Clinton on Clinton: TBI

Last Wednesday, at the Democratic National Convention, former President Bill Clinton spoke, explaining why he believes his wife, Hillary Clinton, is the best candidate to lead this country for the next 4 years.  He spoke of their courtship, their time as new parents, her time as a Senator, etc.  Bill’s speech was long, many say too long, but interesting.  Of particular interest was Bill’s statement that, “she worked for more extensive care for people with traumatic brain injury.”

Mr. Clinton’s statement came right after he discussed Hillary’s time on the Armed Services Committee.  Because of her time on the Committee, many of the TBI-related pieces of legislation she sponsored were directed to those in Service.  For example, she sponsored the Heroes at Home Act of 2007 (S.1065) which “directs the Secretary of Veterans Affairs to establish a program on training and certification of family caregivers of veterans and member with traumatic brain injury”.   However, the TBI-related legislation that she co-sponsored was not necessarily directed solely towards the troops.  As an example, the Traumatic Brain Injury Act of 2008, which includes 6 Sections, “authorizes the Secretary, acting through the Director of CDC, to conduct a study to (1) determine the incidence of traumatic brain injury and prevalence of traumatic brain injury related disability; (2) report national trends in traumatic brain injury; (3) identify common therapeutic interventions which are used for the rehabilitation of individuals with such injuries; (4) identify interventions and therapies that can prevent or re-mediate the development of secondary neurologic conditions related to traumatic brain injury; and (5) develop practice guidelines for such rehabilitation”.

Given that former President Clinton stated that Clinton worked tirelessly for those suffering from traumatic brain injury, one would think her efforts would be more evident.  However, legislation review seems to show that former President Clinton’s statement is correct.  It is those who suffer from traumatic brain injury and their caregivers to decide if public knowledge of legislation or the legislation itself is of more import.

Tax Returns Could Trump Trump’s Philanthropy Claims

Donald Trump often speaks of all the donations he makes to various charities.  In January, Trump held a fundraiser for at least 40 veterans-focused nonprofits, which raised $4.5, $5.5, $5.6 or $6 million, depended on which member of his staff you ask and when you ask them.  Some of this money was donated by Trump himself, with the majority of the money coming from fundraiser attendees.  The Bob Woodruff Foundation received a check for $75,000, which Woodruff said, “We can put it to very good use to help our vets and their families.” Also, in May, “[Trump] gave $1 million to a nonprofit group helping veterans’ families.”

Recently, The Wall Street Journal looked into the history of donations from the self-proclaimed philanthropist to all charities throughout the years.  The title of the article that followed this investigation is “Trump promised millions to charity.  We found less than $10,000 over 7 years.”  (I think the title of this story explains the findings of the Journal, although it can neither be proven nor repudiated without Trump’s tax returns.)

Money or Safety: Who Wins?

 

Mixed Martial Arts combines the skills needed in wresting, kickboxing and jiu-jitsu into one violent sport.  In this century, MMA has gained popularity and consequently been legalized in most of America.  This past week, the New York legislature, Governor Cuomo and the State Athletic Commission entered the cage.

While MMA matches have been going on in New York for some years, legalization means that there will be regulations.  Specifically, these regulations include classifying 31 Acts that constitute a foul in the arena and would result in “disqualification from a mixed martial arts contest or exhibition… as determined by the referee.”  Five of these fouls specifically involve violence to the brain: Butting with the head, striking to… the back of the head, kicking the head of a grounded opponent, kneeing the head of a grounded opponent, and spiking an opponent to the floor surface on his head or neck.  Other rules are not specifically directed to the head, but could easily result in head trauma, such as “attacking an opponent on or during a break”.  Additionally, “New York [is] to Require $1 Million Brain-Injury Coverage for Mixed Martial Artist,” to be provided by the promoters.

However, the safety of the athletes was not directly the reason of the legalization… it was the money.  It is estimated that legalizing MMA will bring $140 million to New York in economic growth.

In covering this story, Forbes magazine notes that, “insurance doesn’t provide for fighter safety.  It provides compensation after fighter safety has failed.”  (On the other hand, the NYS Athletic Commission says it, “has taken another step toward ensuring the health, safety and integrity of its athletes and event.”)  Some people still want the sport banned.  Currently, the State is seeking comments from the public on this issue.  The proposed legislation can be found on this link and comments can be submitted for review until August 27, 2016.

PTSD = Police Trauma Stress Disorder?

My thoughts are with the Baton Rouge police today, 3 of whom were shot and killed and 3 others injured. With this, and the events in Dallas last week, I understand that many police officers, especially the survivors of these attacks, may be experiencing some form of Post-traumatic Stress Disorder (PTSD).  As President Obama said today, “Attacks on police are an attack on all of us.”  My best goes out to the families of those who lost their lives protecting this country and to all police officers.  I hope all Americans soon realize the good work that police officers, in general, do and that officers are given the respect that they deserve.

America’s Pastime Hopes to Make Concussions a Problem of the Past

He ran for the ball, knocking head-first into a concrete wall in a game versus the Washington Senators at Washington’s Griffith Stadium.  He then lay on the ground, unconscious, for five minutes.  Eventually, he arose, shook off the trauma and returned to play.

Such a story as the one above seems unfathomable in current athletics.  Now, if a player is hit on the head and falls unconscious, he would never be permitted to return to play immediately and, most likely, would be taken to the hospital for neurological testing.  However, this is what happened to America’s famed baseball player for the New York Yankees, Babe Ruth, in 1924.

Compared to many other sports, baseball does not have a high concussion rate.  Between ten to twenty players are put on the disabled list yearly because of concussions.  However, even one concussion is one too many.  Most prone to concussions are outfielders and catchers.

Recently, this was brought to my attention because of the story, Ex-Met Josh Satin explains why retiring is ‘the right thing’ after suffering head injuries.  Specifically, while playing for the Louisville Bats, the Triple-A affiliate of the Cincinnati Reds, Satin collided with his team’s third baseman, as both were going for a pop fly.  After being unconscious for five long seconds, Satin says he had a “weird feeling” and later was “never the same”.  He further stated that his depth perception, once his best skill, never fully recovered.  “The ball was always in a different spot than I thought.”  (Officially diagnosed with post-traumatic stress disorder (PTSD), Satin sat out most of last season.)

Similarly, in December 2012, Toronto Blue Jays’ utility player Ryan Freel, the first pro-baseball player diagnosed with chronic traumatic encephalopathy (CTE) who had to retire from playing the sport because of his injuries, committed suicide.  In 2013, Freel’s family donated some of his brain tissue to Boston University for study.  Though Freel’s behavior after his accident pointed towards CTE, he was not officially diagnosed until this postmortem study.

Dr. Robert Stern, co-founder of the Center of Traumatic Encephalopathy at Boston University, said, “I cringe [whenever] I see two guys going after the same ball.”  The MLB has said, “[it] will remain proactive on concussion and head injuries.”  Home plate collisions are no longer allowed and, in 2013, the MLB said it was instituting educational programs and rule changes to protect from concussions.  The prior year, the MLB mandated that any player who suffers a concussion must be put on the “disabled list” for at least 7 days.

This year, Major League Baseball established a lobbying office in the District of Columbia.  Lobbying is not new for the MLB, as they have always spent time and money lobbying, most notably in the 1998 – 1999 seasons when they spent $1.6 million on it.  (In comparison, last year the MLB spent about $320,000 lobbying.)  The office is run by Josh Alkin, a lawyer who, before the appointment as Vice President of Government Relations in this office, had been handling issues relating to the MLB for 15 years at the firm BakerHostetler.  In 2013, the MLB also stated that it aims, “to remain proactive on concussions and head injuries.”

I don’t think there is a way to entirely eliminate concussions from baseball but the MLB has instituted mandatory educational programs and certain changes to the rules to minimize these injuries. It is a good sign that the MLB, as of this year, has a lobbying office in the country’s capital to address a wide range of key government-facing issues including player safety.  With these steps, the MLB hopes to eliminate some concussions, but still keep the excitement of watching a game of America’s pastime.

“Hearing” Concussions

Though they are quite different on the surface, soldiers and college athletes both function in roles that can result in physical injury.  Unfortunately, this commonality means that both soldiers and college athletes have a higher likelihood of getting a mild traumatic brain injury (mTBI), also known as a concussion.  Because of this, the U.S. Army Medical Materiel Agency (USAMMA) and the National Collegiate Athletic Association (NCAA) joined forces in a search to find a better way of detecting mTBI, which may not be immediately recognizable.  The project, known as the “Grand Alliance”, is being conducted at the Massachusetts Institute of Technology’s government-funded Lincoln Laboratory (MIT LL), with the goal of creating “a U.S. Food and Drug Administration-cleared, real-time mild TBI screening app and hardware device which can be used throughout the echelons of care from point of injury to rehabilitation,” said Brian Dacanay, USAMMA product manager.  Essentially, they are in the process of creating “a computer algorithm to identify vocal biomarkers” to be used on a portable smartphone-size device that could help identify when someone needs medical help for a concussion.  MIT LL hopes to have the device ready for FDA approval by 2018.

America’s BRAIN May Increase In 2017

In 2009, President Obama told the press that his administration will “restore science to its rightful place.”  A list of 100 examples of this “restoration”, called the IMPACT REPORT, was published on June 21, 2016 by the White House press office.  Example #45 on this list is the April 2013 launch of the BRAIN (Brain Research through Advancing Neurotechnologies) Initiative, which was begun in order “to develop neuro-technologies [to] uncover new ways to treat, prevent, and cure brain disorders such as Alzheimer’s, Parkinson’s, schizophrenia, autism, epilepsy, and traumatic brain injury.”  This Initiative, funded jointly by the Federal government and private enterprises, was news when it first was started, but since then there have been few stories in the news and few statements from Obama himself discussing the Initiative’s studies or its findings.

Despite the lack of discussion about the program in the media, online you can find the benefits of the Initiative and its recent, but limited, successes.  In March of this year, Obama proposed to increase the “Federal investment in the BRAIN  Initiative from $300 million in fiscal year 2016 to $434 million in fiscal year 2017.”  (In fiscal year 2013, when program started, BRAIN’s budget was $100 million.)  Though the 2016 budget of $300 million seems high already, for the extensive studies the Initiative does, $434 million may be more appropriate.  This funding for BRAIN has been provided by 5 federal agencies, DARPA, NIH, NSF, IARPA, and FDA, who also run the studies.  In 2017, the President plans to increase this to 6 federal agencies, by adding the Department of Energy.

In looking through the National Institute of Mental Health, a subset of the NIH, BRAIN Initiative’s Science News page, I found only 4 press releases for 4 studies completed since 2013.  Presumptively, that is because comprehensive medical studies often take years to complete and/or more completed study results can be found on other government websites.  More financing may mean that the program can start and eventually complete additional studies, perhaps more quickly because it can add more manpower.

The study I found most intriguing was a study funded both by BRAIN and the Human Connectome Project, and completed in 2015, titled “Our Brain’s Secrets to Success”.  This study examines the cortex of 461 volunteers to see “how the human brain contributed to our success.”

As of July 7, the program has reported the results of one study in 2016, “Ketamine Lifts Depression via a Byproduct of its Metabolism,” with the purpose of finding a new, more effective anti-depressant by using metabolite, a byproduct of ketamine.  (Ketamine is already being used for this purpose in many hospitals.)  The results of this study, published in May, found that ketamine’s use as an antidepressant worked well in rats, but, while human trials with ketamine quickly relieved patient’s depression, it did not have lasting effects.

Patriotic Day Can Traumatize America’s Patriots

Fireworks may be the signature event of the 4th of July, but for those veterans who showed their extreme patriotism by serving on the front line, it may be the most emotionally painful day of the year.  Research findings differ, but up to 20% of the more than 2.5 million veterans and troops who have served in Iraq and Afghanistan are believed to have developed PTSD.  “With PTSD, it’s an invisible wound.  It’s a real physical change in our brain,” says Jeremy Clark, a former technical sergeant for the US Air Force who has both PTSD and TBI. He served in Iraq and was traumatized by the explosions of 14 roadside bombs during his service.  Sam Deeds, a Marine Corps vet, says, “It’s like I’m getting blown up all over again.”  As of 2016, there were free yard signs to veterans that say “Combat veteran lives here, please be courteous with fireworks.”

For non-veterans, fireworks can still be dangerous.  The purchase of fireworks is illegal in some states and, even in states where the purchase of fireworks are legal, they should not be lit without proper knowledge on how to prevent injuries.  According to the Consumer Product Safety Commission, 230 people a year “celebrate” Independence Day with a visit to the emergency room because of fireworks-related injuries.  To prevent injury from happening, the non-profit National Council on Fireworks Safety and the US Consumer Product Safety Commission both have instructions on how to use firework as safely as possible.

(In this post, I have talked about the dangers of fireworks.  However, I think most veterans would say that fireworks are both a patriotic and enjoyable way to celebrate Independence Day.  They probably wish they could still enjoy the fireworks on July 4th.  Clark and Deeds have both found ways to prevent the noise and visuals that lead them to an automatic fight-or-flight reaction.  I very much hope that vets with this issue can find ways to enjoy the holiday without exposing themselves to triggers.)

Trump & Sanders Ignore Woodruff’s Vets/TBI Letter – Clinton Responds

In 2006, Bob Woodruff was a star in the field of news reporting.  He had just earned the position of anchor of ABC’s renowned news show World News Tonight.  Being a diligent journalist, in January 2006, he traveled to Iraq to report on the ongoing war.  Then the unforeseeable happened: He and cameraman Doug Vogt stepped on a roadside bomb that then exploded.  The two men were immediately taken to the U.S. Air Force hospital south of Balad where Woodruff had head surgery to remove the most severely damaged parts of his skull.  Following his time in Iraq, Woodruff was transferred briefly to Germany, then to America.  In a hospital in Maryland, Woodruff was put in a medically induced coma for 36 days and finally, in March 2006, was transferred to a hospital in his hometown of Westchester, New York.

After this incident, Woodruff took a break from news reporting to recover and then in 2007 returned.  However, like many of those with TBI, he went back to his “old life” too quickly.  He was not successful in news reporting, forgetting words and similar things that happen to those who suffer a brain injury.  (Personally, I don’t think Woodruff was wrong for trying to go back on air when he first did.  He remembered what he loved to do and pursued it.  If he hadn’t done this, it would have haunted him forever and, more importantly, he wouldn’t have known what he had to improve before he could return to the air again.)  However, in time, he was able to return to work as a journalist and, “since then, he has reported from around the globe on a variety of subjects for the [ABC] network.”

It’s good to remember that, with every brain injury, there is something positive that comes out, whether it be one thing or many, whether it be in business, family, etc.  For Woodruff and his wife, Lee, their personal experience with brain injury allowed then to understand some of the struggles that veterans with TBI, PTSD and other neurological injuries face, leading them to found a nonprofit focused on veterans and brain injury, the Bob Woodruff Foundation (bobwoodrufffoundation.org).  The mission of this foundation is to “stand up for heroes so that we can find, fund, and shape innovative programs that help our impacted veterans, service members and their families thrive.”  The more than $30 million donated to the Foundation has been used to fund education and employment, rehabilitation and recovery and quality of life.

In January 2016, Woodruff sent a letter to presidential candidates Hillary Clinton, Bernie Sanders and Donald Trump.  To date, the only candidate that has responded to this letter is Clinton.  For Mr. Trump, the lack of response is particularly surprising, as he often talks about how America needs to rebuild the military and says the VA is “absolutely unacceptable”.  As an American and a brain injury survivor, I am quite interested in the responses of Trump and Sanders to Woodruff’s questions.

Link: TBI Statistics Op-Ed

Today, I found a story, Brain injury: A public health crisis in the spotlight, that encapsulates many of the statistics and information surrounding brain injury within the public and government.  This article, an opinion piece that is filled with facts, is linked to in this post and can be later found on the “Brain Injury Statistics” page of this site.