New VA Polytrauma Center Holds an Open House

The main therapy pool that is heated by solar panels on the roof the the Polytrauma Center and the wall of doors open the pool to the outside courtyard.

The main therapy pool that is heated by solar panels on the roof the the Polytrauma Center and the wall of doors open the pool to the outside courtyard.

It’s not your father’s VA anymore as evidenced by just one look inside the Department of Veterans’ Affairs new Polytrauma and Rehabilitation Center at James A. Haley VA Hospital at 13000 Bruce B. Downs Blvd., Tampa.

There’s a putting green, a two-story climbing wall, and an aquatic center for recreational therapy. Each of the 56 new private rooms has large windows for natural light, lush wood paneling, wheelchair accessible bathrooms, a desk and a large-screen TV so veterans and active duty personnel have direct access to education programs and entertainment.

“It doesn’t seem so sterile. I can see green grass. I can see Busch Gardens from here,” David VanMeter, an associate director at Haley who is in charge of facilities, said as he gazed out a second-story window. “There are different things to look at instead of just four cold walls.”

A two-story, therapy climbing wall is part of the common area in the Polytrauma Center second floor area known as Main Street.

A two-story, therapy climbing wall is part of the common area in the Polytrauma Center second floor area known as Main Street.

A ribbon-cutting ceremony, which is open to the public, is scheduled Saturday, April 12, 2014, at 1 p.m. followed by an open house.

Bringing the outside indoors is the theme of the new Polytrauma Center. The home-like environment is filled with technology and conveniences to make life easier for patients like a track system in the ceiling so immobile patients can be moved easily from their bed to the bathroom.

And private rooms are carved into neighborhoods with military inspired names such as Duty, Patriot and Valor. The idea is to create a healing environment where patients and their families feel at home.

So beyond the individual rooms along an angled extra-wide corridor, there are day rooms where families can socialize.

Freeze-dried palm trees line the Main Street common area at the Haley VA Polytrauma and Rehabilitation Center where patients can relax at the internet cafe. There are cooking facilities and a children's play area as well as access to an outdoor deck.

Freeze-dried palm trees line the Main Street common area at the Haley VA Polytrauma and Rehabilitation Center where patients can relax at the internet cafe. There are cooking facilities and a children’s play area as well as access to an outdoor deck.

There’s a two-story atrium called “Main Street” that is lined with freeze-dried, 20-foot palm trees. The concept is bringing the outdoors inside.

Main Street is filled with natural light. It’s a place where veterans can relax at the internet café or take a turn at the two-story climbing wall.

“You have to think of the veterans on active duty we’re seeing. One day they are in the field. They are serving in combat. They are active. They are young. They have expectations a different generation of veterans may not have had,” VanMeter said. “And now, we’re trying to tool what we provide here to them.”

The hallways are angled so the design doesn't feel institutional and the 56 private rooms are broken up into neighborhoods with military inspired names like Valor.

The hallways are angled so the design doesn’t feel institutional and the 56 private rooms are broken up into neighborhoods with military inspired names like Valor.

Interior glass walls continue the open feeling allowing a view inside the rehabilitation center and the kitchen of the transitional apartment. And it’s overlooked by a balcony. The third floor is where the general rehabilitation and chronic pain patients call home.

One of the hidden gems on the second floor is an outdoor deck. It’s surrounded on all four sides by buildings. But there is direct access to open sky above complimented by wood planking below and planters filled with greenery to frame the space.

A putting green, basketball court and horseshoe pit are all part of the new, outdoor recreational therapeutic activity courtyard.

A putting green, basketball court and horseshoe pit are all part of the new, outdoor recreational therapeutic activity courtyard.

The aquatic center is a prime example of bringing the outside indoors. The main therapy pool is enclosed on one side with glass doors that can be opened up to the recreational courtyard.

The smaller pool is like a high-tech treadmill that can be raised and lowered for easier patient access.

The recreational space outdoors has a multi-surface area where wheelchair patients can practice traversing stone, brick and gravel surfaces. There’s a putting green, basketball court and a horseshoe pit plus plenty of benches – some of them shaded – for those who want to feel the breeze and sun on their face.

Associate director David VanMeter points to the flat-screen TV that connects patients to everything from education to entertainment.

Associate director David VanMeter points to the flat-screen TV that connects patients to everything from education to entertainment.

You can listen to an audio tour of the new James A. Haley VA Polytrauma and Rehabilitation Center on WUSF 89.7 FM.

Lush wood cabinets and flooring help the private rooms to feel warmer and more like home.

Lush wood cabinets and flooring help the private rooms to feel warmer and more like home.

The exterior of the Aquatic Center.

The exterior of the Aquatic Center.

The circular drive entrance to the James A. Haley VA Polytrauma and Rehabilitation Center.

The circular drive entrance to the James A. Haley VA Polytrauma and Rehabilitation Center.

 

Obama: VA Disability Claims Backlog Is Shrinking

Veterans take photos of President Barack Obama as he works a ropeline after speaking at the Disabled American Veterans convention in Orlando, Fla., Saturday, August 10, 2013. (Official White House Photo by Pete Souza)

Veterans take photos of President Barack Obama as he works a ropeline after speaking at the Disabled American Veterans convention in Orlando, Fla., Saturday, August 10, 2013. (Official White House Photo by Pete Souza)

President Barack Obama acknowledged the obvious when addressing the Disabled American Veterans gathering Saturday in Orlando. He noted that there’s still a backlog of benefits claims at the Department of Veterans Affairs.

However, it’s just under 500,000 claims according to the Associated Press. And that’s smaller than the 611,000 claims backlog in March.

“Today I can report that we are not where we need to be, but we are making progress,” Obama said. “So after years when the backlog kept growing, finally the backlog is shrinking.”

A claim is considered “backlogged” if it’s been in the system for four months.

The president also unveiled a  national plan for prevention, diagnosis and treatment of post-traumatic stress disorder (PTSD) and Traumatic Brain Injury (TBI).

Traumatic Brain Injury Military First: A Tissue Repository

Image courtesy of the VA Research on PTSD.

Image courtesy of the VA Research on PTSD.

The military brain tissue bank was established with the hope that scientists will learn more about the long-term effects of traumatic brain injury (TBI) of service members returning from combat.

After more than a decade or war, service members exposed to blasts “are coming home with troubling, persistent problems and we don’t know the nature of this, whether it’s related to psychiatric responses from engagement in warfare or related to actual damage to the brain, as seen in football players,” said Dr. Daniel Perl, a neuropathologist and director of the brain tissue repository, stated in a press release. “We hope to address these findings and develop approaches to detecting accumulated tau in the living individual as a means of diagnosing CTE during life – and, ultimately, create better therapies or ways to prevent the injury in the first place.”

The Department of Defense established the Center for Neuroscience and Regenerative Medicine Brain Tissue Repository for Traumatic Brain Injury at the Uniformed Services University of the Health Sciences (USU) in Bethesda, Md. to advance the understanding and treatment of TBI in service members. 

TBI Questions to be Answered

  • Does TBI lead to Chronic Traumatic Encephalopathy (CTE) – a neurodegenerative disorder that involves the progressive accumulation of the protein tau in nerve cells within certain regions of the brain? As the tau protein accumulates, it disturbs function and appears to lead to symptoms seen in affected patients such as boxers and, more recently, football players with multiple head trauma according to the DoD press release.
  • What does blast exposure do to the brain?
  • Do the different forms of brain injury experienced in the military lead to CTE?
  • What are effective ways to treat and prevent CTE?

You can get more information on donations to the brain tissue repository and their research by contacting the Repository team at CNRM-TBI@usuhs.edu or 855-366-8824.

4 Things Not to Say to Someone with a Brain Injury

An IED blast. Traumatic brain injuries are most often caused by powerful blasts from improvised explosive devices. A roadside bomb explodes and the concussive effect violently shakes the brain inside the skull.

An IED blast. Traumatic brain injuries are most often caused by powerful blasts from improvised explosive devices. A roadside bomb explodes and the concussive effect violently shakes the brain inside the skull.

Traumatic brain injury (TBI) is one of those “hidden wounds” that goes unnoticed by many. It’s also one of the signature wounds of Iraq and Afghanistan war veterans.

And while many times the wound is not visible, a brain injury comes with real side-effects that make it difficult for the injured persons.

A recent article on brainline.org written by Marie Rowland, PhD, EmpowermentAlly, details 9 Things NOT to Say to Someone with a Brain Injury.

Rowland focuses her advice for the caregiver who, out of frustration and exhaustion, may say something to the brain injured person without realizing its impact. Here are Rowland’s top 4 Things NOT to Say:

1. You seem fine to me.

What does not show is the fatigue, depression, anxiety and pain that may accompany a brain injury. Something like a memory problem can be far more disabling than a physical wound like a limp.

2. Maybe you’re just not trying hard enough (You’re lazy).

Lazy is not the same as apathy (lack of interest, motivation, or emotion). Apathy is a disorder and common after a brain injury. Apathy can often get in the way of rehabilitation and recovery, so it’s important to recognize and treat it. Do beware of problems that mimic apathy. Depression, fatigue, and chronic pain are common after a brain injury, and can look like (or be combined with) apathy.

3. You’re such a grump!

Irritability is one of the most common signs of a brain injury. Irritability could be the direct result of the brain injury, or a side effect of depression, anxiety, chronic pain, sleep disorders, or fatigue. Think of it as a biological grumpiness — it’s not as if your loved one can get some air and come back in a better mood. It can come and go without reason.

4. How many times do I have to tell you?

It’s frustrating to repeat yourself over and over, but almost everyone who has a brain injury will experience some memory problems. Instead of pointing out a deficit, try finding a solution. Make the task easier. Create a routine. Install a memo board in the kitchen. Also, remember that language isn’t always verbal. “I’ve already told you this” comes through loud and clear just by facial expression.

You can read all 9 Things NOT to Say HERE as well as learn other tips for living with, preventing and treating TBI at Brainline.org .

VA Backlog of Benefits Claims Got Worse in 2012

VA-logo2Making it easier for veterans to apply for benefits and disability for traumatic brain injury, post-traumatic stress disorder and agent orange exposure served to swell the backlog of VA benefits claims in 2012.

The VA has processed about 1 million claims a year, but more than 1 million new ones keep coming in reported Quil Lawrence of NPR.

Hundreds of thousands of veterans who suffered injuries while serving in the military must wait many months for care and compensation. Slightly more than 863,000 people had pending compensation claims with the VA in December, according to a Dec. 17 report.

A Backlog Worsens

At the start of 2012, the department promised to cut into that big backlog of claims. But over the course of the year, that backlog has gotten worse, not better.

Continue reading

There is Recovery from TBI: One Army Sergeant’s Story

Army SGT Amber (Greer) Brooks in June 2011 three months after her accident. The medical team had to shave off her waist-length strawberry blonde hair to access her skull and save her life.

“The big shock to me was ‘Why am I not at work? Why can’t I go to work? I don’t understand why I can’t be around people I served with.’” Army SGT Amber Greer said. “It was a huge shock to me and something that was so foreign to me. I probably cried for about a week that I couldn’t go to work.”

That’s how Greer described her struggle to recover from multiple injuries including Traumatic Brain Injury after a traffic accident in 2011.

Thankful for her recovery and hoping to encourage others  traveling the same path, Greer (now Amber Greer Brooks) sent me this recent update:

By Amber (Greer) Brooks

Recovering from any major trauma is extremely difficult and takes a lot of time and patience. I spent from March 20, 2011-August 17, 2011 in the hospital only to end up in one of the Army’s Warrior Transition Units (WTU).

These WTU’s are designed for soldiers to go to heal and transition either back into the Army or back into civilian life. Fortunately for me, the Army decided that I met the standards of being returned to the Army.

Since then, I have married a wonderful man and will be taking a new job in the Army.

I am leaving for training in January 2013 to work for the Army as a contractor. I will be signing and negotiating government contracts on behalf of the Department of the Army.

I have also scored the highest on my Physical Fitness Test (APFT) ever (even before the auto accident) with a perfect 300! 46 push ups in 2 minutes, 80 sit ups in two minutes, and running two miles in 14 minutes 51 seconds.

Anyone can achieve anything, it just takes a lot of focus, motivation, and never giving up.

TBI: Testing Cognitive Skills of High School Football Players

Courtesy of SUNY Youth Sports Institute.

Before they put on their pads, before they strap on their  helmet, high school football players have to take a test in South Florida according to an Associated Press report.

The 20 minute computer test gives doctors a baseline to be able to determine if there’s cognitive impairment after a season of play. The testing begins Monday in Palm Beach County but similar testing has been ongoing for two years in Miami-Dade County.

And South Florida isn’t the only place high school football players are being monitored for concussions.

Purdue University released a two-year study in February in which impact sensors were embedded in helmets of an Indiana high school team.

Purdue found that players received 200 to nearly 1,900 hits to the head per season. Researchers also suggested that concussions are likely caused by repeated blows rather than a single jolt. Such evidence is why the Sports Legacy Institute and other advocates say a “hit count” is necessary to protect young, developing brains that are more susceptible to injury than those of adults.

Long term effects of blows to the head and concussions are a concern. Diana Brett, the mother of a 16-year-old who suffered numerous concussions and killed himself, is pushing for more more education and study of concussions in young athletes.

Judge Patt Maney Inspires Veterans Dockets in Florida

Judge Patt Maney and his wife Caroline when he was awarded Patriot of the Year (2010) by the Military Order of the Purple Heart.

This year, lawmakers gave Florida’s chief judges the power to set up a “Veterans Docket” for military members and veterans in minor legal trouble. Retired Army Reserve Brigadier General and Okaloosa County Judge T. Patt Maney advocated for the idea.

“We need to look at what the real problems are for the service members and the veterans and their families and to address those problems,” Maney said in an interview with WUSF. “And if they’re legal problems, we need to create a structure that will protect the public, save the public money and do justice to the veterans their families and the service members.”

Maney understands those veterans’ problems first-hand. His vehicle was blown up by improvised bomb when he was serving in Afghanistan in 2005. He spent almost two years in Walter Reed Army Medical Center in Washington D.C. recovering from injuries including traumatic brain injury or TBI.

In an interview with Bobbie O’Brien, Judge Maney shares what it’s like living with TBI symptoms where you struggle to accomplish even the simplest task like using a self-service gasoline pump or remembering a word.

JUDGE T. PATT MANEY: Literally, you’d get three or four or five words out and then have a 15 or 20 second pause while you tried to think of the next word. Those pregnant pauses make it hard for people who are listening also to keep track of the conversation. But, it’s very frustrating for the person who is speaking

BOBBIE O’BRIEN: At that point were you thinking I’ll never be able to sit on the bench again?

MANEY: Well, the Army had already told me they were going to medically retire me and I was convinced at that point I was not going to be able to go back on the bench because I did not at that point have the capacity to do the job.

People want judges not only who are fair but judges who listen, who remember and then apply law to the facts they’ve heard in evidence and I couldn’t do that.

O’BRIEN: That had to have been a terrifying time for you?

MANEY: But it all turned out very well and because of that experience. I am fortunate enough to judge in community that has a large number of veterans and a large number of active duty people. We’re the home of Eglin Air Force Base. And so, I started noticing in court defendants coming through that demonstrated in court some of the symptoms that I had lived. And so I started paying more attention to them and asking them if they were veterans and asking them if they had deployed and asking them if they had been blown up. Continue reading

Concussions: Why Woodpeckers Don’t Get Them

Microscopic scan of a woodpecker's cranial bone. Courtesy of Science Life.

Humans could learn a thing or two about preventing traumatic brain injury (TBI) from woodpeckers according to an article in Live Science. Concussions and TBI have become a common injury for combat veterans.

Researchers in Beihang University in Beijing and the Wuhan University of Technology found that a woodpeckers beak pounds into wood at the force of 1,000 that of gravity. But, a thick boned skull, strong neck muscles diffuse the force and a third eye-lid keeps the eye from popping out.

Scientists are studying the sponge-like structure of the skull bone to find to find further ways to prevent serious brain injury and concussions by designing better headgear.

Microscopic photos of the bones and beak are part of the article in Live Science:

The findings could be important for preventing brain injuries in humans. Each year, more than 1 million people in the United States alone sustain and survive a traumatic brain injury, according to the Centers for Disease Control and Prevention. Another 50,000 people die of their injuries.

TBI Research: Nanoscientists Developing Detection Tool

Photo courtesy of UNCG.

A nanoscience assistant professor at University of North Carolina Greensboro, Marinella Sandros, is working with a team to develop a device that will measure blood proteins to detect moderate TBI, traumatic brain injury.

Sandros wrote an opinion piece detailing the journey of discovery and teamwork for the News & Record online:

Currently, there are no medical tools available to objectively diagnose mild traumatic brain injuries. Only subjective testing is available. For severe to moderate TBI, a physician can detect morphological changes in the brain using an MRI or CT-scan, but for an mTBI there are often no changes that can be detected using these devices.

Therefore, these medical diagnostic tools are not reliable. With the help of the device we are making, we can look at the chemical changes that occur in the brain. If the blood-brain barrier, or the cells that separate circulating blood from the brain membrane, is breached following an mTBI, specific proteins are released into the central nervous system and then into our bloodstream. This device will be able to monitor these proteins.

You can read Marinella Sandros‘ full opinion article HERE.

More information on TBI research, detection and treatment is available through the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

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