Traumatic brain injury - the critical role of the family on the road to diagnosis and treatment of recovery

Brain injury is a major cause of death in people under 45. many injuries sustained by the moderate, of course, can not be easily hurt and have some external physical manifestations of injury. In short, "they" look good, despite the fact that all suffered a serious injury to knowledge can mean the loss of employment, destruction of personal relationships and anxiety that accompaniesthat was lost.

Survivors of mild to moderate traumatic brain injury routine memory reassured by doctors in their slow recovery from fatigue, thought, and reduces them, as they expect broken bones to recover from cuts, bruises e. The all too common belief is that time heals all wounds. For every rule there is an exception and unfortunately time does not heal all traumatic brain injuries. Over time, doctors destination addressInjury, but head injuries do not receive the special needs physical attention and undiagnosed head injury. As a result, many patients with head injuries with permanent disability has never received a complete evaluation by a neuropsychologist, including neuropsychological testing. Without supervision of a neuropsychologist, accidents, this can not be diagnosed and these patients do not receive adequate care and treatment for their physical, cognitive, psychological,impairments.Famili sexual and social, a complete copy of the medical records of survivors, including emergency services and medical care, emergency room and hospital records, if a license. A complete set is crucial, because it contains all the detailed evaluations and objective measurements violations of paramedical staff, nurses and ER doctors and neurologists that they need to understand the nature and scope.

Sincethe brain regulates our state and level of consciousness, much has been learned about the extent of brain damage by the evaluation, if the level of consciousness is different from the normal, serious head injury, no matter what a physical examination or other evidence can. indicating the kinds of disturbances of consciousness are:

Confusion - The mildest form of disturbance of consciousness in which people have difficulty thinking,consistent. For example, they may not be able to solve a simple math problem or remember what they ate for breakfast. They often seem disoriented and can not speak much.

Wonder - At this level, individuals are often close to a coma and not responding to normal stimuli. It can only be triggered by intense or painful stimuli, as with their fingers crushed or stuck with a needle. You can open your eyes, but only if they have to respond forcefully.

Delirium - This intense altered state of consciousness is often the result of exposure to a toxic substance. People with delirium are confused, anxious, irritable and more responsive. You do not have an understanding of what I see or hear, and are prone to visual hallucinations.

Coma - The most severe form of disturbance of consciousness, in which a person completely unconscious and responds to all types of stimuli.

Physicians use a system calledthe Glasgow Coma Scale (GCS) to clearly identify and describe the levels of patient awareness. To understand the severity of brain injury, patient condition in the initial evaluation is significant. Heavier than the first presentation, the most serious injuries and the probability of recovery is complete and the reduced. The scale is based on three individual responses measuring eye, verbal and motor responses. Doctors consider the expression of a GCS total score of limited interest, in particular, the score in each of three categories. Every step of the reaction shows the degree of brain damage.

The minimum value is 3 and there is no response from the patient. A person who is alert and oriented would be released in 15 years.

Any period of unconsciousness is a red flag to exclude permanent brain damage, ie, the brain assesses the nature and extent of> Accidents. Loss of consciousness is much to see. However, no report of loss of consciousness does not mean that the brain damage did not occur. Many head injuries result in a longer period of confusion with the spotty memory. E 'common for patients asked what you remember after waking. Even more important, learning, memory continues to be restarted. In many cases where there is no time lost specifically identifiedAwareness, memory continues not start for several hours or days later.

The most common type of brain damage is a quiet and hard-to-prehensive. Called post-concussion syndrome, the damage is most often through the head, which seems to be detrimental to the damage. Suffered a head injury to people, but never lost consciousness and seem to be quite good. The difference between a post-concussion syndrome and head trauma PCS is temporary. TBI is not. Days or weeks later, people have problems with memory, reasoning and decision, or may simply announce to feel "out" and not the same person they were before the accident. These lesions are not easily shown in the records injured survivors, doctors, friends but they are understood by family members, neighbors and employees who know that the survivors was "not the same person," have you been at this a result of serious> Injury changed their lives.

In today's world of short visits to physicians, doctors do not want the time and in many cases, training to ask the patient to change details on injuries in their ability to cope with his head. Since many people to improve over time, certain common form of medical care by a family doctor or general practitioner is provided. The result is that "calm" to the patient refuses treatment because it does not guarantee an honestDiagnosis.

Family members are the first to detect violations and deficiencies caused by a change in head, long before the patient is willing to admit that chronic deficit, but unfortunately the doctors important information not reported in full. person, also, by definition, impaired memory asking for details of their cognitive decline is problematic. And 'the equivalent of asking a patient, "How long was thrown out?" Once you lose consciousness, you do not know and rarelySomeone regain full consciousness immediately. Coming in and out of the acute awareness is widespread. For the same reasons it is required of a person with memory problems in what I do not remember, is not helpful. And there is a bright line between depression, fatigue, irritability and causes loss of memory caused by brain damage or other, although these patients have symptoms characteristic of brain injuries. That is why it is so important to the parents or siblings spouseto see first-hand knowledge examinations for medical monitoring.

After 3 to 6 months if the deficits persist or improvement is slower than expected, the main deficiencies noted in writing to the primary care provider and ask for a referral to a neuropsychologist.

In many cases, such as the attorney for the surviving head injury, I worked with members of the family ability to prepare a detailed letter to a doctor determines that the changes in learning and communicationsuffered, inter alia, by the patient and consequently received a reference to a neuropsychologist for evaluation and testing. Obtaining adequate medical care and treatment, especially for TBI survivors, needs the assistance and support of family and, often, an experienced lawyer who knows and understands the signs and symptoms of brain damage.

A word of caution. Get a doctor to fall in neuropsychological testing as a CT scan to be discouragedO MRI shows no lesions, that is, read the images in normal limits.

First, no, CT scans, the diagnosis of TBI, except in severe cases of fractures and bruises. Second, the same is true for most MRI. If the MRI was performed on a T-3 MRI machine to spread the sophisticated software tensor imaging and fiber tracking studies carried out and interpreted by a neuroradiologist in this protocol designed to provide the availability RMReport is not final.

Note that an MRI of a T-3 by itself is not sufficient if it is software that diffuse tensor images and fiber tracing. This combination of hardware and software that allows specially trained professionals to identify axonal shearing machines and other damage done, otherwise invisible magnetic resonance imaging performed on 1.5 T or T-1. More importantly, MRI is the first step in the diagnosis of brain damage. The accepted methodfor the detection of residues of traumatic brain injury test trained neuropsychologists evaluated by a head injury.

When a recovery is expected and to what extent? The general rule is that the shorter the time required for recovery, the recovery will be more complete. While each person is different, the patient's sensory, motor and language skills tend faster and easier than writing and math skills, memory, attention, the general recoveryIntelligence and social / emotional balance. In addition to the recovery time longer, the loss of these skills are usually more devastating.

Motor and language recovery is usually within three to six months of injury. Attention and memory are usually the most difficult to recover.

The pace of recovery is usually greatest in the first three months. Recovery then more slowly, the balance of the first year. This is one of the reasons whyvalue received neuropsychological assessment shortly after the head injury now and is the basis for comparison with subsequent changes to tests to measure and assess the scope for improvement.

Usually after six months, some improvement may occur, but usually is not significant. After that date, there is no cure in the classic sense. Damaged nerve cells in the brain can not regenerate and trains. People can and do learn to compensate for theirLesions with other skills and that is where the specialists of rehabilitation are very useful.

ABC Reporter Bob Woodruff's Incredible Recovery From Traumatic Brain Injury

You have may have seen a few weeks ago the interview between former US presidential contender John Edwards and reporter Bob Woodruff. All the resulting media coverage centered on Edwards' declarations. However, there is something much more remarkable that surfaced at that interview: Bob Woodruff's spectacular recovery.

This is the same reporter who suffered a severe traumatic brain injury when a roadside In an Instant - Bob and Lee Woodruffbomb detonated next to his vehicle in January 29th 2006 as he was covering news developments in Iraq.

Today I am fortunate to interview Lee Woodruff, Bob's wife and pillar throughout his recovery. Lee and Bob co-wrote the fantastic book In an Instant: A Family's Journey of Love and Healing.

Alvaro Fernandez (AF): Lee, many thanks for your time. I was amazed reading your book, where you share your journey, and then watching Bob interview John Edwards, the best display I can imagine of his recovery. Can you please summarize for us what Bob -and you- went through since January 2006?

Lee Woodruff (LW): As you know, Bob suffered a life-threatening traumatic brain injury in Iraq. He was promptly taken under military care and underwent a series of surgeries for head injuries, with a joint Army & Air Force neurosurgical team in Iraq, in a US Army Medical Command hospital in Germany, and at Bethesda Naval Hospital, back here in the US.

During this time, spanning around 4 months, he spent 37 days in coma, and his skull had to be surgically rebuilt. The cognitive rehabilitation process started then, at a medical facility closer home.

AF: Can you please explain what kind of cognitive rehab Bob has gone though-both in a formal way, with a therapist, and informally, on his own?

LW: The first thing I'd like to say is that rehab is a long process. Doctors told me that Bob, despite the severity of his injuries, had better chances to recover than other victims, because of the reserve of neurons and connections he had built thanks to an intellectually stimulating and diverse life, including living in China for several years and traveling to dozens of countries, having worked as a lawyer and as a journalist, and his overall curiosity and desire to learn. It seems that more and more research shows how people who are mentally active throughout their lives, either through their jobs, or doing puzzles, sudokus...are, of course up to a point, better prepared to deal with problems such as TBI.

Still, recovery is a long process. Bob had six months of structured cognitive therapy focused on speech and languages areas, because that was the part of his brain that had been most damaged. The therapist identified the main tasks for him to work on in a challenging, yet familiar way, usually asking Bob, for example, to read the New York Times, then try to remember what he had read, and write a short essay on his thoughts and impressions.

Since then he has, in a sense, used his work in the documentary To Iraq and Back and other projects at ABC as his informal, but very effective, way to keep improving. I am amazed to watch in real time how, even today, how he gets better and better. To give you an example of his motivation to recover: he recently took on Chinese lessons to see if working on that also helped him.

AF: In the book, Bob says that, if he had to say in one word what he was experiencing during much of the recovery, he would use the word "slower". His brain was slower at processing new information, at remembering words. What progress has he experienced?

LW: A lot. He is not exactly at the same level he was before the injury, but he is again an amazing reporter, father, and husband. And I see progress every month, so we have hope that he will continue getting better and better.

Sometimes Bob tells me he is not the person I married. And then, as I mention in the book, I laugh and reply "I am not either. I'm older, wiser and more wrinkled." I have learned to trust him. Especially in the beginning, it wasn't always easy to fully accept and follow his judgment, but I have seen how little by little he grew perfectly able to recreate his role as a husband and as a father, and to recreate our respective roles in the family. It has been wonderful to see that happen. It has been a miracle.

AF: Bob has been a very fortunate survivor of traumatic brain injury. There are over a million cases every year of TBI. Many of them are military-related (a recent RAND study estimates that over 300,000 US service members have sustained TBI during assignments in Iraq or Afghanistan), but also happen in civilian life, mainly due to traffic accidents or sports concussions. What do we know today about how to prevent and treat TBI?

LW: The Iraq War is literally re-writing the book, the way researchers and doctors see and tackle the problem. Most of the progress is happening in the military, but I hope that transfers into benefits for civilians, too. From a preventive point of view, the military has been stepping up to improve the body armor of soldiers, and I can now see why wearing seat belts as we drive and helmets as we bike can make a big difference.

From the recovery point of view, there is much more optimism and hope today than only a few years ago about how many TBI patients can improve, if given the opportunity to, through a supportive environment and physical and cognitive therapy. The military has recognized the problem of the so-called "Walking Wounded', and is devoting significant resources to analyzing best options and treating them. As we chatted earlier, the Army recently announced that from now on soldiers will get a cognitive screening before they get deployed to the field, so that in case there are problems that screening can serve as a good baseline to compare functions to.

But the improvement in the area is only starting. We need to see much progress.

AF: Can you now tell us more about the Bob Woodruff Foundation for Traumatic Brain Injury? What are your main priorities?

LW: Bob and I are devoting much time to raising awareness of the problem and the need to find and implement good solutions for cognitive care. Our foundation supports community, grass-roots approaches to helping TBI survivors and their families. Given the huge scale of the problem among the military, and the fact that Bob survived thanks to the excellent care he received from the military along the way, we are focusing first on helping military victims.

For example, we recently funded four scholarships for TBI-related research, and also bought 300 mattresses for a small non-profit that helps patients and their spouses rebuild their lives once they have to leave Army bases-many of whom cannot afford to move all their belongings, including beds and mattresses, out of the bases.

And there are many more things to do. For example, while many more soldiers are getting better care, that is not always the case with National Guard reservists who, despite having a dedicated branch of the armed forces oversee their progress, are often at more at risk of living with undetected TBI since they don't have to report at bases once they are back.

It is also not clear that the military (as well as insurance companies) are always willing to pay for the long-term costs of care.

AF: What are some specific ways people can support the work of your foundation?

LW: They can visit our new website, Bob Woodruff Foundation (http://remind.org/), to learn about the problems and to donate funds, no matter how big or small.

But probably the most important thing every one can do is to recognize the sacrifices the soldiers have made, and find active ways to look for them and help them in their own communities. Soldiers and their families often have grown in a culture of self-reliance, of not asking for help, so here we all need to take the initiative to figure out how we can help. Ask yourself, how can I help the TBI survivors in my neighborhood? Perhaps by giving them a job, or offering them help or training, so they can secure one? How can I help their spouses and families maintain healthy and happy environments? Perhaps by offering them free movie tickets? A massage?

AF: Lee, many thanks for those suggestions. Is there something else you would like to add, that you would know everyone to be aware of?

LW: I'd say never give up. We have seen how Bob has recovered, which I think is a miracle. Let's simply try our best to help everyone out there.

Copyright (c) 2008 SharpBrains

Traumatic Brain Injury - The role of family in the process of diagnosis and treatment of recovery

Brain injury is a major cause of death among people under 45 years. Many people suffer from mild to moderate injuries are not obviously injured and have to call external physical manifestations of injury to a few. In short, "look" good, despite the fact that they have suffered serious injury that can mean the loss of jobs, destruction of personal relationships and the fear that knowledge of all that accompanies themlost.

Survivors of mild to moderate traumatic brain injuries that are regularly carried out by doctors of their fatigue, inertia of thought and memory, reduced again, as they expect to recover from cuts, bruises and fractures. The all too common conviction is that time heals all wounds. For every rule there is an exception, and unfortunately, time heals all traumatic brain injuries. Over time, doctors destination address, the physical injury,but the head injury does not require special attention and TBI is not diagnosed. As a result, many patients suffered severe head injuries has never been a comprehensive evaluation by a neuropsychologist, including neuropsychological tests. Without examination by a neuropsychologist is not this injury is diagnosed, and these patients is never a proper care and treatment for their physical, cognitive, psychological, sexual and socialimpairments.Famili to obtain a complete copy of the medical records of survivors, including rescue and ambulance services, the emergency room and hospital records, if a license. A complete set is of fundamental importance, since all the detailed evaluations and objective measurements by paramedics, nurses and ER doctors and neurologists, who are required to understand the nature and scope made it clear that personal injuries.

Since the braingoverns our state and awareness, we can learn much about the extent of brain damage through the assessment of consciousness itself. If the level of consciousness different from normal, serious head injury, no matter what kind of a physical examination or other tests may indicate. The categories of disorders of consciousness are:

- Confusion The mildest form of altered consciousness, in which individuals are consistent thinking. Egmay not be able to solve a simple math problem or to recall what they ate for breakfast. Often seem disoriented and can not do much.
Stupor - at this level, people are often close to a coma and unresponsive to normal stimuli. It is only possible through intense and painful stimulation, as if they squeezed my toes or a blocked PIN be awakened. They can open their eyes, but only if they are forced to react vigorously.
Delirium - Thisintense altered state of consciousness is often the result of exposure to a toxic substance. People with delirium are confused, anxious, irritable and more responsive. You do not have an understanding of what he sees or hears, and are prone to visual hallucinations.
Coma - The most severe form of impaired consciousness, in which a person is completely unconscious and unresponsive to any type of stimuli.

Doctors use a system called the Glasgow Coma Scale (GCS)determined accurately describe the level of consciousness of the patient. To understand the severity of brain injury, is the condition of the patient at the first evaluation. The more severe the initial presentation, the most serious damage and the probability of a full and complete recovery is reduced. The scale is measured on three different responses of the eye, verbal and motor responses. Doctors consider the expression of a GCS score of limited overallInterest, what is most important is the score for each of the three categories of individuals. Each step of the reaction indicates the degree of brain damage.

The minimum value is 3 and there is no response from the patient. A person who is alert and oriented would be rated a 15.

The duration of unconsciousness is a red flag to rule out permanent damage to the brain, that is, the nature and extent of brain damage. Loss of consciousnessshould always be considered significant. However, there is a report of any loss of consciousness does not mean that brain damage has not occurred. Many head injuries over a long period of confusion with the spotty memory. E 'for patients are often asked what they remember after waking. More importantly, if constant, is taken constant reminder. In many cases, where there is no specific time leakage consciousness, do not restart a permanent storagelater for many hours or days.

The most common injuries to the brain is a quiet and hard to book. Called post-concussion syndrome, personal injury is often caused by seemingly innocuous injuries to the head. Individuals can receive a head injury, but did not lose consciousness and seem to do well. The difference between a post-concussion syndrome and traumatic brain injury is that the PC is temporary. TBI is not. Days or weeksLater, people have problems with memory, thought, experience of discernment, or they may simply feel "off" and not the same person as before the accident. These lesions are easily violated in the medical records of survivors reported, but it can also be seen by family, friends and associates who know that is not the survivor, "the same person" he / she is against this serious harm their body life has changed.

In today's world of shortMedical examinations, the doctors do not have the time, and in many cases, training with the patient about the specific changes in their ability to search for a head wound. Since many people improve over time, is the common form of reinsurance in medical care by a general practitioner or family doctor predicted. The result is that "denied relief," the treatment of the patient for failing to ensure a diagnosis honest.

Family members are the first to recognize the shortcomings and causes changesfrom a head wound, long before the patient is willing to admit the chronic deficits, but unfortunately this important information is not fully compatible with the doctors reported. It was also, by definition, a memory impaired person asking details of their cognitive loss is problematic. The question is the equivalent of a patient, "How long have been put out?" Once they have lost consciousness, not known, and rarely has anyone soon full consciousness. Come inside and outside the acuteAwareness is widespread. For the same reasons, calls for a memory-person reduced, I do not know what is more useful. And there is no clear boundary between depression, fatigue, irritability and memory loss from head trauma or other causes the product, even if these symptoms indicate a brain damaged patients. For this reason it is so important to follow a spouse, parent, brother or sister with a firsthand knowledge regarding the medical examinations.

After 3-6Months if there are gaps and improve more slowly than expected, the relationship the most important deficiencies in writing to the primary care provider and request a referral to a neuropsychologist.

In many cases, the lawyer for the surviving head injury, I, along with a detailed letter to the family of a doctor that the changes in the process of learning and communication skills, among others, supported by the patient and identified as a result have gained a ready referenceNeuropsychologist for evaluation and testing. Obtaining adequate medical care and treatment, especially for survivors of TBI, requires the assistance and support of family members, and often an attorney who knows and understands the signs and symptoms of brain injury.

A word of warning. Do not be deterred by the doctor fell on neuropsychological tests as a CT or MRI, no damage, ie, the images are seen aswithin normal limits.

First, CT can not be used to diagnose TBI, except in cases of serious fractures and contusions al. Secondly, the same goes for most of the MRI. If the MRI on a 3-T MRI machine, was created to disseminate sophisticated tensor images and fiber tracking software, is to be studied and interpreted by a neuroradiologist formats used in this protocol, the relationship of magnetic resonance is not definitive.

Note that an MRI using a T-3 in itself is notadequate supply of software, if diffuse tensor images and fiber analysis is used. This combination of hardware and software that enables professionals specially trained for the injuries of cut axons, and the other finished, otherwise invisible to MRI performed by T-1 or T-1 ,5-machines for identification. More importantly, MRI is not the first step in diagnosing brain injury. The accepted method for diagnosis of residual traumatic brain injury is testedassessed by a trained neuropsychologist TBI.

When you need to wait for a rally and to what extent? The general rules is that the shorter the time taken for the recovery, the greater the recovery. While everyone is different, patients tend to recover motor sensory and language skills faster and easier than writing and arithmetic skills, memory, attention, general intelligence and social / emotional balance. In addition to the recovery time longer, the loss of theseSkills and abilities are usually disastrous.

Motor and language recovery is usually within three to six months after the accident. Attention and memory are usually the most difficult to recover.

The pace of recovery is usually greatest during the first three months. Recovery tends to be on the budget for the first year slowly. This is one reason why it is valuable, a neuropsychological examination shortly after the head injuries suffered andTo understand with this basis of comparison with subsequent tests to determine the changes and the degree of improvement.

In general, it can occur after six months, some improvement, but usually is not significant. After that date, there is no cure in the traditional sense. Nerve cells in the brain and ways not regenerate. People can learn and do this to offset the damage from other skills and that's where the specialists of rehabilitation are very useful.

ABC Reporter Bob Woodruff incredible recovery from Traumatic Brain Injury

You may have seen a couple of weeks ago the interview between former U.S. presidential candidate John Edwards and reporter Bob Woodruff. All the resulting media coverage focused on Edwards 'declarations'. However, there is something much more remarkable that surfaced at that interview: Bob Woodruff's spectacular recovery.

This is the same reporter who has been a severe traumatic brain injury, if a road was detonated in an instant - Bob and Lee Woodruffbomb beside hisVehicle on January 29, 2006, when it was a new development in Iraq.

Today I am lucky to interview Lee Woodruff, wife of Bob, and pillar throughout his recovery. Bob Lee and co-author of the book in a fantastic immediate trip to a family of love and healing.

Alvaro Fernandez (AF): Lee, thank you for your time. I was amazed reading your book, where your journey, and then Bob interview John Edwards was the best display I can imagine his recovery. CanPlease provide a brief for us what Bob and has gone through since January 2006?

Lee Woodruff (LW): As you know, Bob suffered a life-threatening brain injuries in Iraq. E 'was immediately under military assistance and has undergone a series of operations for head injuries, with a joint Army and Air Force neurosurgical team in Iraq, the U. S. Army Medical Command hospital in Germany, and at Bethesda Naval Hospital, back here in the United States.

During this period, extends around the 4Months, spent 37 days in a coma, and his skull had to be surgically reconstructed. The cognitive rehabilitation began, closer to a medical center at home.

AF: Can you please explain what cognitive rehabilitation Bob is gone, however, both formally, with a therapist, and informally, on their own?

LW: The first thing I would say that rehabilitation is a long process. The doctors have told me that Bob, despite the seriousness of his injuries, had a better chance of recovering otherVictims because the reserve of neurons and connections he had built thanks to an intellectually stimulating and varied life, including living in China for several years and traveling to dozens of countries, such as the admission of a lawyer and worked as a journalist and his general curiosity and the pleasure of learning. It seems that research increasingly shows that people who are mentally active throughout life, through their work, or doing puzzles, Sudoku puzzles ... are, of course, at some point, betterprepared to deal with problems such as TBI.

However, the restoration of a long process. Bob had six months of cognitive therapy focused on language and the areas of structured languages, because it was part of the brain were damaged the most. The therapist identified the main tasks for him to work so hard, but familiar, usually asking Bob, for example, read the New York Times, then try to remember what you read, and write a short essay on his thoughts andImpressions.

Since then he has in a sense, he used his work in Iraq and back in the documentary and other projects at ABC as his informal but very effective way to optimize, so updated. I am surprised to observe in real time, as now, as you get better and better. To retrieve an example for his motivation: he has seen recently in the Chinese language, if the work he has contributed.

AF: In the book, Bob says that when he said in a word, what he has experienced duringMost of the rest, would be the word "slow". His brain was slow to process new information to remember the words. What progress has lived?

LW: A lot. Not exactly on the same level it was before the injury, but is once again an extraordinary journalist, father and husband. And I see progress every month, so hopefully that will continue to always do better and better.

Bob tells me that sometimes is not the man I married. And then, as I mentioned the book, I have to laugh and answer: "I'm not. They are big, wiser and more wrinkled." I learned to trust him. Especially at the beginning it was not always easy to fully accept and follow its decision, but I'm little by little, he was perfectly capable, his new role as man and father, and our respective roles, RI - seen family. It 'wonderful to see what happens. It 'was a miracle.

AF: Bob has a very lucky survivors were traumatic> Brain damage. There are more than a million cases a year of TBI. Many of them are military related (a recent RAND study estimates that more than 300,000 service members in the United States have suffered a head injury occur during the contracts in Iraq or Afghanistan), but also in civilian life, particularly road accidents or sport shock. What we now know how to prevent and treat TBI?

LW: The Iraq War is literally rewriting the book to see how researchers and physicians, and the fight againstIssue. Most of the progress made in the military, but I hope that the transfer of benefits for the civilian population, too. From a preventive point of view, the military has been strengthened to improve the body armor of soldiers, and now I can see why wearing seat belts while driving and bicycle helmets, as we can make a big difference.

From the restore point of view, there is an optimism and hope a lot more than it did a few years ago about how many patients with head injury may improve when theWay through an environment, physical and cognitive therapy. The army has acknowledged the problem of so-called "Walking Wounded" and devotes significant resources to analyzing best options and deal with it. When we spoke earlier, the Army recently announced that from now on a cognitive screening of soldiers before you get on the pitch to get used to, so if there are problems that screening can serve as a good basis for the functions Compareto.

But improvements in the area just begun. We need to see progress.

AF: You can now tell us more about the Bob Woodruff Foundation for Traumatic Brain Injury? What are your priorities be?

LW: Bob and I devote much time to find the awareness of the problem and the need to design and implement good solutions for cognitive care. Our foundation supports community, grass-roots approaches to helping TBI survivors and their families. Givenenormous scale of the problem between the soldiers and the fact that Bob survived thanks to the excellent care received by the military on the road, we focus first of helping military victims.

For example, we recently funded four scholarships for TBI research, and bought 300 mattresses for a small non-profit organization that helps patients and their spouses, their lives once they leave military bases, many of which can not afford to move all their belongings, includingBeds and mattresses, from the basics.

And there are many other things to do. For example, while many more soldiers are getting better care, which is not always the case, National Guard reservists who, while monitoring their own branch of the armed forces for their progress, which often goes unnoticed at a greater risk of living with TBI since they do not report on the basis whenever you return.

It is also clear that the military) are (as well as insurance companies increasinglywilling to pay for long-term costs of care.

AF: What are some specific ways people can support the work of his foundation?

LW: You can visit our new website to learn Bob Woodruff Foundation (http://remind.org/), on the problems and to donate funds, no matter how big or small.

But probably the most important thing anyone can do is to identify who made the sacrifice of soldiers, and find ways to actively look for them and help them in their communities.The soldiers and their families, often grown in a culture of self-confidence, which does not ask for help so that each of us must take the initiative to find out how we can help. Ask yourself, how can I help the TBI survivors in my neighborhood? Perhaps giving them a job or offer them assistance or training, so they can be safe? How can I help their spouses and families to achieve healthy environment and happy? Perhaps giving them free movie tickets? A massage?

AF: Lee, thank you forthese proposals. Is there anything you'd like to add that you know know them all?

LW: I would say never give up. We have seen how Bob has recovered, which I think is a miracle. Let's just do our best to help everyone out there.

Copyright (c) 2008 Sharp Brains