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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

We all know by now that Traumatic Brain Injury is the signature wound of the Iraq War. Explosions that would have killed soldiers in previous wars are now less often fatal, due to the improved protective qualities of military helmets. What happens, however, is that the brain is knocked around inside the skull, as the head forcibly hits the helmet during the explosion. The result is less fatalities, but more brain injuries. According to the Defense Department, more than 134,000 service men and women suffered traumatic brain injuries from 2003 through 2009. The military has planned clinical trials using pure oxygen in a pressurized chamber to determine if the technique can help brain-injury sufferers heal.

From The Associated Press:
The U.S. military plans clinical trials next year to see whether breathing pure oxygen in a pressurized chamber might help thousands of Iraq and Afghanistan war veterans suffering from traumatic brain injuries.

About 300 service members with mild to moderate damage will participate in the trials of hyperbaric oxygen therapy to help determine whether it can help them heal, or at least ease the headaches, mood swings or other symptoms linked to brain injury.

Some will spend a total of 40 hours over 10 weeks breathing pure oxygen in a hyperbaric chamber, where the atmospheric pressure is increased to a level similar to what they would experience about 20 feet under water.

According to the Defense Department, more than 134,000 service men and women suffered traumatic brain injuries from 2003 through 2009.

Read the story here.

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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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From the Tallahassee Democrat:
Unemployment, incarceration and divorce can all be experienced by those suffering from traumatic brain injury.
To address this, the state Department of Health recently developed a five-year plan to help people suffering from these and other problems resulting from TBI.

The plan was created as a way to enhance the traumatic brain injury system of care currently in existence and to increase advocacy, education and funding.
We'll try to get a copy of the five-year-plan and let you know more about it when we do.
Thom DeLilla, bureau chief of the Florida Department of Health Brain and Spinal Cord Injury Program, said a lack of knowledge about the injury is another important issue that needs to be solved by the five-year plan.

"Generally most people are not aware of TBI, the consequences of brain injury or resources available throughout the state," DeLilla said.
Well, Jack has been saying that since the mid 1980s. In fact, there were little or no resources available when Jack had his TBI. Although increased awareness and treatment options are what Jack's been fighting for these many years, it's a bittersweet victory that positive change, however delayed, is now in sight.

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Concussions confer tremendous brain damage," reports CNN. That's the latest finding from the Center for the Study of Traumatic Encephalopathy (CSTE), at the Boston University School of Medicine. From a Boston University press release:
Leading medical experts at the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) reported today that nine-year NFL veteran, former Tampa Bay Buccaneer Tom McHale was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45. In addition, the CSTE has discovered early evidence of CTE in the youngest case to date, a recently deceased 18-year-old boy who suffered multiple concussions in high school football.
Jack has argued for many years that concussions were more serious than popular opinion made them out to be. In fact, he was concerned enough to found a study at his prep school alma mater that administers neuropsychiatric tests to every incoming athlete. This serves as the baseline for future tests. Then, if a student athlete suffers a head injury, a subsequent test could presumably measure the extent, if any, of brain damage.
The discovery of the initial stages of CTE in an 18-year-old should move the discussion of football's concussion crisis toward youth football. The identity of the 18-year-old will not be revealed at the family's request. According to Cantu who wrote the first return-to-play guidelines, "Our efforts to educate athletes, coaches, and parents on the need to identify and rest concussions have only been moderately successful because people have been willing to look the other way when a child suffers a concussion. I hope the discovery of CTE in a child creates the urgency this issue needs. It is morally and ethically wrong to allow our children to voluntarily suffer this kind of brain trauma without taking the simple educational steps needed to protect them."
By the way, Jack doesn't limit his concerns to athletes. He thinks everyone should be tested as part of routine medical care.

According to the results of the study:
McHale, a Cornell University graduate, former restaurateur, husband and father of three boys, is the sixth former NFL player to be diagnosed post-mortem with CTE since 2002. CTE, a progressive neurodegenerative disease caused by repetitive trauma to the brain, is characterized by the build-up of a toxic protein called tau in the form of neurofibrillary tangles (NFTs) and neuropil threads (NTs) throughout the brain. The abnormal protein initially impairs the normal functioning of the brain and eventually kills brain cells. Early on, CTE sufferers may display clinical symptoms such as memory impairment, emotional instability, erratic behavior, depression and problems with impulse control. However, CTE eventually progresses to full-blown dementia. McHale died due to a drug overdose after a multi-year battle with addiction. Expert consensus is that drug abuse of any kind would never cause the neuropathological findings of CTE seen in McHale.
We encourage you to read the entire press release.

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The Atlanta Journal-Constitution, By ANDY MILLER, 11/20/07 --

Room 491, where Ben Fuller lives, has filled with family.

Fuller's parents and older brother are there. His son, Logan, romps about the Floyd Medical Center room, crawling under furniture and playing with an inflated medical glove.

Fuller is slow to react to the action. Sitting in a wheelchair, he stares out into space for long periods of time. His mother asks him occasional questions, and each answer seems a struggle.

The Fullers have spent three frustrating years searching for needed services for Ben, who suffered a traumatic brain injury at 24 that left him prone to profane and violent outbursts. At each turn, they seem to run into roadblocks. It's estimated that thousands of other Georgia families have encountered similar problems.

A new report says Georgia lacks services for patients like Fuller, whose behavioral problems are linked to jarring blows to the head.

An estimated 187,000 Georgians have a disability related to a traumatic brain injury (TBI), and up to 10 percent of those may need ongoing care for TBI-related behavioral problems, according to the report from the Brain and Spinal Injury Trust Fund Commission. Those problems can include physical aggression and an inability to communicate and control emotions.

Because of that, many of those TBI victims end up institutionalized: in jails, prisons, even the state's mental hospitals. Some become homeless.

The absence of a coordinated system of rehabilitative care for these brain injury victims is largely due to a lack of public and private funding, according to the report, which calls the situation "a crisis."

Money is scarce because of a lack of understanding by lawmakers and insurers, experts say. Private insurers, as well as Medicare and Medicaid, "don't see these services as medically necessary," says Susan Johnson, director of brain injury services at Shepherd Center in Atlanta and a commission member.

The report calls for more training and support for caregivers, better screening of TBI-related behavioral problems and more funding for rehabilitation. Often, residential and community services for TBI patients are either too expensive or don't exist. The report also calls for the Georgia General Assembly to look into the state's deficiencies in dealing with traumatic brain injury.

Continue reading the article.

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Jack can certainly speak on this topic. If you've read the beginning of his book, posted here online, you'll remember that, after his TBI, Jack was "fired" by his first doctor because of his behavior -- behavior he couldn't help.

From a recent article:
The council's study centers on the disruptive behaviors and emotional problems that brain-injury patients often exhibit and ways to help them, said Paul Aravich, a neuroscientist at Eastern Virginia Medical School and the council's past chairman.

Such problems often affect a person's impulse control, emotional skills and thinking skills and can be "the most disabling features of a brain injury," Aravich said. That's because the behavior, including anger and aggression, is often misunderstood, he said. The patient may be perceived as a "jerk" or as someone a nursing home or other center doesn't want to deal with, he said.

"If you are a person with a physical disability who is well-mannered and compliant, you can get help," he said. "But if you are a person with a challenging behavior, it is an entirely different problem. There is not a facility available to take care of them."
Read the whole article.

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Doctors say older people who had a stent put into the main artery of their brain to prevent strokes got a real bonus: improved mental function.The small study, which included 37 patients, found that 16 (43 percent) of them scored higher on a battery of 11 cognitive tests one year after the procedure, according to Dr. Rodney Raabe, chief of radiology at Sacred Heart Medical Center in Spokane, Wash. Read the entire article here.

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Smokers with a damaged insula -- a region in the brain linked to emotion and feelings -- quit smoking easily and immediately, according to a study in Science.
The study provides direct evidence of smoking's grip on the brain. Here's a link to the whole story in Science Daily.

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