#codeofmedicalethics

  ********************* SGT Jerrald Jensen is one of over 100,000 service members issued Other Than Honorable discharges since 9/11. The majority are combat veterans, most with undiagnosed or mis-diagnosed brain wounds. A Pulitzer Prize-winning series catalogs SGT Jensen's travails, along with multiple others caught up in a surreal legal web that is merciless, even when confronted with documented BLAST injuries and diagnosable brain wounds. Though changes in law may allow a Veteran with an OTH to get some health benefits, the losses are punitive and life-altering. OTH, bad conduct, or dishonorable discharges can prevent employment, ability to obtain a security clearance, and assuredly taint self-image and mental attitudes. While the system needs retributive justice for certain kinds of conduct, the use of diminished mental capacity due to brain injuries to expedite separation from service is a travesty. This tragic misuse of military justice continues as more details come to light about the BLAST injuries sustained by combat veterans. Even firing your own weapon, much less larger caliber weapons and M777 howitzers, can cause brain damage. As we wrote about the Marine Battalion in Iraq, the damage done to dozens of Marines resulted from unprecedented combat. 'The artillery battalion “fired more rounds in five months in Raqqa, Syria, than any other Marine artillery battalion, or any Marine or Army battalion, since the Vietnam War.” During a Marine Corps Times roundtable discussion in 2018, the former senior enlisted adviser to the chairman of the Joint Chiefs of Staff said 35,000 artillery rounds were used to kill ISIS terrorists “by the dozens." 'For comparison, 60,000 rounds were fired by the Marines and the Army during the First Gulf War. And during the initial invasion of the Iraq War, over 34,000 artillery shells were fired." Unprecedented firepower, and unprecedented and undocumented brain damage. True, mental health problems accompanied that wounding, but root cause analysis would have found mitigating circumstances for the behavior that followed. The military is not alone in downplaying or ignoring the ravages of repeated brain wounding. The International Conference on Concussion in Sport once again failed in October last year to recognize brain wounding as a potential cause of Chronic Traumatic Encephalopathy. Even, perhaps especially, the world of sports appears willfully clueless about the links between brain wounding and physical, mental, and behavioral deterioration. Dylan Hartley, former Captain of the all-England rugby team, is too familiar with brain wounds from his playing days. He is not part of the suit being brought a group of former players against World Rugby, the Rugby Football Union and the Welsh Rugby Union, for "failure to protect (the claimants) from the risks caused by concussions". He did, nevertheless, experience the plethora of traumas that led to his feeling "virtually broken" prior to his treatment and transformation with Hyperbaric Oxygenation in Dubai. Rugby worldwide is awakening to the long-term damage that can be inflicted on the brain playing high-level impact sports. They are following a path being trod in many sports. The NFL is still not able to come to grips with the documented links between head trauma and the post-mortem proof of a life lived with degenerative CTE: 345 out of 376 brains of dead former NFL players riddled with brain wounds caused by CTE. Hundreds of former college athletes are suing the NCAA. The claims are that “For years (the NCAA) has kept players like Matthew Gee and the public in the dark about an epidemic that was slowly killing college athletes,” Alana Gee's lawsuit said. “Long after they played their last game, they are left with a series of neurological conditions that could slowly strangle their brains. . . . problems ranging from headaches to depression and, sometimes, early onset Parkinson’s or Alzheimer’s disease." BLAST injury, contact sports, falls, assaults, strokes, concussions. In one sense, Other Than Honorable discharges are the least of a Veterans problems alongside the slow deterioration of the brain. As we continue to insist: Heal Brains. Stop Suicides. Restore Lives. Use a proven, scientifically validated treatment: Hyperbaric Oxygen Therapy. TreatNOW. Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Heal Brains. Stop Suicides. Restore Lives. TreatNOW   Read the full article

BRINGING YOU CURRENT INFORMATION ABOUT HOW TO HELP TREAT AND HEAL BRAIN WOUNDS: CONCUSSIONS, TBI, PTSD This report brings you information about how HBOT can be used to help with symptoms due to BLAST damage, and advances in seeing "invisible" wounds. Remember: despite loose talk about how "almost all mild Traumatic Brain Injuries heal themselves," evidence shows that 25% - 30% of TBIs lead to lifetime complications. ********************* Early Brain Amyloid Accumulation at PET in Military Instructors Exposed to Subconcussive Blast Injuries In this prospective study from January 2020 to December 2021, military instructors who were routinely exposed to repeated blast events were evaluated at two different points: baseline (before blast exposure from breacher or grenade) and approximately 5 months after baseline (after blast exposure). Age-matched healthy control participants not exposed to blasts and without a history of brain injury were evaluated at similar two points. In the blast-exposed participants, four brain regions showed significantly increased amyloid deposition after blast exposure. . . . No amyloid deposition was observed in the control participants. . . . Our results may have direct clinical implications: if the individuals that are at risk for developing amyloid-related neurotoxicity can be identified, therapies to clear amyloid β in the brain might reduce or slow the development of long-term secondary traumatic encephalopathy. New AI tool can spot ‘invisible’ brain damage in college athletes A new AI tool developed by NYU researchers can effectively spot brain changes that happen from repeated head injuries. Specifically, it can pick up on injuries that traditional medical imaging misses. Evidence is now starting to show that that repeated head impacts, even if they seem to be mild at first, may lead to cognitive decline over time. Advanced MRI can identify microscopic changes in brain structure from head trauma, but the scans yield a lot of data that can be hard to examine. This new technology utilizes machine learning to accurately compare the brains of male athletes who played contact sports like football and non-contact sports like track and field. The researchers studied hundreds of brain images from 81 male college athletes, 36 contact sport players (mainly football players) and 45 non-contact sport athletes (mainly runners and baseball players). The team found repeated head impacts with small structural changes in the brains of contact-sport athletes. Most interestingly, none of the participants had been diagnosed with a concussion. UK issues The UK Concussion Guidelines for Non-Elite (Grassroots) Sport "If in Doubt, Sit Them Out." Amateur sports in the UK now have updated Guidelines aimed at identifying and improving the handling of concussions in amateur sports. Teams can be part of a two-year programme of research into concussion in grassroots sport, using an app to track the symptoms of injury and their treatment. According to the guidelines, anyone who sustains a concussion should not play contact sport for 21 days and should not return to any form of training for 14 days. VA Neurologist Terminated Following Care Denials Mary Jo Lanska, MD, has been terminated by the Veterans Administration (VA) after an investigation by KARE 11 in Minneapolis revealed a pattern of misdiagnosis and benefit denials spanning decades, the outlet reported. Since 2002, Lanska has evaluated more than 1,000 veterans at the Tomah VA in Wisconsin -- 600 of whom were denied benefits and are now eligible for re-testing by the VA. An earlier review of a "random selection of Dr. Lanska's benefits exams found 31% were done incorrectly," according to KARE 11. Many of those who had care denied were evaluated for traumatic brain injuries. They will now have their cases reviewed and could be granted backdated benefits. The House Committee on Veterans Affairs recently called for the Inspector General to investigate a "systemic failure" to provide adequate care for traumatic brain injuries to veterans across the nation. Lanska's firing comes after a larger pattern of denials was revealed starting in 2015, and led to a national review of mishandled compensation claims for similar reasons. Alpha Cognition Receives Army Medical Research Grant for Study on Mild Traumatic Brain Injury (mTBI) from Blast Induced Functional Deficit and Brain Pathology Alpha Cognition Inc., a biopharmaceutical company developing novel therapeutics for debilitating neurodegenerative disorders, is pleased to announce the that it has been awarded a $750,000 grant from the Army Medical Research and Material Command (AMRMC) for a pre-clinical study on the use of ALPHA-1062 Intranasal (IN) to reduce blast mTBI induced functional deficit and brain abnormalities. The aim of the study is to evaluate the efficacy of ALPHA-1062IN in reducing the adverse effects of repetitive blast induced-mTBI in pre-clinical models. A blast injury can lead to long-term functional issues and brain abnormalities, which can have a significant impact on the quality of life of those affected. “The body of evidence is growing to show that people who have suffered a TBI, even a mild TBI, are at greater risk of developing dementia in later life and are at risk for additional neurocognitive issues." An integral part of this research program will evaluate ALPHA-1062’s ability to reduce a toxic form of a brain protein known to be increased in this military relevant TBI model. . . . Accumulation of toxic Tau in the brain is linked to dementia progression, and was previously shown to be decreased by ALPHA-1062 in a separate pre-clinical model of moderate TBI. Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Heal Brains. Stop Suicides. Restore Lives. TreatNOW     Read the full article

This report deviates a bit from a focus on Brain Wound healing. It steps up to a strategic level and asks a hard question: What is it going to take to change the way the VA thinks about Veteran overall health and wellness? More importantly, how do we as a society get institutions to open up to obvious truths and accept that there is an additional way to think more broadly and ACT to heal wounds, reduce costs and suffering, and restore lives and families? ********************* Memorial Day. Remembering. Reverence. Celebration. Resolve. Speeches, TV Specials, Proclamations, documentaries, parades, fireworks and reverential religious ceremonies make clear on Memorial Day that we care about veterans and active duty service members, living and dead, who have fought and in too many cases died to preserve American freedoms. Lost in the "Rolling to Remember" rallies, in too many cases, are the avoidable deaths that are little noted nor long remembered. "Suicide rates among active-duty military members are currently at an all-time high since record-keeping began after 9/11 and have been increasing over the past five years at an alarmingly steady pace. In fact, some branches of the Armed Forces are experiencing the highest rate of suicides since before World War II." Rates of Special Operations deaths due to suicide may be even higher. In 2021, research found that 30,177 active duty personnel and veterans who served in the military after 9/11 have died by suicide - compared to the 7,057 service members killed in combat in those same 20 years. That is, military suicide rates are at least four times higher than deaths that occurred during military operations. Added to that figure must be those spouses and family members of service members who are suicide victims: in 2020, the same report found that 202 dependents died by suicide, including 133 spouses and 69 other dependents, and that firearms were the primary method of suicide death for both Service members and family members. (For reference, CBS 60 Minutes, Vietnam 101, 4 Oct 86] broadcast that more than 100,000 Vietnam veterans were suicide victims. In 1988, a network news anchor asserted that between 26,000 and 100,000 suicides had occurred among Vietnam veterans depending on which reputable source you believe.") Suicide. Lethal. Final. And in too many cases preventable. If only. If only something or someone had noticed. If someone had taken the time to remember that as a nation we are not very good at diagnosing, let alone treating, some underlying damage done to warriors that have been called "unblooded wounds." Invisible wounds. Shell shock. Soldier's heart. Battle fatigue. PTSD. Traumatic Brain Injury. We're good at studying and naming, but miserable at actually diagnosing and treating brain wounds that in too many cases lead to suicidal ideation. Done properly -- and the VA and DOD so far are not doing it properly -- root cause analysis of the "mental health" condition of combat veterans and the families of those veterans, will discover an epidemic of brain wounds large and small among the force. The Defense and Veterans Brain Injury Center (DVBIC) reported nearly 414,000 TBIs among U.S. service members worldwide between 2000 and late 2019. A more accurate estimate is that 877,450 brain wounds are festering among post-9/11 veterans. Mis-diagnosed and mal-diagnosed brain wounds are a plague among veterans, particularly those being mustered out of the military with Other Than Honorable discharges (estimated between 100,000 and 200,000 "bad paper" discharges since 9/11.) And Memorial Day properly understood would also have a silent moment for Veterans who have suffered and died needlessly due to Lower Limb Amputations (LLAs). Diabetic Foot Ulcers (DFUs) leading to LLAs have been responsible for 796,340 Veteran deaths since 9/11, more than all service member deaths since the start of World War I (624,147). Wounds, whether to the feet or to the head, can be diagnosed and treated prior to avoidable death. Unfortunately, this is not reality. We can leave it to Inspectors General to discover whether the deaths are due to negligence, policy, institutional resistance, ignorance, mistakes, or simple bureaucratic "business as usual." Wounds such as DFUs and brain injury can be safely and effectively treated with Hyperbaric Oxygen Therapy (HBOT). The FDA and CMS and medicine in general accept and use HBOT with insured coverage for DFUs. Over twenty peer-reviewed studies attest to the safety and efficacy of HBOT to treat and help heal brain wounds. Since you've read this far, we owe it to those who died in service to the nation, those in the throes of suffering, and those who will volunteer to carry the burden of military service for us, to act on the knowledge that we can do better. These wounded men and women need not die. We must do better. We in the TreatNOW Coalition can point to over 21,000 safe and effective successes treating and healing brain wounds in the last decade. Ten states have passed legislation calling for the use of Hyperbaric Oxygenation to heal brain wounds/TBI/PTSD. Congress is awakening with Bills from Congressman Murphy, MD and Senator Tuberville calling for action. We're winning, just not fast enough. Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Heal Brains. Stop Suicides. Restore Lives. TreatNOW* Read the full article

This is the second of a weekly compendium of events, research, news, and insights about Brain Wounds: Concussion, TBI, PTSD. The focus is on Brain Wound healing and reduction of suicidal ideation; the use of Hyperbaric Oxygen Therapy as a safe and effective treatment for brain wounds; and the clinical and evidence-based proof of a new era in our understanding of how to improve brain health and Quality of Life after a brain wound. ********************* Congressman Murphy (R-NC) Introduces Legislation to Provide Hyperbaric Oxygen Therapy to Veterans May 24, 2023 Press Release Washington, D.C. – Today, Rep. Greg Murphy, M.D. introduced the Veterans’ National Traumatic Injury Treatment Act. This bipartisan bill would establish a pilot program at the Department of Veterans Affairs to furnish hyperbaric oxygen therapy (HBOT) for veterans who have post-traumatic stress disorder (PTSD) or a traumatic brain injury (TBI). The perils of contact sport: pathologies of diffuse brain swelling and chronic traumatic encephalopathy neuropathologic change in a 23-year-old rugby union player There have been only isolated autopsy studies of young athletes reporting evidence of CTE-NC. To date, however, none with RHI/TBI exclusively through rugby union. This observation provides evidence of established neurodegenerative pathology in early life, active, contact sports participants, in advance of any recognizable clinical manifestation. Detection of CTE-NC at such young age supports the hypothesis that the processes driving TBI-related neurodegeneration are established many years prior to clinical presentation, reinforcing calls to limit exposure to sports-associated RHI and TBI. Football bonded them. Its violance tore them apart. . Harvard football teammates went separate directions; some suffered brain injuries unto death. None have been treated for brain wounds, but at least one continues to worry and warn about risks after the early death of their captain. BU Finds CTE in Nearly 92 Percent of Ex-NFL Players Studied Significant Research Findings (starting in 2009) from Boston University's CTE Center. According to its latest According to its latest report, the BU CTE Center said it has diagnosed 345 former NFL players with CTE out of 376 former players who were studied, a rate of 91.7%. The disease can be diagnosed only after death. CTE Center Director Ann McKee says the NFL ignores the risks of repetitive blows to the head and that it’s “foolish” to think the league will police itself   The information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Heal Brains. Stop Suicides. Restore Lives. TreatNOW. Read the full article

This is the first of a weekly compendium of events, research, news, and insights about Brain Wounds: Concussion, TBI, PTSD. The focus is on Brain Wound healing and reduction of suicidal ideation; the use of Hyperbaric Oxygen Therapy as a safe and effective treatment for brain wounds; and the clinical and evidence-based proof of a new era in our understanding of how to improve brain health and Quality of Life after a brain wound. ********************* Virginia becomes 10th state to pass legislation calling for the use of Hyperbaric Oxygen to treat and heal TBI/PTSD. SENATE BILL NO. 1082 A BILL to allow the Department of Veterans Services to contract with any hyperbaric clinic or any hospital in the Commonwealth that furnishes a comprehensive treatment program to any veteran who has been certified by the U.S. Department of Veterans Affairs or any branch of the United States Armed Forces as having post-traumatic stress disorder or traumatic brain injury. Be it enacted by the General Assembly of Virginia: That the Department of Veterans Services may contract with any hyperbaric clinic providing medical-grade 100 percent oxygen in U.S. Food and Drug Administration-approved chambers in the Commonwealth or any hospital that furnishes a comprehensive treatment program that may include medication, psychotherapy, and hyperbaric oxygen therapy, from an accredited program, to any veteran in the Commonwealth who has been certified by the U.S. Department of Veterans Affairs or any branch of the United States Armed Forces as having post-traumatic stress disorder or traumatic brain injury. Unanimously passed in VA House and Senate and signed into law, March 2023. Soccer: CTE cases in soccer players raise fresh questions about safety of heading the ball New diagnoses come as officials gather in Chicago for a Head Injury Summit (May 2023). The Concussion Legacy Foundation announced Tuesday that English pro and Oregon State head coach Jimmy Conway, Scottish and Seattle NASL midfielder Jimmy Gabriel, and NCAA champion Franny Pantuosco also were found to have the degenerative brain disease that has been linked to concussions in athletes, combat veterans and others who have sustained repeated head trauma. They are the first diagnoses among those who played in the NASL, a precursor to MLS as the top U.S. pro soccer league that attracted attention with high-profile signings — including Pele — before folding in 1985. Early Brain Amyloid Accumulation at PET in Military Instructors Exposed to Subconcussive Blast Injuries Early brain amyloid β deposition was found in the brains of otherwise healthy adult men exposed to repeated subconcussive blast injury using amyloid PET. Military instructors who were routinely exposed to repeated blast events were evaluated at two different points: baseline (before blast exposure from breacher or grenade) and approximately 5 months after baseline (after blast exposure). Age-matched healthy control participants not exposed to blasts and without a history of brain injury were evaluated at similar two points. Neurocognitive evaluation was performed with standard neuropsychologic testing in both groups. In the blast-exposed participants, four brain regions showed significantly increased amyloid deposition after blast exposure. . . No amyloid deposition was observed in the control participants. Hyperbaric Oxygen Therapy in the Treatment of Acute Severe Traumatic Brain Injury: A Systematic Review This review summarizes 40 years of clinical and pre-clinical research on the treatment of acute TBI with hyperbaric oxygen therapy (HBO2) in the context of an impending National Institute of Neurologic Disorders and Stroke–funded, multi-center, randomized, adaptive Phase II clinical trial —the Hyperbaric Oxygen Brain Injury Treatment (HOBIT) trial.... These studies provided evidence that HBO2 significantly improves physiologic measures without causing cerebral or pulmonary toxicity and can potentially improve clinical outcome. These results were consistent across the other four reviewed clinical studies, thus providing preliminary clinical data supporting the HOBIT trial. This comprehensive review demonstrates that HBO2 has the potential to be the first significant treatment in the acute phase of severe TBI. Fighting and Penalty Minutes Associated With Long-term Mortality Among National Hockey League Players, 1967 to 2022 National Hockey League (NHL) "enforcers" with 50 or more career fights or 3 or more penalty minutes per game died 10 years earlier and more often of drug overdose and suicide when compared with age-matched NHL player controls.  This matched cohort study of 6039 NHL players from 1967 to 2022 confirmed that NHL enforcers died at similar rates but approximately 10 years earlier when compared with NHL controls. Furthermore, the causes of death in the 21 enforcers included neurodegenerative disorders, drug overdose, suicide, and motor vehicle crashes, whereas only 1 of the 24 age-matched controls died of any of these causes (motor vehicle crash).   The information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Heal Brains. Stop Suicides. Restore Lives. TreatNOW. Read the full article

**4th in a five-part series on the Implications of HBOT when used to heal brain wounds, prevent suicides, restore lives, and save Billions of dollars It should be well known by doctors, but not too often by patients, that the doctor-patient relationship is governed by trust, but also by obligations by medical professionals. Among those obligations are the ethical, legal and medical requirement that the doctor inform patients about treatments. This is covered by the doctrine called informed consent. The Code of Medical Ethics is built around ensuring that both doctors and patients participate meaningfully in decisions about health care. Physicians have a responsibility to provide information and help patients understand their medical condition and options for treatment. This doctrine of informed consent seeks to ensure that doctors: tell patients of their diagnosis; that patients understand the nature and purpose of recommended interventions; and, most importantly, that patients are made aware of the burdens, risks and expected benefits of all options. Of course, doctors cannot be expected to know all there is to know even inside their specialty, much less outside their field of expertise. Nevertheless, in the cases of TBI/Concussion/PTSD/ PCS/Brain Wounds, doctors and mental health professionals in general should be expected to know, talk about, and inform patients about options that, while generally deemed experimental, are widely available, safe, effective and potentially helpful. Such is the case with hyperbaric oxygen therapy (HBOT) and alternative therapies for brain wounds. It is equally important for FDA-approved treatments. A concussion is a form of traumatic brain injury. It is a wound to the brain. Blast injury, head impacts, stroke and brain insults of many kinds, result in damage that is less widely known but still degenerative. Medicine understands the nature of wounds and the phases in wound healing. The so-called "concussion cascade" that follows the wound to the brain creates conditions that impede healing in the closed environment inside the skull. A blast or jolt to the head begins a series of negative consequences. These can include: inflammation; interrupted blood flow; oxygen starvation/hypoxia; tissue and nerve fiber ripping and tearing; cell stunning/ inactivation; and/or cell death. The symptoms of that brain wounding include: headaches, confusion, memory loss, nausea, vomiting, dizziness, fatigue, sleeplessness, emotional instability. These symptoms and many more are linked to complex negative processes affecting the brain, induced by biomechanical forces. These forces can lead to sometimes fatal brain inflammation and swelling, damage to blood vessels and brain cells, ringing in the ears (tinnitus), visual and balance problems, and a myriad of other overt and/or subtle physical, emotional, cognitive, and functional difficulties. Given the seriousness of brain wounding, the seeming passivity on the part of medicine and care providers with respect to the treatment of the wound to the brain is deeply troubling. “Concussion Protocols” are uniformly about diagnosis and management of a concussion; symptom reduction techniques absorb the vast amount of time, money and energy. Yet the treatment of the wound is seldom mentioned; worse, there are few medical professionals who will even discuss active intervention to treat and heal the wound to the brain. An instructive document is the Sports-Related Concussion Research document that attempts to bring to bear a broad range of multidisciplinary challenges to the processes and products of sport-related concussion movement. A prior document from the 6th Conference states: “It is important to note that the effects of targeted post-concussion treatments on the underlying pathophysiology of concussion are unknown. To date, there are no empirical data to inform the timing, intensity or type of treatment for patients with concussion. Additional empirical research on the efficacy of various treatments for concussion is warranted. Until then, the guidelines for targeted treatment can serve as an evolving framework for managing athletes.” Note that this document has no mention of the brain wound, nor is the word oxygen even mentioned. Any number of “treatments” are mentioned, but no mention of hyperbaric oxygenation which is an empirically proven, fact and data-backed method of treatment. Similar silence about wound healing is the norm across DOD/VA/Army medicine, professional sports, colleges, high schools, and medicine in general. In fact, there is enormous evidence and empirical research over many decades that speak to the benefits and mechanisms of action using hyperbaric oxygenation to treat and help heal the wound to the brain . In accordance with the doctrine of informed consent, doctors, medical professionals, trainers, health care providers, even insurers should be made aware, if they are not already, that there is a proven safe, effective and economical treatment which, administered for brain wounding can lead to a resolution of symptoms and brain healing within days. This document contains the essential information that any parent, care-giver, veteran, athlete or citizen can provide to the medical team seeking to deal with TBI/Concussion/PTSD/PCS/Brain Insults. Brain wounded patients, and those who care about them, deserve to know. Patient autonomy and self-reliance are the route to getting help that is available. Getting that help depends on patients educating doctors who, for a variety of reasons, may not be sufficiently well-informed about the HBOT treatment option. Heal Brains. Stop Suicides. Restore Lives. TreatNOW.   The information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article