New Brain Injury Support Group forming in North Fork-Suffolk County, New York
A recent article in The Suffolk Times reports that a new brain injury support group is forming on the North Fork of Suffolk County, New York.
The group they will start up in the fall is aimed at patients and also their families and friends. The purpose is to provide a refuge for area people who have suffered brain injuries from accidents, illnesses or even drug use.
No decisions have been made as to where or when the group will meet, but the founders are putting together a list of interested people. If you would like to participate, contact Ms. Slade or Ms. Myers .
July 3, 2009 | Permalink | Comments (0) | TrackBack (0)
Following Severe Brain Injury: Need to Monitor For Seizure Activity
Two new studies published in the Annals of Neurology and Critical Care Medicine demonstrate a need for more vigilant monitoring for seizure activity among intensive care patients who may be experiencing subtle seizures that are typically unrecognized. These subtle seizures may be affecting patients' prognoses and causing long-term brain damage, death and severe disability.
It has previously been shown that unrecognized seizures are common in the critically ill, particularly in those with acute brain injury, and that these seizures are associated with unfavorable outcomes.
The two studies found that electroencephalography (EEG) was effective in detecting subtle seizures that are often impossible to detect by visual observation.
The findings demonstrated the value of continuous EEG (where electrodes are placed on the scalp – a noninvasive procedure used in nonsurgical ICUs) and intracranial EEG (ICE), an invasive technology where a probe is placed in the cortex of the patient's brain. ICE is mainly used in Neurological ICUs for serious acute brain injuries, such as subarachnoid hemorrhage, severe head trauma and very large strokes (hemorrhagic or ischemic), which require other invasive brain monitoring devices.
The papers, are entitled "Intracortical Electroencephalography in Acute Brain Injury," and "Continuous Electroencephalography in the Medical Intensive Care Unit".
July 2, 2009 | Permalink | Comments (0) | TrackBack (0)
Kaplen appointed legal advisor to Sarah Jane Brain Foundation
I am honored to report that I have been appointed as a member of the legal advisory board of the Sarah Jane Foundation. As a brain injury attorney, I am pleased to be able to offer my years of experience in representing victims of brain trauma to the foundation.
The Mission of The Sarah Jane Brain Project is to create a model system of care for children suffering from all Pediatric Acquired Brain Injuries. You can learn more about the Sarah Jane Foundation by viewing their web site.
The foundation has joined together 51 health care institutions representing states across the country to address issues related to the treatment of brain injury, the number one cause of death and disability in children and young adults in the United States. The goal is to develop a national collaborative network to address brain trauma in children.
Member centers in the new network will share information and research findings on pediatric brain injuries in an effort to establish a standardized national medical plan for dealing with these injuries.
July 1, 2009 | Permalink | Comments (0) | TrackBack (0)
Limiting Malpractice Law Suits Will Not Fix Nation's Health Care Crisis
Our nation's health care system is a mess. Those who work with injured individuals on a daily basis are well aware of the frustrations that our clients have in obtaining health care that is both readily available to them and affordable. Insurance companies constantly are throwing up road blocks to accessing medical care. We need health care reform and we need it now. Those who are victims of brain injury know the difficulties they have in getting proper rehabilitation care and the arbitrary limits that health care insurers place upon treatment. Those who have sustained brain damage as a result of medical errors, know that they are entitled and deserving of full compensation for their injuries, disabilities and loss of earnings.
Health care reform however should not be confused with medical malpractice deform and proposals to link changes in the medical malpractice compensation system with health care reform should be disregarded as ill founded and without merit in attempting to solve our health care crisis.
The following guest editorial from the president of the American Association for Justice is reprinted here for your review.
The health care crisis is one of the most complex issues facing our country. Ultimately, a national solution will boil down to two major tenets: lowering costs while improving quality, and covering the uninsured.
Changing the legal system will not solve any of these problems. Doing so will only make it harder for patients injured by medical negligence, through no fault of their own, to pursue legal recourse.
Discussing negligence as part of health care reform is a distraction from the debate. Numerous studies and economic experts, such as the Government Accountability Office and Congressional Budget Office, have detailed how tampering with the legal system will save health care practically no money. One study showed that medical negligence lawsuits were a tiny percentage of civil cases.
Fixating on the legal system ignores the larger issue: patient safety. As many as 98,000 people die every year because of medical errors. If medical negligence becomes rarer, so will the number of injured patients who need to seek legal recourse.
A few hospitals are using programs that encourage doctors to disclose errors and apologize to injured patients as a way to avoid litigation. As long as there are strict protocols to protect the legal rights of patients, these programs offer compelling ways to foster openness and defuse what is often an emotional and difficult experience. Even so, these programs are not one-size-fits-all. For patients injured by clear negligence, saying "I'm sorry" does not repair physical disfigurement or relieve pain and suffering. Proper compensation must be provided.
Any "reform" that makes it more difficult for injured patients to seek legal recourse is unacceptable. Alternatives such as health courts not only deny people their guaranteed right to trial by jury, but they also nonsensically create a whole new bureaucracy to accommodate just one select profession.
Limiting the legal rights of patients will do nothing to provide insurance coverage or lower health care costs. Eliminating errors and keeping patients safe will most certainly accomplish these goals. And this is something all of us can support.
The brain injury attorneys and medical malpractice attorneys at the New York law firm of De Caro & Kaplen, LLP support changes in our health care system without limiting patient right's to sue for full and fair compensation.
July 1, 2009 | Permalink | Comments (0) | TrackBack (0)
Protecting service members from medical malpractice in the military
Senator Charles Schumer has introduced the Carmelo Rodriguez Medical Accountability Act of 2009 (S. 1347 / H.R. 1478), which would guarantee active military servicemen and women the right to sue for medical malpractice. Under the Feres Doctrine, a 1950 Supreme Court ruling, active military members cannot sue the government for non combat related injuries. The bill would offer service members injured by medical negligence the same protections currently provided to veterans. It is named after Carmelo Rodriguez, who died from skin cancer in 2008 after his doctor had failed to report his melanoma more than 10 years ago.
More details about the Feres Doctrine and the Carmelo Rodriguez Medical Accountability Act of 2009 can be found at the American Association for Justice website.
Our law firm, DeCaro & Kaplen, LLP handles medical negligence cases causing brain injury as well as other catastrophic personal injuries.
June 30, 2009 | Permalink | Comments (0) | TrackBack (0)
Could TV Pitchman, Billy May's Sudden Death Be Caused By A Traumatic Brain Injury?
TV Pitchman Biilly May, suddenly passed away on Sunday. Word is spreading that on Saturday, while on board an airplane, he struck his head after the plane's tires blew out during a rough landing.
Sounds similar to the fate of Natasha Richardson who also died suddenly after she struck her head.
The condition causing these sudden deaths is termed, "talk and die" syndrome. What is implied by this terms is that someone hits their head and seems to initially be OK, but due to a rapid accumulation of blood, called epidural hemorrhage (bleeding between the skull and the brain), their are serious pressure changes within the brain, leading to death.
The take away message is that any head injury must be taken seriously. The individual experiencing the head trauma needs to checked out by qualified medical personnel to determine if the head injury requires treatment.
June 29, 2009 | Permalink | Comments (0) | TrackBack (0)
Blast Injuries and Traumatic Brain Damage
Blast-induced traumatic brain injury (TBI) has reached critical levels in modern-day warfare. The current issue of Journal of Neurotrauma focuses on the intensive efforts to develop effective treatment strategies and model systems for studying the cause and effects of explosive blast TBI. This special issue of Journal of Neurotrauma, can be viewewd free on line. View blast exposure and traumatic brain injury here.
June 29, 2009 | Permalink | Comments (0) | TrackBack (0)
Decompressive Craniectomy: Studies Underway To Determine Effectiveness
Decompressive craniectomy , a procedure where a portion of the skull is removed to allow the brain to expand is widely used to treat intracranial hypertension (high pressure within the brain causing brain damage) following traumatic brain injury (TBI).
Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI.
It is important to determine if this procedure is really effective in reducing death and disability following a severe brain injury because there are many complications that can develop as a result of this procedure.
The complications surrounding this procedure are discussed in an article in the June issue of NeuroSurg Focus, vol. 26 No. 6 To evaluate the complications of decompressive craniectomy, a review of the literature was performed restricting information to literature pertaining to decompressive craniectomy for patients with TBI.
An understanding of the pathophysiological events that accompany removal of a large piece of skull bone provides a foundation for understanding many of the complications associated with decompressive craniectomy.
The author determined that decompressive craniectomy is not a simple, straightforward operation without adverse effects. Rather, numerous complications may arise, and they do so in a sequential fashion at specific time points following surgical decompression. Expansion of contusions, new subdural and epidural hematomas contralateral to the decompressed hemisphere, and external cerebral herniation typify the early perioperative complications of decompressive craniectomy for TBI.
During the later phases of recovery, patients may develop a new cognitive, neurological, or psychological deficit termed syndrome of the trephined. In the longer term, a persistent vegetative state is the most devastating of outcomes of decompressive craniectomy.
The risk of complications following decompressive craniectomy is weighed against the life-threatening circumstances under which this surgery is performed. Ongoing trials will define whether this balance supports surgical decompression as a first-line treatment for TBI.
June 28, 2009 | Permalink | Comments (0) | TrackBack (0)
Traumatic Brain Injury Can Cause Premature Death
An interesting news report from ABC News examines the link between traumatic brain injury and premature death .Can Brain Iinjury Lead To Death Years Later?
It is important to realize that the impact of a traumatic brain injury may have long term consequences including premature death. Traumatic Brain Injury (TBI) for to many years has been overlooked as a source of long term disability and premature death. The investigation and the studies cited in the news report have serious implications for the many service members returning from oversees with brain damage. This signature wound may be a cause of premature death. Who would argue that these service connected deaths are not entitled to proper compensation?
June 27, 2009 | Permalink | Comments (0) | TrackBack (0)
Protect the Public From BIG Truck Accidents On Our Roads and Highways
Large trucks on our nation’s road are a significant cause of highway injuries and deaths. Many of these injuries are head injuries resulting in traumatic brain damage.
The following statistics are shocking:
Every year, about 5,000 people die and over 100,000 people are injured in large truck crashes. Despite only making up 3 percent of all registered vehicles, large trucks represent 9 percent of all vehicles involved in these fatal crashes and are responsible for 12 percent of all crash fatalities.
Fortunately, Congress is working on a new transportation spending bill that would prevent increases in truck sizes and weights on the National Highway System, including the Interstates – increases that endanger the safety of the motoring public, our roads and bridges.
America's highway infrastructure is crumbling, in part due to oversized trucks, which also are responsible for far too many crashes resulting in deaths and injuries. Also, the bigger the rig, the bigger the impact on greenhouse gas emissions and fuel consumption. We simply cannot afford all of the costs of allowing bigger and heavier trucks on our roads and highways.
PUBLIC CITIZEN, the national non-profit public interest organization of which I am a proud supporter is seeking support for legislation currently pending in the United States House of Representatives: H.R. 1618, the Safe Highways and Infrastructure Preservation Act of 2009. They have requested that you contact your congress person and ask them to both co-sponsor and support this legislation.
Here is some language that you can use when writing to your congressal representative:
I am writing to relay my strong support for H.R. 1618 and S. 779, the Safe Highways and Infrastructure Preservation Act of 2009 (SHIPA), and urge you to co-sponsor this important legislation. The SHIPA bill is co-sponsored by more than 80 Democratic and Republican Members of Congress, and supported by national highway and truck safety groups, victims and survivors of truck crashes, as well as leading national environmental and public interest organizations.
Every year about 5,000 people die in truck crashes including more than 800 truck
drivers and over 100,000 are injured. Large trucks represent 9 percent of all vehicle involved in fatal crashes, are responsible for 12 percent of all crash fatalities but make up only 3 percent of all registered vehicles.
The purpose of SHIPA is to prevent the constant increases in truck sizes and weights on Interstate and non-Interstate portions of the federal National Highway System (NHS) that endanger the motoring public as well as our roads and bridges. Enactment of SHIPA will extend the safety and infrastructure protection that was achieved in 1991 when Congress overwhelmingly enacted the freeze on longer combination vehicles (LCV) in the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA).
Enacting H.R. 1618 and S. 779, the SHIPA Act, would save lives and prevent injuries, limit damage to our crumbling roads and bridges, reduce global warming pollution and curb our dependence on oil, and help achieve a balanced multi-modal transportation system. I urge you to support this sound and sensible legislation and look forward to working with you to build a safer, cleaner and more efficient transportation future for our nation.
Your assistance in protecting our nation’s roads and the health and safety of the public is appreciated.
June 27, 2009 | Permalink | Comments (0) | TrackBack (0)
Reducing the severity of brain trauma following a car crash
The Centers for Disease Control (CDC) continues to look at new technologies to reduce severe brain injuries following motor vehicle accidents.
In a new report titled, Recommendations from the Expert Panel: Advanced Automatic Collision Notification and Triage of the Injured Patient the CDC looks at inboard car computer programs that provide information following a car crash.
This report presents the findings of a national expert panel and outlines recommendations for the use of new technologies, such as Advanced Automatic Collision Notification (AACN) or vehicle telematics, to help identify the likelihood of severe injuries, including traumatic brain injury (TBI), among individuals involved in a vehicle crash.
The panel found that using available technology, such as AACN, shows promise in helping save lives through:
- the potential to predict the severity of injuries of vehicle crash victims, including Traumatic Brain Injury (TBI), which can help emergency care providers more quickly identify, diagnose, transport, and treat injuries; and
- Use of rapid communication and vehicle locating capabilities, which can help decrease response time by emergency medical services (EMS) providers.
Read the full advanced automatic collision notification report now.
June 26, 2009 | Permalink | Comments (0) | TrackBack (0)
Pool Safety Tips
Pool accidents are a leading cause of traumatic brain injury. It's easy to prevent drowning and other injuries around the pool with proper care.
Whether you are a pool owner or guest, go to the lake or beach, safety is a priority. Kessler Institute for Rehabilitation has offered these Top 10 Water Safety Tips:
- If you are a pool owner, be sure to have clearly marked depth indicators around the entire pool. Post “No Diving” signs - and enforce that rule!
- Watch your guests. More than 90% of injuries occur to visitors, rather than owners.
- Never dive into an above-ground pool and be careful around ladders and other equipment.
- Never drink and dive. “Drinking impairs an individual’s judgment and slows reactions,” explains Kirshblum. “Nearly half of all diving accidents resulting in a serious injury involve alcohol consumption.”
- Don’t swim alone. Ideally, a lifeguard or someone trained in water safety should always be present.
- Always check the depth of water before going in. Levels may be deceptive, especially where drought conditions existed. Be sure that there are no rocks or debris below the surface.
Enter the water at lakes and ponds feet first to avoid injury. - Never dive into the ocean. It’s difficult to see what’s under the surf, particularly sand bars. And tides constantly cause the ocean sands to shift.
- Even if areas are marked as being safe for diving, do not dive if your trajectory will place you in less than nine feet of water. When diving from a board, the water should be deeper than 12 feet.
- Educate children. Safe water behaviors should be taught at an early age so children can make smart decisions when involved in water activities.
June 25, 2009 | Permalink | Comments (0) | TrackBack (0)
Progesterone Study For Traumatic Brain Injury Now in Third Phase
Preliminary research studies at Emory University, Atlanta, Georgia have shown that patients who receive progesterone injections shortly after sustaining a severe head or severe brain injury have reduced risk of death and long term disability. The small pilot study had enrolled 100 Participants.
Now the National Institute of Health (NIH) has provided an additional 14.5 million dollars for a three year comprehensive study that will enroll 1,140 patients at 17 medical centers across 17 states to further study the protective effects of progesterone in minimizing death and the long term consequences of traumatic brain injury.
Read the full Emory press release: progesterone for traumatic brain injury.
June 24, 2009 | Permalink | Comments (0) | TrackBack (0)
Three Years and Not One Service Member Tested for Subtle Brain Damage
Subtle brain damage is often missed by conventional MRI testing, leading many to falsely conclude that no structural brain damage has taken place. This false premise has subjected many individuals who have sustained brain injury, including returning veterans to have their claims rejected.
The absence of proof is not proof of the absence of an injury and the fact that often times brain injury is not detected using MRI Studies does not mean that an individual did not suffer a traumatic brain injury.
Newer MRI techniques such as the more powerful Tesla 3 MRI machines are now capable of detecting brain injuries that were missed in the past. Other useful techniques for detecting subtle brain injury include functional MRI studies (fMRI)
Three years ago, the Department of Veterans Affairs established a laboratory at the University of Texas at Austin with high expectations that it would conduct state-of-the art research into combat-related brain injuries using powerful MRI technology. However after 3 years no studies have ever taken place!
Last month, the VA announced it was moving the facility to Waco, Texas, after spending more than $3 million without testing a single veteran with traumatic brain injury. The Waco facility is reported to have the world’s most powerful research MRI machine.
The decision follows a two-year battle between VA and the former director of the Brain Injury and Recovery Laboratory, who has accused his superiors of fraud, mismanagement and wasting taxpayer money.
The uproar has sparked a congressional inquiry, an investigation by the federal Office of Special Counsel and several internal investigations.
Hopefully, research will finally get underway to objectively document subtle brain injuries in returning vets.
You can read more on the controversy and investigation of the Austin facility by clicking a story in the Washington Post , “VA Moves Texas Brain Laboratory After Years Pass Without Testing”
June 23, 2009 | Permalink | Comments (0) | TrackBack (0)
Comparing Brain Damage in Brains of Wounded Vets to Brain Damage in Football Players
The Sports Legacy Institute and the Boston University Center for the Study of Traumatic Encephalopathy have announced that they will be now examining the brain tissue of service members who have passed away after suffering from blast injuries. They will be comparing the pathological findings in the brain tissue of victims of blast injury to the findings in tissue examined in football players who have sustained multiple concussions. The full story is reported in the New York Times article, "A Chance for Clues to Brain Injury in Combat Blasts".
The researchers hope to determine whether single, non-impact blasts in battle can cause the same type of brain damage found in the brains of football players who have been subject to years of repetitive head injury.
They researchers also are interested in determining whether their are physical changes to the brain in service members who have been diagnosed with post traumatic stress disorder (PTSD) since many of the symptoms associated with this condition, such as depression, erratic behavior , diminished ability to concentrate are all similar to the post concussion symptoms faced by professional athletes and other concussion victims.
June 23, 2009 | Permalink | Comments (0) | TrackBack (0)
Brain Injury Resource Lecture at The George Washington University
I am thrilled to be in Washington DC today to again lecture at the Master's Degree Program in the Center for Education and Human Services Acquired Brain Injury Masters program at The George Washington University.
This semester’s lecture is focused on examining the various sources of information that is available on the internet in the area of traumatic brain injury. We will be exploring government web sites such as the Center For Disease Control and the National Institute of Health, great brain injury resource sites such as BrainLine, web sites that emphasize management of sports concussions, web sites that provide useful information on special education, various neuropsychological accrediting groups, brain injury association pages, brain injury professional societies and of course the brain injury news and information blog and brain law and the brain injury legal guide web site.
The Master's Degree Program in Special Education: Emphasis in Acquired Brain Injury is focused in addressing the national shortage of special education and related service personnel qualified to meet the needs of students with traumatic brain injuries (TBI) and their families. Graduates are uniquely prepared to be educators and systemic improvement specialists in schools, hospitals, rehabilitation programs, advocacy programs, and related organizations. Scholarship support for qualified students is available. You can obtain more information on the GW Acquired Brain Injury Program by clicking here.
June 22, 2009 | Permalink | Comments (0) | TrackBack (0)
Grants to assist youths in trouble with the law following a traumatic brain injury
Adolescents suffering from traumatic brain injury (TBI) often face behavioral issues which may cause them to incur difficulties with the law. Unfortunately, rather than address these behavior and anti-social difficulties, these youths are identified as criminals and become part of the criminal justice system.
The federal government has now recognized the need to address these behavior issues and has targeted funds and grant programs to address the special obstacles faced by incarcerated and about to be incarcerated youth who are at high risk of having and undiagnosed and untreated TBI that interferes with both physical and mental health.
These grants are part of the Presidential New Freedom Initiative to reduce barriers to community living for people with disabilities and to address lack of access of families to the services, advocacy and assistance they need as mandated in The Family Opportunity Act of 2005.
According to an announcement from the offices of Health and Human Services:
“ This initiative ultimately will provide for State systems change that is needed to assure that all high risk youth that are part of a juvenile corrections systems can be identified accurately and receive services that are appropriate for individuals with TBI. The overarching goal of this activity is to treat rather than just incarcerate youth with TBI so that they can ultimately become educated, productive, and contributing members of their communities Specifically, a State or Territory receiving these Targeted Issues in TBI Funds will be able to work across State systems to provide identification, appropriate treatment, including alternative education and training, mental health and substance abuse treatment, and diversion into those State Programs that can provide an environment that will encourage good decision making skills, risk avoidance, and independence. Because TBI is a multi faceted condition, requiring the skills of many professional disciplines, these grants will permit training for all involved professionals, including State Corrections and Probation officers. A careful evaluation of activities and their outcomes will provide much needed data to the field, as well as informing program progress monitoring to allow for program changes as needed. The evaluation of targeted issues grants should be particularly rigorous as they are first Step efforts in expanding knowledge in a particular field of interest in TBI. Core values across all MCHB programs include family-centered care, family professional partnerships and cultural and linguistic competence. These MUST be integrated throughout project policies and activities. MCHB will also require additional data and will provide technical assistance, as needed. Review criteria for all of these issues will be described in the guidance. Although a Letter or Email of Intent is not required, it is encouraged.”
You can link to the full announcement by clicking here.
June 21, 2009 | Permalink | Comments (0) | TrackBack (0)
More State Brain Injury Association Annual Conferences Scheduled
The Brain Injury Association of Michigan has announced that their 29th annual conference will be held on Sep 24-25 in Lansing, Michigan. More information is available at the Michigan Brain Injury Association web site.
The Brain Injury Association of Ohio is hold their 28th annual conference on Oct 1-2 in Columbus, Ohio. More information is available at the Ohio Brain Injury Association web site.
June 21, 2009 | Permalink | Comments (0) | TrackBack (0)
Department of Defense Announces New Campaign to Remove Stigma of Seeking Assistance For Post Traumatic Stress Disorder
Post-traumatic stress is a common problem among American service members returning from Iraq and Afghanistan. To combat the stigma that keeps some members of the military, veterans and their families from seeking needed psychological help, the Department of Defense launched the Real Warriors Campaign. The campaign, themed "RealWarriors--Real Battles--Real Strength" is hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCOE).
You can view the video from the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
According to the Department of Defense, this multimedia public education effort makes reaching out easier by providing access to psychological health information and resources 24 hours a day, seven days a week. Individuals can chat online with psychological health coaches through the campaign website, They may also reach out by calling the Outreach Center at 866-966-1020.
The Defense Department claims that this campaign is part of a larger effort "to ensure that warriors and their families can access necessary treatment for the invisible wounds of war as well as the visible wounds. Many service members and veterans deny themselves treatment for psychological wounds out of the fear that doing so would hurt their careers, embarrass them or harm their families."
June 20, 2009 | Permalink | Comments (1) | TrackBack (0)
Spanish Language Resources for Brain Injury Survivors
Thanks to brainline for providing a tip on where to obtain spanish language information for individuals with brain injury and their families. The material was prepared by the Defense and Veterans Brain Injury Center (DVBIC) and are Spanish translations of three popular DVBIC handouts. Signs and Symptoms of Traumatic Brain Injury (TBI), Frequently Asked Questions About the Defense and Veterans Brain Injury Center (DVBIC), and the DVBIC Fact Sheet on TBI. They may be downloaded at the Defense and Veterans Brain Injury Center web site. In Spanish, click here. To order print copies, you can email your request to the Defense and Brain Injury Center
June 19, 2009 | Permalink | Comments (0) | TrackBack (0)
Pennsylvania Brain Injury Association Annual Conference
The Brain Injury Association of Pennsylvania is holding their annual conference on Jun 22-23 in Lancaster, PA. For more information go the the Brain Injury Of Pennsylvania web site.
June 18, 2009 | Permalink | Comments (0) | TrackBack (0)
New Concussion Guidelines for Children and Teens: Keep Them Off the Field!
An international panel of neurologists, updating their recommendations on concussion care in the May issue of The British Journal of Sports Medicine, said that any athlete 18 or younger who was believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day.
The group had previously said that such athletes could return if cleared by a doctor or certified athletic trainer, An international panel of neurologists, updating their recommendations on concussion care in the May issue of The British Journal of Sports Medicine, said that any athlete 18 or younger who was believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day.
The new consensus is from the International Conference on Concussion in Sports.
The group had previously said that such athletes could return if cleared by a doctor or certified athletic trainer, but now contend that such determinations are too difficult and dangerous for same-day return to be considered safe.
When it comes to concussions, children and teens require different treatment, according to the international experts who recently published their consensus recommendations. The British Journal of Sports Medicine's new guidelines say children and teens must be strictly monitored and activities restricted until fully healed. These restrictions include no return to the field of play, no return to school, and no cognitive activity.
The guidelines also point to the important role parents, coaches, and teachers play in assessing and treating young athletes."
For children and adolescents, the guidance strongly reiterates several key points for coaches, parents, and physicians:
The group's recommendations for children and adolescents were based on the fact that though 80 to 90 percent of adult concussions resolve in seven to 10 days, for children and adolescents, the recovery time is often longer. In all cases, the decision to "return-to-play" should be made based on the individual's progress, not a standard time period. Careful post-injury evaluation of the injured student-athlete is essential.
June 17, 2009 | Permalink | Comments (0) | TrackBack (0)
Brain Injury Legislative Update
This week's brain injury legislative update has been prepared by the Brain Injury Association of America (BIAA):
Health Care Reform Update
On June 9, 2009, the Senate Health, Education, Labor and Pensions (HELP) Committee released a draft health care reform bill. In summary, the draft would expand Medicaid eligibility to those with incomes up to 150 percent of the federal poverty level, impose federal tax penalties on most individuals failing to purchase coverage, mandate a public plan option, require employers to provide coverage or pay into a pool, and stiffen regulation of private health insurance plans.
Importantly, the plan eliminates life-time insurance caps as well as provides for the establishment of a medical advisory council that will submit a report to the Secretary of Health and Human Services including recommendations on essential health care benefits eligible for credits which includes rehabilitative services. In issuing the report, the council will ensure that the recommendations take into account the needs of diverse segments of the population including persons with disability.
The HELP committee plans to begin considering this bill on June 16, 2009. BIAA will continue to monitor the situation carefully.
NIDRR Grant Forecast
This week, The National Institute on Disability and Rehabilitation Research (NIDRR) announced it will include two TBI grant programs in its forecast for 2009.
The first grant application notice, rehabilitation research and training centers (RRTC) on traumatic brain injury interventions, will be available on June 30, 2009, while the second, RRTC on developing strategies to foster community integration and participation for individuals with traumatic brain injury will be available on July 24, 2009.
BIAA will report on the details of these applications when they are released.
Coalition for Regenerative Stem Cell Medicine update
As part of the Coalition for Regenerative Stem Cell Medicine, BIAA enthusiastically endorses two important pieces of legislation aimed at advancing the therapeutic potential of newborn stem cells, the unique stem cells that can be collected immediately following birth from umbilical cord blood and the cord itself, as well as helping to advance the use of one's own newborn stem cells in regenerative medicine.
HR 1718 - The "Family Cord Blood Banking Act" amends Section 213(d) of the IRS Code to add cord blood banking services as a qualified medical expense. This change will allow individuals and couples to use tax advantaged dollars to pay for umbilical cord blood banking services through flexible spending accounts (FSAs), health savings accounts (HSAs) health reimbursement arrangements (HRAs) or the medical expenses tax deduction.
The "Family Cord Blood Banking Act" will make cord blood banking more affordable for American families and provides incentives to ensure that this valuable health resource is never thrown away.
HR. 2107 - The "Cord Blood Education and Awareness Act of 2009" will provide expectant mothers with straightforward, accurate and easy to understand information about the value of their child's umbilical cord blood stem cells. It will offer a government stamp of approval on all available cord blood banking options and will give expectant parents confidence in the information they are reviewing.
June 16, 2009 | Permalink | Comments (0) | TrackBack (0)
Congratulations to Shana De Caro, Esq.
Congratulations to my partner, brain injury attorney, Shana De Caro who has again been selected for inclusion in the 2009-2010 Edition of Who's Who in American Law. According to the editors, this edition will chronicle the country's most distinguished legal professionals who have made significant contributions to the advancement, understanding and appreciation of the legal profession.
Shana is also is an officer of the American Association for Justice, Traumatic Brain Injury Litigation Group, a trustee of the Civil Justice Foundation and an editor of the New York State Academy of Trial Lawyer's monthly legal update.
June 16, 2009 | Permalink | Comments (0) | TrackBack (0)
Take The "R" Word Out Of New York State Vocabulary
Thanks to my friend, disability advocate, Ralph Shields for bringing this important legislation to my attention and to the work of the Center for Disability Rights for the following memo:
Action Alert – No More "R" Word! Support A07566!
For many years, advocates have pushed for a name change for OMRDD (Office of Mental Retardation Developmental Disabilities) and are extremely pleased at the possibility that New York will now join all but a few states in the USA that have removed the words 'mental retardation', often referred to as the "r-word", from the name of the state agency that supports people with developmental disabilities. A name change has been proposed by the Governor's Office and OMRDD: New York State Developmental Disabilities Service Office--NYSDDSO.
The Senate passed a bill sponsored by Senator Huntley (S 4383) supporting this name and Assemblyman Rivera's proposed a similar bill in the Assembly (A 07566), which, despite our best efforts, is currently stuck in the Assembly Ways and Means Committee. The problem seems to be that there are too many bills on the docket, but this bill MUST be pushed forward to the Assembly for a vote.
Words and language matter. The "r-word" has become a symbol of all of the negative words that are offensive to people with disabilities; words that hurt and sting when used in school yards or heard in movies, words that do not acknowledge our value and contributions as citizens. As many advocates have said, "that word is the same as a curse word to many of us".
There are only a few short weeks left in this session of the Assembly and it is imperative that the name change comes before the Assembly for a vote on the floor as soon as possible. It is important that our leaders in Albany hear from you!
You can take action by clicking here
June 15, 2009 | Permalink | Comments (0) | TrackBack (0)
Elected to Board of Governor's: American Board of Professional Liability Attorneys-Medical Malpractice
I am honored that I was elected to the Board of Governors of the American Board of Professional Liability Attorneys this past weekend during their annual meeting. The Board is the only association accredited and approved by the American Bar Association to certify attorneys in medical and legal malpractice. There are very vigorous standards for certification including a comprehensive written examination and a review of credentials and experience.
June 15, 2009 | Permalink | Comments (0) | TrackBack (0)
Cognitive Fatigue Following Brain Injury Documented in New Study
A recent study by Kessler Foundation Research Center published in Brain Injury, the official journal of the International Brain Injury Association, uncovered the possible cause of cognitive fatigue in patients suffering from traumatic brain injury (TBI). Cognitive fatigue has been shown to be one of the most challenging symptoms following TBI, greatly affecting everyday life activities such as work and school.
The study also addressed the difficult task of measuring cognitive fatigue through the use of functional MRI (fMRI), an advanced imaging technology. It is hoped that this information will also be useful in addressing the symptoms of traumatic brain injury in returning service members.
It has been reported that 73 percent of TBI patients report significant levels of fatigue even five years after they have sustained brain trauma.
A roadblock in the progress for treating patients for cognitive fatigue is the availability of assessment tools. Researchers have been struggling for nearly a century to find ways to measure and diagnose cognitive fatigue. Common methods include self-reporting and objective assessments. This study offers a new and innovative paradigm to investigate brain activation during a cognitive task.
The study entitled “The Neural Correlates of Cognitive Fatigue in Traumatic Brain Injury Using Functional MRI” (Kohl et al, Brain Injury 2009;23(5):420-32), details how fMRI was utilized to assess cognitive fatigue in people with TBI while they were performing behavioral tasks. Researchers compared the readings of eleven healthy controls with those of eleven participants with moderate to severe TBI. The fMRI images illustrated increased brain activity in the patients with TBI, which indicates greater cerebral effort indicative of cognitive fatigue.
“Cognitive fatigue has been shown to be one of the most debilitating symptoms after a traumatic brain injury. It can hinder every aspect of a person’s life,” stated John DeLuca, Ph.D., one of the study author’s. “The study could potentially improve the quality of life for civilians and veterans with TBI as well as stroke survivors and individuals with multiple sclerosis, Parkinson’s disease, and AIDs.”
June 11, 2009 | Permalink | Comments (0) | TrackBack (0)
Aphasia Awareness Month
Aphasia, an impairment in the ability to use (speak) words or comprehend words frequently occurs as a result of a traumatic brain injury or other head injury. June has been designated National Aphasia Awareness Month.
Aphasia can affect multiple functions of the brain including:
- auditory comprehension (understand words said to you)
- verbal expression (expressing your want and needs)
- reading comprehension (understanding written words)
- written expression (writing words)
The type and extent of impairment with aphasia differs from person to person and is highly dependent on the degree of damage to the brain and the location of the brain damage.
The National Aphasia Association is a not for profit association committed to assist persons suffering from aphasia and to supply useful information. They sponsor support groups to assist victims of aphasia and their families. More information can be obtained from the aphasia association web site where they list support groups throughout the country.
June 8, 2009 | Permalink | Comments (1) | TrackBack (0)
Traumatic Brain Injury Research Studies at New York City's Mt Sinai Brain Injury Reserach Center
The following traumatic brain injury research studiessponsored by the Mount Sinai Brain Injury Research Center (888) 241 5152 have been announced:
Needs After Traumatic Brain Injury:
Researchers at Mount Sinai Hospital are developing a questionnaire to assess the needs of people with traumatic brain injury.
If you have been diagnosed with a traumatic brain injury and are 18 years or older and speak English, you can participate in this study.
After you consent to participate, you will be interviewed about what needs you have and how important they are. You may be asked to complete the interview a second time about a week later. The total duration of the interview, which can be performed over the telephone or at Mount Sinai is about two hours.
Volunteers will be reimbursed for their time. You are are interested, please call 212-241 5152.
Treatmentof Post-Traumatic Brain Injury Depression:
The research and training center for traumatic brain injury interventions at Mount Sinai School of Medicine is seeking people who have had a TBI and are experiencing depression. The research study will evaluate te effectiveness of two different psychotherapy treatments in helping individuals who are depressed after brain injury.
To be in this study you must be experiencing depression and be willing to participate in one of the psychotherapies for 4 months. If interested, please call 888 241 5152.
Exercise Study:
The New York Traumatic Brain Injury Model System at Mount Sinai School of Medicine is seeking persons who have sustained a traumatic brain injury to participate in an exercise study.
The research study will evaluate the effectiveness of an 8 to 16 week exercise program on improving people's mood, thinking skills and fatigue levels. Participants will exercise for an hour, three times a week, over a period of 8 or 16 weeks. You will be compensated for your travel expenses and testing sessions. If interested, please call 888-241 5152
Day Treatment for People with Traumatic Brain Injury:
Mount Sinai is conducting two research projects designed to examine the effectiveness of outpatient day treatment programs for persons who have sustained brain injuries, which are designed to reduce problems with thinking, planning, remembering and problem solving.
There will be 5 day a week treatment program for six months or a 3 day a week program for three months. You will be asked to participate in formal testing and to answer questions about your health and quality of life.
If you are interested in participating in this study, contact Hafina Allen at 212 241 4820
June 7, 2009 | Permalink | Comments (0) | TrackBack (0)
Weekly Brain Injury Legislative Update
Here is this week's traumatic brain injury legislative update provided by the Brain Injury Association of America (BIAA)
Health Care Reform Update
Currently, the Senate Finance Committee has reached no consensus on major provisions of the anticipated health care overhaul, raising doubts that it will be considered this month. Committee members remain at an impasse in part because members still lack a clear picture of what potential policy choices would cost.
The Congressional Budget Office (CBO), which estimates what legislation will cost the taxpayers, is scrambling to analyze dozens of policy options the committee is considering. Without cost estimates, lawmakers say it is difficult to decide which provisions they can support. (CQ)
BIAA will continue monitoring the situation closely.
BIAA mobilizes Grassroots Advocates in Support of The conTACT Act
On Thursday, June 4, 2009, BIAA circulated an action alert with the intent to urge members of Congress to sign on to HR 1347, the Concussion Treatment and Care Tools Act of 2009(ConTACT Act).
The bill would require the Centers for Disease Control (CDC) to convene a conference to adopt official concussion guidelines. The bill would also provide grants to states for the purpose of ensuring that elementary and secondary schools implement these guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.
BIAA Submits Comments to NIDRR in Response to Proposed Priorities for RRTCs
This week, BIAA submitted comments to the National Institute on Disability and Rehabilitation Research (NIDRR) specifically regarding the fourth priority included in the proposed plan for the Rehabilitation Research and Training Centers (RRTCs) entitled, "Developing Strategies to Foster Community Integration and Participation for Individuals with Traumatic Brain Injury."
BIAA expressed strong support for the inclusion of a brain injury related research priority. However, BIAA also detailed some concerns related to the strategies used in the priority to foster community integration and participation for affected individuals. As proposed, this priority would develop a classification system based on symptoms experienced by individuals with TBI who are living in the community.
BIAA explained that no two brains are alike and each and every individual presents with different symptoms, and each injury results in different challenges. Therefore, trying to categorize these injuries could be counterproductive to the priority's goal.
BIAA also suggested several suggestions in lieu of a categorization strategy. For further reading, the full text will be posted on BIAA's web site shortly.
June 6, 2009 | Permalink | Comments (0) | TrackBack (0)
