Articles Posted in Brain Injury

soccerknee-300x97Here’s another painful reminder to grownups about youngsters and sports: Moderation matters, and youthful games are supposed to fun, diverting, and character building—and most definitely should not leave today’s aspiring athletes as tomorrow’s hobbled adults.

The New York Times has reported on what a pediatric sports medicine expert has described as a “dirty little secret” of orthopedics, which is “the chance of getting arthritis within a decade of tearing a tendon or a ligament in the knee is greater than 50 percent.” And more and more youths, as they participate aggressively and frequently in sports programs, are undergoing surgeries on damaged or torn anterior cruciate ligaments, a procedure well-known as the ACL repair.

The sports medicine doc says he is gathering data for a study that will show that patients at 26 children’s hospitals he has focused on underwent 500 ACL repairs in 2005, but by 2014, more than 2,500 youths had these surgeries.

soccerheader-211x300Although state and local laws may be curbing some of the harms the young can suffer with sports-related concussions, parents, coaches, teachers, and players may wish to reconsider even more the risks of head traumas: That’s because early such injuries may be tied to later diagnoses of multiple sclerosis.

To be sure, this is a developing area of research and the studies suggest an association between MS and head trauma, and not that concussions are a cause of the chronic, unpredictable disease of the central nervous system.

MS, as the disease’s national society reports, “can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may come and go or persist and worsen over time.”

muddy_sunday_feature-300x199Parents happily send their eager youngsters off to a demanding array of sports activities,  in the belief that athletics will improve their health and well-being. But, especially for active young men, life as a jock can carry costly long-term risks and immediate infection perils.

A Yale economist and colleagues have scrutinized available public data and estimated that by changing some contact sports like football into their less violent forms (like touch or flag versions), almost 50,000 fewer collegiate and 600,000 or so high school injuries would be averted. Figuring in the costs of medical care and time lost, this could mean a savings of $1.5 billion at the college level and $19.2 billion for high schools.

The researchers came to these big sum conclusions after looking at four types of serious injuries: concussions and damage to the nervous system, bone injuries, torn tissue, and muscle and cartilage injuries. They said that the popularity and prevalence of high contact sports like football in explaining why athletics’ economic toll can be so high.

Chronic_Traumatic_Encephalopathy-300x153Football players and fans, if they had doubts before, have taken yet another hit to their favorite sport, with a retrospective study of hundreds of pro players’ brains finding a damaging disorder in a startling percentage of the donated organs.

Experts reported in the Journal of the American Medical Association that 110 of 111 brains of onetime players in the National Football League, examined by neuropathologists and other experts, showed evidence of chronic traumatic encephalopathy, or CTE. It’s a degenerative disease that experts think is caused by repeated head blows. It has been linked with multiple symptoms, including memory loss, confusion, depression and dementia. The problems can crop up long after the head trauma stops.

Caution needs to be exercised with this research because the athlete-brain donors and their families were extremely self-selecting. They participated in the post-mortem study, some with guarantees of confidentiality about identities, because they had experienced or started to show likely CTE-related debilitation before their deaths.

bike-300x300As more Americans try to stay healthier and to beat the pains of commuting by car, bus, or light rail systems, many (including yours truly) have turned to bicycling. But as a result, non-fatal bike injuries have skyrocketed—especially for men and for riders older than 45—and two-wheel collision treatment has become expensive: The annual cost of medical care for bike crashes in 2013 alone exceeded $24.4 billion, double the amount for all occupational illnesses.

Those are findings of a multi-year study (1997-2013) of electronic records on 3.8 million non-fatal and 9,839 bike-related deaths, research published in Injury Prevention, an online specialty journal.

A key reason why the cost of cycling wrecks—including for emergency transport, hospital charges, rehabilitation, nursing home stays, and lost work and quality of life—has raced upwards: Bikers more than ever are mixing it up with cars on streets.  Road collisions accounted for just under half of biking injuries in 1997. They’re almost two-thirds of such wrecks now.

Florida_Supreme_Court_Building_2011-300x266As congressional Republicans pursue their counter factual campaign this week to strip patients of their rights to pursue legal redress for harms they suffer while seeking medical services, the Florida Supreme Court has sent a powerful message to federal lawmakers about the wrongheadedness of some of their key notions.

The justices in Tallahassee have repudiated state lawmakers’ assertions of the existence of a “malpractice crisis,” in which dire action is needed to ensure doctors can get affordable liability insurance and be sufficiently protected to practice good medicine.

They also have rejected caps on patients’ claims for pain and suffering, finding that these limits on “non-economic” damages violate constitutional rights to equal protection under the law, and “arbitrarily reduce damage awards for plaintiffs who suffer the most drastic injuries.”

softball-300x197Although fans may fret when pros like the Nationals’ Bryce Harper get hit by a pitcher—and brawls ensue—some amateur athletes are the most likely to be struck and hurt: Ball-contact injuries are highest among female softball players, followed by women who play field hockey.

That’s according to new research on thousands of college athletes that found that less than half of the female athletes’ injuries when hit by balls caused them to lose playing time. Most suffered bruises (30.5 percent) and sprains (23.1 percent). But concussions were among the most commonly recorded serious injuries, occurring in 16.1 percent of cases, with finger fractures an issue, too.

When injuries were compared between men and women in baseball-softball, basketball, and soccer, female athletes had a larger proportion of ball-contact injuries diagnosed as concussions than did men, researchers found.

nhlDo the leaders of professional hockey need to spend some time in the penalty box? It might seem so based on a report in the New York Times that the National Hockey League, as it battles its own players in court over the harms caused by repetitive head injuries, is adopting the dubious legal playbook used by pro football, Big Tobacco and Big Sugar.

The $4-billion-a-year NHL, it seems, has taken off its mitts, thrown them on the ice, and is throwing blows to challenge the ever-mounting, evidence-based research that finds that concussions are detrimental to brain health and can lead to the disease known as chronic traumatic encephalopathy or CTE.

The National Football League, after years of CTE denial, including efforts to undercut its medical science and to attack its researchers, conceded that repeated head trauma harmed its players, and pro football settled with them for more than $1 billion.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

US_Congress_02It’s almost 1,000 pages,   culminates at least three years of work, and provides a $6.3 billion boost for an array of health-related agencies and initiatives. Will the U.S. Senate join the House in bipartisan passage of the 21st Century Cures Act, a sweeping measure that some say could affect American health care as much as the Affordable Care Act aka Obamacare?

After the bitterly divisive presidential campaign, House members surprised many with their swift consideration of the health funding bill, which passed 392-26. Congressional leaders then crowed about how they can work together and how the legislation will help. The act now has moved to the Senate for consideration. Senators, notably Massachusetts Democrat Elizabeth Warren, have been far more critical of components of the measure, particularly how Big Pharma and device-makers may benefit.

I’ve written how Congress, around this time last year, provided holiday cheer by approving the framework of the 21st Century Cures Act, an omnibus bill that took a year for funding details to get worked out. Because the legislation covers so many health areas and still must be acted on by the Senate and signed by the president, it still needs wary watching. Lobbyists for many different causes already have had a field day on this bill, and they will continue to do so.

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