Quickly approaching its first anniversary since opening, the Center for Comprehensive Services Orlando at Avalon Park has featured great success since beginning operation on April 22 last year. In partnership with MENTOR ABI, CCS Orlando has been one of the newest facilities in the MENTOR network, offering a variety of rehabilitative and supportive services for people suffering from brain and spinal cord injuries.

CCS Orlando at Avalon Park is one of five CCS facilities throughout Florida. Other locations include Tampa, Lutz, Sarasota, and St. Augustine. The facilities provide neuropsychological assessment, physical therapy, occupational therapy, speech language pathology, dietary consultation, specialized nursing care, physician coverage and individual and family counseling for victims of brain and spinal cord injuries, as well as their loved ones.

The Avalon Park facility is licensed for brain and spinal cord rehabilitation, and is part of a fully-inclusive medical community in southeast Orange County. Housed in the Keith A. Ewing Medical Building, the rehabilitation facility is part of a 1,860-acre neighborhood that offers myriad events and entertainment options for patients. When not utilizing MENTOR’s therapy services, patients and residents can enjoy retail shopping, a wide variety of restaurants, parks, movie theaters, and some of Florida’s top schools.

Avalon’s convenient location makes the facility easily accessible to and from downtown Orlando, the University of Central Florida, and Orlando International Airport.

For additional information about CCS Orlando at Avalon Park, visit the MENTOR Web site at www.thementornetwork.com or for specific information on the services offered at CCS, email Deb Kilgore at deb.kilgore@thementornetwork.com. Information is also available by phone at (321) 354-0023.

Faculty and staff from Blythedale Children’s Hospital, Maria Fareri Children’s Hospital, and the New York Regional Chapter of the Society of Pediatric Nurses (NYRC/SPN) came together on Tuesday, February 23 in Valhalla, New York to hold a comprehensive brain injury symposium.

The conference included a review of case studies as well as a “review of the incidence of brain injury, pathophysiology of injury to the brain, acute treatment and interventions, and the critical aspects of team rehabilitation,” according to a PR Log press release prior to the event. The symposium attendees also gained important insights into the nuances of caring for children with brain injuries.

Prior to the event, the Director of Education at Blythedale Children’s Hospital said, “More than 1.5 million brain injuries occur annually in the United States. Our goal for this conference is to provide education about the broad spectrum of brain injuries, as well as information about equipment that can be used in the rehabilitation process,” according to the press release. The conference was open to the public.

The symposium included guests from the general public, SPN members, hospital employees, and nursing students. Highlights of the symposium included: a talk on “Brain Plasticity and Healing” by Joelle Mast PhD, panel discussions on various case studies, a talk on brain injury specific “Intensive Nursing Care,” and a tour of the Maria Fareri Children’s Hospital. The keynote speaker, Carey Goltzman, M.D., presented a speech on “The Pathophysiology of Brain Injury.”

An information pamphlet on the purpose of the symposium said, “Brain Injury can present as a localized lesion such as an arterio-venous malformation, brain tumor, trauma and/or a diffuse insult such as meningitis or encephalitis. Recovery from different types of insults to the brain may proceed differently. The timing of rehabilitation is extremely important.” Further, the conference pamphlet promised to deliver, “critical information necessary to provide care for a child with brain injury.”

References:

Blythedale Children’s Hospital. (February 21, 2010) “Significant Brain Insult Symposium.” Retrieved on February 22, 2010 from the Blythedale Children’s Hospital Web site: http://www.blythedale.org/pdf/brain-symposium.pdf

PR Log staff. (February 19, 2010) “Blythedale Children’s Hospital to Sponsor Brain Injury Symposium on Feb. 23rd.” Retrieved on February 21, 2010 from the PR Log Web site: http://www.prlog.org/10540222-blythedale-childrens-hospital-to-sponsor-brain-injury-symposium-on-feb-23rd.html

A recently released study revealed that spinal cord stimulation has no more effectiveness than pain medications after failed back surgery, according to a Reuters article. However, spinal cord stimulation may still provide some relief and assistance to certain patients, said Dr. Ajay D. Wasan in his commentary on the study. Dr. Judith A. Turner of the University of Washington in Seattle and her colleagues conducted the study, published in a recent edition of the journal, Pain.

The study consisted of following and comparing the outcomes of 51 people who tried spinal cord stimulation after their back pain persisted following surgery. Researchers compared the outcomes with 39 patients who underwent specialized pain treatments at a pain clinic and 68 patients who received neither pain treatment nor spinal cord stimulation, according to the Reuters article.

The results were not promising, with less than 10 percent of the patients in all three groups showing any kind of improvement in pain levels or movement abilities. However, the spinal cord stimulation group did report less leg pain after 6 months of treatment. The results are not conclusive, since the same group used more opiods than the other groups. At one and two years after surgery, there was no notable difference in results among all three groups.

Dr. Wasan pointed out that 30 percent of the patients who had spinal cord stimulation electrodes implanted did actually show improvement in leg function and a lessening of leg pain after two years of treatment. The Reuters article noted, “While the findings show that spinal cord stimulation is clearly not appropriate for every person with persistent back pain after surgery, people with radiating pain on one side of the body, those who are functioning better before undergoing the procedure, and those in better psychological health are more likely to benefit,” Dr. Wasan said.

While spinal cord stimulation has been proven relatively ineffective in some circumstances, it remains likely that the treatment will continue to be available. Further study is necessary to determine which patients the procedure can benefit the most.

References:

Reuters Health. (February 17, 2010) “Spine stimulation may not help after failed surgery.” Retrieved on February 22, 2010 from the Reuters Web site: http://www.reuters.com/article/idUSTRE61G55R20100217

A Pomona Superior Court jury recently awarded a Pomona woman $12 million after she was forced to sit in a hospital waiting room for several hours with an air-rifle pellet lodged in her brain. Twenty-two-year-old Jessica Ramirez was shot in the head with an air rifle pellet gun at a family member’s home. Details of the shooting were unavailable at the time of this writing. However, Ramirez walked to the hospital with the pellet in her brain. She was still conscious when she entered the hospital emergency room with an increasingly dangerous brain injury.

While Ramirez waited in the emergency waiting room, her brain continued to bleed, which increased the pressure inside her skull, causing her to nearly lose consciousness over the 5 hours she waited before being flown to Huntington Hospital to undergo brain surgery. The neurosurgeon who operated on Ramirez testified in court on her behalf. He told the courtroom that Ramirez’s outcome would have been less severe if doctors would have operated immediately upon her arrival in the emergency room. He added that due to the extended waiting period before receiving treatment, Ramirez will require 24-hour care for the rest of her life, according to a New York Injury News article.

The incident occurred in September of 2007. The owner of the hospital, AHMC Healthcare, Inc., and hospital officials plan to appeal the $12 million ruling. Ofelia Reynaga, Ramirez’s mother, brought the suit to court on behalf of her daughter. While Ramirez was conscious enough to walk into the emergency room, she was left in a vegetative state, which her lawyer and the verdict confirm was due to negligence on the part of the Greater El Monte Community Hospital.

References:

Associated Press. (February 12, 2010) “US jury awards $12 million for brain injury.” Retrieved on February 21, 2010 from the Hindu Web site: http://beta.thehindu.com/news/international/article105487.ece

New York Injury News Staff. (February 17, 2010) “$12 million verdict awarded to California woman with severe brain injury.” Retrieved on February 21, 2010 from the New York Injury News Web site: http://www.newyorkinjurynews.com/2010/02/17/12-million-verdict-awarded-to-California-woman-with-severe-brain-injury_201002172496.html

In 2004, Ryan “Gooch” Nelson, the slide guitarist for the band 61 North, suffered a spinal cord injury in a disastrous car accident. After six weeks of intensive rehabilitation, Nelson could play his guitar again. While still confined to a wheelchair, Nelson’s is a success story that provides inspiration for many. On February 20, Nelson and his band played at the second annual benefit concert for spinal cord injury in Carney’s Point, New Jersey.

The first benefit concert in October 2008 raised $4,000, while the totals for this year’s concert have not yet been reported. The money from the benefit will go to the Magee Rehabilitation Hospital in Philadelphia and the Adam Taliaferro Foundation. Nelson underwent his rehabilitation at the Magee Hospital after his accident in 2004. Brian LaPann, singer for 61 North, told NJ.com, “Part of 61 North’s mission is giving back to the community in charities that we believe in. That is why we put together the 61 North Benefit Concert for Spinal Cord Injuries.”

From Nelson’s bandmates descriptions, this year’s benefit sounds bigger and better than the last. NJ.com reported, “This year’s event has more sponsors, a really great sound person and an experienced lighting person.” The show was held at Salem Community College at the Davidow Theatre. Tickets were $20 for adults and $10 for students.

We congratulate Nelson and his band mates for their efforts at raising funds and awareness for those suffering from spinal cord injuries. Nelson exemplifies the attitude of never giving up, even in the face of serious debilitating injuries. 61 North’s music stands as testament to the power of successful rehabilitation and community outreach.

References:

61 North Band. (January 6, 2010) “61 North is proud to announce the Second Annual Benefit Concert for Spinal Cord Injury.” Retrieved on February 22, 2010 from the 61 North Band Web site: http://www.61northband.com/index_2.html

Cormier, Ryan. (February 18, 2010) “Concert benefits rehabilitation hospital.” Retrieved on February 22, 2010 from the Delaware Online Web site: http://www.delawareonline.com/article/20100218/ENTERTAINMENT/2190306/Best+bets+for+the+weekend

Marine, Jaime. (February 18, 2010) “Concert at Salem Community College will raise funds, awareness for spinal cord injuries.” Retrieved on February 22, 2010 from the NJ.com Web site: http://www.nj.com/salem/index.ssf/2010/02/concert_at_salem_community_col.html

Not to be confused with the recent breakthroughs in brainwave communication with supposed vegetative patients recently reported on this blog, multiple news releases have said that a Belgian coma patient who was supposedly communicating with a speech therapist by way of arm movements was never communicating after all.

Rom Houben, a car accident victim who was diagnosed as vegetative 23 years ago, was reported last November to have communicated with his doctors and family. Now, doctors have reported that the claims were false.

The case arose after brain scans revealed Houben’s brain as almost fully conscious, although his body remains immobilized. The news gave great relief and hope to friends and family members of patients diagnosed as vegetative. The hopes may still be unfounded, although research into other methods of communication – including the use of fMRI scans to monitor changes in brainwave activity – continues.

The initial stories of Houben’s alleged communication were based on a technique called facilitated communication in which a speech therapist’s hand is guided above a keyboard by a patient’s hand. When the therapist feels gentle pressure when his or her hand is above a particular letter, the letter is typed. Skeptics claimed early on that the technique was faulty, but it took further testing to prove the technique false. Houben’s neurologist, Steven Laureys, conducted an extensive 15-stage test that Houben failed every step of the way.

Although Houben was proven unable to communicate, Laureys acknowledge that his brain scans prove that the man is conscious and not completely vegetative. It is unclear whether or not he is a candidate for brain-scan communication attempts; however, results of early studies on other vegetative patients have proven successful.

A Canadian Press article reported that, “Experts say the larger question of whether people like Houben who have a traumatic brain injury are conscious and alert remains unanswered.” While facilitated communication has proven faulty in this case, doctors continue to explore myriad variations in diagnoses of patients in vegetative states to determine whether or not the diagnosis still retains validity.

References:

Cheng, Maria. (February 19, 2010) “Belgian coma patient can’t communicate after all, doctor acknowledges after testing.” Retrieved on February 21, 2010 from the Google Web site: http://www.google.com/hostednews/canadianpress/article/ALeqM5gEBQiSW8WJ2UK56qvwwLzwmJ2vsw

Connolly, Kate. (November 23, 2009) “Trapped in his own body for 23 years – the coma victim who screamed unheard.” Retrieved on February 22, 2010 from the Guardian Web site: http://www.guardian.co.uk/world/2009/nov/23/man-trapped-coma-23-years

Hall, Allan. (November 23, 2009) “ ‘I screamed, but there was nothing to hear’: Man trapped in 23-year ‘coma’ reveals horror of being unable to tell doctors he was conscious.” Retrieved on February 22, 2010 from the Mail Online Web site: http://www.dailymail.co.uk/news/worldnews/article-1230092/Rom-Houben-Patient-trapped-23-year-coma-conscious-along.html

Med India Staff. (February 21, 2010) “Belgian Coma Patient Unable to Communicate by Computer: Doctor.” Retrieved on February 22, 2010 from the Med India Web site: http://www.medindia.net/news/Belgian-Coma-Patient-Unable-to-Communicate-By-Computer-Doctor-65357-1.htm

Metro Reporter. (February 21, 2010) “23-year coma man Rom Houben’s ‘communication’ proved to be fake.” Retrieved on February 21, 2010 from the Metro Web site: http://www.metro.co.uk/news/814078-23-year-coma-man-rom-houbens-communication-proved-to-be-fake

On December 11, 2007, 16-year-old Luke Vogel attempted a ski jump in a park in Colorado. After crashing to the ground, Vogel found his body unable to move as he had just before the crash. In that single instant, Vogel became a quadriplegic. In the beginning, he was angry – rightfully. Two years later, Vogel told NBC News, “I’ve come to terms that this is what it is right now, and it’ll be better to deal with it instead of just being pissed off at everyone.”

Vogel continues to work out to keep his body in perfect shape for the day when a full recovery becomes possible, which his doctor says might not be far off. Dr. Stephen Davies from the University of Colorado School of Medicine said, “I feel confident in saying that I’d be really disappointed if we didn’t have something within the next five years that is of major benefit to people with spinal cord injuries,” according to NBC News. Davies’ research into astrocytes and stem cells could provide major contributions in that direction.

Davies’ research focuses on ways to rid the spinal cord of scar tissue buildup and to encourage the neurons in the spinal cord to reconnect across injury sites, which might allow spinal cord injury survivors to regain the ability to walk and move as they did before their injuries. Davies’ suggested that, “by placing astrocytes made by using a specific kind of stem cell into the injury site, he can fuel growth across the once impenetrable,” the article noted.

His research has so far proven viable and powerful in rat models. The next step is to make the leap to studies on human spinal cords. Davies suggests that spinal cord injury victims do everything in their power to keep their bodies strong and healthy, so that when the time comes to attempt new techniques, their bodies are in prime condition to accept and make use of the treatments. Davies told NBC that the human clinical trials are only a couple of years away.

Meanwhile, Vogel continues working out on electrical stimulation bicycles (FES bikes) to keep in shape and to keep the remaining connections in his spinal cord strong. He said he is not holding his breath for a paralysis-reversing discovery, but he holds out hope that he will one day walk again.

References:

Wolf, Jeffrey. (February 18, 2010) “Waiting for a miracle that could come soon.” Retrieved on February 22, 2010 from the NBC News Web site: http://www.9news.com/seenon9news/article.aspx?storyid=132991&catid=509

Photo courtesy of braininjuryclubhouse.org

The Midwest Brain Injury Clubhouse opened its doors in Chicago in 2000. The clubhouse currently provides a space for rehabilitation for 75 brain injury and stroke survivors from age 20 to 73. A recent ABC News piece reported that the clubhouse has plans to expand its facilities and services. The clubhouse offers work opportunities and internships for brain injury patients who need time and assistance before returning to work unassisted. Clubhouse programs provide, “a wide range of post-rehabilitation work and independent living skills to individuals with different brain injuries,” according to the report.

The clubhouse’s budget is $275,000, and they are attempting to raise more funds and secure a new building to increase their offerings to clubhouse members. The members range from young Iraq war veterans like 27-year-old Andrew David Wagner, to 57-year-old aneurysm survivor Harvey Williams. Wagner sustained a traumatic brain injury from exposure to explosions in Baghdad, Iraq.

Williams told ABC News “I love this clubhouse, because it gives us a place to come to where we can relate to people who have gone through certain things that we’ve gone through in a way.” Deborah Giesler, a clubhouse representative, said, “The great part about clubhouse is that this is their own program, so if they need to be here six months to finalize and fine tune some return-to-work skill, that’s what they can do. If they need to be here eight years because they’re not able to return to work or be home alone yet, they are continuing to learn other skills, they can be here as long as they need,” according to the news piece.

The clubhouse’s Web site detailed their programs, including a free internship for Operation Enduring Freedom and Operation Iraqi Freedom veterans with brain injuries. The site said, “These internships provide an excellent opportunity to build one’s work skill set, add to your resume and address potential problem areas related to mild TBI that can arise in a work environment.”

Currently, the clubhouse staff is busy making phone calls to local businesses to generate funds for their planned expansion. They rely mostly on private donations to keep the clubhouse running. We wish the clubhouse the best of luck in meeting their expanding needs.

References:

Brain Injury Clubhouse Staff. (February 22, 2010) “Brain Injury Clubhouse Programs.” Retrieved on February 22, 2010 from the Midwest Brain Injury Clubhouse Web site: http://www.braininjuryclubhouse.org/programs/

Meyer, Karen. (February 18, 2010) “Brain injury clubhouse needs more space.” Retrieved on February 22, 2010 from the ABC News Web site: http://abclocal.go.com/wls/story?section=news/disability_issues&id=7284489

Photo courtesy of kevinpearce.com

Will Kevin Pearce ever snowboard again? That was the first question that came out of Kevin’s mouth when he regained consciousness and the ability to speak after sustaining a traumatic brain injury on an icy halfpipe in Utah in December 2009. Kevin was training to compete against multiple gold medalist snowboarder Shaun White when he hit his head on the halfpipe and sustained a severe traumatic brain injury.

White told the Vancouver Sun, “Obviously, there’s been injuries happen to people very close to us – you get an injury and somebody goes down and crashes and it just really shocks people. This sport hasn’t got more dangerous. It was dangerous to begin with. We drive around in cars and that’s pretty dangerous, too.” White also mentioned that he thought restrictions on difficult tricks would be preposterous. He continued, “It’s not just going up there and being a daredevil. There’s a plan about it. The progression of tricks is on the right path. Hopefully we haven’t hit the ceiling yet.”

An NBC Nightly News video commented that Kevin has suffered memory loss and vision impairment, and that he must relearn to walk again with the help of physical therapists. Another NBC news feature also aired on Monday, February 22.

The Facebook page “Well Wishes for our Friend Kevin Pearce” continues to amass fans. There were 40,442 supporters of Kevin at the time of this writing. Prayers and well-wishes from fans continue to appear on the page at the frequency of about 5 per hour. One of the most recent posts read, “Kevin My dear u r the inspiration to us all! we miss u and love u to death! get better soon!! i keep u in my prayers and u have inspired me to learn how to snowboard!!! once i do the first thing i will get is the I ride 4 Kevin to put on me and my board!!! Kevin we all know u will b back on ur board as soon as possible and i cant wait!” Excessive exclamation points and text message grammar notwithstanding, it is evident that thousands of people want Kevin healed and back out on the slopes.

We will continue to report on Kevin’s progress toward a full recovery as more information becomes available.

References:

NBC Nightly News. (February 18, 2010) “Kevin Pearce on NBC Nightly News.” Retrieved on February 21, 2010 from the Snow Rev Web site: http://www.snowrev.com/Videos/interviews/Kevin-Pearce-must-learn-to-walk-again

Pearce, Adam. (February 22, 2010) “Well wishes to our Friend Kevin Pearce.” Retrieved on February 22, 2010 from the Facebook Web site: http://www.facebook.com/pages/Well-Wishes-to-our-Frend-Kevin-Pearce/232366118918?ref=ts

Walker, Ian. (February 18, 2010) “Star’s top challenger watches Olympics from brain injury facility.” Retrieved on February 21, 2010 from the Vancouver Sun Web site: http://www.vancouversun.com/sports/2010wintergames/Star+challenger+watches+Olympics+from+brain+injury+facility/2580023/story.html

A study will commence at 17 hospitals around the country in the spring of 2010 to determine the effectiveness of progesterone as an emergency treatment for traumatic brain injuries. Since brain injury patients often arrive at the hospital, the FDA has regulations in place to allow doctors to perform experimental treatments on patients without getting informed consent under emergency conditions. The study, coordinated by Emory University and the University of Michigan, will involve comparing the differences between an intravenous dose of progesterone and a placebo in brain injury patients, according to the Detroit Protect Web site.

In Detroit, the study will be conducted at the Henry Ford Hospital, the Detroit Receiving Hospital, Sinai Grace Hospital, and Beaumont Hospital. Patients who arrive at one of the four hospitals within four hours of enduring a moderate to severe traumatic brain injury will be eligible to participate in the study and will receive either progesterone injections or placebos. The scientists’ goal is to determine whether or not progesterone can lessen patients’ chances of becoming disabled or dying from their brain injuries, according to a Detroit Free Press article.

The study will receive funding from the National Institute of Neurological Diseases and Stroke, a division of the National Institute of Health. Traumatic brain injury is the leading cause of death and disability in children and adults under 44, according to a Henry Ford News article.

Previous studies using progesterone to treat brain injuries in animal models have proven successful in reducing the amount of brain damage suffered by the subjects. The current study will demonstrate the efficacy of the same methods in human subjects. Within a year or two, progesterone may emerge as a safe and effective treatment for reducing the severity and long-term damage associated with traumatic brain injuries.

References:

Anstett, Patricia. (February 10, 2010) “4 metro Detroit hospitals take part in brain injury study.” Retrieved on February 10, 2010 from the Free Press Web site: http://www.freep.com/article/20100210/BUSINESS06/100210029/1320/Hospitals-take-part-in-brain-injury-study

Detroit Protect Staff. (February 10, 2010) “Detroit ProTECT Trial” Retrieved on February 11, 2010 from the Detroit Protect Web site: http://www.detroitprotect.org/

Olejarz, David. (February 11, 2010) “Study Tests Using Progesterone to Treat Brain Injuries.” Retrieved on February 11, 2010 from the Henry Ford Health System Web site: http://www.henryfordhealth.org/body.cfm?id=46335&action=detail&ref=1057