Wisconsin native works to understand concussions   (copy)

In this Dec. 14, 2011 photo, Ann McKee professor of Neurology and Pathology of Boston University School of Medicine and co-director of the Center for the Study of Traumatic Encephalopathy, inspects a brain in the Veterans Affairs Medical Center in Bedford, Mass. 

These days when we hear “concussion” or “traumatic brain injury” we tend to think first of football, but a recently completed study in the Fox Valley illustrates a more troubling, and less known, aspect of the brain injury epidemic.

In 2014 a group of volunteers representing over a dozen health care and social service organizations in the Appleton area came together around the idea that TBI could be a significant issue among local homeless populations and those living in domestic violence situations. After planning for much of 2015 and 2016, the group conducted a study between September and December of last year. The results were eye opening.

Using a TBI identification process designed by Ohio State University, volunteers from five nonprofit organizations assisting Fox Valley homeless and domestic violence populations performed TBI assessments on 179 individuals utilizing their programs. The assessment identified an individual’s history of head injuries, including the frequency and source of the injuries and whether the injury led to a loss of consciousness. In total, 96 women and 83 men were assessed with ages ranging for 18 to 70. The data collected was turned over to experts from the University of Wisconsin–Oshkosh for analysis and tabulation.

Among the study’s findings was 87 percent of those assessed reported experiencing a head injury. Among those people, 86 percent reported feeling dazed or having memory gaps as a result of the injury and 52 percent reported the injury left them unconscious for a period of time. Forty percent reported they had received more than one head injury. The sources of the head injuries varied, but included assaults, auto accidents and being in the proximity of an explosion.

To those of us who work in the field of TBI these numbers are not surprising. In fact, many of us wonder why it took so long to connect the dots between TBI and many unfortunate life situations.

Think of the heart-wrenching stories from the sports pages about “punch drunk” boxers or retired football players who are debilitated from repeated blows to the head. Now think of a woman who is being physically abused at home several times each week. Doesn’t it make sense such a woman might have a similar, if not worse, brain injury?

According to the Centers for Disease Control, among the many symptoms of a traumatic brain injury are memory lapses, impaired cognitive functions, headaches, extreme fatigue, depression and anxiety. TBI has also been shown to affect people’s earnings potential and living situation. Approximately 60 percent of persons with TBI ages 16 to 60 who were discharged from inpatient rehabilitation between 2001 and 2010 were unemployed two years post-injury.

Knowing this information, it stands to reason a person with TBI might lack income and wind up homeless, or that a person who sustained a TBI via domestic abuse might become dependent on the abuser.

So why has it taken so long to make these connections? One reason is people with TBI often appear “normal” on the outside and go undiagnosed. The damage is on the inside, and unfortunately in the part of the body that controls every thought, movement and emotion. We expect those who look “normal” to fit seamlessly into society, but the chaos in their brains makes a traditionally “normal” life difficult.

For the Fox Valley social service workers, adding TBI awareness to their toolbox has the potential to create better service delivery to those seeking help. For example, by accounting for TBI-related memory issues they can develop better strategies for ensuring clients remember and attend scheduled appointments. Similarly, making adaptations for TBI-related anxiety or sensitivity to light and sound can make interviews and meetings more successful. The possibilities are endless.

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The Appleton study is the latest example of how TBI may be affecting some of our more troubled citizens. Recent studies in Pennsylvania and Canada have connected TBI with recidivism among prison inmates. Earlier in May the National Institute of Health reported soldiers experiencing concussions from blast injuries in Iraq and Afghanistan continue to experience mental health symptoms and lower quality of life more than five years after the concussive incident.

It is important to remember most bumps on the head won’t send your life into a downward spiral, but it is always better to be safe than sorry. As the Appleton study illustrates and as we at the Brain Injury Alliance of Wisconsin know too well, for the unlucky minority an untreated TBI can have devastating results. So if you hit you head and see stars, regardless of how it happened or how long ago, see a doctor. You only have one brain, and it needs to work well for your entire life.

Karl Curtis is executive director of the Brain Injury Alliance of Wisconsin, which is housed in Madison. The Brain Injury Alliance of Wisconsin is a nonprofit organization serving the state’s brain injury community since 1980. Its mission is the prevention of brain injury and the full participation in life for individuals with brain injury. 

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