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Victoria Tilney McDonough, BrainLine (page 2 of 2) Page 2 of 2
Dr. Flanagan: We definitely don’t know all the answers about Alzheimer’s disease, especially as it relates to brain injury. There is ongoing research on many fronts related to Alzheimer’s, but, to date, we don’t have any definitive answers. However, studies suggest that there is an association between genetics and developing the disease and between TBI and developing the disease. Again, there is an association with severe TBI, not a cause and effect. That is an important distinction.
It’s important to remember that most people in general do not get Alzheimer’s. The best thing to do is to stay focused on staying physically active, socializing with supportive friends and family, getting out and staying involved in the world, and keeping our minds sharp and engaged.
BrainLine: More and more studies are being conducted about contact sports and progressive brain injury. What is chronic traumatic encephalopathy, and what should we be doing to protect young athletes?
Dr. Flanagan: For years, we have known about a type of neurodegenerative disease that may affect amateur and professional boxers, known as dementia pugilistica. Symptoms and signs of dementia pugilistica can develop progressively over a long period of time. Chronic traumatic encephalopathy, or CTE, may be similar and may be seen in more and more athletes who play contact sports like football or ice hockey. How much can the brain take, after all? It makes sense that a football player who is hit time and time again and who suffers multiple concussions could develop some sort of neurological trauma. The research that is being done on CTE is important, but it needs to be followed up with more research.
I think the increased awareness about traumatic brain injury is very helpful as is the awareness that a person doesn’t have to lose consciousness to sustain a concussion. This awareness will help everyone — from young athletes and coaches to soldiers serving in Iraq and Afghanistan. Everyone, including healthcare professionals at all levels, needs to know that TBI is not necessarily a benign event and sometimes symptoms do not go away.
BrainLine: How long do you follow up with a patient after a brain injury?
Dr. Flanagan: For most of my patients, they remain my patients for life. I never discharge them. For those with moderate to severe TBI, once their active rehab or restorative therapy is over, I follow up with them approximately one to two times a year. When they are still in rehab, I am actively involved and check in with them about once a month or so.
For my patients with mild TBI — unless they make a full recovery and are symptom-free within the first three months post-injury — I also follow up with them once or twice a year.
I find it important to follow up once or twice a year with patients to make sure the therapy and/or medications are still appropriate for them. For example, a patient may no longer need the same amount of an anti-depressant or a sleep aide as his life settles back into a new normal. Or maybe a patient needs more physical therapy for balance or strength. Recovery is a life-long endeavor for many people with TBI, and we want to make sure they are getting the right care at every step along the way.
BrainLine: What type of long-term medical follow-up do you recommend for people with brain injury? Which specialists should they see, and how often?
Dr. Flanagan: When necessary, I refer my patients to specialists like endocrinologists, psychiatrists, or neurologists. I also make sure that all my patients have a primary care doctor to ensure that they are doing the “regular” health maintenance checks like cholesterol tests, pap smears, and colonoscopies.
BrainLine: Why is long-term follow up important for people with TBI?
Dr. Flanagan: In a nutshell, long-term follow up is important for people with TBI because they can be more susceptible to the effects of aging, like depression or physical and cognitive changes that naturally come with age.
BrainLine: Does having a brain injury put a person at greater risk for other health problems? Of dying at a younger age?
Dr. Flanagan: Depending on the severity of the injury and the associated long-term consequences, some people may be at risk for certain health problems. Certainly, if people are less physically active or emotionally unhealthy, they are more susceptible to age-related effects — from problems with balance to depression. The stronger people’s bodies, minds, and spirits are — whether they have a TBI or not — the more effectively they will postpone the effects of aging … and enjoy life.
Dr. Steven Flanagan is professor and chairman of the Department of Rehabilitation Medicine, New York University School of Medicine, and the medical director of the Rusk Institute of Rehabilitation Medicine, New York University Langone Medical Center. He has served on medical advisory boards of many national and international committees and has presented at scientific meetings both nationally and internationally, most notably on topics pertaining to brain injury rehabilitation.
BrainLine
Steven Flanagan, MD,
Dr. Flanagan is professor and chairman of the Department of Rehabilitation Medicine, New York University School of Medicine, and the medical director of the Rusk Institute of Rehabilitation Medicine, New York University Langone Medical Center.
He was formerly the vice chair of the Department of Rehabilitation Medicine, Mount Sinai School of Medicine and the medical director of the Brain Injury Rehabilitation Program.
Dr. Flanagan has served on medical advisory boards of many national and international committees and has presented at scientific meetings both nationally and internationally, most notably on topics pertaining to brain injury rehabilitation. He has authored numerous chapters and publications and has participated in both federally and industry sponsored research, funded by such organization as the National Institute on Aging.
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Comments [8]
My husband was 50 when he had his colloid cyst resection. He's now 52 and has cognitive deficits from permanent brain damage. He goes to a psychiatrist for mood and sleep disorders. It is trial and error with the medication and what does/doesn't work. I stumbled upon this article and found it to be most helpful and supportive. I have had people tell me to put him in an institution. I think these people are wrong. He has good quality of life in his home with me being in the community and having his friends and family around.
im 42 and my TBI happened at 16...i feel that the lack of awareness on my part; playing rugby in college (a few concussion), multiple car accident, drug n alcohol abuse; may have a more significant impact to my future than i imagined. Honestly speaking i never thought i'd still be alive today and never really managed to create a map for my life. Thanks to this article i am more aware of my situation for the future.
I had a severe TBI 22-years ago and find word finding problems getting worse and concentration. IT just made sense to me when I got hurt that the natural aging process and the confusion that goes along with getting older would come harder and sooner. I am 52 years old now, my physichiatrist prescribed valproic acid for me to help me cope with my 9-year old son and it has made a signifacant difference in my ability to think which lowers my frustration. This has made it possible for me to be the father I am trying to be. With out the research common sense tells us if we have the cognitive ability of a 60-year old at 30 becasue of a TBI. I remeber the first time I drove a car at he rahab hopital, I was as confused at the intersection just like my 60-year old father.
I came across this site seeking answers some kind of movement forward. I read this one gal being 53 and 17 months since her tbi occurrence, I was thinking how close in age we are and the same months have passed since this happening to us. I'm 54 and now its been also 17-months. The truth is the Doctors say 70% is a good comeback, well since I'm always in pursuit to ce day one I have said NO you see I want 110% :)
It has almost been 18 months since my major TBI. I have not been to a doctor for a year now. I keep looking for answers. I am healthy! I am 53 years old & stay happy running! I am also looking for answers. Please send me any tips to keep me getting better. What should I be doing?
similar to the 1st comment I too have had two incidents of brain injury - the 1st a car accident at 17 and the 2nd meningitis when I was 52. I am very fortunate in that I have a loving family and am gainfully employed. I too get frustrated now and then. I would be interested in talking to the person who wrote the 1st comment and had 2 incidents of TBI.
I found this article interesting in that my husband has suffered two headinjuries in his life, at 19 and then again at 39. He is now 61. We have had little support so it is interesting to read things from time to time. He is happy enough but I find things quite frustrating at times!!
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A family member is now 27 years post severe traumatic brain injury (incl. 72 hrs in coma, seizures, a second hospitalization, dilanton therapy, etc). While I continue to urge appropriate medical followup, I am witness a serious LACK of such by medical professionals. There has been NO MRI since the original injury in 1984, there has been NO referrals for specialist care, and no provision of resource materials. Now 27 years post injury and manifesting various commonly identified behavioral issues such as cognitive decline, suicial ideation, peristent depression, lack of ability to multitask, frequent agitation, my family member has also lost marriage relationship, home of 17 years & ability to work full time. The greatest irony here is HIPPA laws prevent the family physican from hearing/discussing my concerns while my family member remains hindered and even medically neglected as congitive declines hinder persuit of necessary followup. More antidepressants and sleep meds are the only prescriptions given. I am enormously concerned and I do not understand this system or the lack of appropriate treatment.
Jul 5th, 2011 12:52pm