Groups around the country are raising awareness about traumatic brain injury (TBI) through education during March.
Staff at Regional West Medical Center (RWMC) have worked for many years to raise awareness not only during March, but year round. Educators, coaches, trainers, parents and medical professionals have attended lectures given by Air Link Chief Flight Nurse Tracy Meyer and learned about TBI in relation to sports. Knowledge and understanding of TBI has grown in athletics, but more education is needed about it in everyday life.
Most school sports teams have students perform a baseline exam, which can be compared to a scan done after an injury to determine the severity of the injury. In everyday life, people don’t have baseline scans, which makes medical professionals’ job a little bit harder to determine what is wrong, especially since the number one cause of injuries is falls at all ages. There is a greater risk in those older than 65.
“They are often on a lot of anticoagulants,” said Shermaine Sterkel, trauma program manager at RWMC. “When they hit their head, it may not be a hard hit and you don’t see anything right away, but give them a few days and they could have a bleed.”
According to the Centers for Disease Control and Prevention 1.7 million people sustain a traumatic brain injury annually. An estimated 36,000 Nebraskans live with a disability due to brain injury.
“An injury that happens in an instant can bring a lifetime of physical, cognitive and behavior challenges. Early, equal and adequate access to care will greatly increase the overall quality of life,” said Peggy Reisher, executive director at Brain Injury Association of Nebraska, in a press release.
TBI is a life-changing event. Some struggle with depression and relationships. It affects the individual and those around them, including family and friends. Marriages can fall apart. A person who has suffered a TBI may not be able to hold a job or have chronic problems relating to their injury, including memory loss.
“Even with moderate TBI, some people can’t remember things,” Sterkel said. “It changes their whole life.”
Meyer said most people probably know someone with TBI.
“They learn how to compensate,” Sterkel said. “It’s amazing how you can go in and have a conversation with them and they have a real way of being subtle.”
Sterkel and Meyer have seen TBI outside of sports, including motor vehicle accidents, elder abuse and child abuse.
RWMC sees a lot of TBI from motorcycle accidents. Most were not wearing a helmet.
“We get a lot of Wyoming injuries,” Meyer said.
Sterkel and Meyer are trained to treat injuries, but there’s a sadness in their eyes and a hesitancy in their voice whenever they speak about non-accidental trauma.
Non-accidental trauma abuse in the elderly is not uncommon.
“It’s hard to prove when they can’t speak for themselves or defend themselves,” Sterkel said.
Non-accidental trauma abuse in children is more common than people would think. Sterkel has seen children as young as 2 months old with head injuries. A typical scene is the child comes into the emergency room throwing up. Doctors will diagnose based on that, but bleeding can be slow and the child could return, this time with seizures. Hospital staff have to walk a fine line to not be accusatory while looking out for the best interests of the child.
“The amount (of head injuries in children) we see for the population is significant,” Sterkel said.
Another type seen often is when a baby is shaken or thrown.
“Almost always they have some type of bleeding in the brain,” Meyer said. “That’s prevalent in the community.”
Meyer said if you ever get to the point you want to harm a child, put them down and walk away.
“That’s also why we have parenting classes,” Meyer said. “I understand being at the end of your rope, but you have to walk away.”
Preventing TBI takes a multidisciplinary approach. There are many steps in recovery and follow-up care, including discharge instructions, assessments, acute rehab and referrals.
“The schools have been fantastic with follow ups,” Sterkel said. “And there are support groups.”
In 2010, Meyer was knocking on doors to get people to listen about TBI. Now, she has so many requests for her to speak, it’s difficult to keep up.
“I thought that requests would slow down, but it hasn’t,” Meyer said. “You can tell there’s a change in culture, compared to 5-6 years ago. You hear people talking about it all the time.”
Meyer has put her lecture on DVD for those she can’t get to classes and speaks to a variety of groups.
“Each group we talk to we tweak it for that target audience,” she said.
Research into comparisons between boxers, those living with dementia and teens that had TBI that ended in fatality have found similarities in the Tau protein in the brain.
“If you look at boxers, a lot of them have Parkinson’s and dementia,” Sterkel said. “They think the Tau protein is the connection.”
The Alliance Brain Injury and Stroke Suppot group meets at Box Butte General Hospital the second Tuesday of each month at 3 p.m. Contact Martha Douglas at 308-761-3372 for more information. The Panhandle Brain Injury Support Group meets at ESU #13 the third Tuesday of the month at 4:30 p.m.. For more information, contact 308-761-3372.