The Gary Galiher Law Hour: Episode 16 w/ Coach Vince Goo! (part 2)

This is part two of a program about sports and concussions featuring Vince Goo, former head coach of the University of Hawai‘i Wahine basketball team.

When the news broke about the discovery of chronic traumatic encephalopathy—the degenerative brain disease that haunts NFL players—our founding partner, Gary Galiher, realized very soon that this is a much bigger issue than just the NFL’s. Gary’s background in psychology and special education led him to deduce that children’s developing brains could be affected to degrees varying with the amount of contact in their sport. Since then, the science of concussions has developed and that insight has been validated.

A concussion is pretty hard to ignore when a kid gets knocked out, but there are all kinds of things that happen in-between. We’re talking not just about the National Football League, here, but about kids who play in grade school, taking damage they carry with them for the rest of their lives.

Coach Goo has coached a variety of sports at many different levels. While he was not allowed to play full-contact football as a boy, as a father he did allow his sons to play. At the time, the revelations about brain injuries in football had not yet come to light, so the risks were unknown. Today, he sees things differently. “Knowing what I know now, I probably would’ve been in the same thought process as my dad, not letting my sons play,” he said. “My grandsons, I hope they never play the game.”

The coach agrees with Mike that “there haven’t been enough precautions, enough checks and balances so that you can take a kid out [of play] when he gets hurt.” We’re getting there education-wise, and trainers are putting the priority on the health and welfare of the student-athletes, said the coach.

Tune in to hear about plans to make sports safer, and how we can get leadership involved to make the right decisions for Hawai‘i.

The Gary Galiher Law Hour: Episode 16 w/ Coach Vince Goo!

We are proud to present part one our two-part episode with the University of Hawai‘i’s Wahine Basketball team’s legendary head coach, Vince Goo.

During his tenure in that role, the Wahine won 334 games, gained 10 post-season bids, and earned the most wins by any basketball coach in school history. Coach Goo has also had the distinction of coaching the team with the highest graduation rate among any collegiate women’s basketball team in the US, and every player who finished her playing eligibility on one of his squads at UH earned a degree.

In a wide-ranging conversation, Coach Goo joins our hosts Gary Galiher and Mike Buck to discuss the vital subject of concussions in sports.

“Risking the health and welfare of a player is not worth one more victory,” says the coach. He had to be vigilant about these concerns due to the surprisingly high rate of concussion in women’s basketball.

Coach Goo exemplifies the best approach to athletic safety: “I had our team doctor and our trainer make all the calls when it came to the health and safety of our players, and I would not second-guess them: they say they play or they don’t play. At the same time, I say you do your job, don’t tell me what offense and what defense to play. (Laughs.) You do your job, I do my job.”

The coach has certainly noticed the changes in the understanding of concussion issues. “Growing up playing basketball, whether in a league or at the playground, if you fell and your head hit the floor, okay, then you start to worry. Other than that, you’re not going to have a concussion. But little did we know that a forearm or an elbow can cause all of those things.”

Yet, he recognizes that the understanding has a ways to go: “When we look at football [now], the big hits with the head: we see concussion. But what about all those little contacts that you’ve had along the way,” wonders Coach Goo.

Only in the last few years has it become apparent that in football, full-blown concussions are just the tip of the iceberg. The helmet itself enabled a false sense of the security that the brain would be protected, when it did anything but that.

If you look at the small print the manufacturer puts on the helmets, it tells you this will only prevent skull fracture. With respect to concussion, it won’t protect you. When it comes to chronic traumatic encephalopathy, which comes from the repeated blows to the head, it masks that and doesn’t help that at all.

The science is showing us—and science should be our guide—that if you take the helmets off, concussions go down. It’s counterintuitive, but that’s the fact.

“I’m looking forward to that day we have more money, and hopefully HCAMP’s research at UH can go forward,” says Gary. “We’d like to see it get more sophisticated, from the standpoint they’ve done wonders keeping kids out of play after concussions, before they can come back in.”

“There’s no simple-simon answer to this,” he continued. “We’ve just got to be honest about the research that’s out there, and we get more feedback and feel our way along intelligently so we’re not just letting our kids play bloodsport out there.

“I mean, I’m a pretty liberal guy, I’d let people do what they want with their adult brains, as nuts as it might be. On the other hand, when it comes to our kids, we have a higher duty than that. When your whole brain, your sense of self, your life, your way to find success is in-between your ears, and we’re kicking around for bloodsport, I don’t think so. The parents can really see that, yeah, it’s going to take a little fun out of the sport, but what a compromise! Pop Warner, everybody wants to see it, but the kids shouldn’t be playing with helmets. If a kid gets injured with a helmet, I’d go after the helmet company.”

Tune in for a lively talk with one of Hawai‘i’s most respected and important figures in sports.

Keep the Money Follows the Person Program Alive!

savethemfp

The Money Follows the Person Grant program has helped more than 50,000 people move out of assisted living and nursing home institutions, back into their communities of choice. The program gives people the right to decide where they live and receive home and community services and supports.

Nearly half of the people who gained this new freedom were seniors. The rest were struggling with physical or developmental/intellectual disabilities, or mental illnesses—people most in need of the kind of support the MFP program provides.

Moving out of institutional care not only gives participants a renewed sense of independence and belonging: it saves the state and federal government (and, therefore, the taxpayer) money, because providing services costs less in the community and outside of dedicated care facilities.

That’s why we all win with the MFP program, and why it has broad bi-partisan support. Yet, without action in Congress to renew, it will be discontinued at the end of September, 2016.

If you would like to help, click the banner above and tell your members of Congress to continue the MFP Program. It takes about a minute.

5 Hawai‘i Community Resources for Sports-Related Brain Injury

Community resources and advocacy groups like these help us make the world a safer place for our athletes.

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State of Hawai‘i Neurotrauma Supports
http://health.hawaii.gov/nt/

The State’s Neurotrauma Supports department develops, implements, and monitors a comprehensive system of statewide supports to address the needs of people with neurotrauma injury and their families.

 

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Brain Injury Association Hawai‘i
http://www.biausa.org/hawaii/

Brain Injury Association of Hawai‘i is a non-profit 501(C)3 agency dedicated to serving those affected by brain injury through advocacy, education, prevention, and support.

 

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Hawai‘i Concussion Awareness Management Program
http://hawaiiconcussion.com

Hawai‘i Concussion Awareness and Management Program (HCAMP) is an organization intended to provide Hawai‘i’s physically active community and medical community with evidence based research education, support and resources to manage concussions.

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Hawai‘i Pacific Neuroscience
http://www.hawaiineuroscience.com

Hawai‘i’s first fully integrated multidisciplinary neuroscience specialists working in a patient centered care model. Hawai‘i Pacific Neuroscience employs the latest and most advanced diagnostic capabilities to solve and diagnose complex neurological conditions. HPN also leads the state in bringing neuroscience clinical trials to the islands so Hawai‘i patients do not have to travel to the mainland to seek advance treatments.

 

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League of Denial
http://tinyurl.com/leagueofdenial

OK, so this one isn’t local, but it’s too good not to share: It’s a portal to information Frontline’s ongoing investigation into CTE after the feature documentary and non-fiction book by Steve and Mark Fainaru. The League of Denial details the history of the NFL brain injury fraud and the scientists on either side of the story.

10 Resources for Persons with Disabilities

We’ve previously posted a roundup of Hawai‘i-based community resources on elder abuse, which can show you where to turn if you are concerned about the well-being of any older person or need to report a problem. In the spirit of that post, we are presenting a new collection of 10 free online resources, which run the gamut of health issues for older people.

We hope you’ll find them as useful and fascinating as we have. We’d also like to send a big thank you to Patricia Sarmiento from the Public Health Corps, who brought many of these resources to our attention.

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1. How to Cope with Sudden Illness or Disability
Disabled World

http://www.disabled-world.com/disability/coping-disability-illness.php

The whole world is upside down and you are in the middle of it believing life will never be the same again with you just being miserable fighting your illness or disability. You might lose your friends because you will no longer be able to socialize as you used to. This is also the time to find out who your real friends are.

 

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2. Top Tips for Getting Fit if You’re Disabled
DisabilityHorizons.com

http://disabilityhorizons.com/2014/11/top-tips-for-getting-fit-if-youre-disabled

Want to get fit but assume using a personal trainer would be out because of your disability? We talk to Dom Thorpe, a personal trainer specialising in helping people with all kinds of disabilities get fit. Read on to see how you can get fit too.

 

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3. Learn About the Different Types of Service Dogs
Anything’s Pawsable

http://www.anythingpawsable.com/types-of-service-dogs

Did you know there are over a dozen different specializations for Service Dogs? Have a look at this article if you’re curious what all these types of Service Dogs are, and what they do.

 

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4. Preparing for Disaster for People with Disabilities and other Special Needs [PDF]
The American Red Cross

http://www.redcross.org/images/MEDIA_CustomProductCatalog/m4240199_A4497.pdf

For the millions of Americans who have physical, medical, sensory or cognitive disabilities, emergencies present a real challenge. The same challenge also applies to the elderly and other special needs populations. Protecting yourself and your family when disaster strikes requires planning ahead. This booklet will help you get started.

 

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5. How to Stay Physically Active
Washington University Healthy Aging & Physical Disability Rehabilitation Research & Training Center

http://agerrtc.washington.edu/info/factsheets/exercise

Exercise is a proven way to improve the health, physical functioning and well-being of older adults who have disabilities. This article has more information about the myriad benefits to regular exercise, as well as helpful advice about how to come up with an exercise plan, get started, and keep up with exercise.

 

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6. Grants for Home Modification: 16 Resources for Homeowners with Disabilities
HomeAdvisor.com

http://www.homeadvisor.com/r/grants-for-home-modification

There are many grants available to disabled persons for home modifications to help better accommodate them. It’s heartening to see how many organizations are making it their mission to provide comfort and safety through these grants. Here is a collection of sixteen of those grants, with a good summary of background information about the American Disabilities and Fair Housing acts.

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7. The Ultimate Guide to Home Accommodations for Persons with Disabilities
Redfin.com

https://www.redfin.com/blog/2016/04/the-ultimate-guide-to-home-accommodations-for-persons-with-disabilities.html

Nearly 57 people in the US live with a disability. Ensuring the places they live provides support and helps them lead happy lives should be a top priority. This guide covers every area of the home with recommendations for how to make the home a fulfilling place where people with disabilities can thrive.

 

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8. Depression and Disability: A Practical Guide [PDF]
The North Carolina Office on Disability & Health

http://fpg.unc.edu/sites/fpg.unc.edu/files/resources/other-resources/NCODH_Depression.pdf

Depression is a serious medical problem that is often misunderstood. Fortunately, effective treatments are available. As one of the most common “secondary conditions” among people with disabilities, recognizing depression and seeking treatment is very important. This free guidebook helps explain what depression is, why it occurs and how it can be treated.

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9. Disability Etiquette
United Spinal Association

http://www.unitedspinal.org/disability-etiquette

This booklet has tips to follow for anyone—with or without a disability—who wants to interact more effectively with people with disabilities.

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10. Violence against Persons with Disabilities
Western Regional Coalition to End Violence

http://www.wrcev.ca/get-the-facts/persons-with-disabilities

Disabled populations are especially likely to be victimized by physical violence, sexual violence, psychological or emotional abuse. Victims seldom report abuse or neglect. This article has information on the factors that make people susceptible to violence, how to recognize signs of abuse or neglect, and how to help someone victimized in these ways.

Adolescence & TBI

Does getting a concussion younger mean the brain heals quicker? Or is it worse for the long-term? In the case of repetitive concussions, how many is too many?

Some argue that youth concussions cause no long-term damage if they are allowed to completely heal. A study published by the Official Journal of the American Academy of Neurology examined 42 former NFL brains between the ages of 40-69 from Diagnosing and Evaluating Traumatic Encephalopathy using Clinical Tests (DETECT) study.

The brains were divided in half based on the date of first exposure to football —two groups consisting of those who started playing football before and after age 12. The findings showed an association between participation in tackle football prior to age 12, greater later-life cognitive impairment measured using objective neuropsychological tests. The test group was small but shows the need to explore the safety recommendations for youth sports. Further studies require a larger sample size and longitudinal designs.

The developmental effects of brain injury on young brains are difficult to study – there are many factors that make it complex to see clear results. This is due to concussions setting off a series of chemical dysfunctions, and chronic cell death. Gaining further knowledge of the neurobiology of concussions and the cellular process will help us see the early clinical symptoms in a new light.

Data concerning the incidence of sports-related concussions in youth will also help understand the scope of the problem. Although the amount of reported concussions has risen, this could be because of better awareness leading to greater recognition of the injury. The Center for Disease Control is setting up a nationwide surveillance system to more accurately determines sports-related concussion in youth ages 5-21. This is part of a $257 million project proposed for the 2016 President’s Budget Request for CDC’s Injury Prevention and Control.

Because there are between 30 million to 45 million youths participating in sports , understanding the impact of concussions on younger brains is becoming a pressing area of research and awareness. In a poll conducted by HBO Real Sports and Marist College, 14% of U.S. adults have heard nothing about football and long-term brain injury though nearly 7 in 10 talk about the sport and follow it closely. More research around the topic of sports-related concussions will hopefully lead to positive changes to the game and improved safety guidelines.

Gender & TBI

Gender & TBI

Scientists are researching the differences between male and female brains. Data shows surprising differences in how they receive and respond to injury.

If there were two brains on a medical table, it would be easy to mistake a woman’s brain for a man’s. Although similarly built, subtle differences in processing, chemistry, structure, and cultural conditions make mTBI experiences unique for each gender. Studies focused on risk factors for sports-related concussions use reported mTBI incidents in youth and high school sports to analyze patterns. Yet a review of existing studies still demonstrates there is a need for larger sample sizes, finer metrics for risk exposure and prospective cohort studies.

In sports such as American football or high school lacrosse, males were found to be at greater risk when compared to female athletes, particularly at the junior high level. This does not necessarily mean males suffer more brain injuries in sports—female athletes were at greater injury risk in basketball and soccer, with risk increasing during high school. There is also a bias to consider, as culturally men play sports with more physical contact.

In sports with similar rules, female athletes sustain more concussions than male counterparts. Additionally, female athletes generally report a higher number and severity of symptoms as well as a longer duration of recovery than male athletes.

Female soccer players are 1.5 to 2.5 times more likely to receive a mTBI as compared to males, while female basketball players have a 1.5 to 3 times more likelihood. While playing soccer, females were found to increase head acceleration during impacts compared to males, showing decreased neck strength and effective head mass.

One reason female populations show a higher rate of concussions and symptoms could be because girls and women are more likely to self-report their concussions when they’re injured and follow up. Regardless, studies show both male and female populations tend not to report concussions when they occur in sports.

Hawai‘i Elder Abuse Community Resources

Community Resources and advocacy groups are helping us make the world a safer place for our athletes.

State of Hawai‘i Neurotrauma Support

http://health.hawaii.gov/nt/

Neurotrauma Support develops, implements, and monitors a comprehensive system of statewide supports to address the needs of people with neurotrauma injury and their families.

Brain Injury Association Hawai‘i

http://www.biausa.org/hawaii/

Brain Injury Association of Hawaiʽi is a non-profit 501(C)3 agency dedicated to serving those affected by brain injury through advocacy, education, prevention, and support.

Hawai‘i Concussion Awareness Management Program

http://hawaiiconcussion.com

Hawaiʽi Concussion Awareness and Management Program (HCAMP) is an organization intended to provide Hawai‘i’s physically active community and medical community with evidence based research education, support and resources to manage concussions.

Hawai‘i Pacific Neuroscience

http://www.hawaiineuroscience.com

Hawai‘i’s first fully integrated multidisciplinary neuroscience specialists working in a patient centered care model. Hawaiʽi Pacific Neuroscience employs the latest and most advanced diagnostic capabilities to solve and diagnose complex neurological conditions. HPN also leads the state in bringing neuroscience clinical trials to the islands so Hawaiʽi patients do not have to travel to the mainland to seek advance treatments.

League of Denial

http://tinyurl.com/leagueofdenial

A portal to information from the feature documentary and investigative non-fiction book by Steve and Mark Fainaru. The League of Denial details the history of the NFL brain injury fraud and the scientists on either side of the story.