Skiing Into a Head Injury

Gliding down a ski slope at 60 mph, taking a ramp that lifts you up in the air with a heavy board attached to your feet and just snow below, or racing against others while doing both.  These three activities are all part of the winter routine for individuals who enjoy the extreme sports of freestyle skiing, snowboarding or snowcross.  Extreme sports are, by definition, dangerous.  A Google search of snowboarding, for example, found two pages of articles related to snowboarding deaths and accidents this year alone.

First coming into existence either in the 1950s, 1960s or 1970s, depending on which source you reference, extreme sports tap into a person’s sense of adventure.  Head and neck injuries due to winter extreme sports are common, when compared to other sports, partly because, “many extreme sports take place in environments where medical care may not be readily available.”

Throughout the years, extreme sports have become more popular, perhaps as the opportunity for adventure and physical risk of everyday life goes down and mental stress goes up.  Head and neck injuries due to winter extreme sports have also significantly increased through the years.  There is a cost to these injuries, both emotionally for the individual and monetarily for both the individual and the government through evacuation costs, rehabilitation costs and community costs in the future.  This month, the government pays more attention to these risks, as well as the needed research, as January is National Winter Sports Traumatic Brain Injury Awareness Month.

Although finding new means to treat traumatic brain injury in extreme winter sports is very important, “prevention is the top priority”.  The Office of Disease Prevention and Health Promotion reminds people to always wear a helmet and to make sure to watch your surroundings by staying in the boundaries in ski slopes and watching for obstacles and hazards on your path.  Just as importantly, “make sure medical care is close.”  Additionally, Dr. Pickett of the National Intrepid Center of Excellence reminds people that, “It’s important to consider how weather conditions… increase the risk for these injuries.”  While equipment is now safer and access to medical care has improved, prevention should always come first.  If you enjoy the thrill of extreme winter sports, I hope you enjoy it this winter, but know and use all available information to make it safe.

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Brain Injury Task Force Loses a Chair

This week, the 116th Congress was sworn in on Capitol Hill.  Unfortunately, that means that the Congressional Brain Injury Task Force lost one of its Chairs, Congressman Thomas Rooney (FL), who did not seek reelection.

Having served in the Army for 4 years in combat and 4 years in the reserve, Rooney accorded special attention to brain injury in the military on the Task Force.  This summer, it was reported, “House Approves Rooney-Requested Funding for Traumatic Brain Injuries.”  (Seen now on the website VoteSmart, this article is a repost first seen on the official Congressional website for Rooney, which is now defunct.)  The requested funding given was $125 million.

As a member of the House Appropriations Committee, Rooney dealt with the financing of government bills and other such actions.  (The House Ways and Means Committee is also focused on financial needs, a Committee that counts co-chair of the Brain Injury Task Force Congressman Pascrell as a member.)  Of this victory, Rooney stated, “The reality is our service members take great risks when they enlist to fight for our country. One of the biggest risks is TBIs, which can lead to severe mental health issues like depression and even suicide. These problems are serious and real and each dollar we spend towards research and treatment puts us one step closer to helping our military.”  (It is important to note that the VA conducts research that benefits all Americans, not simply those in the armed forces.)

Rooney is succeeded in Florida’s 17th District by former State Legislator Greg Steube.  Like his predecessor, Steube is a veteran with 4 years in combat.  Hopefully, Steube will have as much consideration for brain injury as his predecessor, too.

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.)

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.

November 11th – Veterans Day

November 11 is a day to celebrate and honor the millions of Americans, of all races and genders, who served this country with honor as veterans of the US military – today is Veterans Day!  It is time to recognize the veterans who are living with the “signature wound” of more recent wars: traumatic brain injury and often the co-occurring post-traumatic stress disorder.  These men and women fight on the battlefield for the citizens of the United States and now fight for their health and/or equality back at home.  (Visit the articles links or click the Government/Military link on the right side of this page to find more information about veterans and TBI.)

Originally published: November 11, 2017

New Research Center Focuses on Care to Givers

Caregivers and family members play a critical role in the “health and well-being” of traumatic brain injury survivors.  However, this medical and personal care of another can result in an additional toll, specifically on the health and well-being of the caregivers.  Last year, for example, the NIH published a report that concluded, “There is a definitive existence of psychological problems in overburdened caregivers.”  This understanding is why, last month, the VA established a new Center of Excellence focused on caregivers.  “Advocates say [that this Center] could significantly boost research and support for families caring for ailing veterans.”  There are an estimated 5.5 million veteran caregivers in the United States and an unknown millions of other citizen caregivers.

In actuality, this Center is located at four VA sites – Texas, Florida, Utah, California.  Steve Schwab, the Executive Director of the Elizabeth Dole Foundation, whose mission is to “strengthen and empower America’s military caregivers and their families by raising public awareness, driving research, championing policy, and leading collaborations that make a significant impact on their lives,” has high hopes and believes, “This Center is going to own the research in this area and a lot of areas that are still undiscovered.”

Link: Defense and Veterans Brain Injury Center

In the early 1990s, during the Gulf War, advances in weaponry and medical knowledge meant that injury, not death, was of foremost concern – included in this was brain injury, caused by both physical or chemical injury.  In response, in 1992, Congress created the Defense and Veterans Brain Injury Center (DVBIC) – an organization headquartered in Silver Springs, Maryland with 22 other locations around the continental United States of America.  According to their mission, “the Defense and Veterans Brain Injury Center promotes state-of-the-science care from point-of-injury to reintegration for service members, veterans, and their families to prevent and mitigate consequences of mild to severe TBI.”  Throughout its 26 years, their “science care” has extensively investigated, through research and sponsorship, what has been termed the signature wound of modern war.  In response to this, in 2007, “DVBIC [was] designated the primary operational TBI component of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE).”

(As of today, there will be a link to the DVBIC in the ADDITIONAL RESOURCES bar on the Home Page of this site.)

New Technology, Same Problems

Last year, I reported on the secondary danger that can arise from using the shoulder-launched heavy artillery Carl Gustaf.  Carl Gustaf has a twin though – heavy artillery known as SMAW…  and, just like with Carl Gustaf, SMAW is strong enough both to blow up a tank and to cause severe brain injury to the shooter in the process.

Late last month, NPR reported on the effects the use of SMAW had on two former soldiers.  After every shot, you felt a “concussive wave”, one soldier said, before continuing to say “it’s an awesome thing”.  Based on this description, as well as these soldiers’ ongoing support for the military, one can see that “blaming” an institution that they love so much for their current deficits is a difficult thing for these soldiers.  For the same reason, many other soldiers find themselves in a conundrum when it comes to their opinion of the military.  (Statistics show, for example, that though enrollment in the military is at a low, retention is up.)  However, it seems that the military recognizes that, in some way, they, specifically their weaponry, are at fault for some injuries, as they keep putting more money into research (e.g. with animal models).  They also have set up a TBI Recovery Support Program and, as a member of that Program states, “If you talk to us in a year… I think we’re going to have exponential growth in our knowledge.”

However, is some of this concern over brain injury just unnecessary worry?  The soldiers NPR quotes in their article ask that question.  (This is very similar to the responses of some players, coaches and parents regarding brain injury in football.)

(Another interesting subject in the above-linked NPR article is the difficulty soldiers, who acquire a brain injury while not in combat, have in getting healthcare coverage for their recovery.)

Virginia Battles BI with Targeted Funds

Being home to the Pentagon, headquarters of the Department of Defense, Virginia has been the center of much brain injury research and treatment.  Having a background in pediatric neurology and a past residency at the Brooke Army Medical Center, a military hospital located in Texas, Governor of Virginia Dr. Ralph Northam has seen the short-term and long-term effects of brain injury.  Given this, Gov. Northam authored a proclamation for Brain Injury Awareness Month in March, stating, “WHEREAS, early, equal, and adequate access to care greatly increases the overall quality of life of Virginians with TBI, enabling them to return to home, school, work, and community.”

From 2014 to the present, “Virginia has received $3,573,485 in Federal TBI Planning, Implementation, and Implementation Partnership Grants. The State has provided $1,785,260 in matching support.”  However, this federal grant is set to expire after 2018.  Last week, Northam awarded a three-year $900,000 grant to the Virginia Department for Aging and Rehabilitative Services (DARS), earmarked for Brain Injury Services Coordination (BISC) Unit.  (Notes DARS Commissioner Kathryn A. Hayfield, this new grant is just another example of Virginia’s support for brain injury services, which has been ongoing since the 1980s.)  As it is, the goal of BISCU is to, “enhance the quality of life and vocational goals of persons with… brain injury.”  The goal of this grant is to go further than this, as the agency continues to enhance the “health, wellness and independence of people with TBI,” by enhancing “access to supports and services,” states Dr. Daniel Carey, Secretary of Health and Human Resources.

Alexa and Her Friends Promote Independence

The new technology of smart homes has sparked the interest of all Americans, as they imagine Alexa and other such tools closing the blinds, turning off the stove and other such activities at a specific time.  For those with a brain injury and/or other disabilities, the possibilities are even greater, allowing them to, “independently plan, organize and complete everyday activities.”

Nearly a decade ago, in 2009, the government saw the potential of smart homes for the disabled, when it concluded, “more outcomes-based research and collaboration among stakeholders is essential in order to establish guidance for designing, selecting and implementing individualized smart home solutions for those with neurological disability.”  To identify both the needs of those with brain injuries, as well as their caregivers and their rehabilitation and home healthcare providers in smart homes, the government conducted such studies, as that in 2016.  To condense the findings of this study, it found that “to meet participation needs of people with ABI, the design of smart homes must consider all categories of daily and social activities.”  More so, the VA found that smart homes actually aid in cognitive rehabilitation, as VA smart homes send technological reminders when someone goes “off track”.  The VA has stated smart homes have been described as a ‘cognitive prosthetic‘, telling someone when to take their medication and even such things as notifying someone how long they have been shaving.

Last month, the Gary Sinise Foundation, an organization whose mission is to “serve our nation by honoring our defenders, veterans, first responders, their families, and those in need,” built a smart home in Wildwood, Missouri for a veteran who lost both his legs and suffered a brain injury after stepping on an IED in Afghanistan.  This month, the Gary Sinise Foundation gave a smart home that they built in Richland County, Ohio to a former Army Sergeant who also suffered a traumatic brain injury and leg injuries while serving in Afghanistan.  As smart homes become more available, for both individual residence and community living, further independence can be known to many more with brain injuries.