TBI May Be Under-Reported, According To Mayo Clinic Study

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Posted on 18th February 2012 by Gordon Johnson in Brain Injury

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Traumatic brain injury (TBI) can be a extraordinarily difficult condition to rebound from. And now there’s a report that a lot more people may be suffering from TBI than the Centers for Disease Control and Prevention (CDC) estimates.  

Researchers at the Mayo Clinic in Rochester, Minn., are the one who have raised the issue of TBI being under-reported, according to a story in Science Business.

http://sciencebusiness.technewslit.com/?p=8233

The Mayo researchers, using their own new method to classify head injuries, did its own sample and found that TBIs occur in as many as 558 per 100,000 people, according to Science Business. That’s significantly higher than the CDC’s estimate, which is 341 TBIs per 100,000 people. 

“The findings indicate that 60 percent of injuries fell outside the standard categorization used by the CDC, even though two-thirds (66 percent) of the cases reported symptoms, such as dizziness or nausea,” Science Business wrote. “The results also show the elderly and the young were most at risk for TBI, respectively, and men were more at risk than women.”

Why the difference in the Mayo and CDC TBI figures?

The Mayo researchers classified head injuries using a new yardstick, the Mayo Traumatic Brain Injury Classification System. To gauge potential TBIs, this new measure takes into account symptoms such as complaints of nausea and dizziness, and whether a patient lost consciousness, to put patients in categories of “definite/probable/possible/no” for TBI, according to Science Business.      

The bottom line is that TBI may be even more prevalent than we believe.  

Hall Of Fame Catcher Gary Carter Dies Of Brain Cancer

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Posted on 18th February 2012 by Gordon Johnson in Brain Injury

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Baseball Hall of Famer Gary Carter, a pivotal player when the New York Mets won the 1986 World Series, succumbed to brain cancer Thursday. He was 57.

http://www.nytimes.com/2012/02/17/sports/baseball/gary-carter-exuberant-power-hitting-catcher-dies-at-57.html?_r=1

I recently blogged about Carter, who was a star player on the Montreal Expos and the Mets, when it was revealed that his condition had taken a dramatic turn for the worse.

Carter, described as a “slugging catcher” by The New York Times, was diagnosed with brain cancer in May. He underwent treatment, chemo and radiation, but by January he had new brain tumors.

His daughter Kimmy Bloemers, who disclosed that he had developed new tumors, announced her father’s death on her journal on CaringBridge.org. 

http://www.caringbridge.org/visit/TheKid8

“I am deeply saddened to tell you all that my precious dad went to be with Jesus today at 4:10 p.m.,” she wrote. “This is the most difficult thing I have ever had to write in myentire life but I wanted you all to know. He is in heaven and has reunited with his mom and dad. I believe with all my heart that dad had a STANDING OVATION as he walked through the gates of heaven to be with Jesus.”

Bloemers said that she was happy her father was free of pain now, and added that he was now in God’s Hall of Fame.

Carter died in West Palm Beach, Fla. 

 

Company Offers Baseline Cognitive Tests For Athletes To Detect Concussions

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Posted on 11th February 2012 by Gordon Johnson in Brain Injury

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With all the press about the dangers of concussions suffered during sports, at least one company is offering a product that could help child and youhful athletes.

A company called Axon Sports, for $7.50, says it can perform a cognitive baseline test that can be used to essentially gauge whether someone has sustained a concussion or not. “Take the test that aids decisions about managing concussions,” Axon’s website says. 

http://www.eastbay.com/axonsports/?cm_mmc=Email-_-020912-_-EBFS75Axon-_-main&cm_em=g@gordonjohnson.com&SID=7465

Axon claims that it offers a quick and cost-effective way for athletes to take “snapshots” of their normal brains and cognitive abilities, the “baseline” reading.

Doctors can compare that baseline to a “snapshot” taken after an athlete has had a blow to the head to determine if that athlete has a concussion. So doctors can use the test to determine when injured athletes can return to the classroom, practice or actual games. 

Axon has several videos on its site, all of them featuring Dr. James Moriarity, head team physician for Notre Dame University and a consultant for Axon. He says that the test that athletes take online is a card game, and there are shots of teens doing the test.

The Axon website says the online test entails four simple tasks.

“Repeating the same tasks After Injury identifies any cognitive changes from the baseline performance,” Axon says. “This helps indicate whether the brain has fully recovered from the injury. Qualified medical providers use the online concussion test results in making decisions about when it is safe for athletes to return to the classroom, practice, or competitive play.”

Axon says, “The baseline test is a record of the athlete’s cognitive ability when in his/her normal state (free from head injury or other medical, sleep or mood conditions). If the athlete is suspected of suffering from a head injury during the sport season, the athlete can take an After Injury test and the results of this test can be compared to his/her baseline test. A physician will be able to determine, based on the comparison of baseline to After Injury test results, if there has been a change in the athlete’s cognitive abilities. If there are changes from the baseline test, then a physician should determine whether the athlete should return to play or return to the classroom.”

Axon’s offering is an interesting one, and one that I think could be a real tool in the management of concussions.

The One Thing Hockey Enforcer Derek Boogaard Couldn’t Beat In A Fight: Brain Injury

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Posted on 5th February 2012 by Gordon Johnson in Brain Injury

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Pro hockey player Derek Boogaard was paid to fight. He made a living as a so-called “enforcer,” doing what other men are arrested for: Beating the living daylights out of his opponents. But ultimately, the game beat him – and his brain.

Last May, Boogaard’s brothers discovered his body in his Minneapolis apartment. He was 28, and the cause of death was an accidental drug overdose. We are all responsible for our own actions, but I’d argue that Boogaard’s particular role in hockey is what ultimately led to his demise.

The New York Times basically made the same case in a three-part, Pulitzer-Prize worthy profile of Boogaard, “Punched Out: The Life and Death of a Hockey Enforcer,” that ran in December.  It’s a shocking, horrifying story about what it means to be an enforcer in the National Hockey League, and what it did to Boogaard’s brain.

The series is especially important because while there’s been a lot of attention paid to the long-term impact of concussions on pro football players, the effect on hockey players has only come into the spotlight recently. Why?

After Boogaard’s death, two other pro hockey enforcers, young guys in their prime, committed suicide. As they say in the newspaper business, three’s a trend. People believed the deaths were no coincidence, and were sad proof of the devastating impact that fighting and concussions have on enforcers. 

The first part of The Times series, “A Boy Learns to Brawl,” describes how Boogaard saw hockey as his calling ever since he was a kid in rural Saskatchewan, Canada. His skills playing the game were not particulary pro-worthy, but his fighting ability was.

http://www.nytimes.com/2011/12/04/sports/hockey/derek-boogaard-a-boy-learns-to-brawl.html

That installment takes up the entire first page of The Times sports section, illustrated with just a small photo of Boogaard as a 2-year-old.

Part Two of the series, “Blood on the Ice,” chronicles why other players feared 6-foot-8 Boogaard so much. His fist should have been classified as a lethal weapon, like a boxer’s. Just ask Todd Fedoruk about that. He described for The Times how one punch from Boogaard shattered the bones in his face. Doctors had in insert metal plates and mesh on the right side of his head.

http://www.nytimes.com/2011/12/05/sports/hockey/derek-boogaard-blood-on-the-ice.html

“The thought of Boogaard’s right fist kept rival enforcers awake at night,” wrote John Branch, the author of the series. 

I’m still astounded by the role that enforcers have in hockey. As The Times pointed out, hockey leagues in other nations don’t permit such fighting. The justification is just absurd, even when the newspaper explains the logic.

“The best way to protect top players from violent onslaughters, teams have long believed, is the threat of more violence, like having a missile in a silo,” according to The Times.

These fights take a toll on enforcers, including Boogaard. They sustain concussions, but try to hide those injuries. They don’t want to ruin their careers by being perceived as prone to head injuries. According to The Times, Boogaard “likely had dozens of concussions before his death in May.”

Like most enforcers, Boogaard’s hands were totally mangled. His father said that when Boogaard fought, his knuckles would be pushed up to his wrists, and had to be “manipulated” back in place, according to The Times. His right hand was covered in scar tissue.

On top of all this, Boogaard began talking prescription pain killers for a back injury. He became addicted, and wound up in rehab. He later underwent surgery on his nose, and was prescribed Percodet. Boogaard was such a huge man, he needed to take eight to 10 of the pills for them to have an effect, The Times reported. He wound up in rehab again.

The photo on Part 2 of the series depicts Boogaard with a bloody nose.

But that’s nothing compared to the photo in Part 3, “A Brain ‘Going Bad.’” It’s a picture of Boogaard’s bright pink brain. His family donated that organ to the Bedford V.A. Medical Center in Massachusetts, for study.

 http://www.nytimes.com/2011/12/06/sports/hockey/derek-boogaard-a-brain-going-bad.html

Doctors determined that Boogaard had chronic traumatic encephalopathy, or CTE, a degenerative brain disease whose symptoms are similar to Alzheimer’s, according to The Times. CTE has been linked to repeated concussions, and has been found in the brains of 20 deceased National Football League players and boxers.

But most of those boxers and football players were older, as were three other hockey players whose brains had been tested and found to have CTE. Boogaard was a young guy.

In a conference call to Boogaard’s family last October, scientists said they “were shocked to see so much damage in someone so young. It appeared to be spreading through his brain. Had Derek Boogaard lived, they said, his condition likely would have worsened into middle-age dementia,” The Times reported.

In detail, that third installment of the series details the personality changes that Boogaard’s family noticed in him, the events leading to his death, and exactly what damage scientists found in his brain. 

This series from The Times is a must-read for those interested in sports, concussions and long-term brain injury. It is wonderfully written and researched, an explanation of a tragedy.

But perhaps this quote from the story, from one of the heads of the Center for the Study of Chronic Traumatic Encephalopathy at Boston University, sums it all up in terms of athletes: “They are trading money for brain cells.”        

 

While Watching The Super Bowl, Think Of Concussion-Suit Plaintiff Tony Dorsett

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Posted on 4th February 2012 by Gordon Johnson in Brain Injury

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Well, the Associated Press has done the legwork, and gotten some of the stories behind, the batch of concussion-related lawsuits that have been filed by ex-players against the National Football League. These tales may put tomorrow’s football dog-and-pony show, the Super Bowl, in a new perspective.

There have been many articles written about the suits that recently have been filed against the NFL, suits that charge that the league either knew about, hid, or ignored evidence that repeated concussions can cause long-term brain damage in players.

But AP went quite a few steps beyond that, spending the last two months interviewing about a dozen of the more than 300 former players who are plaintiffs in the various suits.    

http://www.cbssports.com/nfl/story/17085305/battling-with-memory-loss-dorsett-joins-concussion-lawsuit-against-nfl

AP’s conclusion won’t leave NFL officials with a warm and fuzzy feeling: “What emerged was, at best, a depiction of a culture of  indifference on the part of the league and its teams towards concussions and other injuries. At worst, there was a strong sense of a willful disregard for players’ well-being.”

Ouch. That may make the wings, chips and dip go down a little harder tomorrow if you’re an NFL official.

One of the former players that AP interviewed indepth was Tony Dorsett, who played for Pittsburgh and Dallas. An NFL Hall of Fame member, Dorsett offers up a chilling anecdote, particularly in light of what we know about concussions today.

Dorsett, who is only 57 now, recalled getting the worse hit in the head that he ever had in his career during a 1984 Cowboys-Eagles game. The Cowboys gave Dorsett a very brief exam in a locker room, and then sent him back out to play.  

To do something like that today would, in theory, be unthinkable. Dorsett would have undergone a thorough exam by a doctor, and undoubtedly would have been benched. Dorsett told AP that he was dazed and couldn’t think straight during that 1984 game, and that there were similar incidents were he suffered a concussion and was sent back out on the field.

Those helmet-to-helmet hits have taken their toll. Dorsett showed AP some of his brain scans, which indicate that the left side of his brain, which governs organization and memory, is lacking enough oxygen.

“He already forgets people’s names or why he walked into a room or where he’s heading while driving on a highway, and fears his memory issues are getting worse,” AP reported.

But that’s not the half of it.

“Other players describe an off-camera NFL that is darker than the carefully scripted show presented during  Super Bowl week,” according to AP.

The widespread use of painkillers by players, with the alleged encouragement of the league, and pressure from peers and coaches to play even if you were in incredible pain, are among the issues outlined by AP.

Dorsett isn’t the only ex-player who is bitter about what happened. Another retired player told AP that he expects the NFL to drag out the litigation, in the hope that older players will be dead by the time the whole mess is resolved.

So enjoy that half-time show with Madonna tomorrow, everyone.     

    

NFL’s Super Bowl Commercial: Rehabiltating An Image, Despite The Lawsuits

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Posted on 1st February 2012 by Gordon Johnson in Brain Injury

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Brace yourself to see a commerical Sunday that you wouldn’t expect to pop up during the Super Bowl: An NFL ad on player safety.

The league, according to The New York Times, has anted up several million dollars to produce the TV spot and a companion website, nfl.com/evolution. It looks like it is an attempt to rehabilitate the NFL’s image.  

http://www.nytimes.com/2012/01/31/sports/football/nfl-to-address-head-injuries-in-commercial.html?_r=1&src=me&ref=sports

The NFL has 120 seconds of very, very valuable commercial avails on NBC during the big game, which is pitting the New York Giants against the New England Patriots.  The Times reported that 30 seconds of ad time during the game is selling for an average $3.5 million. But the NFL  will still devote half of its ad time, 60 second, to its safety spot.

A cynic might question the NFL’s timing and motives.

The league is now facing a dozen lawsuits from ex-players who allege that the NFL hid, or ignored, evidence that repeated concussions can cause permanent brain damage. In fact, The Times quoted a lawyer who is representing some of those players. He believes the TV spot will paint an unrealistic, rosy picture about how the NFL has been addressing player safety for years. 

The ad was directed by a talented TV actor/director, Peter Berg, who was the force behind the high-school football drama “Friday Night Lights,” The Times reported. It will run at the end of the third quarter of the game, and will depict the sports “evolution,” in terms of gear and rules.

The commercial with apparently end with a comment by Ravens player Ray Lewis, who The Times reported will say, “Here’s to making the next century safer and more exciting. Forever forward. Forever football.”

In another interesting tidbit, The Times said that the players’ union and the NFL are talking about devoting much of the $100 million they have for medical research, as part of their contract, to the Foundation of the National Institutes of Health. That money would go toward research on concussions.

The commercial will probably be well produced and memorable, but it won’t make a batch of lawsuits disappear.   

The Battle Between NFL And Ex-Players Over Concussion Suits Begins

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Posted on 28th January 2012 by Gordon Johnson in Brain Injury

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On Thursday the National Football League offered a preview of its defense against 21 lawsuits filed by several hundred retired players in six states: These ex-players can’t seek damages for concussions, since safety issues fall under the collective bargaining agreement they had with the league.

http://www.washingtonpost.com/sports/us-panel-mulls-whether-to-merge-nfl-player-concussion-lawsuits-against-the-football-league/2012/01/26/gIQAxawGSQ_story.html

There were numerous press reports, including one by the Associated Press, on the hearing that took place before the U.S. Judicial Panel on Multidistrict Litigation in Miami. 

At that proceeding, attorneys for the NFL and the suing ex-players argued that the cases should be consolidated for pretrial matters before Judge Anita Brody of the Eastern District of Pennsylvania.  She is located in Philadelphia, where the first players lawsuits over concussions were filed.      

The panel in Miami reserved judgment on consolidating the suits.

At least 300 players, and roughly that equivalent in terms of wives and family members, have charged that the NFL for years knew, and downplayed, the fact that repeated concussions can cause long-term damage to the brain. In retirement, many of these players are getting early-onset dementia, memory loss, depression and degenerative brain disease. 

Among those who are suing are former star players such as Lem Barney, Otis Anderson and Marvin Jones. But there was only one ex-player in court in Miami last week: Rich Miano, who played for the Jets, Eagles and Falcons.

He was quite eloquent in his comments to AP. Talking about concussions when he was playing, back in the day, Miano said they were referred to as “getting a stinger” or ”getting your bell rung.”

He told AP, “It was just, ‘Get back out there.’”

The NFL, like the player plaintiffs’ attorneys, wants the suits put together. But Beth Wilkinson, the league’s lawyer, wants them consolidated so that she can get them dismissed en masse.

She argued Thursday that the retired players’ grievances shouldn’t be litigated, that the allegations raised by the players should be be resolved under the NFL-player collective bargaining agreement. Needless to say, the players feel differently. So do I.

Several of the suits have named the vendor that supplies helmets to the NFL, Riddell, as a defendent, as well. According to The Miami Herald, Riddell’s attorney wants the lawsuits that cite Riddell handled separately from the one that don’t name the helmet company. 

http://www.miamiherald.com/2012/01/26/2610282/nfl-ex-jocks-spar-in-miami-courtroom.html

This battle, of the NFL versus its former warriors, may end up rivaling the Super Bowl in terms of drama. And it could be a long one.

 

To Focus On Her TBI Recovery, Giffords Resigns From Congress

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Posted on 22nd January 2012 by Gordon Johnson in Brain Injury

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U.S. Rep. Gabrielle “Gabby” Giffords has made remarkable progress for someone who was shot through the brain a year ago. Just surviving that gunshot wound was a miracle. But as I know from my career in traumatic brain injury, recovery is a long and difficult process.

So, quite frankly, I was saddened but not surprised to hear today that Giffords, an Arizona Democrat, is stepping down from office. Giffords announced that next week she will leave Congress to concentrate on her recovery.  

The Arizona Republic reported Sunday that Giffords announced her resignation in a video on YouTube. She will be attending President Obama’s State of the Union address Tuesday, and then leave office, according to The Republic.

http://www.azcentral.com/news/politics/articles/2012/01/22/20120122gabrielle-giffords-stepping-down-congress.html

Giffords’ speech has been dramatically affected by her brain injury, which was the work of a mad gunman who slaughtered a half dozen people outside a Tuscon supermarket, wounding Giffords in that bloodbath. 

But despite her difficulty speaking as the result of her injuries, Giffords got her message across in her video.    

 ”I have more work to do on my recovery, so to do what is best for Arizona, I will step down this week,” she said.

She also thanked her constituents for their prayers and support.

There will now have to be a special election to replace Giffords in her 8th Congressional District.

President Obama released a statement on Giffords’ resignation Sunday.

http://www.whitehouse.gov/the-press-office/2012/01/22/statement-president-resignation-congresswoman-gabrielle-giffords

“Gabby Giffords embodies the very best of what public service should be.  She’s universally admired for qualities that transcend party or ideology – a dedication to fairness, a willingness to listen to different ideas, and a tireless commitment to the work of perfecting our union.  That’s why the people of Arizona chose Gabby – to speak and fight and stand up for them.  That’s what brought her to a supermarket in Tucson last year – so she could carry their hopes and concerns to Washington. And we know it is with the best interests of her constituents in mind that Gabby has made the tough decision to step down from Congress.

Over the last year, Gabby and her husband Mark have taught us the true meaning of hope in the face of despair, determination in the face of incredible odds, and now – even after she’s come so far – Gabby shows us what it means to be selfless as well.

Gabby’s cheerful presence will be missed in Washington.  But she will remain an inspiration to all whose lives she touched – myself included.  And I’m confident that we haven’t seen the last of this extraordinary American.”

U.S. Rep. Bill Pascrell Jr., D-N.J., co-founder and co-chair of the Congressional Brain Injury Task Force, also issued a statement in response to the news that his friend and colleague Giffords had decided to resign from office.

“My heart is a little heavy after hearing of Congresswoman Giffords’ intentions to leave Congress. But it is also filled with the spirit of hope and optimism that she has given to everyone she has ever worked with and served. Congresswoman Giffords and her husband, Mark Kelly, have taught us all tremendous lessons in courage in the face of tragedy. They showed tremendous resolve in the midst of great challenges.

Even in the months that followed that horrible day in Tucson, Congresswoman Giffords sought and found opportunities to serve the people of the United States. She worked especially hard in pushing for federal support for every American who sustains a traumatic brain injury.

 I, like so many members of Congress, will never forget the day Congresswoman Giffords returned to the House to vote in support of averting a government default and shutdown.  It is my prayer that Congresswoman Giffords receives the blessings due to her for having given so much to others. I hope that she continues her remarkable progress in her recovery and that she and Mark have many, many fulfilling years together. She will always be a special person to me and a true friend.”

I, too, wish Giffords all the best in her journey of  healing.  

Third Lawsuit Filed In Philadelphia Against NFL By Ex-Players Over Concussions

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Posted on 21st January 2012 by Gordon Johnson in Brain Injury

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The City of Brotherly Love is now the venue of three lawsuits filed by former pro-football players who claim their concussons lead to permanent brain injury. And a decision will soon be made about whether similar suits across the country should be consolidated there, according to the Associated Press.

http://www.cbsnews.com/8301-505245_162-57362087/more-players-join-nfl-concussion-suits-file-in-pa/

The latest lawsuit filed in Philadelphia was brought by ex-Philadelphia Eagles players Ron Solt, Joe Panos, Rich Miano, four other players and their spouses, according to AP. 

The wire service quoted part of Wednesday’s lawsuit: ”Rather than warn players that they risked permanent brain injury if they returned to play too soon after sustaining a concussion, the NFL actively deceived players, by misrepresenting to them that concussions did not present serious, life-altering risks.”

More than 100 former players filed a similar lawsuit in Philadelphia earlier this month, and the very first complaint of this kind was brought against the National Football League in Philly last year, AP reported.

So far at least eight suits, claiming that the NFL ignored or kept secret evidence tying concussions to permanent brain injuries, have been filed in New Jersey, New York, Florida and Georgia, according to AP.

The league is seeking to consolidate the lawsuits in Philadelphia, where the very first case filed last year has been assigned to U.S. District Court Judge Anita Brody, AP reported.  

The NFL denies the allegations in the lawsuits, and claims the litigation should be thrown out because the claims are prohibited under collective bargaining agreements.      

One of the plaintiffs in the suits is former Minnestota Viking Brent Boyd, whose lawyers, according to AP, claim he is the only living player diagnosed with chronic traumatic encephalopathy, CTE. It is a degenerative brain disease that has been detected in tests on brain tissue from deceased football and pro hockey players.

Freestyle Skier Sarah Burke Dies Of Brain Injuries From Training Accident

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Posted on 19th January 2012 by Gordon Johnson in Brain Injury

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Freestyle skier Sarah Burke, 29, Thursday died of brain damage she sustained in an accident nine days ago, when she fell while practicing on the halfpipe in Salt Lake City, according to the Associated Press.

http://www.usatoday.com/sports/olympics/story/2012-01-19/freestyle-skier-sarah-burke-death/52680120/1

Burke, a Canadian, had her ultimately fatal accident on the same halfpipe where champion snowboarder Kevin Pearce hit his head in a crash. Pearce’s accident happened Dec. 31, 2009, and he sustained life-changing traumatic brain injury.

So did Burke. But she died from her’s. When she fell Jan. 10 at the end of her run, she severed her vertebral artery, and that caused bad bleeding on her brain, according to AP. Burke then went into cardiac arrest and was given CPR right at the scene. She was then hospitalized.

Burke’s publicist issued a statement that said the skier died of “irreversible damage to her brain due to lack of  oxygen and blood after cardiac arrest,” AP reported.

The statement also said, “The family expresses their heartfelt gratitude for the international outpouring of support they have received from all the people Sarah touched.”

The young athlete’s organs will be donated to those who need them.

Burke was a big advocate for so-called “superpipe” skiing, and had convinced the Olympics to add the sport to its program. It is set to debut in the 2014 Games, but Burke obviously won’t be there to compete.”   

Extreme sports and the halfpipe, which is 22 feet high, go hand in hand. And it seems like TBI is part of that equation now, too.