Update: Bipartisan Appeal for Reauthorization of TBI Act

On Friday, December 21, 2018, “H.R. 6615, which reauthorizes appropriations for programs and activities relating to the study, prevention, and treatment of traumatic brain injury (TBI),” was signed into law by President Trump.  Officially called the Traumatic Brain Injury Program Reauthorization Act of 2018, the bill previously passed the House with a 353-6 margin and passed the Senate unanimously.  (Reauthorizations were also given to other key health bills, H.R.1222, the Congenital Heart Futures Reauthorization Act of 2017, and H.R. 1318, the Preventing Maternal Deaths Act of 2018.)

Earlier this month, Congressman Pascrell spoke of the bill in House, “Mr. Speaker, I rise to support H.R.6615… I would like to thank Chairman Walden and Ranking Member Pallone for their work to move this important legislation forward.”  Following being signed into law, Chairman Greg Walden (OR) said, “These bipartisan bills… represent a continuation of the hard work [the House Energy and Commerce Committee] has done this Congress to protect and improve the health of all Americans.  From reauthorizing programs so we can better treat and understand congenital heart defects to increasing our understanding of traumatic brain injury, to improving maternal health outcomes… these bipartisan bills will have a profound effect of the lives of children, families, and communities all across the country.”

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See also: Bipartisan Appeal for Reauthorization of TBI Act

 

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Link: Promoting better understanding, treatment of traumatic brain injury

Throughout the year, the armed forces have either started or continued to care for the thousands of injured soldiers who suffer from brain injury.  In addition, they have persevered in their research into various neurological issues related to TBI and new methods of treatment for TBI recovery.  Yesterday, the Military Health System Communications Office posted on their website a press release that serves as a synopsis of their activities throughout the year.  Beyond highlighting achievements, the release, entitled Promoting better understanding, treatment of traumatic brain injury, also notes the need for further research and care.  On the webpage, below the press release, are links to articles that further explain the accomplishments mentioned.  (They particularly note the discovery of a blood test to detect brain injury, an accomplishment that was first reported on this website in March 2018.)

Government Studies Brain Injury in the Bible

America is, and should be, a country of religious freedom.  The roots of the winter holiday season, though, are based on the beliefs of Judaism and Christianity expressed in the Bible.  (Currently, more than 70 percent of Americans consider themselves either Christian or Jewish and all but two of our Presidents have been officially affiliated with some form of Christianity.)

Although the Bible is seen as the word of God by many, according to the American government, “the Bible is not just a religious text.  It is also a historical account.”  Taking this point of view, the government has studied the existence of brain injury in the Old Testament.  In 1995 and 1997, the NIH reviewed, “the death of Sisera by the hand of Jael (Judges 4: 21; 5: 25); the skull fractures of Avimelech incurred at the tower of Tevetz, (Judges, 9: 53, 54); and the slaying of Goliath by David, (Samuel I 17: 49-51).”  In addition, the government studied the child of the Shunammite woman in II Kings 4.  They determined that the child had a subarachnoid hemorrhage, also known as bleeding around the brain.  In 2010, an NIH study entitled New insights to the neurological diseases among biblical characters of old testament found evidence of stroke in 1 Samuel, Psalms 137 5-6 and Ezekiel.

Notwithstanding the conclusions of these new studies, the Hebrew and Christian Bibles are ultimately religious books – the government calls them books of love, peace and hope.  Searching through the Bible, I discovered a quote that expresses love, peace and hope to all brain injury survivors: “More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame,” (Romans 5:3-5).

Bipartisan Appeal for Reauthorization of TBI Act

The federal Traumatic Brain Injury Act provides many benefits to survivors.  For example, much of the research that I reference on this website is done by organizations funded through the Act.  When it was originally signed into law in 1996, the TBI Act defined its goals as to “identify methods of preventing traumatic brain injury; expand biomedical research efforts to prevent or minimize the severity of dysfunction as a result of such an injury; and to improve the delivery and quality of services through state demonstration projects.”  More than 20 years later, the basic goals of the bill remain the same.  However, every few years reauthorization is required, and new amendments are added.

This year, Congressman Bill Pascrell presented H.R. 6615 to the House for this reauthorization on July 26, 2018.  (Rep. Pascrell is the co-chair of the Congressional Brain Injury Task Force.  The bill was co-sponsored by the other co-chair of the Task Force Rep. Thomas Rooney (FL), and by Rep. Brian Fitzpatrick (PA), Rep. Eleanor Holmes (DC), Rep. Steve Cohen (TN) and Rep. Brian Higgins (NY).)  “I am proud to introduce this critical bipartisan, bicameral reauthorization of the Traumatic Brain Injury Act,” Pascrell said.  In particular, the bill is seeking a $186,000 increase in the annual budget of the National Concussion Surveillance System.  (From $6,564,000 each fiscal year from 2015 through 2019 to $6,750,000 each fiscal year from 2019 through 2023, to perform aspects of data collection and evaluation.)  Established in 2016, NCSS seeks to, “determine the prevalence and incidence of concussion,” through such activities as household telephone surveys.  Additionally, the bill aims to increase the budget for state and federal research grants.  (Full information regarding budget increases and activities to be completed can be read fully in bill.)

This week H.R. 6615 passed the House and was sent to the Senate.  Termed S. 3657 in the Senate, the Traumatic Brain Injury Program Reauthorization Act of 2018 is sponsored by Sen. Orrin Hatch (UT).  (The fact that the main sponsor of the bill was Rep. Pascrell, a Democrat, in the House and Sen. Hatch, a Republican, in the Senate is further proof of its bipartisan appeal.)  As Hatch said, “We know TBI is a serious problem, but we fail to grasp its severity and scope. Our bill will change that… our legislation will extend important research, education, and advocacy efforts to help us better understand the nature of brain trauma and reduce the prevalence of these injuries going forward.”

TBI Beyond the Brain: Intestinal Impact

The brain maintains executive function over the entire body.  As we have all learned, when someone has the flu, it’s really the brain that “tells” them that their stomach hurts.  However, what happens when the brain and its functioning therein are injured?

The medical field has been studying this for some time.  About a decade ago, for example, the NIH concluded that a traumatic brain injury brings an increase in intestinal permeability.*  (Beyond TBI, increased intestinal permeability can be cause by such things as excess alcohol consumption.)  “Intestinal permeability is a barrier feature closely linked to the intestinal commensal microbiota as well as to the elements of the mucosal immune system.”  The term is often used synonymously with “intestinal barrier,” even though the two do not have the same exact definition.

In 2015, the NIH found, “Deficits in intestinal permeability may underpin the chronic low-grade inflammation observed in disorders such as depression.”  Depression is, of course, all too common among those with brain injury, so discovering one of the causes and perhaps finding a cure could be of extreme benefit.  Last year, the University of Maryland again studied the correlation between traumatic brain injury and intestinal damage.  (This study only examined the effects in mice.)  To summarize their findings into one sentence, scientists now recognize that, “brain trauma can make the colon more permeable, potentially allowing harmful microbes to migrate from the intestine to other areas of the body, causing infection.”  In essence, they found it to be a two-way street: the brain can “harm” the gastro system and the intestinal system can do the same to the brain.  (At the moment, damage discovery seems to be the only goal.  Perhaps fixing the problem and preventing later brain damage will come next.)

* As interesting as the above results are, traumatic brain injury is so named because it is severe and the resulting health problems likely go beyond the brain.  Other internal and external organs may be affected by the incident.  If the gastrointestinal system is physically harmed, it will no longer function in an optimal manner.  Digestion may no longer be such an easy/painfree activity.   Absorption of all nutrients may no longer be possible.

R.I.P. President George H.W. Bush

Today, at 11:00am ET, former Presidents, dignitaries, family members and others pay tribute to the 41st President of the Unites States, George H.W. Bush.  For the purpose of this website, it is a day to remember all that President Bush did for those with brain injuries, and for those with disabilities, at large.

President Bush was America’s last president to serve in the military overseas at war.  (President Clinton, President Obama and President Trump did not serve.  President George W. Bush served stateside as a pilot during the Vietnam War.)  Specifically, as a 20-year-old man, he served as a pilot in the Pacific during World War II.  As detailed in the book Flyboys, on September 2, 1944, while targeting a Japanese radio transmitter on the island of Chichijima, his plane was shot over the Pacific Ocean.  Bush did not abandon his plane, instead continuing to fight until his plane went down.  One source states that his injuries from this combat tragedy, that took the lives of many of his squadron, included “bleeding from a headwound”.

“Why had I been spared and what did God have in store for me?… there’s got to be some kind of destiny and I was being spared for something of Earth,” Bush later said about his trauma in WWII.  For those with disabilities, part of that reason was definitely his signing of the American Disabilities Act on July 26, 1990.  Modeled after the Civil Rights Act of 1964, the ADA aimed for equal opportunity for those with disabilities.  While a list of what impairments constitute a disability is not defined in the Act, a disability is defined as, “a physical or mental impairment that substantially limits one or more major life activities of such individual.”  These limiting impairments include, “functions of the… neurological, brain…”

Following his presidency, President Bush continued to support those with brain injury.  For example, in 1996, President Bush created a PSA for the Pediatric Brain Injury Prevention Campaign.  Prior to the PSA, the Campaign had no association with President Bush.  He agreed to do the PSA simply based on a request submitted through letter.

Recently, President Bush suffered through his own trauma – vascular Parkinsonism.  Thought to be caused by a multitude of mini strokes, vascular Parkinsonism is so named because it shares many of the characteristics of Parkinson’s disease.  (Some dispute this correlation, as Parkinson’s can be helped by medication, but vascular Parkinsonism cannot.)  On Friday, November 30, 2018, President, Vice President, Congressman and CIA Director Bush passed away.  After his funeral, his body will travel to Texas where he will be laid to rest next to his wife of over 70 years, Barbara and his young daughter Robin.  For the disabled, his legacy of the ADA will continue.

Mercury on the Mind – 2

Following the posting of my last article, I found additional interesting information about mercury and dentistry (dentistry may not be the primary use of mercury, but it is the most visible one).  Although mercury is no longer toxic once it is absorbed into a compound in a dental filling, laws regarding the use, particularly the dental use, of mercury exist.  For example, in New York, the environmental conservation law was amended in 2002 to state, “no dentist shall use or possess elemental mercury in the practice of dentistry unless such elemental mercury is contained in appropriate pre-encapsulated capsules.”

As it relates to a medical procedure that many brain injury survivors undergo, this summer the journal Radiology published an article: High-Strength MRI May Release Mercury from Amalgam Dental Fillings.  Further study of the possible effects of MRIs and mercury, show that while MRIs on someone who has mercury in their body may not cause or cause harm to a brain injury per se, NIH studies, “provide further support for the noxious effect of MRI (exposure to strong magnetic field) and release of mercury from dental amalgam fillings.”  (Additionally, MRIs can harm implants, such as brain stimulators, which may contain mercury.)

(In relation to the use of other of the ten chemicals of health public concern, particularly as it relates to dentistry, I would also advice people to be wary of fluoride.  The World Health Organization warns of both inadequate or excess fluoride intake.  Just like mercury, fluoride can help teeth at certain levels, but overexposure can lead to such things as tooth decay and skeletal fluorosis.  Smile! New water fluoridation level called for by government read the title of an article related to the 2015 federal increase in the amount of fluoride allowed in drinking water.  In fact, all articles I found related to this increase were positive.)