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Brain Pain

Michigan association advocates for retaining law, helping patients,

Brain Pain from page 1

miraculous recovery from an exploding
device while in Iraq. This interest was accel-
erated during the 2010-11 season, when
Pittsburgh Penguins hockey player Sidney
Crosby missed playing for 10 months while
rehabilitating from his fourth concussion.
And then U.S. Rep. Gabrielle "Gabby"
Giffords, D-Ariz., was shot in the head dur-
ing an assassination attempt early last year
in Tucson, raising even more attention to
traumatic brain injuries. Her husband, Capt.
Mark Kelly, spoke at BIAMI's annual Legacy
tribute dinner this spring. Giffords, who
resigned from Congress, continues to recover.
Locally, concussions and brain injury
moved from the pages of medical journals
to mainstream mediatlast year when Detroit
Lions running back Jahvid Best was taken
off the active roster for head injuries. Parents
and coaches became more interested in head
injuries received in school sports, and more
focus was placed on mild concussions.

Michigan A Leader
Dr. Owen Perlman of Ann Arbor, a physiat-
rist, or rehabilitation medicine specialist,
volunteers many hours for BIAMI.
"Michigan is among the largest state
chapters of the Brain Injury Association of
America," he says. "Our
state chapter has a net-
work of 50 Commission
on Accreditation of
Rehabilitation Facilities
[CARF] affiliated with
our organization. These
are accredited programs
and services in Michigan
Dr. Owen
for
treating and caring for
Perlman
brain-injured patients.
Most states have only two
or three CARF facilities."
Because of this extensive network of
health organizations working with BIAMI,
anyone receiving a brain injury or small con-
cussion in Michigan is more likely to receive
an early diagnosis and treatment as well as
long-term rehabilitative support.
"This all happened because of Michigan's
No Fault Insurance Law put in place in 1973:'
Perlman says. "Forty years ago, they recog-
nized that early stabilization and care were
critical to recovery. Previously, an injured
person had to sue and go to court first to
receive money for treatment. By that time,
many who were injured lost functionality
and the amount collected seldo" m paid for
care needed throughout their life'
Perlman points out that the Veterans
Administration (VA) recently recognized its

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May 31 • 2012

Ruthan Brodsky

I

Special to the Jewish News

own system was not in a position to treat all
of the returning veterans with brain inju-
ries. It subcontracted several of the CARF
facilities in Michigan to treat the country's
wounded warriors.
"This is groundingbreaking," Perlman
says. "I don't recall the VA ever working with
the private sector to provide health services
for veterans:'

New Research
Dr. Joel Saper, founder and director of the
Michigan Headache & Neurological Institute
in Aim Arbor, has been restoring patients
with head injuries to normal life for more
than 40 years. He was
recognized at the BIAMI
dinner for his many years
in the field.
"There has been an
enormous amount of
research about what hap-
pens during the two main
es of brain injuries:'
Dr. Joel Saper
Saper says. "The first is the
penetrating type, such as
the bullet that penetrated
Gabby Giffords' skull and damaged the brain
matter in that bullet's path. Research points
to a wide range of nerve cells that were also
damaged during the course of penetration.
"The second type of brain injury, a
concussion, can be even more substantial
because of its broader range of damage
Saper adds. "Its wide disbursement of dam-
age can lead to pain plus mental and behav-
ioral changes over time. Today, we're discov-
ering new ways to treat this type of damage,
which is prevalent among our returning
soldiers and identified in young athletes."
Saper says there is now greater recogni-
tion that even a minor concussion can have a
lasting effect on a brain. In sports, it may be
multiple events in which the player is dazed.
Coaches are more cautious, and players are
more likely to be taken out of the game.
"Current research points to the possibil-
ity of a genetic vulnerability to headaches,
such as migraines, and a genetic liability to
brain damage with a concussion:' Saper says.
"It appears that people who have migraines
are more susceptible to both short-term and
long-term brain damage from injuries, and
to more concussions. Interestingly, the symp-
toms of headaches and concussions often
overlap. The good news is we've made a lot of
progress in treating head and neck injuries:"
West Bloomfield neuropsychologist
Charles Seigerman, Ph.D., who served as
advertising chair for the recent dinner, said,

"Patients are receiving early treatment to
prevent primary and secondary damage
before they come to me. Chemical changes
can take place in the brain, causing more
brain destruction. BIAMI, made up of pro-
fessionals, families and survivors of TBI
[traumatic brain injury], exists to provide
advocacy, support, resource information and
prevention approaches for those suffering
from TBI."

Advocating For Patients
Proceeds from the dinner help support the
organization's advocacy efforts to defeat the
bill in the Michigan Legislature limiting no-
fault insurance payments to injured citizens
and medical professionals, Seigerman says.
Opponents to the current no-fault system
propose that a cap be placed on benefits
an injured person can receive. It also cre-
ates a new fee schedule for medical services
and limits home care benefits. The new bill
requires the coordination
of benefits with other
third-party insurers such
as Blue Cross Blue Shield
and Medicare.
State Rep. Pete Lund,
R-Shelby Township, intro-
duced House Bill 4936.
"I've worked with
Dr. Charles
people
for the past 16
Seigerman
years who have TBI," says
Farmington Hills-based
Pamela Feinberg-Rivkin, RN, BSN, CCM
and CRRN, and a consultant for catastrophic
injuries and geriatric care management. "I
know the recovery of many brain-injured
patients in Michigan is supported by pay-
ments they received as a result of Michigan's
no-fault insurance law. The impact of limit-
ing no-fault insurance would be detrimental
to their survival and to becoming contribut-
ing members of the community"
"This is an important year for BIAMI,"
says attorney Jody Lipton of Huntington
Woods, BIAMI's political liaison chair. "Many
elected representatives attended this dinner,
and they received a heavy dose of informa-
tion regarding the treatment of traumatic
brain injuries and the needed support for
patients and their families. This is critical to
our strategy for dealing with the bill that was
introduced to put a cap on medical treatment
and change no-fault legislation."
Zealous about her volunteer work for
BIAMI, Lipton views the organization as a
huge advocacy arm for patients and families
who deal with brain injuries. ❑

Mild
Traumatic
Brain Injury
Facts
(MTBI)

• 7 million people suffer a TBI
each year in the U.S.; of these,
between 75 and 90 percent are
categorized as MTBI.
• MTBIs cost the nation nearly
$17 billion each year.
• Research indicates that up
to 15 percent of patients diag-
nosed with MTBI may have per-
sistent, disabling problems.

Defining MTBI

Occurrence of injury to the
head arising from blunt trauma
or acceleration or deceleration
forces involving any one of the
following:
• Any period of loss of con-
sciousness.
• Any loss of memory for
events immediately before or
after an accident.
• Any alteration in mental state
at the time of the accident.
Early treatment is essential
for maximum recovery. Early
intervention can provide signifi-
cant benefits in rate of recov-
ery, cost per unit of recovery,
care requirements and
reduction of lifetime costs.

Symptoms Following
A MTBI

• Dizziness
• Vertigo
• Musculoskeletal complaints
• Headaches
• Balance and spatial
disorientation
• Visual disturbances
• Altered taste and smell
• Hearing changes
• Fatigue
• Sensitivity to light
• Decreased attention and con-
centration
• Reading and auditory compre-
hension problems
• Increased irritability
• Depression and anxiety
• Sleep disturbances