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An Ohio company, Synapse Biomedical, created a novel device designed to stimulate natural breathing processes in patients suffering from decreased and degenerating respiration due to upper spinal cord injuries. Dr. Michael DiMaio of the University of Texas Southwestern Medical Center told EurekAlert that, “Patients who have high-level spinal-cord injuries are unable to breathe efficiently because the nerve signals no longer function.” The U.S. Food and Drug Administration approved the NeuRx device for medical use in 2008.
The device, called the NeuRx diaphragm pacing system, seeks to make many improvements upon older respiratory aid models. Older models consisted of electrodes inserted directly on the phrenic nerve by way of incisions through the neck and chest. The phrenic nerve sends impulses from the brain to the diaphragm by way of the spinal cord, causing the large muscle to expand and contract properly, making the lungs inhale and exhale in a relatively natural fashion.
Other common treatments for spinal cord injury-based respiratory dysfunctions included the use of external mechanical ventilators that work by way of a tube inserted through the front of the throat, which has potential to interfere with speech.
The NeuRx device creators hope to revolutionize the respiratory-aid process with their new device, which works through 4 electrodes implanted into the diaphragm by way of incisions through the front of the lower abdomen. Dr. DiMaio also said of the NeuRx, “[It] has some advantages over traditional ventilators,” … “Patients have more mobility because they don’t have an external ventilator to carry around, and the surgery to implant the device is less invasive than previous treatments.”
The earlier nerve-stimulating electrodes had potential to scar and/or fatigue the phrenic nerve, whereas the NeuRx device works directly on the diaphragm with more diffuse electrical stimulus. The NeuRx also aids spinal cord injury patients to retain their natural speech, since the device does not involve incisions or tubes in the throat.
Other reported benefits of the NeuRx are: decreased incidence of infection, more natural breathing patterns, more mobility, less chance of scarring after surgery, and less chance of infection due to weakened respiratory ability.
Surgeons at the University of Texas Southwestern Medical Center are ready and equipped to begin implanting the device into eligible patients. The hospital is one of 25 total hospitals in the U.S. who are ready to implant the NeuRx in spinal cord injury and other respiratory-impaired patients. Hopefully the NeuRx diaphragm pacing system will provide relief and benefit to spinal cord injury patients in the near future.
References:
Morales, Katherine. (November 25, 2009). “New device implanted by surgeons help paralyzed patients breathe easier.” Retrieved December 9, 2009 from the EurekAlert website: http://www.eurekalert.org/pub_releases/2009-11/usmc-ndi112509.php
Brain and spinal cord injuries are two common results of automobile accidents. A large number of lawsuits have been filed against General Motors by persons suffering from brain and spinal cord injuries sustained in accidents involving defective GM vehicles or parts, and many of those cases are currently pending. On June 1, 2009, GM filed for protection from creditors in the Bankruptcy Court for the Southern District of New York, resulting in all pending lawsuits being stayed until the bankruptcy is finalized. The case was assigned to Judge Robert E. Gerber who is holding hearings on GM’s proposed reorganization at the time of this post.
One of the issues Judge Gerber is expected to rule on this week is whether persons injured by defective GM products will retain their rights to sue or continue lawsuits pending against GM. There are three categories of injured people whose rights will be affected by the Court’s rulings. The first are people who had filed lawsuits against GM and received judgments prior to the bankruptcy, but had not yet been paid. These people are considered unsecured creditors of GM. The second category are those who were injured by GM products and filed lawsuits that were not resolved before the bankruptcy, so their claims are pending subject to the stay. The final group, are those who will be injured in the future by GM products sold before bankruptcy. Under pressure from consumer groups and Attorney’s General from more than ten states, , GM agreed in negotiations leading up to this week’s hearings to allow people injured by GM products in the future to retain their rights to sue. GM has not, however, capitulated on recognizing pending claims and judgments.
An example of the types of claims that would be extinguished if the court approves GM’s proposed plan is the claims of four year old Alyssa Perrino. Alyssa was a healthy, intelligent little girl who sustained catastrophic brain injuries requiring removal of a large portion of her skull when a weak seat in the GM vehicle in which she was riding failed rearward and struck her head. At the time of the accident, Alyssa was properly strapped into her car seat in the rear of the vehicle. Prior to the accident, Alyssa spoke three languages, but as a result of her brain injuries, she is now only able to speak ten to fifteen words. Her mobility is severely limited. Alyssa was lucky to survive the accident, but her life and the life of the Perrino family has been forever changed. While the Perrino family’s lawsuit against GM was resolved prior to GM’s bankruptcy, it is typical of cases in which defective vehicles caused irreversible brain and spinal cord injuries.
The bankruptcy plan proposed by GM would transfer automotive brands Chevrolet, Cadillac, Buick and GMC to a new company called Vehicle Acquisition Holdings LLC (Newco). Under the plan, the United States Government would own 60 percent of Newco, the Canadian government would get 12.5 percent, the United Auto Workers Union, 17.5 percent and unsecured creditors, 10 percent. Existing GM shareholders are not expected to receive any interest in Newco. Technically, People whose lawsuits the bankruptcy court does not extinguish will proceed against Newco. Those lawsuits that do not survive the bankruptcy can continue against the “old GM”, but the old GM is not expected to have assets to pay claims even it the lawsuits were successful.
While the proposed reorganization plan submitted by General Motors, would extinguish claims for injuries like Alyssa Perrino’s if they were pending at the time the bankruptcy was filed, ironically, GM has agreed that the new owner of GM would assume GM’s liability for warranty claims. Thus, approval of the plan would lead to the illogical result that if a GM part fails under warranty, the new GM would be liable for the repair, but if the same part killed or injured a person prior to the bankruptcy, the new GM would have no liability at all.
On June 19, 2009, the deadline for filing objections to the proposed GM sale, consumer groups, unions and creditors filed objections to the GM bailout. Philadelphia attorney Barry Bessler is represented a number of consumer groups in the Chrysler bankruptcy and is representing them in the GM proceedings, as well. During the Chrysler proceedings, Chrysler successfully washed its hands of all past and future product liability claims involving Chrysler products sold prior to the bankruptcy. Bressler had argued that the GM case is distinguishable from the Chrysler case in terms of the proper way to treat product liability claimants. Bressler was quoted in Law.Com as saying “[i]n GM, there is no third-party buyer. Hopefully, that means there’s a stronger case [for successor liability].” Attorneys for people with pending asbestos products liability lawsuits against GM, have filed objections to the proposed plan, as well.
In addition to consumer groups, attorneys general from at least eleven states filed objections to the “no successor liability” provisions of the bankruptcy plan proposed by GM. Attorneys general from Connecticut, Kentucky, Maryland, Minnesota, Missouri, Nebraska, North Dakota, Montana, Ohio, West Virginia and Vermont filed objections arguing that GM’s plan to extinguish liabilities for injuries cased by safety defects would take key legal rights away from victims. Attorney General Richard Blumenthal of Connecticut referred to GM’s proposal as “very unfair and unwise “. In an interview, Blumenthal stated “[s]o much is at stake. We have fought repeatedly for repair or recall of vehicles and parts that are defective so that people can be spared injury, and there are far-reaching ramifications of failing to apply accountability to the New GM.”
Attorneys general from a number of states also filed objections to GM’s proposed plan due to the impact it would have on GM dealers in their states. In his statement regarding Montana’s objections to the GM proposal, Montana’s Attorney General Steve Bullock said that GM is attempting to circumvent state laws designed to protect auto dealers. According to Bullock, GM has insisted that current GM dealers sign new dealership agreements that force these dealers to waive state laws that were enacted to protect them. Bullock further stated that, if his state lost dealerships, some consumers in rural areas would have to drive hundreds of miles just to get their cars or trucks serviced.
In addition to objections on behalf of consumers and dealers, objections to the GM restructuring were also filed by various bondholders who argued that they were treated unfairly vis a vis other creditors. Finally, the Steelworkers Union filed objections on behalf of retired steelworkers and engineers who said the plan would leave GM without funds to pay health benefits to union-represented retirees and their families. In their objections, the Steelworkers and Engineers said that “GM has been not only unfair, but cruel” in its treatment of the steelworkers and engineers, and that GM was attempting to renege on a deal to create a health care trust for current workers and to protect the health and life insurance benefits of retirees.
A multi-day hearing on GM’s proposed sale began June 30, 2009 . At the time this article was posted, proceedings were ongoing and Judge Gerber had not ruled on the objections of injured consumers. Persons interested in following the proceedings in near real time can do so at http://dealbook.blogs.nytimes.com.
The outcome of the negotiations and court proceedings will affect many people who stand to lose jobs, benefits or investments, but none will be more profoundly affected than persons who have suffered catastrophic injuries such as brain and spinal cord injuries caused by defective GM products. With many millions of GM vehicles on U.S. roads, it is impossible to estimate the number of people who will be injured, and lack the resources to obtain essential medical and other services. Given that many of these people will become medical wards of the States, U.S. taxpayers will continue bailing out and GM and Chrysler long after the astounding infusion of public funds during the current bankruptcy proceedings has been forgotten.
Four Stages, One Man
By
Benjamin Luskin
When I look back on my life from the ripe old age of 27, I remember many great moments. I recall exciting events, convincing conversations, and adored acquaintances, each of which helped me to build my character and plot my course through life. Yet, when I consider what moment was most influential in my life, I realize that it was not a memory at all, but rather something which I have no memory of.
On Sept. 28, 1994, on a deserted highway on the coast of Lake Superior, the van I was riding in was hit head-on by a semi-truck going 60 MPH. Lucky for me, my seat belt stopped me from flying forward to an early dismissal, but all the same, my head rocked forward so fast that my brain smashed into my skull, sending me into a coma right there on the side of the highway.
Lying there, not breathing, with nothing but my vital signs in-tact, my future looked grim. But then an angel arrived, resuscitated me, called a helicopter, and then drove away. Soon, the emergency helicopter arrived, packed me in, and flew off to the Duluth Emergency Center. To this day, the identity of the angel is unknown.
Following a lengthy three month stay at the hospital, in which I relearned how to walk, talk, eat, and breathe, I proceeded through four successive stages of development before arriving to where I am today. These stages were as follows: denial, acceptance, rejection, and transformation. In the following speech, I will briefly describe the main themes of each stage to you, so that you may better understand the subsequent progression.
Immediately following release from the hospital, after my bracelet had been clipped, I entered the first stage of denial. During this time, I often looked to Alfred E. Newman’s profound words, “what, me worry?” for guidance. Like other kids my age, I could not see beyond a short-term perspective. Happiness was but a sensual and immediate concept to me, so I did a lot of hanging out. I pursued some pleasures, a few vices, and generally did not think of my injury. And then I graduated from high school, left my familiar home in Minnesota and headed for Portland, Oregon, where I started a new life as a college student at Lewis and Clark College.
In this new environment, my limitations suddenly became apparent. Try as I might, I could not seem to integrate into my new environment. My high school strategies for survival proved inadequate and I was left dangling in thin air. Have you ever tried to cut a thick, juicy tenderloin with a dull knife? It doesn’t work, and that’s precisely how I felt. My tools were useless.
During this time, however, I also found myself engrossed in a collage of new ideas and beliefs. And so it was that I became intrigued by the ancient Chinese philosophy of the Dao, or the way, and spent many hours seated in the tall grass of a nearby ravine contemplating its meaning. As a result, I slowly but surely began to accept my lot and just “go with the flow.”
In this new stage of acceptance, I acknowledged my limitations and worked around them, focusing my efforts on intellectual pursuits and self-discovery. One could say I became a bit of a college hermit, reading books by candle light late into the evening. Consequently, college became a worthy venture, fulfilling and entertaining. I excelled in my studies, graduated with a Bachelors Degree in Religious Studies, gained employment with the Portland Public Schools, discovered martial arts, met my girlfriend, and poof, had a baby.
At which point, I was catapulted into the next stage of my development, one of rejection. I realized that I needed to stop dealing with my life as it unfolded, but rather take control of my life if I wished to manifest my desired lifestyle. And so, quick as a lightning flash, I quit my job, moved to Eugene, and entered the blue collar world of hard physical labor. Following suit, I came to devalue intellectual pursuits and academic knowledge and took pride in the new identity I had created for myself. I worked hard and lived an honest and simple life, returning home each day covered in dirt and sweat to a singing partner and a cooing baby daughter.
After several months, however, this romantic existence began to fade. Unable to perform sufficiently, I lost my jobs, sank into depression, and became consumed with self-pity. I spent entire days in bed, convinced that I would never be good at anything worthwhile, that I was destined to be a charity case. In retrospect, it seems that I had become so frustrated, so helpless that I began to crave despair. In the words of Richard Farina, (I’d) “been down so long it looked like up to me.” I refused all help from others, preferring torment to relief, until one day I grudgingly allowed a job-coach to help me find a job at Lane Community College.
Though it was not apparent to me at the time, this job turned out to be my ticket to the next phase of development, transformation. What started out as a basic method to make ends meet soon became a waterfall of opportunity. For the first time in my life, I discovered that my skills were perfect for the job. As a result, I gained confidence, earned my co-workers respect, and like magic, my limitations disappeared.
I was encouraged to develop my ideas and soon implemented a non-combative martial arts training program for my clients as well as designed and drafted a program newsletter. Ideas kept flowing and before long I had developed a new program for rehabilitation and written an extensive article on its design. Then I began a rehabilitation business, “Launch Empowerment Mentoring,” attracted several initial clients, volunteered with various organizations, and taught workshops at Oregon Country Fair.
Which brings me to where I am today, a busy, busy, content, and jubilant young man.
Today, in addition to my job at Lane Community College, I continue to develop and expand my business, travel to Portland once a month for life coach certification training, attend training seminars and tackle various tasks as an intern for LILA, train diligently in martial arts, better my public speaking skills with Toastmasters International, and broaden my horizon through music, reading, and writing. All this, in addition to being an affectionate partner and devoted father to two beautiful girls.
In conclusion, it was not the event, the traumatic incident, that most affected my life, but the challenges it incurred. In rising to meet these challenges, I transformed into a stronger, more capable individual. I looked to these challenges to discover the nature of my strengths and in which realms they might best flourish. I have since used this knowledge to manifest a choice lifestyle and could not be happier.
One last thing before I sit down. I invite each of you to consider your own greatest challenges through life. How did they affect who and where you are today?
Up until this month, the general consensus estimated the amount at 250,000 and about four million, respectively. Large numbers indeed, but according to a study just released by the Christopher & Dana Reeve Foundation, they fall far short of reality.
Add 40% to the number of those living with paralysis and multiply four million spinal cord injuries by five and you will have a better idea of the actual numbers: 1.275 million spinal cord injuries and 5.6 million who live with some kind of paralysis.
The study (that surveyed more than 33,000 households) was simplified by the president and CEO of the Reeve Foundation to mean “one in 50 Americans is living with some form of paralysis, whether caused by disease, spinal cord injury or neurological damage…someone you know is living with paralysis – a family member, a friend or a work colleague”.
Some key findings:
- Paralysis and spinal cord injuries are a great deal more widespread than previously assumed.
- Stroke, followed by spinal cord injuries are the top causes of paralysis.
- “Household income for those with paralysis is heavily skewed towards lower-income brackets and is significantly lower than household income for the country as a whole. Roughly 25 percent of households with a person who is paralyzed earn less than $10,000 per year, compared with only seven percent of households in the general population.”
This survey is the first of its kind and the data that it collected will help this population obtain the health care that they need. In response to this study, the Reeve Foundation plans to launch a campaign to change public policy for the better – stay tuned for more details!
Diabetic gastric stasis and gastroesophageal reflux aren’t much fun. Patients afflicted with these two conditions often experience nausea, vomiting, heartburn, persistent fullness after meals, and anorexia. A prokinetic agent called Reglan (metoclopramide) has been added to the list of suggested short-term therapies for use after conventional therapy fails. Reglan helps by increasing the frequency of gastric contractions and relaxing the pyloric sphincter, a ring of muscle that lets food pass from the stomach to the duodenum (the first section of the small intestine).
While this drug has been shown to provide relief from gastric stasis and gastroesophageal reflux, consumers need to be aware of one of Reglan’s more insidious side effects.
Tardive Dyskinesia, most often linked to the use of antidepressants and antipsychotic drugs, causes the patient’s nerve cells to misfire. This creates involuntary movements such as grimacing, pacing in place, picking at clothes, rocking, and twitching. Long-term or high-level use of Reglan greatly increases the risk of developing this disorder.
The FDA now requires products with metoclopramide in them to add a warning to their labels. “The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research in a February, 2009 press release.
The FDA also states that the movement disorder Tardive Dyskinesia is often irreversible and that the potential increases with duration and accumulation. Women and the elderly are especially at risk, and the warning applies to all forms of Reglan administration, including oral and injected.
With a 20% chance of developing Tardive Dyskinesia from taking Reglan for more than three months, it definitely makes sense to weigh the potential costs with the gastrointestinal benefits. Make sure to communicate with your doctor about the absolute length of administration as well as the amount you need to take.
For more details on Tardive Dyskinesia, click here.
Image from here.
Apple’s App Store, well known for its tight strictures and uptight policies regarding the iPhone applications it chooses to accept, has stepped in it this time.
The Baby Shaker, a $.99 application for the iPhone that requires users to shake their phone in order to quiet crying babies, incited outrage from brain injury organizations and children’s groups, causing it to be removed two days after its release.
“See how long you can endure his or her adorable cries before you just have to find a way to quiet the baby down!” read the iTunes description.
Apple has apologized for the mistake, though they have yet to address how Baby Shaker, created by Sikalosoft, made it into the App Store in the first place.
“This application was deeply offensive and should not have been approved for distribution on the App Store,” Apple said in a statement.
Visit the Sikalosoft web site and you will find a statement acknowledging the app’s poor taste, “Yes, the Baby Shaker iPhone app was a bad idea. You should never shake a baby! Even on an Apple iPhone Baby Shaking application. In case you are unaware Baby Shaker was an Apple iPhone application that was greatly lacking in taste. It was approved by Apple for download upon the iPhone”.
Apple reviews hundreds of apps every day, a number that argues for the occasional error in judgment, and their quick action to remove the game bodes well for their reputation. Yet the choice to approve the game in the first place points out a glaring flaw in their procedures – “bad taste” may have a variety of definitions depending on the audience, but when in doubt, error on the side of caution.
Never, ever shake a baby. And while we realize that a game is just that – a game, the inference that there is something entertaining about the act is enough, in our opinion, to justify the removal of this app.
The National Center on Shaken Baby Syndrome lists multiple consequences of shaking a baby, from seizures and permanent brain damage to death. With close to 1,500 U.S. children experiencing severe or fatal head trauma from child abuse every year, we’d rather see applications underlining proper education. Rock your child to sleep, don’t shake it to death.
Over the last couple of years we have been hearing of the push to digitize health records, in hopes of streamlining a patients data for easy access across medical facilities. Yesterday the Mayo clinic announced a partnership with Microsoft’s HealthVault to launch the Mayo Clinic Health Manager, a tool that gives people the ability to store their medical records online as well as sign up for alerts and reminders. This is only the latest in a procession of new online storage services being offered to interested patients.
Using these services you can import your health records from your doctors, hospitals, labs, prescription drug plans, and other healthcare providers by typing them in yourself or uploading data directly from devices such as blood-pressure monitors. Now with just a couple clicks of your mouse, you can view your entire medical history – what medications you have taken, which ones you are currently on, adverse reactions, operations, diagnosis, and even childhood diseases. What’s online is up to you and, if he is a participant in the government supported push for electronic records, your doctor.
We aren’t going to advocate for or against the digitizing of your healthcare history, but we do want to make sure you are taking into consideration the potential dangers of such a move. While the convenience of hopping online to find out what date you started a particular medication may make the process of filling out your insurance claim easier, keep in mind that what’s easy access for you is just as easy for someone else. Yes, we are talking about hackers. Those information pirates that keep developing more and more insidious data-mining processes.
What does it matter if some stranger is copying your medical information? What can it hurt besides your feelings of privacy? A lot, actually.It isn’t just insurance claims that are affected by your medical history, your reputation is also potentially at risk.
M. Eric Johnson, director of the Glassmeyer/McNamee Center for Digital Strategies at Dartmouth’s Tuck School of Business, released a paper in which he said he and his fellow researchers “were able to uncover a number of medical records and other files with medical information online, using file-sharing services generally associated with song-swapping, like LimeWire and Kazaa”. He went on to note that many of our records are already in electronic form on computers in small clinics and laboratories whose security can’t begin to match that offered by the larger data storage facilities.
Johnson cites numerous instances of leaked records leading to identity theft, medical insurance fraud, and even financial fraud. Don’t forget, your social security number is more often than not is included in your medical records, and adding that information to identifying data such as your date of birth, address, and full name give thieves everything they need to make a profit from your information.
When you are considering making your records electronic, make sure you choose a company that has multiple safeguards in place. While there are always ways around even the toughest Internet security, the likelihood of keeping your information private greatly increases depending what program provider you go with. Google Health has partnered with Medco, as Microsoft’s HealthVault has teamed up with the Mayo Clinic, giving the resulting storage systems more clout than lesser known companies such as iHealthRecord or myPHR, but before you make a choice, research them well – your private data is on the line!
Image from here.
Amazon’s Kindle e-book reader has a feature that allows users to set it up so that it “reads” their books aloud. A handy application for those with disabilities that limit their reading capabilities, such as paralysis or blindness, this feature has surprisingly gained some heat.
Researchers at the Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research at UCSF have developed a way to reverse the age of adult stem cells (fibroblast cells), using microRNAs to effectively turn them back into embryo-like cells. While not quite a Benjamin Button scenario, these new findings have the potential to aid in brain injury repair by replacing damaged cells in areas affected by a traumatic impact.
These newly “young” cells have the ability to do what the controversial cells from embryos can – they are able to become any cell type (a state known as “pluripotency”). This makes it possible for scientists to stop their use of retroviruses that have been employed to create this cell flexibility, making stem cell therapy safer.
According to the study, previous methods for creating cells similar to embryonic stem cells used DNA to influence the production. The issue with this method is that three of the four genes promote an uncontrolled growth reaction in the cells, much like cancer.
The use of microRNAs has further benefits as reprogramming a patients cell instead of introducing a foreign one prevents it from being rejected, an issue that scientists have long been working to find a way around.
You can read more in the April 12, 2009 advanced online edition of the journal Nature Biotechnology.
Image from emergentarchitecture.com.
The tragic death of Natasha Richardson has brought the need for traumatic brain injury (TBI) awareness into stark relief. As with many things in life, we tend to look around, look over, and look through dangers that haven’t directly touched our lives. Like the child whistling in the dark, we skim over the short news piece that notes another life irrevocably changed by a brain injury and we think “that could never happen to me”.
This perspective shifts when when the injured person suddenly become someone we are familiar with, who we can in some way identify with. In an article by Bryan Brown, Carlin Flora who is a senior editor for Psychology Today, said that we can develop this identification with someone we have no personal knowledge of because “we see their faces over and over” in the media. “Our brains are tricked into thinking we know these people.”
A study by researchers at the University of Illinois at Urbana-Champaign explain it this way: celebrity identification allows us to feel a connection with some of the ideals they embody and that we consider our own, or as Matthew Hutson, news editor for Psychology Today puts it, “When they die, their memory lives on, and, by proxy, so does yours.”
When Richardson’s death was splashed across the media the people who had felt this connection to the actress, no matter how slight, were suddenly made aware of just how real this type of injury was. Articles were written about the dangers of TBIs, bloggers relayed the details in post after post, and readers found themselves wondering how to keep this from happening to themselves and their loved ones. But, as with even the most incredibly painful experiences, time has started to dim this tragedy. People go on with their lives, they push the uncomfortable emotions down and after a while, they start to forget.
What needs to be realized from this is that while yes, people will and DO forget, the cause of Richardson’s untimely death made an impact and it will, often in subtle ways, affect the lives, choices, and actions of many – hopefully for the better.
