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Personal Injury

Zion’s New Hands

By Jen Jenkins, Market Analyst

We are inundated by new technologies and on an almost daily basis learn of awe-inspiring events in the medical and scientific communities; nevertheless, it remains a momentous occasion when something happens that will so radically change a person’s life. Eight-year-old Zion Harvey, who lost his arms and legs to a life-threatening infection at the age of two, made his way home this week with a brand new pair of hands. Under the care of Dr. Scott Levin and a transplant team at the Children’s Hospital of Philadelphia, Zion became the first child to ever receive a double hand transplant.

The history of this extensive operation is a short one. The first single hand transplant to achieve prolonged success was performed in Louisville, Kentucky in 1999. Since that time there have been hand transplants performed on adults around the world; however, that list of completed surgeries is still relatively short.

Zion endured 11 hours of surgery and has had extensive physical and occupational therapy several times a day since the July surgery, but there are still many challenges he will continue to face. After not having use of these extremities for years, Zion will need to reengage his brain to use his hands to their full ability. Despite that, Dr. Levin shared with NBC News just how remarkable this boy is: “Today he was playing with his action figures and baking cookies with a whisk, doing all sorts of things with his hands we never dreamed he would be able to do within a few weeks of surgery.”  See the full story here.

 

Hyperbaric Chambers and Helmet Sensors: Effective Concussion Treatments?

Start-ups and doctors are in zealous pursuit of new and sometimes controversial ways to prevent, detect and treat concussions, as noted in this article.

A growing industry has developed around concussions, with entrepreneurs, academic institutions and doctors scrambling to find ways to detect, prevent and treat head injuries. An estimated 1.7 million Americans are treated every year after suffering concussions from falls, car accidents, sports injuries and other causes.

While the vast majority quickly recover with rest, a small percentage of patients experience lingering effects a year or longer afterward. Along with memory issues, symptoms can include headaches, dizziness and vision and balance problems.

Since 2007 research spending has increased dramatically. At that time Congress, facing criticism that the military had ignored the psychological and physical toll on soldiers of serving in the Afghanistan and Iraq conflicts, allocated $600 million for research and treatment on traumatic brain injury and post-traumatic stress disorder (PTSD), two major conditions faced by many returning soldiers. In turn much of the traumatic brain injury research has included a look at treating concussions. Many highly publicized cases in the NFL of concussed football players have added to the call for more research and treatment options.

The search for ways to treat and prevent concussions has spawned screening tools, helmet sensors, electronic mouthpieces, diagnostic blood tests and brain imaging devices. Start-ups are marketing their products to the military, schools, hospitals, sports teams and parents, and controversial therapies like hyperbaric oxygen are being promoted to patients. But as the industry booms, medical experts are raising concerns that it is a business where much of the science is sketchy, belief frequently outruns fact, and claims of technological breakthroughs evaporate soon after they are made. Read more…

Careers with the Highest Suicide Rates

In the US, suicide results in roughly 36,000 deaths per year. And since 2009 suicide has been the leading cause of injury-related deaths. A new study published in the American Journal of Preventive Medicine analyzes suicide trends in the workplace, identifying specific occupations with high incidents.

Occupations with the highest rates?

  • Law enforcement officers (5.3 per million)
  • Farming, fishing, and forestry occupations (5.1 per million)
  • Installation, maintenance, and repair (3.3 per million)

This study compared workplace versus non-workplace suicides in the U.S. between 2003 and 2010. During that time period there were 1700 workplace suicides (a rate of 1.5 per 1 million) with an overall US suicide rate of 144.1 per 1 million. The study used data from the Bureau of Labor Statistics’ (BLS) Census of Fatal Occupational Injury (CFOI) database.

  • The workplace suicide rate was 15 times higher for men than for women, and almost four times higher for workers aged 65-74 than for workers 16-24.

Why the high rates in these particular categories? One hypothesis suggests an increased risk based upon availability and access to lethal means. This would include access to pharmaceuticals for medical doctors and firearms for law enforcement officers.

This might help explain the higher rates of death among members of the second two categories noted (i.e. farmers and maintenance workers) who would routinely work with heavy, potentially dangerous equipment, and would also face workplace stressors such as social isolation, higher rates of chronic injuries and pain, a high risk of financial loss, and chronic exposure to toxic chemicals including many types of pesticides and solvents.

“This upward trend of suicides in the workplace underscores the need for additional research to understand occupation-specific risk factors and develop evidence-based programs that can be implemented in the workplace,” concluded Dr. Hope M. Tiesman, epidemiologist with the Division of Safety Research at the National Institute for Occupational Safety and Health (NIOSH) and lead investigatory for the study.

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A Disease of Time

Post Traumatic Stress Disorder is a psychiatric disorder, the fourth-most-common one in America.  Over a decade into the global war on terror, PTSD purportedly afflicts as many as 30 percent of the conflict’s veterans. And the disorder’s reach extends far beyond the armed forces.

David J. Morris, who served in Iraq from 2004 to 2007, provides us with a new understanding in his recently released The Evil Hours: A Biography of Post-Traumatic Stress Disorder. PTSD, he notes, is “in a manner of speaking, a way of institutionalizing moral outrage.”

From Morris’s website is a brief summary of The Evil Hours: Drawing on his own battles with post-traumatic stress, David J. Morris — a war correspondent and former Marine — has written a humane, unforgettable book…Through interviews with people living with PTSD; forays into the rich scientific, literary, and cultural history of the condition; and memoir, Morris crafts a moving work that will speak not only to those with PTSD and their loved ones, but to all of us struggling to make sense of an anxious and uncertain time.

David Morris notes:

I first got interested in PTSD when I read a newspaper article about how some Iraq veterans felt “poisoned” by the war, as if it had fundamentally altered their existential position in the world. I am fascinated by this moral component of survivorship—how events in life can freeze us in time, seeming to render us unfit for the everyday world. This is essentially the same question confronted by Ishmael at the end of Moby Dick, as he looks out on the vast sea from Queequeg’s coffin: How does one live in the aftermath of the impossible?

The Evil Hours has been widely and quite favorably reviewed, from “an eye-opening investigation of war’s casualties” (Kirkus Reviews)  to “Well-integrated autobiographical elements make this remarkable work highly instructive and readable. (Publishers Weekly) Read more…

The Top 8 Jobs with the Highest Injury Rates

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Four of the top eight are medical workers: orderlies, nursing assistants, personal care aids, and registered nurses.

According to the Bureau of Labor Statistics, more than 35,000 nursing employees are injured each year severely enough that they miss work.

Some hospitals have report that they have reduced lifting injuries among nursing staff by up to 80 percent — using an approach often called “safe patient handling.” They use special machinery to lift patients, similar to motorized hoists that factory workers use to move heavy parts. The hospitals also conduct intensive training among the staff.

Yet the majority of the nation’s hospitals have not taken similar action. The injuries are often so severe that they’re career-ending, a problem compounded by the fact that many of those injured are relatively young. To help address the problem, on Jan. 1, 2012, the Hospital Patient and Health Care Worker Injury Protection Act went into effect in California. This NPR article follows several injured medical workers and their stories.

West Point Professor and Iraq War Veteran Weighs in on Disability Pay

Disability benefits, especially for veterans, can be a difficult, often emotional issue to discuss as is witnessed in this The New York Times article and accompanying comments. Lt. Col. Daniel Gade, a professor of public policy at the United States Military Academy, lost a leg while serving as a tank company commander in Iraq in 2005. He spends much of his spare time publishing essays and traveling the country pushing the idea that the Department of Veterans Affairs should move away from paying veterans for their wounds and instead create incentives for them to find work or create businesses.

“It’s a difficult issue to broach. People immediately think you are trying to shortchange veterans,” he said in an interview. “But I’m in a position to do it because I have skin in the game, literally.”

Colonel Gade wants to avoid a partisan fight over his ideas which says are first about helping veterans and second about saving money: “I think we can show we have a no-kidding better way to help veterans that is cheaper and more effective.”

One comment author summed many points up not just on veterans’ benefits but the disability system in general: “We can say that ‘disability status’ can become a disability in itself, without suggesting any sort of malingering or intent to defraud. This applies to vets and civilians alike. There are many cases of disability where the person really can’t work; gaining disability status is a godsend for them. It enables them to actually be more successfully productive in the community than continually failing in the workplace. BUT…Some people don’t do well being disabled. The status itself seems to undermine their ability to take charge of their lives.” Read more…

Munchausen by Proxy and Social Media

by Laura McFarland, Communications Director

As the mother of two small children, this is the kind of article I’d prefer to skip over and never have to know about. This past January Garnett-Paul Spears, aged 5, died from sodium poisoning. His mother, Lacey Spears, has been charged with committing depraved murder and manslaughter in the case.

Munchausen by Proxy Syndrome, a disorder wherein caretakers purposely harm children and then bask in the attention and sympathy, has not been specifically mentioned by the prosecutors though “Spears fits the pattern” of such caregivers as noted by some experts.

Dr. Marc Feldman, a psychiatrist and forensic consultant in Birmingham, Alabama, who wrote the book Playing Sick, said he believes the Internet has contributed to the number of Munchausen by proxy cases, with its quick and easy access to a potentially huge, sympathetic audience. One study estimates there are more than 600 cases a year in the U.S. alone. For example, doctors at Seattle Children’s Hospital found three cases of mothers who falsely blogged that their children were near death and were rewarded with support. In a 2011 case in Great Britain, a childless 21-year-old woman joined an Internet forum for parents, claiming to have five children and chronicling her nonexistent baby’s battle with celiac disease and bacterial meningitis. Most cases rarely end in death; when a death occurs, it’s because of a miscalculation, Feldman said. “It would defeat the purpose to kill the child.” Read more…

Toes are Overrated (and other Post-Plague Observations)

“You’ve got to play the hand you’re dealt,” says Paul Gaylord. This doesn’t sound like a loaded remark, but it is when coming from a man whose hands were, literally, dealt quite a blow; after a bout with bubonic plague he lost eight fingers (and all of his toes, and nearly his life — his recovery came after doctors had discussed with his wife when to remove him from life support after his 27th day in a coma).

MCN processes a lot of reports related to disability claims. As we address questions of causality and medical improvement, it’s important to remember that each claim is not just a report, but that it represents a person, and human suffering, and is also just a very small glimpse into a person’s life. This article is striking in its outlook, and a refreshing reminder not to confuse a misfortune in a life with an unfortunate life. Certainly Gaylord doesn’t.

“I say I’m actually a 1-year-old because I got a second chance at life,” he said. “I can do almost anything I could do before.”

Undoubtedly Gaylord has struggled immeasurably with recovery and adjusting to his new body and all that he had to learn how to do differently. But as the article notes, the Gaylords have a sense of humor about the whole thing, and Debbie Gaylord said her husband has always had a positive outlook about it.

There are numerous studies which show that an injured or sick person’s outlook and attitude are major components not just of how well they will recover but whether they will recover at all. But a study, like a report, is not a human life; and sometimes it is from that individual life that we learn. Certainly there is something to learn from Paul Gaylord and what he has chosen to share with us: that a disability or an illness does not mean that life stops. “Toes are overrated,” Gaylord said. “And I can do a whole lot with just these thumbs.”

Common Surgery May Not Actually Help

The most common orthopedic procedure in the United States appeared to be no more helpful for some patients than a completely simulated surgery, according to an unusual Finnish study.

The Finnish study does not indicate that surgery never helps; there is consensus that it should be performed in some circumstances, especially for younger patients and for tears from acute sports injuries. But about 80 percent of tears develop from wear and aging, and some researchers believe surgery in those cases should be significantly limited.

Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion. Read more…

106 Indicted in $21.4 Million New York Disability Fraud Scheme

An indictment unsealed on Monday by the Manhattan district attorney’s office charges 106 people, four of whom are accused of fraud in a scheme involving Social Security disability payments.

Many of the 72 city police officers and eight firefighters named in the 205-count indictment had blamed the Sept. 11 attacks for what they described as mental problems: post-traumatic stress disorder, anxiety and severe depression.

Several of the defendants documented their activities on Facebook. The bail letter includes photographs culled from the Internet that show one former officer riding a water scooter and others working at jobs including helicopter pilot and martial arts instructor. One is shown fishing off the coast of Costa Rica and another sitting astride a motorcycle, while another appeared in a television news story selling cannoli at the Feast of San Gennaro in Manhattan.

Read more…