Headline News Brain and Spine Injury Law Blog August 2010

 We are almost through August and more than half way through Summer 2010. Parents, children and kids are preparing for the return to school in the next couple of weeks. In Nevada, public schools start August 30.

Meanwhile Nevada, and particularly Las Vegas, continues to muddle through the recession which for Southern Nevada has been a novel experience. The unemployment rate is close to 15% as I write.  The city many thought was immune from economic storms has seen itself hardest hit. Hopefully things will improve.

We face a heated election where the Tea Party candidate, Sharon Angle, accuses Democrat incumbent, Harry Reid, for the current state of plummeted home values while Reid criticizes Angle for not making job creation a part of her job!

The Station Casino’s recent resurface from Bankruptcy with owners, Frank and Lorenzo Fertitta, manning the helm, may be a boost. Of course some creditors had to write off $4,000,000,000 – four billion dollars! But maybe the massive adjustment will re establish the local casino group and have a positive impact on Las Vegas. 

Today’s report of the M Resort, opening just over a year ago, being put up for sale may result in an interesting bid; especially if Boyd gets back into the picture. Boyd’s recent failed effort to take over Station properties may be a prelude to an M resort bid.  Although my sources tell me that Station may make a bid to buy M resort now that they have shaken off 4 billion in debt.

I am reporting on 2 separate topics relating to Brain and Spine Injury issues. First is a look at the Cleveland Clinic’s Las Vegas Lou Ruvo Center. Second is the recent revelation concerning veterans. 

Lou Ruvo Brain Center

Nevada, and specifically Las Vegas, may be on its way to becoming the "go-to" place in the country for Brain Health.  The Cleveland Clinic Lou Ruvo Center for Brain Health (CCLRCBH) provides state-of-the-art care for cognitive disorders and for the family members of those who suffer from them.

 For persons with mild cognitive impairment such as early stage dementia and Alzheimer’s disease, the center offers the most up-to-date and technologically advanced diagnostic imaging services, including 3-Tesla MR, performed by one of the leading neuroimaging academic centers in the world. The CCLRCBH also offers a multimodal treatment program for persons with mild cognitive disorders, including physical exercise, cognitive rehabilitation, and cognitive enhancing medications.

Recently named to head up the Center, leading researcher and neurologist Jeffery L. Cummings, MD, will be the Director of the Cleveland Clinic Lou Ruvo Center for Brain Health.

Prior to joining Cleveland Clinic, Dr. Cummings was the director of the Mary S. Easton Center for Alzheimer’s Disease Research and a professor of Neurology and Psychiatry and Biobehavioral Sciences at David Geffen School of Medicine at UCLA.

He is past president of the Behavioral Neurology Society and of the American Neuropsychiatric Association. Dr. Cummings has authored or edited 30 books and published more than 600 peer-reviewed papers.
 

Misdiagnosis Hurt U.S. Soldiers

We now know that during the height of the Iraq war, the Army routinely misdiagnosed hundreds of soldiers with “personality disorder.” In doing this, the Army was categorizing veterans being dismissed from duty, with a pre-existing condition. Pre existing conditions are not covered by the military health care for veterans.

Leaving wounded veterans ineligible for military health care and with a stigma attached to mental weakness, advocates for veterans, congress and the public actively pushed for re-evaluation of veterans conditions. The Nation, published an article exposing the practice and caused the Defense Department to change its policy. 

All soldiers diagnosed with Personality disorder prior to 2008 are being re-evaluated. Before 2008, over 1000 soldiers were dismissed based on personality disorder. In 2009 only 260 were dismissed for personality disorder.   By 2008, 14,000 soldiers were diagnosed with brain injury or post traumatic stress disorder.   The number of personality disorder cases dropped 75%. Watch this You Tube video.

The significance for those men and women that serve the country in the military is staggering. Could you imagine sacrificing life and limb only to have the U.S. government tell you that you suffered a pre-existing personality disorder? Why, you might ask, did the Army, for example, not make that determination until after my sacrifice of life and limb? How convenient for the Army to take advantage of the sacrifice and not pay the veteran when they can no longer make the sacrifice.

We now know about PTSD as it relates to war, something the Vietnam veterans did not benefit from. We also know, unlike Vietnam, that more soldiers stay alive after blast and concussion trauma due to the enhanced protective gear.

I really hope that the U.S. will be proactive in caring for its military. I think we should all support brain injury groups like the Brain Injury Association of America who are on the front lines, so to speak, in getting legislation for brain injured survivors.

PTSD and MTBI in Veterans Study

Pietrzak and colleagues published their study in the Journal of Nervous and Mental Disease (Posttraumatic Stress Disorder Mediates the Relationship Between Mild Traumatic Brain Injury and Health and Psychosocial Functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom. Journal of Nervous and Mental Disease, 2009;197(10):748-753).

The study, from Yale University, evaluated whether posttraumatic stress disorder (PTSD) mediated the relationship between mild traumatic brain injury (MTBI) and general health ratings, psychosocial functioning, and perceived barriers to receiving mental healthcare 2 years following return from deployment in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF).

"Compared with respondents who screened negative for MTBI, respondents who screened positive for MTBI were younger, more likely to have PTSD, more likely to report fair/poor overall health and unmet medical and psychological needs, and scored higher on measures of psychosocial difficulties and perceived barriers to mental healthcare. Injuries involving loss of consciousness were associated with greater work-related difficulties and unmet psychological needs. PTSD mediated the relationship between MTBI and all of these outcomes." 

The researchers concluded: "These results underscore the importance of assessing PTSD in OEF/OIF veterans who screen positive for MTBI."


For additional information, contact R.H. Pietrzak, Yale University, School Medical, National Center PTSD, VA Connecticut Healthcare Systems, 950 Campbell Avenue 151E, West Haven, CT 06516, USA.
 

PTSD From 9/11

The Las Vegas Review Journal and Associated Press released the results of a study that determined that witnesses of the 9/11 tragedy were many times more likely to suffer from post traumatic stress disorder than those who did not witness it.  The onset was as much as 5 years after 9/11.

These findings are consistent with what we know about post traumatic stress disorder onset.  The condition affects veterans, those subject to horrifying experiences, accident victims and others.

The Sad Untold Story

A tremendously important story has gone virtually untold by the media, ignored by our political leaders and unknown to the American public. Despite the extraordinarily high price they have paid, America's severely wounded veterans are enduring humiliating financial hardships of epic proportions. Home evictions, utility shutoffs, car repossessions and foreclosures are commonplace.

Spouses have to give up their jobs to become caregivers, cutting family incomes by up to 50 percent or more. Most disabled vets receive much less in compensation and benefits than they did while on active duty, reducing incomes even further. Many are too dysfunctional to hold a meaningful job, if any, because of the devastating effects of post-traumatic stress syndrome (PTSD) and traumatic brain injury (TBI). 
 

Rick Amato of the Washington Press.  Rick Amato is a radio talk-show host in San Diego and with Washington Times Radio News. Amato Strategic Communications provides consulting services to nonprofit organizations, including veterans causes.
 

There is a great deal of information out there on PTSD and the military, and this may largely be due to the origins of the PTSD diagnosis.

Post traumatic stress disorder (PTSD) can be considered a "young" diagnosis. It was not until 1980 that the diagnosis of PTSD as we know it today came to be. However, throughout history, people have recognized that exposure to combat situations can have a profound negative impact on the minds and bodies of those involved in these situations.

In fact, the diagnosis of PTSD originates from observations of the effect of combat on soldiers. The grouping of symptoms that we now refer to as PTSD has previously been described in the past as "combat fatigue," "shell shock," or "war neurosis."

It is not surprising that high rates of PTSD have been found among soldiers from World War II, the Vietnam War, the Persian Gulf War, and the war in Iraq.

 Rick's perspectives include getting congress to put soldier and veterans disability right to top of the stimulus packages being authorized of late.  He quotes President Reagan "Until our politicians feel the heat, they won't see the light."

Read the whole article  in the Washington Press including a specific case of a military couple struggling to endure.

 

BIAA Legislative Update April 2008-2

After legislation to reauthorize the Traumatic Brain Injury (TBI) Act successfully passed by Congress last week, the bill still needs to be considered by the President for his signature into law. The Brain Injury Association of America (BIAA) anticipates this consideration will occur in the very near future.

This week saw major activity occur on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. On Wednesday, the bill was unanimously approved by the full House Energy and Commerce Committee, setting up a potential veto showdown with the White House. BIAA has strongly endorsed this legislation and submitted an official letter of endorsement to the bill’s sponsors, Rep. Dingell (D-MI) and Rep. Murphy (R-PA), last week.


Also this week, The Rand Corporation published an important comprehensive study of the mental health and cognitive needs of U.S. servicemembers returning from Afghanistan and Iraq. This groundbreaking study - which focuses specifically on the post-deployment health-related needs and economic costs associated with post traumatic stress disorder (PTSD), major depression and TBI - estimates that 320,000 servicemembers may have experienced TBI as a result of recent combat operations.