Signs & Symptoms of a Mild Traumatic Brain Injury

It is important to be on the lookout for signs and symptoms of mTBI. If you recognize such an injury to yourself or to anyone you care about, speak up.

 
Screen-Shot-2015-11-10-at-17.06.38Pain & Physical Sensation

  • Headache or “pressure” in head
  • Loses consciousness (even briefly)
  • Balance problems or dizziness
  • Nausea or vomiting
  • Numbness or tingling

 

Screen-Shot-2015-11-10-at-17.06.49Problems With Memory & Cognition

  • Appears dazed or stunned; answers questions slowly
  • Can’t recall events after hit, bump, or fall
  • Confusion about what has happened
  • Difficulty thinking clearly, concentrating, or remembering

 
 

Screen-Shot-2015-11-10-at-17.07.13Vision & Sleep Disturbances

  • Blurry or double vision
  • Sensitivity to light and/or noise
  • Drowsiness or fatigue
  • Difficulty falling asleep
  • Sleeping more or less than usual

 

Screen-Shot-2015-11-10-at-17.07.23Changes In Personality

  • Behavior or personality changes
  • Does not “feel right”
  • Feeling slowed down, sluggish, hazy, groggy, or foggy
  • More irritable, sad, nervous, or emotional than usual

 
 

The Myth

Headgear protects the brain from concussions. (It doesn’t.)

The Truth

The real damage is dealt through rotational forces that cause the brain to shear. Brain shearing is stretching what shouldn’t be stretched: brain tissue slides against brain tissue—pulling the axons particularly where white and grey matter meet.

What Is A Concussion?

what-is-a-concussion

Often brushed off as “seeing stars,” mild traumatic brain injury (also called a concussion) is a subset of traumatic brain injury that occurs when an external force alters brain function. The brain, suspended in cerebrospinal fluid, reacts to the sudden motion of the trauma. Despite the inherent resiliency in the human brain, the differential movement of brain matter causes it to bounce, twist and hit the inside of the skull.

A mild traumatic brain injury, also called a concussion, occurs when an external force alters brain function.

This leaves contusions (bruises) on the brain that produce immediate physical, cognitive and emotional symptoms such as headache, nausea, balance problems, emotional imbalance, short-term memory loss, sleep disturbances and irritability. The current understanding of mTBI involves a shift in focus from anatomical damage to a more complex neuronal dysfunction involving a cascade of ionic, metabolic and physiologic events. Brain injuries not only produce a structural change but also a chemical one, fundamentally altering our very perception of the world.

Every Concussion Is Different

Every concussion is different depending on the individual brain, the environment, the genetics, and a host of variables including where in the brain the injury occurred. The pattern of injury within the brain is significantly different depending on how the injuring force was applied to the brain. It frequently takes 2-3 weeks to recover from a concussion, although it varies from person to person. It wouldn’t be abnormal for someone to take a month or longer to recover. The most important symptoms to be aware of are behavioral: personality changes due to brain injury are the most traumatic and disruptive.

Concussions or mTBI happen most frequently during sports and recreation, motor vehicle and bicycle accents, assaults, and falls. Whether on the sports field or at home, traumatic brain injuries happen often, unexpectedly and pose risks underestimated by the general population. The injury leads to permanent or temporary impairment of cognitive, physical and psychosocial functions with an associated diminished state of consciousness. The injury is one of the leading causes of death and disability in the United States.

An Issue Nearing Epidemic Proportions

Mild traumatic brain injury is attracting greater awareness due to a national concussion crisis and the shocking dearth of knowledge regarding concussion management (particularly in schools). Speaking at the White House Concussion Summit, President Obama emphasized, “The awareness is improved today, but not by much. So the total number of young people who are impacted by this early on is probably bigger than we know.”

iStock_000005653851_LargeCongress, the White House and the CDC all agree mild traumatic brain injury is an issue nearing “epidemic” proportions. The indirect and direct cost of mTBI is estimated by the National Conference of State Legislatures to be $70 billion dollars, in addition to the emotional toll on family and friends.

Although CT scans, MRIs and PET scans can image structural abnormalities from brain injury or skull fractures, problems from concussions are based in neurometabolic damages. Scientists are researching objective diagnostic markers that could be used to diagnose concussions. Currently, the symptoms generally must be self diagnosed—the responsibility frequently falls on the individual to report symptoms rather than determined through objective diagnostic markers. When concussions occur during a sporting event, physical trainers and coaches must make high-risk judgments about whether or not to send players back into the game. As more information about the hazards emerges, it becomes clear that it is better to err on the side of caution.

39 People Die in Hawai‘i from Asbestos Every Year

Asbestos Nation, part of the Environmental Working Group’s Action Fund, has found that 589 people died in Hawai‘i due to asbestos-related illnesses between the years of 1999-2013, an average rate of 39 deaths annually, in a study of asbestos deaths in all fifty states.

These figures include estimates of the number of deaths from lung cancer caused by asbestos exposure. Analysis in a study published in 2012 by scientists at the International Agency for Research on Cancer, part of the United Nations’ World Heath Organization, suggests that there are 3.2 to 4 lung cancer deaths in the U.S. for every mesothelioma death among individuals exposed to asbestos. More information about the EWG statistical methods are available here.

asbestos-related-deaths-in-hawaii Source: AsbestosNation.com / Environmental Working Group Action Fund

The widespread belief that asbestos is a problem of the past is a dangerous myth, and common misconceptions about asbestos today are no accident. Corporate interests spend millions upon millions of dollars to manufacture junk science and disinformation campaigns that claim asbestos does no harm. It is part of a strategy to sway courts in their favor, against victims whose lethal asbestos exposure came from their products.

A recent exposé by The Center for Public Integrity found that Ford has recently spent $40 million to reshape asbestos science “to change the narrative on the risks of asbestos brakes.” Ford is one of many auto manufacturers that had knowledge of the life-threatening dangers of using asbestos in brakes, many years before switching to metal and carbon materials. In Ford’s case, their own unpublished study in 1968 indicated the potential harm, yet they did not phase asbestos out completely from their brakes until the mid-1990s.

With so much investment in covering up the truth, it’s clear that asbestos still causes great harm—and that it is still a major liability for companies that put their workers in harm’s way.

Ford’s fabrications are merely the tip of the iceberg. For more, please read our article about how the Asbestos Industry Suppressed and Altered Medical Research, and tune in to our podcasts on Asbestos & Your Health w/ Cynthia Davis and the criminal way Traveler’s Insurance denied ever selling asbestos products in Hawai‘i.

The Gary Galiher Law Hour — Episode 12: The Emerging Science of Youth Sports w/ Cora Speck

Sports-related brain injuries threaten the lives of millions of people in the US today. Parents of student athletes must be especially aware of the risks involved when their kids play contact sports.

The research into this category of injury continues day by day. Now, we are seeing it’s not just concussions: it’s a whole spectrum underneath.

The very same physiological mechanisms that help the brain heal from concussions are unfolding at sub-concussive levels, too. As Gary says, “If a concussion takes 60, or 80 or 100 Gs to lose consciousness, the brain, when it receives contact of 25 or fewer Gs typical of a hit… to repair itself, there’s a cascade of chemicals get released, and it tries to take itself offline, and becomes very delicate for a period of time.”

Our guest today is Cora Speck, Trauma Injury Prevention Outreach Coordinator at the Queen’s Medical Center in Honolulu, Hawai‘i. Among many job duties, she researches innovations that help prevent sports injuries.

Science supports the idea that athletes who sustain injuries on this spectrum will need time before they return to play, but the proverbial jury is still deliberating on how long might be needed. If we are serious about establishing how to keep our athletes from more harm when they return to play, Cora says, “we should be advocating for the Nat’l Institute of Health and Center for Disease Control, probably the Department of Defense as well, to be putting more attention and money into research like this.”

Further research is need, says Cora, for us to know at what age it might be safe for a person to know “at what point is there any sort of structural or chemical changes that could be detected, that could indicate to a family that this is the cutoff point, that if you proceed to choose to proceed, that you are putting your child’s full adult life in jeopardy.”

Concussions can happen even without any contact to the head: blows to the body can cause them, too. Another looming question is what age is appropriate for kids to play contact sports such as football.

We’re learning more every day, and in the podcast we offer lots more valuable discussion on this very big subject. Tune in!

Fight Against Forced Arbitration Heats Up at the Capitol

Whether it’s to get a student loan, get hired, or place an elderly loved one in a care home, people often have no choice but to sign contracts with forced arbitration clauses that make sure a day in court never comes. Instead of court, disputes are settled in arbitration, and the arbitrators often consider the corporations to be their clients.

Today at the Capitol, a diverse group of representatives took to the House Floor to discuss forced arbitration and the harm it does to individuals across the country. For a full hour on the Floor—a rare level of focus for a single topic in this venue—the group discussed common abuses of arbitration law, pending legislation, increased public awareness, and a number of federal regulations aimed at curtailing forced arbitration.

According to Representative Hank Johnson of Georgia, a member of the House Judiciary Committee and the leader of the session, “buried in the fine print of everything from consumer contracts and employee handbooks to nursing home agreements, forced arbitration clauses insulate corporations from accountability by eliminating access to the courts for untold consumers and workers.”

Mr. Johnson introduced a bill this week to prevent civil rights cases from being subjected to mandatory arbitration. The bill includes discrimination cases. Women trying to fight gender discrimination at the workplace would benefit especially from the legislation’s passage, said Mr. Johnson, because arbitration clauses are devastating to their cause.

We at the firm hope this will be the beginning of the end for forced arbitration. If you agree, please show your support and sign this petition to Stop Nursing Homes from Using Forced Arbitration to Deny Residents’ Rights.

The Gary Galiher Law Hour — Episode 11: Making Sports Safer for Kids w/ Sam Lee

We all know what can happen from a single, huge traumatic event like a car crash, or getting your bell rung at a football game, where you have a more life-threatening injury. Less obvious, though, is what goes on throughout a multi-year span of activities by an athlete: they have a cumulative effect that can be as bad as a single, major trauma.

Athletes of all ages who play contact sports take sub-concussive injuries in their day-to-day play. “What’s really happening in the brain when they’re children, especially young children, in these sub-concussive injuries, is the same cascade of chemicals, the same repair mechanisms happen that happen during concussions—it’s just that they’re happening a lot more frequently,” said Gary Galiher, our founding partner.

Researchers in the field of neurotrauma are very aware of this, but we want to see people everywhere begin to understand that many of the sports our children play could have serious negative effects on their cognitive abilities down the road.

Our firm is all for sports—including football—but when children as young as seven or eight years old are playing full-contact and sustaining head injuries, we know that something is wrong. It’s necessary to change how our children are playing, the conversation about how to make these changes needs to begin right away, and it cannot be informed just by what the NFL wants us to know.

We are moving that conversation forward with today’s guest, Sam Lee, an award-winning (and very charismatic!) athletic trainer at Hawai‘i Baptist Academy in Honolulu. He was the recipient of the 2015 District 8 Gatorade Secondary School Athletic Trainer Award, for establishing a concussion management program at his school, as well as helping the Hawai‘i athletic association develop comprehensive heat acclimatization and practice schedule guidelines.

Our talk with Coach Lee covers the vital angles of the issues mentioned here, from the state of things today to the future of student athletics. Tune in and find out why Hawai‘i is a progressive state in the nationwide battle to make sports safer for young people.

Beware of Tax Scams Targeting Kupuna

With this year’s filing deadlines fast approaching, now is an important time to beware of tax scams.

On Saturday, Senator Mazie Hirono, along with spokespeople from the IRS and AARP, spoke at a caregiving conference at the Japanese Cultural Center of Hawai‘i to warn seniors about tax scams, and phone scams in particular.

“Well, we know trusting vulnerable seniors are particular targets for scam artists… Scam artists and predators are clever in their attempts to swindle taxpayers out of their refunds. Kupuna and their families need to remain vigilant and protect themselves as we approach the tax filing deadline,” said Sen. Hirono.

If there are any issues with your taxes, she explained, you should expect first to receive a letter or in-person visit from the IRS. If you do get a phone call from someone claiming to be from the IRS, hang up even if it looks like an IRS number on your caller ID—the numbers can be spoofed.

Here are two helpful online resources:

IRS Special Agent in Charge Teri Alexander called tax scams “epidemic in proportion right now… increasing every day.” The AARP Hawai‘i’s state director said that over “6,000 seniors have reported being defrauded and the average amount of loss is about $2,555.”

Photo c/o Edward Kimmel, “Hawai‘i Sen. Mazie Hirono”, (c) CC BY-SA 2.0