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To an outside observer, traumatic brain injuries (TBI) are invisible…and medically, the injuries are not well understood. As a result, those who suffer often don’t receive adequate—or even minimal—treatment. But the truth is that TBI changes lives. Any head injury is a tragedy, but when TBI happens to children, adolescents, or young adults, the tragedy is magnified. An article on NJ.com says it best:

Imagine you are a parent whose child has sustained a brain injury through something as enjoyable as playing a sport or as horrific as abuse by a caretaker or as patriotic as serving our country as a member of the armed forces. Wouldn’t you want the best system of care possible to maximize the chances of recovery and quality of life for your child? There are many tragic stories about children and youth with brain injury; Congress has an opportunity to provide support and hope for them.

That’s the goal of H.R. 2600, a new bill introduced in the U.S. House of Representatives. Also known as the National Pediatric Acquired Brain Injury Plan Act (PABI Plan Act), this bill would help create a standardized, evidence-based system of universally available care for young people (ages 25 and younger), including those serving in the armed forces. The PABI Plan Act would ensure care at all stages of brain injury, beginning with prevention, and including emergency and acute treatment in medical facilities, reintegration into schools and communities, and transition into an adult system of independent living.

H.R. 2600 was introduced to Congress on July 20, 2011 by Republican Leonard Lance of New Jersey, and it has been referred to committee. But the bill has seemingly stalled, despite the fact that the bill has more than 100 co-sponsors in a rare bipartisan effort. Co-sponsors from North Carolina include:

• Rep. Walter Jones [R, NC-3]
• Rep Larry Kissell [D, NC-8]
• Rep. Mike McIntyre [D, NC-7]
• Rep. Bradley Miller [D, NC-13]

Funding for H.R. 2600 would come from discretionary money held by the Secretary of Health and Human Services, and would not add to the budget deficit.

This is an important bill that would help children and young adults recover as much as possible, and receive support as they age into adults.

“The ultimate goal of the PABI Plan Act is to maximize recovery, enhance quality of life and ensure that New Jersey — and American — youth have the best chance to live productive and meaningful lives,” said Barbara Geiger-Parker, president and CEO of the Brain Injury Association of New Jersey, a nonprofit organization whose mission it is to support and advocate for individuals affected by brain injury and raise public awareness through education and prevention.

We urge concerned individuals to contact their Representative and voice support for the PABI Plan Act. To find contact information for your Representative, click here:  GovTrack.us

To read the full article on NJ.com, click here:  More support needed

from 9News.com

Dylan Hearn probably has a great future ahead of him; he is wise beyond is meager years. The 7-year-old Colorado boy has a personal crusade to made sure that everyone takes concussion seriously.

And he knows what he is talking about:  He suffered two concussions in the past six months. The first was playing football, and the second happened when he ran into the dishwasher at his home (he was chasing his brother.) The injuries put him out of commission for about a month, including his favorite activities—no TV, no video games, no reading.

According to an article on 9News.com, Dylan says:

“It hurts,” said Dylan. “A lot of sick and dizzy. Sometimes, you have blackouts.”

Now, Dylan’s concussions are changing the way people around him view head injuries. For example, his baseball coach, Jeff Pigati, says that the determination of injury used to be totally in the hands of players. If they said they were feeling well enough to play, they played. But kids and athletes being what they are, they typically jumped back into the game sooner than they probably should have.  That’s what killed another boy, 15-year-old Jake Snakenberg:

Snakenberg died in September 2004 after sustaining a serious concussion in a football game. Doctors believe it was his second concussion in a week and he died of Second Impact Syndrome. Just before the game, he told everyone he was fine.

That’s why there is now a law in place called the Jake Snakenberg Act. It requires all coaches, like Pigati, to undergo concussion training to look for signs of possible brain injury.
Dylan and Alex Hearn [Dylan's mother] applaud the new measures.

[If you would like to see the online training program for coaches, click here:  CDC HeadsUp]

Now, coach Pigati watches kids for head injury and tell-tale symptoms, and he’s happy to do so. Like most coaches, Pigati takes the health of his players very seriously. He applauds the Colorado law requiring coaches to undergo concussion training.

And Dylan? He likes the law, too. Why?

“Because it’s safe,” said Dylan.

From the mouths of babes.

To read the full story on 9News.com, click here:  7-year-old applauds new concussion rules

Alzheimer’s disease makes just about everyone’s short list of aging fears. The disorder robs individuals of their memories…their sense of self…their connection to friends and family. It’s hard on everyone who has to watch their loved one disappear before their eyes.

Now, scientific research published in The Archives of Neurology offers a small—but statistically significant—ray of hope for anyone hoping to prevent Alzheimer’s disease. The answer:  Walking!

The scientists studied 201 healthy adults (ages 45 to 88). The participants were tested for genetic predisposition to Alzheimer’s disease, and were given a brain scan to look for signs of amyloid plaques, the abnormal protein deposits that are a characteristic of the brains of Alzheimer’s patients. Fifty-six participants tested positive for the APOE-e4 gene, a marker that increases the risk of developing Alzheimer’s disease by a factor of 15. None of the participants had signs of Alzheimer’s disease at the beginning of the study. Finally, everyone completed detailed questionnaires about their exercise habits.

According to an article in The New York Times:

The volunteers who reported walking or jogging often — meeting (or, in rare instances, exceeding) the American Heart Association’s exercise recommendation of 30 minutes of moderate or vigorous activity five times a week — had fewer amyloid plaques than the volunteers who reported almost never exercising….

The carriers of the gene who reported walking or jogging for at least 30 minutes five times a week had plaque accumulation similar to that of volunteers who were e4-negative. In essence, the APOE-e4 gene carriers mitigated their inherited risk for developing Alzheimer’s by working out.

So moderate exercise was protective against Alzheimer’s disease…even for people who have an extremely high genetic risk of developing the disease. The scientists have a lot more work to do to figure out why exercise is protective, but for the average person, the take-home lesson is that exercise should become a part of daily health habits for everyone—but especially for those with a family history of Alzheimer’s disease.

“There are so many benefits to exercise,” [Denise Head, an associate professor of psychology at Washington University who led the study] says, “and one may be that it helps the brain” to defend itself against the slow leaking away of memory.

Now that’s science we can get behind!

Charlene Harrington, RN, PhD, FAAN

Results of a new study suggest that the nation’s largest for-profit nursing homes deliver significantly lower quality of care, compared with smaller and not-for-profit nursing homes. Why? Fewer staff nurses (despite profits).

The study looked at quality in the 10 largest for-profit chains, which control about 13% of all nursing home beds in the country. They were choses because of their influence and expansiveness. The researchers from University of California, San Francisco (UCSF) found that when nursing homes put profits ahead of people, they cut costs by reducing the number of staff… especially trained and experienced (but more expensive) staff.

“Poor quality of care is endemic in many nursing homes, but we found that the most serious problems occur in the largest for-profit chains,” said first author Charlene Harrington, RN, PhD, professor emeritus of sociology and nursing at the UCSF School of Nursing. Harrington also is director of the UCSF National Center for Personal Assistance Services.

“The top 10 chains have a strategy of keeping labor costs low to increase profits,” Harrington said. “They are not making quality a priority.”

The correlation is so strong that many experts believe that the best predictor of nursing home care is the number of nurses working at the facility.

Something to remember if you should find yourself looking for a good nursing home.

What survives of a marriage when a spouse suffers brain injury?

According to an article in The New York Times, that’s the question being investigated by Dr. Jeffrey S. Kreutzer and other psychologists at Virginia Commonwealth University (V.C.U.) in Richmond. In addition, the psychologists are working to develop marriage counseling techniques for affected couples.

According to a 2007 article published in the journal NeuroRehabilitation, when a spouse suffers a brain injury, the risk of divorce is surprisingly low—approximately 17 percent. Well below the national average for uninjured couples. But the statistic may not be an accurate reflection of the health of the marriages—the couples aren’t necessarily happy. According to Dr. Kreutzer: “While people may technically be married, the quality of their relationship has been seriously diminished.” According to The New York Times:

Dr. Kreutzer and other psychologists at V.C.U. are among the few therapists in the country trying to develop marriage counseling techniques tailored to couples dealing with brain injuries. Traditional marriage counselors often hope to restore people and their relationships to their original luster. For Dr. Kreutzer and his team, recovery often means teaching uninjured spouses to forge a relationship with a profoundly changed person — and helping injured spouses to accept that they are changed people.

“Changed” doesn’t begin to describe what some spouses experience.

Depending on the severity of the brain injury, an individual may be considerably changed by the injury…so much so that he or she may seem like an entirely different person. Injured people often have difficulties with attention, concentration, memory, reading, writing, and speaking. They may appear confused, have trouble with physical coordination, and become impulsive—buying expensive items they can’t afford, take off on trips without notification, or other potentially damaging behaviors. And then there are the possible personality changes:  aggressiveness, irritability, mood swings, depression, lack of motivation, and poor judgment. While every person experiences a different constellation of symptoms, even a small number of these symptoms can make the spouse of a brain-injured individual wonder what happened to the person they married.

The article in The New York Times talks about the experiences of Terry Curtis—who suffered brain injury from a tumor and the surgery needed to remove it—and his wife Vicky:

Mrs. Curtis, 60, was once drawn to her husband’s “sparkle,” she said. After the injury, he “flat-lined” emotionally, and he suffers from depression, anxiety and a lack of motivation. Her husband sometimes makes erratic decisions, she added, like the time he decided to take a do-it-yourself approach to the plumbing at their home in Coralville, Iowa. “Not a good picture when I got home,” Mrs. Curtis said. “And you can yell at him like a little kid, but he didn’t know any better.”

Once a software programming analyst, Mr. Curtis, 57, has “a lot fewer interests” than he did before the injury, and he estimates he has lost 90 percent of his friends.

“It’s a new you,” he said, “and they just can’t cope with that.”

It’s worse for a spouse, who lives with the changed person. According to the psychologists, the factor that seems to keep marriages from falling apart is guilt. It’s hard to be the kind of person who gets a divorce from a brain-injured person. The goal in therapy is to help the couple see that the person will not ever be exactly the same…that they will have to deal with a “new normal” in their lives…but that it may be possible to rediscover a new facet to the old relationship.

That may be the real definition of hope.

To read the full article in The New York Times, click here:  When Injuries to the Brain Tear at Hearts

To learn more about traumatic brain injuries, visit our dedicated webpage here:  HensonFuerst TBI page

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Elizabeth Molloy, from WRAL.com

Car wrecks are the leading cause of death among North Carolina teens, and crashes are surprisingly common. In NC, teenage drivers are involved in car wrecks approximately every 24 minutes.

According to research, the most common mistakes that cause teen wrecks are speeding, inattention and distraction, and failure to yield. And while drunk driving is still rare among teens, it accounts for some of the most tragic and memorable motor vehicle fatalities.

One recent example—Wake County’s first in 2012—is the death of 17-year-old Millbrook High School student Elizabeth Molloy. According to an article on WRAL.com, the driver was 16-year-old fellow student Garrett Prince, who lost control of his 1999 Jeep SUV while driving 75 mph in a 30 mph zone, and ended up hitting a tree. Prince could face charges of felony death by motor vehicle, provisional DWI, careless and reckless driving, having an open container of spirituous liquor, speeding, and possession of marijuana. Jared Sink, man in the neighborhood where the wreck took place witnessed the crash and pulled Molloy from the burning wreck, said what probably everyone is thinking:  ”[It's] just absolutely tragic. To all the young people out there, there’s no taxi that’s more expensive than someone’s life.”

Parent/Teen Driving Agreement

Teens know that underage drinking is illegal, but that doesn’t stop some of them from drinking. They also know—in theory—that they shouldn’t get into a car with someone who has been drinking, but many of them disregard that advice. Why? Sometimes because the teen doesn’t have the confidence to stand up to peer pressure…or because they are afraid to call their parents for an alternate ride home…or because they don’t realize that a taxi is a viable option.

Those are some of the reasons why a Parent/Teen Driving Agreement can be an important tool. The University of North Carolina (UNC) Highway Safety Research Center and the North Carolina State Highway Patrol have created sample Parent/Teen Driving Agreements. It’s a formal agreement between parents and teens. It includes specific things that both parents and teens agree to do. Parents have found that driving agreements work well to keep teens safe when they first begin to drive on their own by making expectations clear.

The agreements are valuable once your child is old enough to be out with friends, even if he or she is not actually driving. An agreement should outline parental expectations for safety, such as never riding in a car with an impaired driver, always wearing a seatbelt, obeying the speed limit, and avoiding distractions, including texting, talking on a cell phone, eating, or applying make up. That’s the teen side of the agreement. The parent side of the agreement should given the child options for how to get out of a potentially hazardous situation, and outline how parents will support their child’s efforts to stay safe.

For example, agreeing that if a child ever feels unsafe, he or she can call home at any hour and request a ride home…without risk of punishment. (As much as parents might want to lash out at a child who has been drinking or at an unauthorized party, the goal is to get the child home safely. A strongly negative reaction from a parent might cause the child to avoid calling in the future, and possibly getting into a dangerous or fatal situation. That’s not to say that discipline can’t be taken for any rule-breaking, but the ride home should be calm and concerned—any discussions or repercussions should wait for the next day.)

We’ve done some of the research for you and attached links to three separate Parent/Teen Driving Agreements. Look at all of them, take what you like from each, and create your own custom agreement. We like the first one, from the UNC Highway Safety Research Center because it allows teens and parents to write their own agreement items in their own words—that means teens aren’t just skimming over the task without thinking. And any additional minute of thinking about driving safety is another opportunity to keep our children safe.

Sample Agreement 1:  University of North Carolina (UNC) Highway Safety Research Center

Sample Agreement 2: North Carolina State Highway Patrol

Sample Agreement 3: North Carolina Division of Motor Vehicles

PROJECT IGNITION

Project Ignition, funded in part by the National Youth Leadership Council, helps students, teachers, and communities address teen driver safety. Students themselves design and lead awareness campaigns–every year, 25 grants are awarded to high schools across the country. The teams often find their inspiration from personal tragedy, but their powerful messages reach across county and state lines. Some examples of the kind of service-learning encouraged by Project Ignition are holding a mock crash on campus, and learning and applying the physics of crashes from a science class, including the potential effects of velocity and crashes on the human body.

This year, we’d like to congratulate the two North Carolina high schools that won grants:

• Pine Lake Preparatory in Mooresville, North Carolina. Title: “Increasing Your Survival Odds.” The Pine Lake Prep Project Ignition team will lead an in-depth 15-30 week integrating the NC Driver’s Ed curriculum to promote safe driving and better driver “road awareness” utilizing a five-prong approach: (1) mock accident scene, (2) speaker series, (3) student-based research projects, (4) obstacle course on site, and (5) service learning.
• Lincoln Charter High School in Denver, North Carolina. Title:  ”As the Wheel Turns.” The Project Ignition team of Lincoln Charter believe that teen driving accidents are a rampant and tragic problem in their area. Their emphasis is to reduce the number of student drivers who exercise unsafe driving habits such as eating, allowing excess passengers, or driving while emotionally inept.

About HensonFuerst

At HensonFuerst, we’ve seen the devastating effects of car wrecks and DWI injuries far too often. It’s never pretty, but there is something particularly tragic when the injured individual is a young person who has barely had a chance to live. Our hearts go out the the family of Elizabeth Molloy, and all families touched by the catastrophe of a DWI wreck. We wish you peace.

True or false: All suspicious deaths are investigated so that justice can be done if foul play is discovered.

Answer: It depends on how old you are.

According to an article on the website ProPublica, a nonprofit investigative newsroom, and PBS’s Frontline, if a senior citizen died under suspicious circumstances, there’s no guarantee that anyone will ever investigate. Although it is impossible to know exactly how many suspicious deaths have been signed off as due to natural causes, the evidence uncovered points to a significant problem. When investigators look closely at deaths of elderly people, they discover many cases of mistreatment, abuse, and even murder.

Case in point: 76-year-old Joseph Shepter was living in a nursing home after a stroke paralyzed much of his body and dementia took away his ability to communicate. When he died, the nursing home’s chief medical officer listed the cause of death as heart failure. No one examined the death any further…until a tip from a staffer at the nursing home prompted the state to re-examine the case.

It was discovered that Shepter died of a combination of ailments related to poor care, including infected ulcer, pneumonia, dehydration, and sepsis. In addition, his death was hastened by antipsychotic drugs—drugs he didn’t need. (We have written about the problem of inappropriate use of dangerous antipsychotic medications. To read that blog, click here:  Antipsychotic Drugs Over-Prescribed in Elderly) According to ProPublica:

Dr. Michael Dobersen, a forensic pathologist and the coroner for Arapahoe County, Colo., said he worries about suspicious deaths in nursing homes. “Sometimes, if I don’t want to sleep at night, I think about all the cases that we miss,” Dobersen said. “I’m afraid we’re not looking very hard.”

How Can This Happen?

The reason so many suspicious deaths are overlooked is because of a number of systemic flaws:

And then there is what is arguably the most common reason of all:  Ageism.  According to geriatrician Kathryn Locatell, who specializes in diagnosing elder abuse, it all boils down to ageism. She said, “We don’t value old people. We don’t want to think about ourselves getting old.”

Catherine Hawes, a Texas A&M health-policy researcher who has studied elder abuse for the U.S. Department of Justice, agrees, calling the issue a “hidden national scandal.” She interviewed 40 coroners and medical examiners about how they handled deaths among senior citizens. They told her that they were reluctant to perform autopsies.

“Many of them made the blanket assumption that when an elderly person dies, it must have been because ‘their time had come,’” she said. “But they don’t make that assumption about any other part of the population.”

A Need to Keep Eyes Open

It’s a sad fact that many legislators work to pass laws that reflect their own experiences, which is why it is so difficult to understand why there are so few safeguards for the elderly. We’ve all had parents, grandparents, great-grandparents, and many of them have ended up in nursing homes. Is it that they were among the lucky ones who had perfect care for their loved ones? Or could it be that no one wants to believe that their loved ones were victims who died painful deaths?

For example, Joe Shepter, the son of Joseph Shepter ”used to think that his father ‘died a somewhat peaceful death’ surrounded by caring professionals. Instead, he now believes, his “father was lying in a hospital bed essentially dying of thirst, unable to express himself….”

It’s a difficult thought to have to live with. There’s no going back from something like that. But it is worth knowing. In fact, some communities are developing new strategies for pinpointing suspicious deaths. For example, some counties formed elder death review teams made up of police, prosecutors, adult protective services, the medical examiner, emergency personnel, and others. They are similar to the kinds of teams used by child-abuse investigators. It’s a way to make sure that more than one set of eyes is responsible for looking for signs of abuse.

It’s also a way to make sure that the elderly get justice…eventually, if belatedly.

To read the full article on ProPublica.org, click here:  Gone Without a Case

Beginning at the stroke of midnight, New Year’s celebrations turn loud. In my semi-rural neighborhood, the fireworks, gun shots, and shotgun blasts lasted a full 30 minutes. It’s a routine way to welcome the new year, but apparently we are lucky to have come away without injuries.

According to an article in the Tampa Bay Times, a Florida boy was severely injured by a falling bullet fired into the air during a New Year’s Eve celebration. He was rushed to the hospital where doctors determined that he had been shot in the top of his head.

No one knows where the bullet came from, but authorities believe it was fired from miles away in a New Year’s celebration.

“Here we have a 12-year-old kid fighting for his life because he happened to be in the wrong place at the wrong time,” said Hillsborough County sheriff’s spokesman Larry McKinnon. [emphasis added]

The family was told that the bullet could have come from two or three miles away. The boy, Diego Duran, remains in critical condition, in a coma with the bullet still lodged under his eye.

Firing weapons into the air is a large problem nationally, especially in farming communities. On New Year’s Day and the Fourth of July, guns become powerful noisemakers. People fire them into the air without any thought of where the bullets might land. In 2010, a 6-year-old boy was injured by a stray New Year’s Eve bullet while at a Miami restaurant with his parents…and in 2007, a 69-year-old man was killed in his back yard on New Year’s Day by a stray rifle bullet. And those incidents were only in Florida.

Obviously, guns and celebrations shouldn’t mix. And if you consider that New Year’s Eve is the biggest night for drunken revelry, it’s a wonder that more people aren’t accidentally shot. But even one is too many. We encourage celebrating the new year, but we value safety more than noise. Can we make a resolution to keep guns away from parties?

To read the full story in the Tampa Bay Times, click here:  Ruskin boy in coma

This year, we saw some of the worst weather ever recorded by meteorologists or experienced by residents. Tornadoes, Hurricanes, and weeks of record-breaking heat caused millions of dollars of damage and killed or injured hundreds of people. For this year, next year, and all the years to come, here is safety information everyone can use. (To read the blog, click on the titles below)

• Tornado Safety Information
• Hurricane Preparedness

Medical stories are some of the most heartbreaking:  You trust your health to a doctor or hospital, and something goes wrong. Maybe you end up sicker than you were before. Sometimes, the error may result in death. Here is a round-up of the most important medical and drug stories of the year. (To read any of the blogs, click on the title and you’ll be taken directly to the story.)

Defective Hip Replacement Devices

The U.S. Food and Drug Administration (FDA) has ordered all producers of “metal-on-metal” hip replacements to study the implants after thousands of patines have had the devices fail, causing tissue damage and requiring second replacements. This serious problem started with DePuy hip replacement devices, and has be expanded. Anyone with a hip replacement should check with their physician to make sure that their devices aren’t in the process of failing.

• Hip Replacements to be Evaluated for Safety
• Hip Implant Complaints Surge
• Hip Replacements Fail, Sometimes Without Symptoms
• Diagnosing Hip Replacement Injury
• VIDEO: DePuy Hip Replacement Injury

Transvaginal Mesh

Over the past three years, the U.S. Food and Drug Administration received nearly 4,000 reports of severe complications (including 3 fatalities) associated with surgical mesh used to treat pelvic prolapse. The most frequent complications include erosion through the vaginal wall, infection, abscesses, pain, and urinary problems.

• Failure of Surgical Mesh a Serious Worry for Women
• VIDEO: Transvaginal mesh