Physicians will only diagnose what they are trained to recognized Treat Now Sometimes the pieces of the puzzle dont come together to form the correct picture Veterans deserve the best possible care we can give. Veterans treated in Hyperbarics experienced significant benefits when compared to approved traditional treatments!!! On 12 December 2014 The Samueli Institute will be meeting to discuss the Recent Studies which were published in JAMA Internal Medicine. The assumption has been that the pattern of signature wounding, the constellation of signs and symptoms, is mTBI or Post Concussion syndrome with out regard to a specific mechanism of injury. The question lies in how can you determine the answer with out considering all the evidence? Is this not evidence based medicine? On fact is true physicians will only diagnose what they are trained to recognize and that that labels tend to create a tunnel vision.several days and there are many reports noting success when HBOz treatments were begun after delays of hours to days (36, 89, 92, 93)........Because of the tendency for patients with AGE to deteriorate after apparent recovery, early HBOz is recommended even for patients who appear to have spontaneously recovered.......The primary treatment of choice for air embolism from any cause is HBOz therapy. Decreased high mortality rates and prevention or moderation of permanent neurologic damage make this modality cost effective. Fox Physiologist, at Centre Hyperbare de LIle Top Contributor thelancet/neurology vol 12 Sept 2013 pg.884 Blast Related Traumatic Brain Injury Several factors determine the extent of brain injury caused by the shock wave. Each tissue type has a characteristic acoustic impedance when ultrasound waves pass through. An acoustic impedance mismatch develops when shock waves pass through tissues of diff erent density, resulting in mechanical disruption (spallation). The blast wave induces suddden changes in intracranial pressure that result in bubble formation, particularly at interfaces between CSF and the brain, and results in penetration and cavitation of brain tissue, disruption of axonal pathways, and damage to capillaries.1,3 Cavitation due to shock–bubble interaction was seen in a simulation model of blast-related TBI.24 1924 Hooker et al - The adverse effects of Blast Injury is a factor of Pressure and Duration 1991- Published by the Walter Reed Institute of Research, The Textbook of Military Medicine Vol 8 Ballistics Blast and Burn Injuries dedicates 90 pages to the discussion of emboli formed by exposure to explosions and blasts (Pressure changes in the combat and training environment). On page 313, an algorthym entitled Neurological Abnormalities in the Blast Casualty, identifies Hyperbaric Oxygen Therapy as being definitive in addressing emboli formed. 1992 The UHMS Committee Report has the following passage Blast injury may cause air emboli by exposure of the vascular to the concussive wave (71-73)..........The primary treatment of choice for air embolism from any cause is HBO therapy. A decrease in the high mortality rates, combined with prevention or moderation of permanent neurological damage, make this modality cost effective 1999 The UHMS Committee Report has the following Blast injury may cause air emboli by exposure of the vasculature to the concussive wave (92-94). ..........Gas bubbles have been known to persist for several days and there are many reports noting success when HBO, treatnents were begun after delays of hours to days (30,58,63,81,106)...........The primary teatnent of choice for air enrbolism from any cause is HBO, therapy. Decreased high mortality rates and prevention or moderation of permanent neurologic damage make this modality cost effective.” 2003 The UHMS Committee Report has reported the following Pulmonary barotrauma can also occur as a result of blast injury in or out of water............. Gas bubbles have been known to persist for several days and there are many reports noting success when HBOz treatments were begun after delays of hours to days (36, 89, 92, 93)........Because of the tendency for patients with AGE to deteriorate after apparent recovery, early HBOz is recommended even for patients who appear to have spontaneously recovered.......The primary treafinent of choice for air embolism from any cause is HBOz therapy. Decreased high mortality rates and prevention or moderation of permanent neurologic damage make this modality cost effective As I write this narrative, I am listening to the lead story on the evening news recounting the suicide of a Canadian Afghan Vet ( active duty) following a holiday party. They dont seem to be report on the suicides of veterans not on activity. Given the suicide epidemic in US Veterans and the significant benefit documented inthe Miller study appearing in the JAMA Internal Med on 17 Nov 2014, would you think it should be time to rethink our approach to this pattern of signature wounding. As a reminder, the DOD studies have found Results showed that both the HBO and sham procedures were associated with significant improvements in post-concussion symptoms and secondary outcomes, including PTSD (which most participants had), depression, sleep quality, satisfaction with life, and physical, cognitive, and mental health functioning.” The only honorable approach is to move to Treat Now Put the Veterans First
Posted on: Fri, 12 Dec 2014 12:53:49 +0000