A Penny for Your Brain

Imagine if all you had to do was carry around a penny to know if something has negatively affected your brain.  The Office of Naval Research (ONR) is sponsoring the development of such a product, called BLAST (Blast Load Assessment Sense and Test).  Specifically, the ONR, in association with NASA, the University of North Carolina, and Applied Research Associates Inc., a New Mexico-based research firm, is in development of a coin-sized device that would be no burden to the soldier and can be worn on the helmet or body armor, and can identify brain injury, letting the soldier know if they should get immediate medical help.  As Dr. Timothy Bentley of the ONR says, “A system like BLAST is vitally important because it can help recognize the signs of TBI early and tell warfighters they might need medical attention.”

While it may take 5 years to be fully developed and tested, the prospect of such a product has great possibilities, both in and outside of the armed forces.  For example, brain injury in American football has been big news in the past several years, and a coin-sized brain injury “detector” attached to players’ helmets could aid in the quick diagnosis and treatment of such an injury in football and other sports where helmets are worn, such as hockey.  Beyond that, the possibilities are endless.

For more information:

Navy BLAST Sensor Development Looking to Improve Data on TBIs, Military.com

BLAST: Greater Speed, Accuracy in Recognizing Brain Injury, AMERICA’s NAVY

Naval Research seeks to tackle traumatic brain injury, MilitaryTimes

 

 

 

Michigan Helmet Law Revision May Save Lives, But Hurts Heads

“Make sure you wear your helmet.”  Many people recall this statement from their parents when they said that they were going outside to ride their bicycle.  As an adult, the government plays the role of a parent about helmet safety issues.  While 3 states have no law about helmet use for motorcycle riders, “28 states require some riders to wear helmets; and 19 states and the District of Columbia require all motorcyclists to wear them.”  In April 2012, Michigan law changed from requiring all riders to wear helmets to merely some.  The purpose of the loosening of the helmet law was to increase tourism to the state.  Unfortunately, all it increased was the number of head injuries.

As the Michigan Secretary of State says, “Michigan law now allows motorcyclists to decide for themselves…”  Granted, there are certain legality conditions that must be met, but for most cyclists, helmets are optional.  Many may find it surprising and positive that some studies show that the revision of the Michigan helmet law has had no effect on, or even lessened the number of motorcycle-related fatalities. However, the law has resulted in a 14% increase in head injuries.  Specifically, reported mild concussions fell by 17%, “while the proportion [of injuries] due to skull fractures increas[ed] 38% during the same period.”

Ultimately, whether or not the government should be telling you to wear a helmet is debatable.  However, there can be no debate on the fact that any law that increases the chance of a head injury is negative.

Another Obamacare?

On December 13, 2016 President Obama signed H.R.34 and so, the 21st Century Cures Act became law. Sponsored by Rep. Suzanne Bonamici* (D-OR) and co-sponsored in a bipartisan manner, many say this is the biggest legislation of Obama’s presidency, after the Affordable Care Act.  However, just like the Affordable Care Act, the bill has its detractors.

H.R. 34 first was introduced on January 6, 2015, “to accelerate the discovery, development, and delivery of 21st century cures, and for other purposes,” as the bills synopsis states.  The 21st Century Cures Act addresses mental (neurological) disorders, such as Alzheimer’s, trys to find a cure for cancer and pays special attention on America’s current opioid epidemic.  Though many articles do not mention that H.R. 34 specifically supports tbi research, an overview of the bill shows that of the $6.3 billion allocated to medical research, $1.5 billion are alloted to the Brain Research Through Advancing Innovative Neurotechnologies Initiative (BRAIN Initiative).  (As I note in a previous article, BRAIN is associated with tbi research.)  “Congressman Frank Pallone, Jr. (D-NJ), ranking member on the House Energy and Commerce Committee, applauded President Obama for signing the 21st Century Cures Act into law… [as he says] the 21st Century Cures Act will advance medical research, fund the fight… towards mental health reform. As a leader in medical innovation, New Jersey and [medical] institutions… stand to benefit from 21st century cures investments in medical research.”

Beyond research, though, the bill focuses on pharmaceuticals.  It is with this that many take issue.  Currently, the FDA has to approve the efficacy and safety of all medications or medical devices before they go on market.  Going through the government’s red tape can take years.  “Under the Cures Act, companies will be allowed to submit observational data and ‘in house’ registry data as evidence for the safety and efficacy of a new product.”  The bill’s proponents attest that this will significantly reduce the cost of medication, thereby promoting research and development.  Detractors, like myself, worry that getting rid of the “safety and efficacy” red tape may mean less safe and ineffective drugs.

*Another bill, also called the 21st Century Cures Act (H.R. 6), was introduced by Rep. Fred Upton (R-MI) on May 19. 2015.  In Uptons words, “21st Century Cures is an innovative game-changer and a truly once-in-a-generation opportunity to bring our healthcare system light years ahead of where it is today.”  The last action on this bill was on July 13, 2015, when it was referred to the Committee of Health, Education, Labor, and Pensions by the Senate.  (Word-for-word, H.R.34 and H.R.6 have the same synopsis, so they essentially seem to be the same bill.)

John Glenn: Astronaut, Politician and TBI Survivor

This past Saturday, December 17, was the memorial service for aviator, engineer, astronaut, and United States Senator from Ohio, John Glenn.  The first man to orbit the Earth, metaphorically left the world on December 8, 2016.  What many are not aware of, though, is that beyond his time in space, Glenn’s success in the U.S. Senate occurred after he had suffered a traumatic brain injury.

In the past, I have written about the issue of space travel and brain injury.  “On February 20, 1962, [Glenn] flew the Friendship 7 mission and became the first American to orbit the Earth and the fifth person in space.”  However, reports and profiles show that Glenn did not suffer any mental calamities during his time working at the National Aeronautics and Space Administration (NASA). In 1964, however, Glenn started his political career, announcing his candidacy for Senator in his home state of Ohio.  Soon after, though, he withdrew his candidacy, as he was injured in a bathroom fall in his Ohio home.  Glenn’s hit to his head was not a mere bump because, as a biography on the Ohio State University website says, “The injury left him bedridden with severe vertigo and unable to campaign.”  Presumptively, vertigo was not the only issue the Glenn had after his fall, even ten years later New York Times referred to it as a “serious head injury”.  However, at the time, the media was not as intrusive as it is now, so even celebrities had some degree of privacy.*

Glenn devoted his life to government service.  Before his time at NASA, he served in the Marines in World War II and the Korean War.  After his time in space, and after his recovery from a TBI, he was a Senator for Ohio for 25 years.  As NASA writes in Glenn’s online biography, “John Glenn, became a national hero and a symbol of American ambition,” after he became the third American in space and the first to orbit the Earth.  The fact that he embarked on a successful political career following a traumatic brain injury makes Glenn an inspiration to the disabled population, too.

*For example, “in 1970, Glenn ran a campaign that relied on his celebrity and patriotic image to draw crowds to his stump speeches. He lost…”  As a personal note that you may disagree with, I ask:  Using celebrity, instead of substance, as the cornerstone of a campaign – who does that remind you of?  (In his later, successful campaigns, Glenn campaigned with celebrity AND substance.)

NHL Commissioner Bettman Denies the Obvious

Hockey is, essentially, thought of as America’s winter sport.  This year, the National Hockey League started its play for the 2016-2017 season, the 100th season of the NHL (99th season of play), on October 12, 2016 with four games in which the Ottawa Senators, the Edmonton Oilers, the St. Louis Blues and the San Jose Sharks won.  Since the teams have already started their season, it is relevant now to look at what the government is doing to support safe play for professional and amateur ice hockey players.

This year, on October 6, four members of the Legislative Committee on Energy and Commerce sent a letter to Commissioner Gary Bettman about the issue of CTE, brain injury, and the NHL.  Specifically, Hon. Frank Pallone, Jr. (D-NJ). Hon. Gene Green (D-TX), Hon. Diana DeGette (D-CO) and Hon. Jan Schakowsky (D-IL), wrote to Bettman, “to request information on the National Hockey League’s (NHL) policies and procedures for the prevention and treatment of concussions and related head injuries…. [as] there is significant scientific evidence to support a link between the types of concussive and subconcussive hits inherent to the game of hockey and brain injury.”  (It seems evident to me that having your head hit repeatedly thoughout the season will result in head trauma.)  The Committee members also noted that participation in contact sports as a youth may increase the likelihood of developing CTE.

In response, on October 24, Bettman wrote a letter to the Committee that stated the National Hockey League/National Hockey League Players’ Association is very concerned about the health of its players.  Prior to this season, for example, the NHL updated its concussion protocol so that it is now mandatory to remove an athlete from play if the coach sees that the player has been physically or neurologically hurt and to then get the player evaluated by a certified athletic trainer.  However, the Committee says that Bettman’s letter of response sounds, “a little bit like the tobacco industry, when it comes to linking concussions with Chronic Traumatic Encephalopathy (CTE).”

Ironically though, just as there are some Congress members who are smokers, annually there is a Congressional Hockey Challenge.  Begun in 2009, “The Congressional Hockey Challenge is a 501(c)(3) organization committed to ensuring that the incredible and dynamic sport of ice hockey is accessible to everyone who wants to play.”  On the Congressional games website, one can note that the game is played for lawmakers’ enjoyment, yes, but also to benefit charity.  This year, the game was played on March 2nd and had five Congressmen on the ice.  Even Bettman, who criticizes Congress, as the above paragraph notes, attended the event in support of the team and the cause.

Personally, just as I believe should be true for all other sports, I do not believe it should be the role of Congress to determine the rules of professional sports, especially one that they enjoy themselves.  Education is the key.  Players need to be informed, by the team and by former players who have suffered the horrible lasting effects of brain injury, of the possible consequences of violent defense in the game and post-game fights.  More so, the National Hockey League needs to fully enforce its concussion/head injury rules.

Link: A Head for the Future

This past Friday was Veterans Day, a time to honor soldiers and veterans who fought for the principles upon which America was founded.  In commemoration, I searched for information about the military and brain injury.  It was upsetting that my search resulted in so many news articles, at least one article per day in the recent past.  However, some of these daily articles involved efforts of the military to help those wounded in service, such as that of a retired General who just received an award for his efforts related to brain injury,  and inspiring stories of recovery, such as one involving the healing support of trained dogs.

Of particular interest was the website A Head for the Future.  The site, a collaboration of the Defense and Veterans Brain Injury Center (DVBIC) and the Defense Centers of Excellence, is associated with every branch of the military.  On the front page of the site, one can find links to sections on how to PREVENT, RECOGNIZE, RECOVER and GET INVOLVED and a section called MATERIALS, in which one can view and download facts about brain injury.  Featured on the site is a BLOG, where veterans and their families can submit personal stories of brain injury to the DVBIC.  The page also allows visitors to view videos featuring veterans telling their stories on camera.  These stories, both those in print and on video, are quite poignant and worth viewing.

Wait and See

Based on his statements and actions, a Trump presidency with a Republican-controlled Congress may seem to be the worst election outcome possible for disabled Americans.  In a poll cited by CNN, for example, people agree that mocking a reporter with the joint condition arthrogryposi was the most egregious error that Trump made during his campaign.

However, those worries may not entirely be warranted.  Trump is a businessman and a television personality.  He says what will get him a deal, acts in a way to give him an audience and, in the case of the election, promises what will get him votes.  For example, one of the hallmarks of Trump’s campaign was his promise to repeal and replace the Affordable Care Act.  Since winning the election, though, “Trump [has] said he would [at least] like to keep the portions of the law requiring coverage of pre-existing conditions and children living at home under the age of 26.”  From what I can determine, Trump simply wants his name tied to a major legislation.  (He wants to keep some of the principles of Obamacare, but replace the wording with some synonyms, so that people will call it Trumpcare?)

As for the Republican-controlled Congress, it is good to remember that most people, including Senators and Representatives, are related to or have some association with a disabled person.  During the Obama Administration, almost half of the brain injury-related legislation that became law were sponsored by Republicans, specifically 8 of 20.  As I noted in the past, Republicans do care.  While Hillary Clinton may have won the popular vote, it is best not to presume that a Trump presidency will negatively impact those with a brain injury or all of those with a disability.

Tomorrow is Election Day…

In August, I posted an article “The Deciding Vote”, which discussed how gaining the vote of the disabled could effect the results of the tight 2016 Presidential race.  What I did not consider, though, is that some of those with mental disabilities have lost their legal right to vote.  “[It is] believed [that]… more than 30,000 Californians — and an unknown number of others in the U.S. — [have] lost their voting rights under state guardianship laws.”  (“A guardian is a person, institution, or agency appointed by a court to manage the affairs of another individual.”)  Given that the current polls show that this election is within the margin of error, these tens of thousands of votes per state could be of great import.

What constitutes a mental disability varies in each state.  For example, ALA [Alabama] CODE § 38-9C-4(7) states, “Persons with developmental disabilities and traumatic brain injury have the right to vote and participate in the political process, subject to applicable laws.”  About 30 other states, however, restrict the voting rights of those with traumatic brain injury and other neurological disabilities, such as autism and cerebral palsy.  For example, in California, “Five years ago, a judge ruled that a traumatic brain injury disqualified [a man, David Rector, from voting].”  (This year, after a trial in the San Diego Superior Court, David Rector regained his legal right to vote.)

To all those who have a disability that may be restrictive to others with the same disability, but who are legally allowed to vote themselves, I believe it is imperative to do so.  Show that your vote matters!

* Click to view a full list of states that have laws related to voting for the neurologically disabled and a description of these laws.

Readying for the Red Planet

Mars planet with Valles Marineris canyon and southern polar ice cap visible

In 2015, Matt Damon was part of a team that traveled to Mars.  Specifically, in the film The Martian, he starred in the story of an astronaut who traveled to Mars and was left behind by his fellow astronauts.  The film had a budget of about $100 million and grossed over $225 million at the box office.  It was nominated for 172 awards, including 7 Academy Awards, and won 33 awards.  Essentially, The Martian played on the fantasy that many humans have: to travel to another planet.  With new technology continually being developed, this fantasy has become much more likely to happen in recent years.  However, the 2015 film, based on a 2011 book of the same name, discounts one of the probable issues when traveling to and from the Red Planet: radiation exposure.

According the National Aeronautics and Space Administration (NASA), “The Martian highlights the neurological, radiation-related dangers that could occur on a round trip to Mars.”  However, simply showing the astronauts living in a radiation-shielding habitat, does not really show why radiation-shielding would be of upmost importance.  The Guardian notes the inaccuracies of the film, such as, “Everyone would die… due to excessive radiation.”  Broadly defined, radiation is “the emission or transmission of energy in the form of waves or particles through space or through a material medium.”  While rare on Earth, it can be emitted by things as televisions and x-rays. It is, however, prevalent in space and the Mayo Clinic confirms that “radiation sickness is serious and often fatal.”

If they travel to another planet, “The astronauts are not going to come back with full-blown Alzheimer’s… but… there will be some mild cognitive impairment,” says Charles Limoli, professor of radiation oncology at the University of California. To prevent these cognitive impairments, which may lead to problems seen in other neurological disorders, such as impaired decision-making and depression, NASA is looking for a way to protect the neural circuitry of the body in space.  In fact, “Researchers hope that the initiatives in place to help send humans on deep space missions will also help those on Earth suffering from diseases like Alzheimer’s and Parkinson’s, as well as depression or traumatic brain injury.”  Currently, they have exposed mice to similar amounts of radiation that the astronauts will receive and found, “their learning, memory, multitasking, cognitive flexibility in changing situations and even behavioral adaptation were altered or negatively impacted.”  As the study notes, humans are not mice and our brains are different; however, they do believe this is a good example of the effects radiation will have on our brains.

People and the media rarely want to think of any negatives related to the possibility of doing something that has always been a mythical dream.  Travel to Mars will happen.  NASA is working on technology to eliminate radiation exposure and to prevent the negative effects of the radiation exposure that will occur during the trip to the Red Planet and on the surface of the planet.  (Mars has three ozone layers, but still less ozone protection than the Earth.)  NASA has already set a manned mission to Mars for the 2030’s.  People just need to let the scientists, and their mice, at NASA find a way to make this international orbital journey to Mars safe for all those aboard.  In the meantime, their research can help humans on Earth, astronauts or not, who suffer from brain injury and other neurological issues.

* Some have proposed that the first trip to Mars be a one-way trip, meaning that astronauts would travel to Mars to permanently inhabit the planet.  While this may be the most cost-effective way for people to travel to the Red Planet, proponents of this idea do not consider many of the risks involved in an interplanetary trip.  For example, the organization Mars One, led by Dutch billionaire Bas Lansdorp, has promised to colonize Mars by 2026.  On the Project’s website, there is a page that answers the question: How safe is the journey?  According to the site, the following risks are conceivable: accident(s) during launch, vital components could malfunction during the journey there, a number of issues might present themselves when entering Mars’ atmosphere, and there could be problems when landing.  The page does not mention the certainty of radiation absorption while on the trip to the planet.

NDEAM: The Beginning

On September 2, 1945, WWII officially ended.  However, for many of the 670,846 wounded in the war, the struggle did not end there.  Discrimination, often unintentional, unknowing discrimination, was rampant against the disabled, meaning that their job prospects were limited.  (Discrimination was much more pervasive than it is now, though that is not to say that current job prospects for the disabled are good.)  Because of this, on September 21, 1945 by Act of Congress and Presidential proclamation, President Truman declared October 7-13, 1945 as National Employ the Physically Handicapped Week.  In Proclamation 2664, the President wrote, “I ask the governors of States, mayors of cities, heads of the various agencies of the Government, and other public officials, as well as leaders in industry, education, religion, and every other aspect of our common life, during the week and at all other suitable times, to exercise every appropriate effort to enlist public support of a sustained program for the employment and development of the abilities and capacities of those who are physically handicapped.”

In response to this, many Senators and Representatives expressed their support.  Given the number of wounded veterans returning home and others with physical disabilities, many of those in Government had a personal interest in aiding those who they knew to be capable individuals.  In particular, Representative Earl C. Michener expressed on the Congressional Record, “Just because one cannot see as others do, or walk as others do, or talk as others do, or hear as others do, is no indication that this person does not have a mission in life and a definite productive place in society and in our economy.  However, it is easy for the American people to forget, and the celebration of this particular week will not only stimulate the memory, but will impress the necessity of remembering that there are in every community some physically handicapped persons.”  When you eliminate the word “physically” from this remark, so that it applies to today’s broader definition of disability, Rep. Michener’s statement is just as relevant now, as it was over 70 years ago.