Brain Injury Lawyer - New York

New Jersey High School Athletes To Get Base Line Concussion Testing

The Brain Injury Association of New Jersey has received funding for the administration of a grant to provide high school athletes at up to 100 schools with  pre-season cognitive baseline evaluations.

These pre-season cognitive evaluations will be kept on file to be used in the future if any athlete has sustained a concussion or is suspected of sustaining a concussion or other head injury.  If a head injury occurs then the athlete will be retested and the results compared to assist in making return to play decisions. 

The computer testing and support is provided through an excellent product known as ImPact.  ImPact is a product devised by the sports and concussion faculty at the University of Pittsburgh Sports Concussion Program and is used by many professional teams through out the country. 

Funding for this program comes from the New Jersey Brain Injury Fund which is administered by the Division of Disability Services of the New Jersey Department of Human Services. Matching grant funds will be available for up to 100 public or private high schools that apply to the program.  Schools must pay $650 for the program's $1,300 total cost and make a three year commitment to participate.  The New Jersey Brain Injury Association will contribute the matching $650.

This is a great program to assist medical personnel in making the important determination as to when it is safe to return to play following a concussion or suspected concussion.  Following the physical symptoms of headache, nausea, dizziness or confusion is just not sufficient for decision making purposes.  The cognitive effects of a concussion are subtle and make days or even weeks to become fully apparent.

Hopefully, more States will follow the lead of New Jersey and provide needed funding for concussion management in school athletic programs.

The Brain Injury Association of New Jersey can be reached by clicking here.  More information on ImPact can be had by clicking here .

New Study: Helmets Greatly Reduce Risk of Head Injury in Skiers and Snowboarders

A study to be reported in today's Journal of the America Medical Association (JAMA) concludes that helmets greatly reduce the risk of head injury to skiers and snowboarders.

I have long advocated the use of helmets for skiing and wear a helmet myself.  To those who suggest that helmets give skiers a false sense of security and may encourage daredevil behavior, I say, maybe people shouldn't wear seat belts when driving?  Does that encourage risky behavior?  This argument that individuals shouldn't be encouraged to wear helmets is just hogwash.  Even its proponents can't argue that helmets don't prevent head injury.

Helmets are now catching on in the ski world.  Approximately one third of skiers are now wearing helmets.  In Aspen, helmet use is now mandatory for skiers in ski school who are 12 or younger.  They were the first ski area to mandate the use of helmets first limiting it to students 6 years of age or younger and then increasing it the following season to age 12.

HEY, ASPEN, AND ALL SKI AREAS,  A SUGGESTION:  WHY NOT REQUIRE ALL YOUR SKI INSTRUCTORS AND SKI PATROL PEOPLE TO WEAR HELMETS?  REMEMBER:  SET THE RIGHT EXAMPLE!

Buffalo Fireman Who Awoke Many Years Following A Coma, Dies

Associated Press reports today that the buffalo fireman who awoke last year after many years in a coma, after sustaining brain damage has passed away.

The fireman, Donald Herbert sustained oxygen deprivation when a roof of a burning home fell on him.   In April of 2005, after receiving a "cocktail" of medication usually given to persons suffering from Parkinson's disease, he awoke from his coma and began communicating with his family.

He was living in a nursing home.  AP reported that as recently as last week, he had been playing catch with his sons from his bed.  Reportedly, he was hospitalized again on Sunday with pneumonia.

To those with family members in a coma or persistent vegetative state, don't give up hope!

Bob Woodruff Update

ABC News has sent the following e-mail updating the condition of Bob Woodurff.

It's good to see that his physicians are "optomistic" about his recovery, although we all know the road to "recovery" from a brain injury is not very predictable and the path is a long one filled with much frustration for the victim as well as their family.   

The e-mail follows:

ABC News President David Westin sent the following email to his ABC News colleagues today:

Bob and Doug continue their treatments in Bethesda, and both continue to make progress.  Bob's brother, David, asked me to pass along this note from him and the family bringing you up to date on Bob:

"On behalf of all the Woodruffs I wanted to reach out to Bob's entire ABC family and thank you again for your seemingly endless supply of love and support.  It means everything to us and to everyone involved in Bob's recovery.

"To update you - Bob's amazing team of doctors, nurses and corpsmen continue to be pleased with the progress he makes each day and they are optimistic about his recovery. But the more we learn about Bob's injuries the more we appreciate just how lucky he is.  We need to remind ourselves it’s only been 2 ½ weeks since he sustained his injuries in Iraq. We live in a world of instant gratification where patience as a virtue is rarely practiced.  Our family now has a whole new appreciation for the word and what it truly means to be patient.

"So many of you have asked about Lee, the kids and her extended family.  She has been at Bethesda almost every day since we all arrived there from Germany.  The kids have come down on the weekends. Thanks to Bob and Lee's dedicated army of friends in their hometown the kids are receiving love, tenderness and most importantly, continuing with their routines as much as possible. My brothers and I and our spouses are rotating in and out of Bethesda along with Lee's sisters and their spouses - remaining a constant presence for Bob, Lee and my parents.

"We see so much sacrifice every day at the hospital and we can't help but feel grateful to the soldiers being treated alongside Bob and their families.  We know World News Tonight is directing their audience to consider giving to the Injured Marine Semper Fi Fund and Fisher House Foundation.  We encourage those of you who want to help to do the same.  We are a very lucky family and here in Bethesda we are constantly reminded that not everyone is as blessed.

"Thanks again for your messages of hope and your prayers.  They are heard and they are deeply appreciated."

Blue Cross Sets New Criteria for Brain Injury Rehabilitation Reimbursement

Obtaining reimbursement from a medical plan for brain injury rehabilitation also referred to as cognitive rehabilitation is one of the most frustrating experiences that a family or their brain injury lawyer must deal with following brain trauma.

Now Blue Cross of Iowa has issued new guidelines authorizing services for cognitive rehabilitation.  Most importantly the guidelines recognize both the validity of cognitive therapy as a valid treatment for brain damage and that these services can be performed by physicians, psychologists as well as by physical, occupational and speech therapists. 

While I find problems with their definition of "medically necessary" especially with the requirement that their is an expectation of "measurable improvements  in a reasonable and predictable period of time" since the rate of improvement and progress following brain injury rehabilitation can take many months or even years with improvements coming at unpredictable times, it is a start.  The difficulty with definitions such as used by blue cross is the attempt to measure improvement following brain damage in the same way that improvements are measured following rehab for a broken hip.  Unfortunately, that's just not the way the brain heals. 

Here are the full blue cross cognitive rehabilitation guidelines:

Description:

Cognitive rehabilitation is a structured set of therapeutic activities designed to retrain an individual’s ability to think, use judgment and make decisions.  The focus is on improving deficits in memory, attention, perception, learning, planning, and judgment.  The term, cognitive rehabilitation, is applied to a variety of intervention strategies or techniques that attempt to help patients reduce, manage or cope with cognitive deficits.  The desired outcome of cognitive rehabilitation is an improved quality of life or an improved ability to function in home and community life.  Cognitive rehabilitation may be performed by a physician, psychologist, or a physical, occupational or speech therapist.

Policy:

Cognitive rehabilitation may be considered medically necessary following a stroke or traumatic brain injury when the plan of care documents specific diagnosis-related goals for a patient who has a reasonable expectation of achieving measurable improvements in a reasonable and predictable period of time.
Cognitive rehabilitation is not a covered benefit if it is considered not medically necessary because it has become a maintenance program. A maintenance program consists of activities that preserve the patient's present level of function and prevents regression of that function. Maintenance begins when the therapeutic goals of a treatment plan have been achieved, or when no additional functional progress is apparent or expected to occur.

You can go to their site and read their references by clicking here .

Important Information on Stokes

Even though it can save lives threatened by stroke, only a very small percentage of patients are getting a powerful clot-busting drug, a new U.S. survey finds.

Of nearly 2,100 people treated for strokes caused by a blood clot at 15 hospitals in Michigan over a six-month period, just 2 percent received tissue plasminogen activator (tPA), according to a report published in Feb. 14 issue of Neurology.

The fault for the low use of tPA lies partially with hospitals, and partially with patients who wait too long to seek help for their symptoms. To work effectively, tPA must be given within three hours of the start of a stroke.

Warning signs of stroke include dizziness, sudden weakness on one side of the body, and headache.

"Ideally, the target is that when patients arrive at the hospital, tPA should be given within an hour," he said. "That requires diagnostic tests to make sure it is a stroke, and an ischemic stroke [one caused by a blood clot], and determining that there are no contraindications to giving tPA. Our data show that most hospitals take between one and two hours to do those things, so hospitals need to process patients more quickly." according to the study's author.

For more on the warning signs of stroke, head to the American Heart Association web site.

 

More on brain damage and Iraq conflict

The epidemic of traumatic brain injury (TBI) and the brain damage caused to military personnel comes from a British television report and exclusive footage from within the U.S. army traumatic brain rehabilitation facility in Palo Alto, California.

With 16,000 American soldiers wounded in Iraq, this news report suggests that as many as 7,000 have become victims of brain trauma with only 800 of them treated at specialized army brain injury rehabilitation facilities.

The footage contained in this news report is quite distressing. The report is useful for its in depth look at the life long consequences of brain damage caused from a traumatic brain injury or a traumatic head injury.  You can view the full program by clicking here and then downloading the video.

Senator Martinez, Senator Frist, President Bush, take a look, hopefully this will convince you that funds must be restored in the Federal Budget for traumatic brain injury rehabilitation.

Florida Senator: Mistake to become involved in Schiavo matter

Florida Senator Mel Martinez said in a television interview that he made a mistake when he lead the charge to get the federal government involved in the decision to keep Terri Schiavo alive.  Read more on this story from the Miami Herald.

NOW, he should lead the charge to get President Bush to restore funding for traumatic brain injury programs that were eliminated in the proposed 2007 budget!  See my post of last week describing the elimination of the traumatic brain injury tbi model programs.

With a brain injury occurring every 24 seconds and with head injury and brain damage as the signature wound in the Iraq war the elimination of funding for these programs is a disgrace! 

It was reported that legal counsel to Martinez had drafted a memo describing the Schiavo legislation as  "a great political issue."  May I respectfully suggest that a really GREAT political issue are the long term needs of those suffering from brain damage and their family members.

Coma Care

As proof that we go around the world in an attempt to bring you the latest information on brain injury treatments, here is some information from Shanghai on a new coma treatment center being developed.

The center at Shanghai's Renji Hospital will research and treat patients through combined therapies. This includes newer techniques such as electrical stimulation and traditional treatments like hyperbaric oxygen therapy and acupuncture.

Doctors have introduced equipment from abroad and are cooperating with hospitals in other provinces to improve research and clinical practices.

Renji Hospital was the first in the nation to introduce a machine that continuously stimulates the nervous system of unconscious patients through electrodes on the wrist. The machine is from the United States. The method was developed in the West in the 1990s.

A reported 30 percent of patients either wake or show increased brain activity.

You can read the full news article  about the new coma treatment center by clicking here.

Facts About Brain Injury

Here is what the Center for Disease Control says about traumatic brain injury (tbi)  and concussions in their brain injury patient fact sheet:

Facts about Brain Injury

A blow or jolt to the head can cause a type of mild brain injury called a concussion.  Some symptoms of a concussion are:

• Persistent low-grade headaches
• Having more trouble than usual remembering things, concentrating, or making decisions
• Feeling tired all the time
• Feeling sad, anxious, or listless
• Becoming easily irritated for little or no reason

For more information on brain and head injury: danger signs, symptoms, tips for getting better, and where to go for help, you can download an 24 page brochure from the CDC site entitled "Facts About Brain Injury"