Farewell to a Sporting Hero - Junior Seau
How repeated shocks to the head effect lives . . .
Mild Traumatic Brain Injury mTBI
Time to focus on our Wounded-Warrior's Survival
There is an assumption that this suicide was somehow tied to the effects of what was once called Post Concussive Syndrome. Our hearts go out to the family of Junior and we can neither condemn nor condone his actions.
However, while the Nation is focused on the apparent suicide of this famous, generous professional sports-star, the headlines of his death have totally eclipsed a story in today's Huffington Post section, ironically named "Impact"
Time to look to the science of a wounded brain.
From a most precise and well-researched scientific book on this subject comes good news:
Veteran Suicide: Are We Losing The Battle?
These staggering figures underscore the need for the VA to develop more mental-health programs and an accurate system for recording the number of veterans and service members who take their lives.
"America is losing its battle against suicide by veterans and service members," authors Dr. Margaret C. Harrell and Nancy Berglass concluded. "And as more troops return from deployment, the risk will only grow."
Sandsie's Comment:
My sister-in-law is a Colonel in the United States Air Force -- and a skilled trauma surgeon ,living for many years in Germany. When a serviceman was wounded in either Iraq or Afghanistan, within eight hours he/she arrived (via C-17 Globemaster) at the huge US Military Hospital at Landstuhl. Dramatically traumatized patients delivered to her surgical teams underwent life-saving surgery.
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| This photograph is copyright to AP |
I recently asked her "T' how is the morale of these veterans after the have lost limbs"
She answered "Well, when they are in the wards with other wounded vet's they are really pumped up with their own survival and it is infectious" She paused a moment or two and then said "I worry what will happen to them when they get back home to a small town, cannot remember their wedding anniversary or their children's birthday . . . It's not really the amputations"
Again, from Huffington Post - this day, May 4 2012
Her words parallel with today's comments in the HP article "And as more troops return from deployment, the risks (of suicides) will grow."
By the time you have read this and turned your computer off, another Wounded Warrior will, just like Junior Seau, have given up. Depression has often been called "the cancer of the soul." And, if is found that mTBI (post concussive syndrome) was the trigger factor for Junior -- it then parallels the loss of our other Heroes -- one every hour and twenty minutes around the clock.
The fact is repeated concussive forces to the skull can cause intricate and delicate damage to our most complex organ -- the brain. The results can be devastating, not only for the wounded, but their loved ones as well.
CAN SOMETHING BE DONE?
WILL USING HYPERBARIC OXYGEN THERAPY AS AN ADJUNCT HELP?
From a most precise and well-researched scientific book on this subject comes good news:
"The features of cellular injury, dysfunction, and death have
been described in detail in this section. It is important to appreciate the
cell death is closely related to injury severity. Mild traumatic brain injuries,
especially injuries on the mild end of the spectrum, are typically
characterized by cellular dysfunction that is reversible. There is a continuum
of injury, at the cellular level, ranging from completely and rapidly
reversible cellular dysfunction, to slow but complete recovery, to slow and
incomplete recovery, to cell death. Very mild concussions likely produce
virtually no permanent damage to cells resulting in long-term symptoms or
problems, whereas severe traumatic brain injuries, especially those involving
considerable forces, often produced widespread cellular death and dysfunction
with clear functional consequences; complicated MTBIs and moderate TBI's likely
to fall in between."
"If you can't explain it simply, you don't understand it well enough" Albert Einstein
So I will do my best to simplify the pathway to the most complex injury to the human body. To accomplish this, I use the following analogy.
Imagine you are standing at the edge of a lovely pond -- full of reeds and water-lilies. Perfection. Undisturbed. You have a bag full of golf-ball sized rocks and the temptation is too much. Instead of throwing into the middle of the pond and watching the generated wave energy dissipate in circles, you slam your first rock into the water, almost at the edge. Weeds, reeds, water-lilies sway backwards and forwards as the crescent shaped energy crosses the pond surface. You repeat the slamming again and again. Then you graduate to larger base-ball sized rocks, heaved into the same disrupted edge. The greater your effort the more immense the energetic pandemonium in the pond.
When you stop, the energy dissipates and the surface looks undisturbed. Most of the pond now looks almost the way it was before you started. But not so. A lot of the vegetation below the surface, has suffered, badly torn, stretched and uprooted. Some of that vegetation that you can see will not survive, wasting away from lack of nutrients.
So too with the brain. Repeating concussive forces tears and stretch axons (the little wires that connect our neurons) and, slowly these axons, as illustrated by the reeds in the pond, degenerate by thickening and even shearing. The brain, a ravenous consumer of oxygen and nutrients -- adenisone triphosphate (ATP) -- starts to "starve" in certain damaged areas. As with the pond, while the damage can be greatest at the edges of the skull, that destructive energy can journey through the entire brain.
Even low intensity mechanical injury produces changes to axonal integrity. Repetitious (as in football) "mild" head concussions over the years is the same as coming back on a regular basis to that same spot beside the pond and slamming more rocks, large and small, into the already damaged area at the edge.
So too with our Wounded War Heroes. Many have been exposed to numerous blasts from roadside IED bombs. Their Humvee is blown on its side and and any unmarked soldier that can stand up and say his name and rank goes back into the firing line. Just like Junior did on the playing field - time after time - accumulating additional concussive damage.
Is there some good news? YES
The "starving" neurons have engines, called mitochondria. They generate a unique emergency signal, a metabolite known as N-acetylaspartate (easier to use the acronym "N-AA") - an indicator of axonal (nerve wire) damage. The higher the N-AA measure, the more wounded the brain.
And, depending on the severity of the initial and following concussive forces, symptoms can range from loss of motor skills to subtle psychological changes . . . depression, mood-swings that run the gamut of panic-attacks, fearfulness and rage for no reason, loss of memory.etc.
When appropriate pressures of 100% oxygen are given to TBI patient in a hospital-grade hyperbaric oxygen chamber, the patient improves. Repeated HBOT reduces the N-AA output and this is now an objective marker of normalization of the brain.
And, depending on the severity of the initial and following concussive forces, symptoms can range from loss of motor skills to subtle psychological changes . . . depression, mood-swings that run the gamut of panic-attacks, fearfulness and rage for no reason, loss of memory.etc.
When appropriate pressures of 100% oxygen are given to TBI patient in a hospital-grade hyperbaric oxygen chamber, the patient improves. Repeated HBOT reduces the N-AA output and this is now an objective marker of normalization of the brain.
From the same authors
Brain Injury Medicine: Principles And Practice (buy that book ASAP):
"Recently, animal experimentation has provided evidence that depressed mitochondrial function might be improved by treatment with hyperbaric oxygenation (see chapter 57 in this book for a discussion of this topic.) In humans magnetic resonance spectroscopy has been useful in detecting additional metabolic changes that can occur following MTBI. N-acetylaspartate (N-AA), a marker of neuronal axonal viability, total choline (Cho), a marker of membrane metabolism, total creatine (Cr), which reflects energy status, and lactate (Lac), an indicator of ischemia were measured at 2 – 30 days following injury in 14 subjects . . . The ratios were consistent with decreased N-AA and increased Cho in severe TBI.”
Sandsie's Comment:
Would treatment sessions in hospital grade hyperbaric chamber avoided the San Diego tragedy, or the one that takes place every 80 minutes, 24/7 . . . a veteran's suicide?
Studies and trials are underway.
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About 6 years ago, I was briefly introduced to the Owner of the Chargers. My staff and I had joined numerous other health services at an outdoor poster session. The owner and his executives strode by and paused a bare moment to glance at our posters. I heard him say "we have a hyperbaric chamber and it does not work." And he moved on. I chased him.
"Is it an inflatable bag?" He grunted over his shoulder "yes" and was gone into the crowd.
I left a bunch of these books with his staff. with the hope that eventually somebody will read them.
Simply put, the so-called mildHyperbaric inflatable chambers just do not deliver what is needed for neuronal repair. More on that in another blog.
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.And, in my next blog, the story of one of the bravest -- and also how you can help by supporting the David Lynch Foundation.
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