Prayers for Senator McCain

As has been widely reported, Senator John McCain was diagnosed with brain cancer on Friday of last week.  As if having to undergo brain surgery to remove what were thought to be benign brain tumors wasn’t enough, now that they are known to be malignant, McCain can look forward to a host of symptoms.  These symptoms can include vision problems, seizures, difficulties with concentration and thinking, difficulties with speech, etc.  In essence, the symptoms of brain cancer largely mirror those of brain injury.  In fact, the National Institute of Health has published the results of a study that shows that there is an, “association between traumatic brain injury and the subsequent risk of brain cancer.”

Despite his medical issue though, McCain has chosen not to stay idle: “Just hours after news broke of McCain’s brain cancer diagnosis, the Arizona senator blasted President Trump amid a report that the administration decided to halt a CIA training program for moderate Syrian rebels fighting Bashar al-Assad’s regime.”  Additionally, his diagnosis has produced an almost unheard-of-now bipartisan show of support, which could perhaps open the door for further cooperation.

Trauma on Trumpcare

 

Update: Today, “President Donald Trump asked Republican senators not to leave town for their August recess without passing a health care reform plan that makes good on seven years of promises to repeal and replace President Barack Obama’s Affordable Care Act.”

*********************************************************************************

Since 2010, health care has been a top talking point for both general Americans and the American government.  Then, Obamacare, the Affordable Care Act, was enacted without a single Republican vote.  Now, the current iteration of Trumpcare, H.R. 1628, has passed the House and seeks to pass the Senate without the support of a single Democrat Senator.  Increasingly though, it is losing Republican support*, as Senators wrangle with the idea on Medicaid cuts and other issues.  (According to a recent report, the bill would cut Medicaid funding for children by at least $43 billion over 10 years.)

Throughout the country, articles continue to show the need for Medicaid for many Americans, often showcasing the needs of the brain injured.  The website MyCentralJersey.com (part of the USA Today network) highlights a 22-year-old and his mother who spoke to members of Congress about the ongoing trauma that the family deals with, caused by an accident that occurred when the boy was 18.  “Many families… will face major health care challenges.  It is important to protect Medicaid to allow these families to focus on their child’s care and recovery,” said the mother.  An article published on cleveland.com highlights the care of a severely brain injured man who lives in a nursing home, but whose family worries he won’t be able to stay at the facility with the proposed Medicaid cut.  A New York-based newspaper notes a 9-year-old girl who survived a horse-back riding accident with the financial support of Medicaid.

Yesterday, Trump expressed his frustration on Twitter with passing this bill.  “Most Republicans were loyal…,” he wrote, as a criticism of those Republicans who did not express support for the law.  However, this statement appears to show that Trump is looking for support to him and party, when he should be seeking support and loyalty towards the American people.

(Notably, Arizona Senator John McCain underwent surgery yesterday to rid him of blood clots in or near his left eye.  While the specifics of his initial condition and the exact surgical procedure he underwent remains vague, it is concerning.  Because of McCain, the vote on this health care bill has been delayed.  It will be interesting, though, to see if McCain’s ordeal affects his views. )

* Yesterday, “Sens. Mike Lee (Utah) [a staunch conservative] and Jerry Moran (Kan.) issued statements declaring that they would not vote for the revamped measure.  They joined Sens. Rand Paul (Ky.) and Susan Collins (Maine), who also oppose it.”  A significant amount of other Republicans have also not declared their support.

Update: Patriotic Day Can Traumatize America’s Patriots

Last year, I noted how July 4th can be traumatizing for some of those with a brain injury.  This year, I want to recognize that some towns do support those who suffer from it.  In Mississippi, a celebration at Old Trace Park in Ridgeland County holds an event that is partially sponsored by the Brain Injury Association of Mississippi.  In Iowa, Brett Greenwood, the former defensive back for the University of Iowa Hawkeyes who suffered a brain injury in 2011, will be serving as Grand Marshall of the Bettondorf parade.  (“The goal is for Greenwood to walk on his own,” says his former Iowa football teammate Pat Angerer.)  As for prevention, the Tucson News Now provided advice on how to ensure the health of pet’s brains amid the summer heat of July 4th celebrations.

The Huffington Post notes the ongoing trauma for some troops, specifically noting the trauma suffered by some of the veterans of the Vietnam War.  On this blog, the article, Patriotic Day Can Traumatize America’s Patriots, also recognizes this trauma.

See also: Patriotic Day Can Traumatize America’s Patriots

In America, Helmets ‘R Us

“Make sure you wear your helmet!”  Many remember their mother reciting this rule before a bicycle ride during their childhood.  In 1987, California became the first state to require children to wear helmets, though at the time it was only required for children under the age of 5.  In the past 30 years, many states and counties have taken California’s cue.  “At present, 21 states, and the District of Columbia, have state-wide laws, and more than 201 localities have local ordinances [requiring helmet use].”

While Ohio does not have a state law mandating helmet use, 24 Ohio cities have passed bicycle helmet laws.  At a meeting 7:00pm meeting tonight, Grandview Heights City Council’s safety committee is discussing whether the city should become the 25th city.  Specifically, Council members will be discussing legislation introduced by Council President Greta Kearns on June 5.  The proposed law states that, “children and teens caught riding without a helmet would be warned [on their first offense], but only if their parents can show proof of helmet ownership.”  Further offenses would include fines and charges.

In the United States each year, 218,000 children are treated in the Emergency Room for bicycle-related injuries.  In Ohio alone, that number is 6,200 children, while 1 in 6 of those children are treated for a traumatic brain injury.  The thought of this law and bicycle laws in general, is that, in time, helmets will become a childhood norm.  If so, doctors say it can reduce the risk of a traumatic brain injury by as much as 88 percent.

June is… National Aphasia Awareness Month

The National Institute of Health defines aphasia as, “a disorder that results from damage to portions of the brain that are responsible for language… The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders, such as dysarthria or apraxia of speech, which also result from brain damage.”  Brain damage is, of course, the defining effect of a traumatic brain injury and other neurological disorders.

The United States government has designated June as National Aphasia Awareness Month.  The subtitle of an article from yesterday’s Huffington Post states what I see as the main purpose of the Month: “Just because you have word-finding problems does not mean you have diminished intelligence!”  Educating the public is the key to Aphasia Awareness, so that those who have a neurological disorder and those who know an individual who has a neurological disorder recognize that their innate intelligence is still very much present.

Update: North Korean Trauma

Yesterday, June 19, 2017, Otto Warmbier succumb to the trauma he suffered for a year and a half while detained in North Korea.  Though Warmbier’s condition has generated more concern over international travel, his comatose mental state is curious.

“He shows no signs of understanding language, responding to verbal commands or awareness of his surroundings,” said Kanter, Warmbier’s neurologist at the University of Cincinnati Medical Center.  However, “He was home and we believe he could sense that,” said his father.

Warmbier’s death, and particularly the fact that it happened almost immediately after he was reunited with his family, begs the question: Does the unconscious brain have more of a sense of self than currently believed?

See also: North Korean Trauma

North Korean Trauma

“An American university student who was returned to the United States this week after being held in North Korea for 17 months has a severe brain injury and is in a state of ‘unresponsive wakefulness’,” doctors told Reuters yesterday.  Specifically, Otto Warmbier, a 22-year-old student of the University of Virginia, was returned to America and is now a patient at the University of Cincinnati Medical Center, where he shows no understanding of any communication around him.  Given the limited amount of information provided by Kim Jong Un’s Korean military, the exact cause of Warmbier’s comatose state is not known.  However, one of the top assumptions is that his condition is the result of a traumatic brain injury.

Warmbier, originally from Wyoming, Ohio, has been in a coma for more than a year, shortly after he was sentenced to 15 years of hard labor for stealing a propaganda sign in North Korea, where he was a tourist.  (I assume that Warmbier stole the sign as a unique type of memorabilia, so he would always remember his once-in-a-lifetime trip.)

This week, the Warmbier family received a call from President Trump, which they termed “kind” of him.  On Wednesday, Secretary of State Tillerson said that America is now considering travel visa restrictions for North Korea.  (Before all of this, last month, a bill was introduced that would ban United States citizens from traveling to North Korea.)  The United Nations human rights division is also carrying out a thorough investigation into North Korea’s actions.

Linking Li to the Brain

In 2014, the National Institute of Health deemed lithium (Li) to be of medical assistance in the treatment of traumatic brain injury.  However, the NIH determination came only from the promising results of a preclinical study.  Now, Rutgers University has released the findings of a three year study, funded by the New Jersey Commission of Brain Injury Research, that corroborates the NIH’s findings.

Commonly used to treat bipolar disorder, “Rutgers researchers discovered that lithium, as well as rapamycin (an immunosuppressant used to treat cancer), protects healthy brain cells from a toxic buildup of a chemical.”  Specifically, this study identified the massive buildup of glutamate.  Glutamate is a chemical in the body that, in healthy doses, promotes learning and memory.  However, in the high doses that can result from the body’s innate response to brain injury, it can be toxic to the cells.

The current results apply to recovery only from concussion.  However, given the positive results thus far, further studies are likely to be in the works.

Legislature Acts to Put Paddling Out to Sea

“The use of any form of corporal punishment is prohibited in any public or secondary school.”  While this statement should be true everywhere, in 18 states the barbaric act of harsh corporal punishment (HCP) is still legal.  However, this exact quote comes from a bill that was presented for vote last month to the Louisiana State Legislature.  Sponsored by Barbara Norton (D-Shreveport), Louisiana House Bill 497 passed the Louisiana House Education Committee on April 26 with a vote of 6 – 5.  (Two Republicans and fours Democrats voted for it.)

Besides Louisiana, state law still permits harsh corporal punishment in Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Wyoming.  (It is prohibited in many school districts, though, largely because of fear of costly lawsuits.)  Specifically, the legality of HCP in some states comes under the protection of states’ rights and under the protection of particular school districts.  Some parents, some states and some school districts believe HCP to be an effective method of controlling a classroom.  The continued use of paddling can be evidenced by the fact that you can buy a paddle online.  (Some of the posted comments on the purchase page of this item are evidence that it is marketed for use on a child.)

The continued acceptance of corporal punishment in some schools is related to another horrifying statistic: “research shows that up to 90% of parents spank their children at least occasionally.”  The LA Times article, from which this statistic is taken, then showcases both the so-called PROs and CONs of mild HCP, spanking, with the divided points of view presented by different doctors.  The pro-spanking doctor states, “In reviewing all the literature, there’s one that leads to better outcomes, reduced defiance, reduced aggression in children, and that’s what I call backup spanking.”  On the other side, the doctor says that, “studies have shown that the more kids get spanked, the higher the child’s score on a post-traumatic stress test.”  More so, statistics demonstrate that spanking simply doesn’t work.  This article demonstrates that just as states and school districts have divided points of view regarding the use of corporal punishment, so do doctors, even with medical evidence at hand.

In addition to HB 497, this year, Louisiana Governor John Edwards declared, “Corporal punishment of children with disabilities should no longer be acceptable in Louisiana.”  In the 2015 – 2016 school year, for example, it is reported that 16% of students who were paddled had a disability.  (Unlike students without disabilities many disabled students are not in full mental control of their actions, particularly in their early years, such as preschool and kindergarten.)   The statement from the Governor specifically refers to HB 79, sponsored by Rep. Franklin Foil (R-Baton Rouge), which was also presented to the House this year at the same time as HB 497.  HB 79, which addresses students with disabilities including autism, intellectual disabilities, traumatic brain injury and others, passed the Committee unanimously.

The irony, for lack of a better word, is that though paddling and other forms of HCP may worsen the symptoms of an existing brain injury, it causes damage to the brain in those who are previously without such injury.  The title of a study conducted by the National Institute of Health provides evidence of this: “Reduced Prefrontal Cortical Grey Matter* Volume in Young Adults Exposed to Harsh Corporal Punishment.”  Specifically, beyond emotional and physical trauma, “HCP may be an aversive and stressful event for human beings that potentially alters the development trajectory of some brain regions in which abnormalities have been associated with major forms of psychopathology.”

* Grey matter in the brain is essentially necessary for everything.  “The grey matter includes regions of the brain involved in muscle control, and sensory perception such as seeing and hearing, memory, emotions, speech, decision making, and self-control.”  There is also grey matter in the spinal cord and, though it is not specifically mentioned, I’ve got to think that it is also compromised by HCP.

Camps for a Cure

Located in San Diego, CA, Camp Pendleton proclaims to be, “The West Coast’s Premier Expeditionary [Marines] Training Base.”  Last Tuesday, May 9, they broke ground on a $12 million, 25,000 square foot facility that aims to make the Camp a premier brain injury research and treatment center, too.  The funding needed to build the facility was raised through private donations and the funding of Arnold Fisher, a New York-based real estate tycoon.   Fisher says that he sees helping the troops as his duty as an American.

Part of the Department of Defense organization National Intrepid Center of Excellence (NICoE), which is headquartered in Maryland, the Camp Pendleton facility will be the seventh of nine planned NICoE facilities focused on brain injury and the first on the West Coast.  Presently, NICoE has erected facilities in Fort Belvoir, Virginia, Camp Lejeune, North Carolina, Fort Campbell, Kentucky, Fort Hood, Texas, and Fort Bragg, North Carolina.  A center at Joint Base Lewis-McChord, Washington, is still under construction and facilities are still to be built in Fort Carson, Colorado and Fort Blass, Texas.

Beyond Marine training, the Camp defines part of its vision to be, “providing superior service and support.”  Therefore, they also deal with the injuries that may come as a result of a brain injury or come in conjunction with it – specifically, physical and behavioral problems.  In fact, Camp Pendleton has been training and supporting the troops for 75 years.

So far, NICoE facilities have about a 90% rate for patients to return to duty.  Still, as Capt. Lisa Mulligan, commanding officer at the Camp Pendleton hospital, says, “Science as a whole remains in the infancy of its understanding of the potential for recovery after head injury.  This center will combine the resources of clinical, research and educational specialists to broaden our horizons.”