CINN’s Dr. Gail Rosseau to deliver keynote lecture at Duke University

Duke’s Sanford School Hosts Lectures on Global Finance, Health Care

Weekend celebration includes keynote lectures by two public policy leaders

Thursday, September 24, 2009

DURHAM, N.C. — Richard Fisher, CEO of the Federal Reserve Bank of Dallas, and neurosurgeon Gail Rosseau, chief of surgery at the Neurologic & Orthopedic Hospital of Chicago, will deliver keynote lectures during a weekend celebration of Duke University’s Sanford School of Public Policy.                                          
                                                                                        
 Prominent journalists Cokie Roberts of NPR and John Harwood of CNBC will engage the lecturers in conversation. Both events are free and open to the public.

The talks are part of a series of events marking the Sanford School of Public Policy’s inaugural year. The former institute became Duke’s 10th school on July 1.

“A year ago, the nation was staring straight into the jaws of economic ruin,” Fisher said in a recent address. “The Federal Reserve stepped into the breach and did what central bankers are called to do: We assumed the role of lender of last resort … instituting unconventional measures to keep the financial lungs of the global economy from collapsing.”

“Policy experts have a very valuable role to play, and their counsel must be in partnership with the people in the trenches putting policy into action,” said Rosseau, who regularly witnesses the consequences of flaws in the current U.S. health care policies through her practice.

 

Use your head - protect it

Moms’ bike-safety effort makes helmets a must

By BILL DWYER, Wednesday Journal of Oak Park and River Forest
Staff Reporter

 

 

In the past year, four River Forest children have been injured in bike accidents. That worried and even frightened River Forest moms Susan Lucci and Sue Gee. Rather than complain and wring their hands, they decided to do something. They came up with a bike-safety program - All Heads in Helmets - that not only is educational and rewarding, it may also be changing some kids’ behavior.

Lucci and Gee get the word out that, while riding a bike, you’ve got to protect your head. They focus on safety gear proven to cut the risk that kids will lose their most irreplaceable asset: their brains.

“If you had a $100,000 crystal bowl, would you ride around with it unprotected?” Lucci asked, not so rhetorically. “No, you’d protect it carefully.”

“Why are we waiting for tragedy?” Lucci asked.

Over the spring and summer, All Heads in Helmets has hosted presentations around the village, at schools, at the park district and at the library. On Saturday, Sept. 12, they held one at the Clear Sky Festival in Keystone Park.

Lucci praised the village’s elected and appointed officials, saying they’ve been very supportive of the program.

Besides education, AHIH looks to incentivize safety, rewarding a few kids seen wearing helmets with raffled prizes like iPods, iTunes gift cards and even new bikes. Dan’s Bike Shop, Barnard’s Schwinn, Panera Bread and iTunes have all contributed prizes.

Kids can go to the library, park district and village hall and drop off the citations. Four tickets are drawn every month in June through August. A fourth drawing was held at the Clear Sky Festival; there will be another drawing in October.

While there’s the possibility police will take a tougher line in enforcement, they don’t appear inclined to do that yet. River Forest’s police chief, Frank Limon, an enthusiastic supporter of All Heads in Helmets, said he’d prefer to keep it voluntary.

“That’s the route we want to go,” he said. “We’re looking for voluntary compliance.”

Limon said his officers also liked the positive interaction that passing out the incentive citations affords them with the village’s youth, calling it a “win-win situation.”

There have been obstacles. While the program has been well accepted at the village’s two grade schools, Willard and Lincoln, it’s been more of a slog in the middle school.

“The older kids don’t think it’s cool,” said Lucci.

Whether they realize their mortality or not, older kids are getting hurt. A seventh grader was recently hit by a car backing out of a driveway and suffered broken ribs. Another child was stuck last year, suffering broken ribs, collar bone and wrist, but no head injury, despite his helmet being demolished.

Anna Gebert said her 13-year-old daughter Julia was crossing Ashland at Chicago in a crosswalk Thursday morning on her way to school when she was struck by a driver on her front wheel. Julia was knocked off her bike and sustained bruises, but no other injuries. She was wearing a helmet. Whether that saved her from head injury isn’t clear, and Gebert said that’s not the issue.

“Julia always wears a helmet,” her mom noted, acknowledging her sons do not. “They say, ‘Don’t worry, Mom, I’m not going to fall.”

But cold statistics show that’s not necessarily true.

“A child is killed in the U.S. every day,” said Gail Rosseau, a River Forest resident who is a neurosurgeon. “An adult every six hours. A person is injured every four minutes.”

“One child in seven will receive a brain injury as a result of a bike injury,” she said. There is only one sure way to protect against devastating brain injuries while on a bike - all heads in helmets all the time. Every time. No exceptions.

“It’s impossible to overstate this,” she said. “Bike injuries are the No. 1 sports-related injury in the U.S.” Unhelmeted riders of all ages, she said, are 15 more times likely to be killed in a crash than those who skulls are protected.

No one is immune, said Rosseau. It’s not how old you are or experienced or how far you are from home or even if you avoid the street. The average distance from home for bike accidents is five blocks.

Her point was underscored recently when a 59-year-old Oak Park man, a veteran cyclist, was struck by a car door as he rode his bike Aug. 31. Besides a broken foot and painful bruising to his tailbone and arm, the man suffered a serious skull fracture.

The man’s wife, who asked that their last name not be used, underscored Rosseau’s comments - she wants people to know that age and experience make little difference in a biking accident. Her husband, she said, logged over 3,000 miles last year.

“He had 3,700 miles already this year,” she said. Doctors weren’t sure of the extent of his injuries, and whether he would fully recover. While he’s doing “remarkably well,” she said, he’s still home from work and not out of the woods.

“It’s just been a horrible thing to go through,” she said. “It’s been a nightmare.”

There is, Rosseau stressed, no way to predict how and when serious accidents will happen. Staying off the street won’t guarantee safety, either.

“Many of the most serious injuries are in driveways and on sidewalks, and not in the street,” she said. “Almost 78 percent of serious bike-related head injuries occur not at an intersection.”

Like Lucci and Gee, Gebert said she’s “frightened for the kids out there.”

“There are a lot of drivers out there who are distracted.”

“These head injuries take a long time to heal,” the wife of the 59-year old cycling veteran said.

If, in fact, they ever do. The clinical realities of brain injuries are chilling.

“I’d love to be able to tell you that neurosurgeons have found the answer to this and are able to put a scrambled brain, a damaged spinal cord, back together,” said Rosseau.

“The treatment is prevention,” she said. “What you want to do is take them back in time before the accident happened, upfront, where it counts.”

Rosseau refers to studies that show the effects of rapid deceleration on watermelons.

“The brain keeps moving when the skull stops,” she said. It can literally bounce around off the inside of the skull. The brain can be literally turned into mush.

“The brain is very, very soft,” she said.

The All Heads in Helmets program will likely become formalized soon.

“The River Forest Park Board Foundation has agreed to take it under their umbrella,” said Lucci. Rosseau suggest that, while the program is an excellent addition, and police enforcement is good, it can’t replaced parental involvement.

“Kids are 10 to 20 times more likely to wear a helmet if their parent do so,” she said. “Kids really do what you do, and not what you say.”

 

 

GUARDING THE BRAIN

September 21, 2009

By TONY GRAF tgraf@scn1.com
Sideline safety is more important than gridiron glory if a high school football player has just suffered a concussion on the field, say two groups conducting a public awareness campaign on the issue.

Getting back in the game is not toughness or heroism. In fact, a young player who returns to the playing field the same night has the potential to harm a developing brain — creating effects that are still not completely understood, said Joe Cunnane, head athletic trainer at Lockport Township High School.

The two groups conducting the campaign are the Illinois Athletic Trainers Association and the Chicago Institute of Neurosurgery and Neuroresearch. As a member of the association, Cunnane is on board with the effort. The groups are raising awareness about the potential for concussion, the need for monitoring, and the importance of “sitting it out.”

But don’t the pros sometimes return to the game in football, hockey or other sports? Some young players may ask that question, but their situation cannot be compared with that of older, professional athletes, Cunnane said.

“One of the biggest mistakes that happens is that we watch athletes in professional sports, for instance, have a concussion and potentially return to the same game — and we make this person to seem like they may be a hero,” Cunnane said.

“The reality is: If that athlete is a 25-year-old man, he has a much different brain than a 17-year-old boy,” he said.

Simply put, there are too many unanswered questions about the impact a concussion has on the developing brain, Cunnane said.

Given the uncertainties, the two organizations are calling on all high school athletic departments to develop more stringent procedures on screening for and monitoring concussions:

The procedures being urged include:

• If there is a suspected concussion, a player should be benched for the game or until fully evaluated by a medical professional;

• Every high school should have a concussion testing mechanism in place. This may be as simple as a battery of questions or as advanced as a software program to measure concussions;

• There should be a team approach in handling concussions involving the athletic trainer, coach, physician, parent and teachers. This is especially important because concussions may not be symptomatic until several hours, or even days, after the hit.

Awareness campaign
This month, the two groups released a statement alerting high schools, parents and athletes about the dangers of returning to a game too soon.
“Studies show that young, high-school-age players who get back in the game and are hit again are at risk of ‘Second Impact Syndrome,’ a condition where the brain swells rapidly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided,” the statement said. “This syndrome has led to severe neurological problems and, in some rare cases, death.”

So though physicians may not fully understand the effect, there is evidence of an effect, Cunnane said.

Lockport seminars
Cunnane teaches in the physical education department at Lockport. He has been head athletic trainer for 16 years in the district.
In 2000, Lockport Township High School began hosting a concussion seminar, sponsored by the Illinois Athletic Trainers Association. Five such seminars were held in the earlier part of this decade. Athletic trainers from Illinois and other states attended. Top-level speakers from all over the country visited to discuss the issue.

At the seminars, one of the goals was improving the use of neurocognitive baseline testing.

In essence, a preseason evaluation — or baseline test — is conducted regarding the cognitive function of the brain. Later in the year, if the school suspects that a student athlete has suffered a concussion, that student’s cognitive functions will be tested again. Experts then can see if functions have been affected.

“This has become one of the gold standards in helping us make better return-to-play decisions in the last 10 years or so,” Cunnane said.

The most common symptom of concussion is a headache, Cunnane said. But recent studies show that amnesia, or memory loss, tends to be an indicator of a significant concussion that would require a longer recovery process, he said.

Visit www.cinn.org to order a wallet reference card that details the signs and symptoms of concussions. Consider ordering one — the cards are free — for every family on your team!

Illinois Athletic Trainers and Doctors Tackle Concussions

Hinsdale, IL, Sept. 4, 2009 -Ted Hirschfeld, athletic trainer for Hinsdale Central, is joining other Illinois athletic trainers and doctors, in a campaign to head off serious concussions in young athletes that may affect them later in life. Officials of the Illinois Athletic Trainers Association (IATA) and neurosurgeons at the Chicago Institute of Neurosurgery and Neuroresearch (CINN) are requesting that Illinois high schools have more stringent procedures on screening for and monitoring concussions.

Concerned about recent research indicating a younger, less developed brain that is concussed more than once is more prone to future neurological impairment than an older, mature brain, the IATA and CINN have created an awareness campaign to better educate coaches and athletic trainers that concussions should be taken very seriously.

They are recommending the following:

• If there is a suspected concussion, a player should be benched for the game or until fully evaluated by a medical professional.

• Every high school should have a concussion testing mechanism in place. This may be as simple as a battery of questions or as advanced as a software program to measure concussions.

• There should be a team approach in handling concussions involving the athletic trainer, coach, physician, parent and teachers. This is especially important because concussions may not be symptomatic until several hours, or even days, after the hit.

“I think many players and coaches don’t realize how dangerous a concussion really is,” says Dean Karahalios, MD, CINN neurosurgeon who is a champion for the cause of concussion prevention. “A brain injury is so different than any other injury because you can’t measure the full potential of the damage for days or even years to come. Because of this, we created an awareness campaign to educate football players, coaches, parents and teachers about the signs and symptoms of a concussion and the importance of “sitting it out.”

“In the past, football players were told to suck it up and get back in the game,” saysTed Hirschfeld, IATA Board Member and Athletic Trainer for Hinsdale Central High School. “But there are too many unanswered questions about the impact a concussion has on the developing brain. We are trying toeducate coaches, players and parents that sitting out a game or two could make the difference in a young player’s life.”

Studies show that young, high-school age players who get back in the game and are hit again are at risk of “Second Impact Syndrome,” a condition where the brain swells rapidly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided. This syndrome has led to severe neurological problems and in some rare cases, death.

Members of the IATA and CINN physicians are offering a wallet-size tool to help players, coaches, parents and teachers better identify and monitor concussions in high school athletes. The card is available as an educational tool for those who work with young athletes to assist in identifying signs of a concussion or other brain injury and to prevent further harm to the youngster. The purpose of the card is twofold: One side features warning signs that the coach or parent can observe and symptoms the athlete may report following a concussion; the other outlines a mental status test the coach or parent can initiate with the athlete they suspect of having a concussion. The wallet resource also includes a phone number at which a CINN concussion expert may be reached if, and when, help is needed. For more information, or to order the card, log on to www.cinn.org or email: info@cinn.org.

High schoolers at higher risk for concussions

Fast fact

The Chicago Institute of Neurosurgery and Neuroresearch, along with trainers across the state, recently created a wallet-sized card to help coaches and parents identify and monitor high school athletes suspected of having a concussion. For more information, visit www.cinn.org.

September 17, 2009

By PATRICK MOONEY pmooney@scn1.com
For as progressive as football has become, it still amounts to trying to knock the snot out of the guy in front of you.

Four- and five-receiver sets have placed a premium on speed and athleticism, the ability to play the entire width of the field, nearly 54 yards. Players care more about health and nutrition — today Bear Bryant could never get away with forbidding them from drinking water during practice. Technology has changed the way the game is analyzed, enjoyed and understood.

» Click to enlarge image Naperville Central’s Conor Philbin (foreground) gets pumped up with his teammates before a rivalry game with Neuqua Valley on Sept. 4 at North Central College. “If anybody tells you they had a concussion (and) it’s not in the back of their head, they’re wrong,” Philbin said. And he knows.
(Danielle Gardner/Staff Photographer)
Fast fact

The Chicago Institute of Neurosurgery and Neuroresearch, along with trainers across the state, recently created a wallet-sized card to help coaches and parents identify and monitor high school athletes suspected of having a concussion. For more information, visit www.cinn.org.
But all that hasn’t eliminated its underlying violence.

In a sense, Bill Hughes’ career path began as a 90-pound, 14-year-old freshman at Homewood-Flossmoor, where he sustained three concussions in two days. Hughes woke up in a hospital after the third one.

The Naperville Central trainer is now in his 37th year responding to these crises.

“When I started, I had kids that would get dinged, and 15-20 minutes (later they) claimed they felt fine,” Hughes said. “I sent them through the sideline assessment and if they passed everything, I handed them their helmet back and they kept on playing. Now how many of those kids are still having results of head trauma? I don’t know.

“The more research they do, the scarier it gets.”

Several former NFL players — and more than one from the Pittsburgh Steelers organization — who have died in recent years have been found with significant brain damage. These were middle-aged men close to dementia.

Micky Collins, a Steelers team physician, helped develop the ImPACT software used by Central the past several years. It’s a computerized test that gauges memory and reaction times. If a red circle flashes on the screen, click the mouse right. If it’s a blue square, click left.

“There’s no right or wrong. It just kind of shows how that kid’s brain processes,” Hughes said. “We run a baseline test on all incoming freshmen in football and soccer. (We keep) a hard copy and we throw that in the file.

“And so then during the four years, if they ever get dinged, we bring them back in. We go through our assessment of them and after they experience seven symptom-free days, we’ll take them back to the library and give them the test again.

“Until they can get back to that baseline score that they got before they were concussed, we won’t let them play.”

A study conducted by researchers from the University of Illinois published in July found that high school football players are at a greater risk for concussions than college ones.

Besides receiving less uniform medical coverage and attention, prep athletes sustain greater head accelerations after impact. College players experienced blows to the front of the helmet 10 percent less frequently and with less force. They are also more physically mature and better able to withstand the hits.

Last year, during the first sophomore game of the season, Central free safety Conor Philbin led with his helmet and the collision with a Waubonsie Valley running back left him with a concussion.

After the helmet-to-helmet tackle, Philbin had trouble walking. His vision was blurry, and he could smile on only one side of his face. He couldn’t stand the noise during the varsity game and left with a headache at halftime that night.

Philbin eventually passed the computer test, but admitted that it took most of last season to stop playing tentative. There are no lingering effects — though the junior has missed time this year after suffering a fracture of the radius during preseason practice.

But Philbin has learned to pump air into his helmet to keep it tight and braced for the next crash.

“If anybody tells you they had a concussion (and) it’s not in the back of their head, they’re wrong,” Philbin said.