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Device Shows Concussion Effects Linger Off The Field

It’s an August tradition: Football training camps open, and we’re treated to warnings about working out in the heat.

In the past few years, however, when it comes to football, there’s been a new emphasis on traumatic brain injury (TBI). This has caught our eyes here at MedGadget.

We’ve covered innovative impact-sensing helmet technology before (as well as smart helmets for temperature monitoring). But for the athlete with a concussion, what happens off the field? Unless a neurologist is involved, it’s up to the players and trainers to follow guidelines or make guesses about when to return to play.

Hopefully that will change, and a device like BrainScope will lead the way. When we first covered BrainScope, they were positioning their new device, based on controversial technology, as a sideline decision-making aide. Now their research seems to be focused on the weeks and months post-concussion. Read more »

*This blog post was originally published at Medgadget*

Dr. Val Tells ABC News How To Stave Off Memory Loss

Did you know that physical activity can reduce your risk for memory loss and dementia? I had the chance to speak to ABC’s Let’s Talk Live team about important lifestyle choices that can keep the mind healthy and active. The good news is that you really can teach an old dog new tricks, and those new tricks can stimulate growth of new brain cells. Watch the video and check out the Alzheimer’s Association website for more information about dementia prevention:

Botox For Stroke, Brain Injury And MS

Until recently, the therapeutic use of non-cosmetic Botox (botulinum toxin) for adult upper extremity spasticity was considered off-label use. The U.S. Food and Drug Administration (FDA) has now approved Botox to treat spasticity in the upper extremity flexor muscles in adults.

Spasticity is common after stroke, traumatic brain injury, or the progression of multiple sclerosis. Spasticity is defined as:

“a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex as one component of the upper motor neuron syndrome.”

Spasticity often creates problems with mobility, self-care, and function. The spastic muscles can become stiff. Associated joints can be affected by lack decreased range-of-motion with contractures forming. Read more »

*This blog post was originally published at Suture for a Living*

Book Review: The Water Giver

EverythingHealth strongly recommends a wonderful new book called “The Water Giver” and I predict you will not be able to put it down. Author Joan Ryan is a remarkable writer who takes the reader on a journey she lived when her son, Ryan, sustained a near -fatal severe head and brain injury on a skateboard. It is both a medical drama and a meditation on motherhood.

The book begins with Joan’s description of her son’s learning difficulties and years of psychological and developmental testing. Her style as a mother was to intellectualize, do research and try to fix what was “wrong” with her son. The years went by with family stress and teachers conferences and medical consultations but it wasn’t until the day he fell, that Joan realized some things are too big to be studied and fixed.

The nightmare began when he was 16 and went skateboarding without a helmet. The fall on a hill near their home caused a huge brain bleed that obliterated much of his brain tissue. He remained in a coma for weeks and underwent multiple surgeries to relieve pressure. The book chronicles months of near death events in the Intensive Care Unit that nearly drove his parents insane with worry. I will let you read it to find out how it turns out. Read more »

*This blog post was originally published at EverythingHealth*

Can Mobile Technology Improve Patient Compliance And Health Outcomes?

I recently interviewed the CEO (Bill Reed) and SVP (Stuart Segal) of AllOne Health at the World Health Care Congress. Their enthusiasm for mobile technology rivals Better Health’s own Dr. Alan Dappen. Will mobile technology get people more engaged in healthy behaviors and assist with disease management? I hope so.

Dr. Val: What is “All One Health?”

Reed: All One Health provides a bundle of customized offerings to small employers – including insurance and health and wellness programs. We provide the same kinds of benefits that large insurers offer to large employers except we spend a lot of time analyzing the specific needs of small companies before initiating a health program for them. Some small companies have employees with diabetes-related challenges, and others might be more concerned about asthma. We also use predictive modeling (health risk assessments) to help the companies customize preventive health strategies for their employees.

Engagement and compliance are very important in bringing about substantive changes in healthcare – and good health can be incentivized by employers. All One Mobile is our means for connecting patients (or employees) with health coaches and nurses, which we believe is critical for affecting lifestyle changes.

Dr. Val: What does your “menu of services” look like from the employee’s perspective?

Reed: Each employee begins the relationship with a health risk assessment (HRA). That HRA recommends programs for the employee based on their risk factors, and prioritizes the top three things for them to work on. There are performance trackers linked to employer incentives for health improvements and the programs are available via the phone so that employees don’t have to be in front of their PC to interact with their health coaches. We have proactive outbound calling with an opt out feature. We believe that the mobile phone is critical for encouraging consistent participation in health programs. Our services center on phone-based reminders and personal relationships with coaches.

In the near future we’ll include blue tooth technology to have patients upload data from their home monitoring devices for their coaches to review. This is a more proactive approach to health management.

Dr. Val: And Stuart, tell me about the All One Mobile program for the Department of Defense (DOD).

Segal: The DOD was having difficulty with follow up care for military personnel returning from Iraq and Afghanistan with traumatic brain injuries (TBI). Once they returned to their communities, it was very hard to reach them. All One Mobile won a contract with the army to provide constant messaging services to soldiers with TBI because they need regular reminders to keep their rehabilitation on track. Army case managers can push out questionnaires to soldiers and depending on how they answer, the case manager might be triggered to give them a call while they have the phone in their hand. So the phone-based communication tool is the primary tracking device for soldiers who return to the US with TBI.

Dr. Val: What are the educational qualifications of your coaches?

Reed: Registered nurses, dieticians, and psychologists.

Dr. Val: And what if the patient needs to see a doctor?

The coaches are trained to refer patients to their doctor when it appears that they need it. We can also track their prescription patterns and send the patients a “gaps in care” letter to remind them to fill their prescriptions. Non-compliance with medications is a major problem that All One Health can address.

Dr. Val: How would a doctor use All One Mobile?

Segal: We’re currently working on making EMRs accessible via phones – so that no matter where a physician is, he or she can review patient records and track their progress remotely.

Dr. Val: Or better yet, when one doctor is taking call for her group, she can have access to patient records so that when she’s called in the middle of the night, she’ll be fully informed about the patient problem list and understand the context of the concerns much better.

Segal: Yes, and All One Mobile can be used in the Emergency Department setting – so that when patients are discharged home, they receive 30 days of our service. The hospital can send them their lab results (that were drawn in the ER) and easily contact patients to bring them back in if necessary. In addition the patients can take photos of their wounds, for example, and have the physicians see how they’re progressing.

Dr. Val: Any closing thoughts?

Reed: This kind of health communication is incredibly convenient. Patients don’t need to carry around a smart card, a thumb drive, or a paper record. They’re already carrying around what they need – their own cell phone. And almost everyone in the US, regardless of economic class or age, has a phone.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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