain-scanning equipment in hopes of finding a more accurate way to identify hard-to-diagnose wounds...

To date, the Army has not extensively used neuroimaging equipment to detect brain injuries in returning soldiers because not enough testing has been done to judge the

Read the rest of the article.

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Former GOP Sen. Bob Dole
The government is finally beginning to address the myriad problems faced by our returning wounded troops, including those with TBI. Found this at PostStar.com:
WASHINGTON - Injured soldiers returning home for medical treatment face an unacceptable maze of paperwork and bureaucracy, leaders of a presidential commission on veterans' health care said Saturday.

At its first public meeting, the nine-member panel heard from veterans, spouses and advocacy groups who decried what they said was a failed system. The commission pledged to work quickly to find solutions rather than assign blame.

"This is not going to be a witch hunt," said former GOP Sen. Bob Dole of Kansas, one of the heads of the Commission on Care for America's Returning Wounded Warriors.

Dole said the commission planned to build upon the work of at least nine congressional committees and other government panels that are investigating veterans' health care problems. Those inquiries followed disclosures in February of squalid conditions and poor outpatient treatment at Walter Reed Army Medical Center in Washington.

Their reviews in recent weeks have pointed to inadequacies with the treatment of brain injury and post-traumatic stress disorder, as well as outpatient care.
Read the entire article.

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Sen. Hillary Clinton
From ABC NEWs:
April 11, 2007— "Where do I go to get my brain back?"

That's what a member of the armed services recovering at Walter Reed Army Medical Center said when Sen. Hillary Clinton, D-N.Y., asked him how he was doing last week.

Clinton recounted the story Wednesday on a conference call with journalists to announce new legislation aimed at helping victims of traumatic brain injury.

The legislation, sponsored by Clinton and Sen. Evan Bayh, D-Ind., would allow TBI victims to extend their "active duty" status for up to one year from the date that their injury is determined.

Brain Injuries Plague Veterans

"We are not addressing the unique challenges posed by TBI in the way that we need to be," Clinton said.

Under the current system, those recovering from TBI are forced to choose between remaining on active duty and receiving the best state-of-the-art care from the Department of Defense or entering retired status and returning to their hometowns to receive care under the umbrella of the Department of Veterans Affairs.

Patient's Advocate for Victims

The bill would also provide that every TBI victim be given a "patient's advocate" to help the patient wade through what can be an enormously complicated and frustrating system.
All of this is very good news, of course, but a "patient's advocate" is a big step forward and a subject dear to Jack's heart. He believes that if he'd been given a "caretaker / advocate / physiatrist / case manager" -- whatever you want to call it -- his care and recovery during those first couple of years would have been much improved. Jack strongly believes this is necessary for all TBI patients.

Read the complete article.

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Assignments lengthened to 15 months.
The following seems a little "after the fact," because Traumatic Brain Injury was labeled the signature wound of the Iraq War last year. Still, even if the military has been slow to fully address this issue, the following AP article from the "Boston Herald" sounds promising (except for identifying TBI as "military parlance"):
AUGUSTA, Maine - Traumatic brain injuries are common among wounded soldiers returning from Iraq, but they’re also commonly misdiagnosed or undetected, according veterans’ activists and Maine’s congressional delegation.

For some soldiers, the injury is graphically obvious.

”They’re the ones with part of their skull missing,” Ron Brodeur, state inspector for the Maine Department of Disabled American Veterans, said during a forum Wednesday on soldiers’ health care.

For others, the traumatic brain injury, or TBI in military parlance, presents itself in subtle ways, said Jack Sims, director of the Togus Veterans Administration Medical Center.

”Our providers are now aware of TBI and are on the lookout for it. We’re trying to be much more proactive in recognizing these things than we were in past conflicts,” he said.
Read the entire article.


Here's more from the "IndyStar":
WASHINGTON -- Sens. Evan Bayh and Hillary Rodham Clinton said Wednesday that soldiers with traumatic brain injuries should get extended treatment through the Defense Department instead of the Veterans Affairs Department, which they argued is less capable of handling such injuries.

The Democrats, who serve on the Senate Armed Services Committee, said they would pursue legislation to make that change.
"The VA does a great job," Bayh said. "But they've simply been overwhelmed by the number of these types of injuries and are still in transition in terms of how best to treat them.
Read the article.

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In conjuction with Brain Injury Awareness Month, and to raise awareness about brain injury and its life-altering consequences, BIAA announces the availability of new materials for the public, those who have experienced a brain injury, their family members/caregivers, professionals and interested persons.

A new brain injury awareness packet and materials are now available.

The 2007 kit includes: (note - some of these are large PDF files)

Behavioral Challenges after Brain Injury booklet;

Challenges, Changes, and Choices: A Brain Injury Guide for Families and Caregivers booklet;

Driving After Brain Injury: Issues, Obstacles and Possibilities booklet;

Falls: The Leading Cause of Brain Injury booklet;

A Physician Talks about Severe Brain Injury. The Basics booklet;

A poster reflecting the diversity of traumatic brain injury across the United States;

Four fact sheets outlining personal stories of traumatic brain injury;

Centers for Disease Control and Prevention’s Facts about Traumatic Brain Injury fact sheet;

Directory of the Association’s Chartered State Affiliates;

Frequently Asked Questions about the Defense and Veterans Brain Injury Program;

BIAA Bookstore informational sheet

Visit the BIAA site for links to the above information.

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How sad that it's taken someone famous to finally shine a spotlight on traumatic brain injury. It wasn't enough that every year "1.4 million Americans suffer a TBI — more than are struck by heart attacks." It also wasn't enough that more than a year ago TBI "officially" became the signature wound of the Iraq War.

I remember having a somewhat heated conversation with a producer for Larry King Live because she was adamant that they would only do a show on TBI if it was headline news. I questioned just exactly what more they wanted -- newspapers had reported that TBI was the war's signature wound. Hundreds of young Americans were being shipped home from Iraq with this life-altering injury that the general public apparently knew very little about. But that was not newsworthy enough, and very soon, even the few newspapers who'd carried stories were silent.

Now that Bob Woodruff has published a book on his own injury, TBI is all over the media. Television, radio, newspapers, magazines. It's what we've wanted for so long -- for people to recognize both its seriousness and pervasiveness. I'm relieved and grateful that the country's getting this education, but I still wonder what it says about us and our media that it took celebrity status to accomplish what TBI's millions of victims and the war's recent wounded could not -- get someone to listen.

Read a good MSNBC article here.

And go here for a New York Times piece on the problems our newest severely wounded veterans are facing.

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Losing the Physical Self

Tower of Hanoi: Instructions for this popular puzzle can be viewed simply by clicking the Instructions button on that page.

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