I came across an interesting website dedicated to ‘Preventing, treating and living with brain injury’. I have to say i am very impressed with the content on there.

I spotted a starting page with a FAQ and i will report on some of the things I’ve read there.

The article responds a wealth of questions and i will just pick on some of the most important to me

1. What is a Traumatic brain injury and what is TBI versus ABI?
Traumatic brain injury or TBI happens when you experience any forceful contact to your head, and it disrupts your brain’s natural functions.Your brain can be injured by other conditions, like infections or strokes, but those kinds of injuries are called “acquired brain injuries,” or ABIs. They can be just as life altering as a TBI.

TBIs can be either mild, moderate, or severe. Most TBIs are mild and a lot of the mild TBIs sufferers find that their symptoms get better over time. In the most serious cases of TBI, the effects of the damage can last a lifetime.

2. How many people have TBI?
The website states that almost 1.6 million Americans sustain a TBI each year.More than 50,000 people die as a result of the TBI every year, and some 125,000 are permanently disabled as a result of the injury.

3. What causes TBI?
The leading causes of TBI are:
Falls (28%); Motor vehicle/traffic crashes (20%); Other events, like industrial accidents or sports-related injuries (19%); Assaults (11%).

4. Who is at highest risk for TBI?
Males are approximately 1.5 times as likely as females to sustain a TBI.The two age groups at highest risk for TBI are 0 to 4 year olds and 15 to 19 year olds.

5. How does a TBI affect the brain and body?
When a TBI occurs, anything having to do with your brain is potentially affected. That means your basic body functions, like eating and sleeping, can be altered. It also means that the complex parts of your life — your emotions, your thoughts, and your ability to communicate — can also be disrupted.

I read an article published in the New York times and published yesterday. In the article a doctor named Colin Fernandes tells of the inadequacy of drugs offered to treat some diseases notably trauma and back pain.

As an example, the author describe the case of young veterans, frequently in their 20s, coming back from combat. They mostly have chronic pain and traumatic brain injury, untreated post-traumatic stress disorder, and sleep and mood disorders.

The challenge he faces if to find a balance between pain relief and side effects; For example the only treatment available for these problems is giving opioid painkillers (Percocet or Vicodin). But these drugs affect mood and sleep and he finds himself in the unenviable position of limiting access to pain medications if their use will lead to functional decline.

He he is sobered by the fact that the only study of efficacy of these drugs is a 16 weeks test where in practice the use of these drugs are often maintained on opioids for years or decades.

Colin Fernandes also note that trials suggest that on average, patients given opioids experience an improvement of only 2 to 3 points on a pain scale of 0 to 10 [=not much compared to the side effects]. Side effects and risks are many: chronic constipation, sedation and somnolence, a worsening of mood, opioid-induced hyperalgesia (a paradoxical phenomenon in which pain medications actually increase pain), hypogonadism (impaired endocrine function) and addiction [sic]. Recent studies also suggest an adverse effect on immune function.

Colin concludes that the guiding principle learned in medical school “First do no harm” is easy to understand but as a doctor saying to your patient “There is nothing more I can offer you” is very hard.

Feel free to tell me of your experiences in comments below..