Army Ranger Cory Remsburg Returns to Haley VA

 Dr. Steven Scott, director of the Polytrauma Center at James A. Haley VA Hospital, talks with his former patient, Army Ranger Cory Remsburg. Bobbie O'Brien WUSF Public Media


Dr. Steven Scott, director of the Polytrauma Center at James A. Haley VA Hospital, talks with his former patient, Army Ranger Cory Remsburg.
Bobbie O’Brien WUSF Public Media

Army Ranger Cory Remsburg returns each year to James A. Haley VA Hospital in Tampa to show the staff his progress. He was severely injured in 2009 and spent two years recovering at Haley’s Polytrauma Center.

Remsburg was on his tenth deployment when he was injured by an IED in Afghanistan. His teammates found him face down in a water-filled canal with shrapnel in his brain.

He was in a coma when he arrived at the Haley.

More than 800 patients have come through the polytrauma system according to Haley Chief of Staff Dr. Edward Cutolo, but he remembers Remsburg.

“He’s not a hard one to forget. He was very ill when he came here, very ill,” Cutolo said.

And Remsburg has not forgotten them, the therapists, nurses and doctors.

He returned this year with one goal in mind, to walk, unassisted to Dr. Steven Scott, director of the Haley Polytrauma Center.

Trailed closely by his stepmother, Annie Remsburg, Cory Remsburg successfully navigated about a 10-foot stretch, unaided, and was greeted with a handshake from Dr. Scott and applause from onlookers.

“One of the things that’s so interesting about Cory’s story is he was told by so many, so many people said he couldn’t do things. ‘You’re not going to walk, you’re not going to do this. You know what I mean,’” Scott said. “So, Cory always said, ‘Yes, I’m going to, yes I can.’”

Cory Remsburg responds slowly, “Being a Ranger, I had the mental part down. It’s the physical part I’m learning to overcome.”

His speech is labored because he had to learn to speak all over again. That’s just one of many things he’s had to overcome: dozens of surgeries, blindness in his right eye, a partially paralyzed left side.

He was in a coma more than three months. The treatments and people at Haley brought him back.

U.S. Rep. Gus Bilirakis (FL-R), on the left, made a special trip to meet Army Ranger Cory Remsburg (right) and his father, Craig Remsburg (center) when they visited the medical staff at Haley.

U.S. Rep. Gus Bilirakis (FL-R), on the left, made a special trip to meet Army Ranger Cory Remsburg (right) and his father, Craig Remsburg (center) when they visited the medical staff at Haley.

Craig Remsburg, credits a combination of ‘the man above’, Haley’s Emerging Consciousness Program, family and familiarity for bringing his son back.

“We knew that he loved vanilla extract, so we would burn that aroma. We would play Scrubs, he loved Scrubs. So, we had that playing always on a reel,” Craig Remsburg said.

There was no great awakening like in a movie. Instead, it was gradual and took a lot of hard work every day for two years.

As soon as Cory could eat solid food, Dr. Scott would sneak him two Boston Cream doughnuts each morning as incentive.  And even though Cory now lives in Arizona – Dr. Scott is still motivating his prized patient.

He asked Cory for his goals which are to walk independently for a sustainable distance and then run.

“That’s what I hoped you would say. I’ll give you a third,” Dr. Scott said. “Run up hill. Alright? The reason why you run uphill is because the view is better.”

At that suggestion, Cory smiled, held up his large cup of coffee as a toast affirming his new goals and said, “He knows me.”

You can listen to the story which is part of he WUSF Veterans Coming Home project on WUSF 89.7 FM.

Dr. Steven Scott (left) shows off the Haley Trauma Center's treadmill pool to former patient Cory Remsburg (center) and his dad, Craig Remsburg.

Dr. Steven Scott (left) shows off the Haley Trauma Center’s treadmill pool to former patient Cory Remsburg (center) and his dad, Craig Remsburg.

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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 .

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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