Injuryboard Commentary - Spinal Cord Injuries

Disc Herniation

Jeremy Thurman — Tue, 01 Dec 2009 13:12:00 GMT

One of the more commonly injured parts of the body in a car or truck accident is the back and spinal column. As a result of the force and speed involved in automobile accidents, many injuries sustained by those involved is a herniated disc. The discs within the spinal column are soft and malleable, which buffer the hard bones of the vertebrae. These allow for flexibility and mobility of the spinal column and act as shock absorbers for our body. These discs are not indestructible however, if injured in an automobile accident the cushioning affect from these discs may be destroyed causing pain to radiate to different parts of the body due to the heavy concentration of nerves running along the spinal column.

There are many options for those with herniated discs, including conservative treatments and surgical treatments. The conservative treatments involve rest, rehabilitation, medication, osteopathic manipulations, physical therapy, and epidural steroid injections. These conservative alleviations are for patients that do not report severe pain and can function without too much detriment for a period that the treatment usually covers. Most of the alternatives to surgery take up to twelve weeks before a patient reports normal range of motion and little to no discomfort.

After this period of conservative care, surgery may be recommended for those who do not recover as quickly. Surgery is designed to alleviate pain and help the patient recover more quickly. Treatments for a herniated disc include microdiscetomy, lumbar laminectomy, and microendoscopic surgery. Microdiscetomy is the most common of these procedures. This involves removal of a small portion of the bone that is located over the nerve that is being impinged, to provide the nerve with ample room to heal. This surgery is normally provided for those that are experiencing leg pain resulting from a herniated disc.

If you or anyone you know has been the victim of a automobile accident and suffering from lower back pain, or other pain that may be related to a herniated disc, please seek medical care and legal representation immediately. Your health should be your first priority when involved in such an accident.

Originally posted at InjuryBoard by Jeremy Thurman

Spinal Cord Injuries Require Skilled and Experienced Assistance

David Mittleman — Thu, 12 Nov 2009 16:59:44 GMT

A spinal cord injury is a serious and potentially debilitating injury that cause damage to the white matter of the spinal cord that carries signals to and from the brain. Spinal cord injuries can result from traumatic events (car crashes and falls) or one of many different types of biological origins. The vast majority of spinal cord injuries occur from some type of accident. The leading cause of spinal cord injuries are automobile accidents.

Approximately 12,000 people experience spinal cord injuries a year in the United States. Approximately 250,000 people live with a spinal cord injury. An overwhelming number of new injuries occur to people under the age of 30.

Symptoms of a spinal cord injury range from paralysis to loss of sensation at the level and below. These injuries can be located even without a complete cut off the spinal cord. Spinal cord injuries can often be a cause of death, due to respiratory failure. Survival within the first 24 hours as well as the first year after the injury greatly increase the chances of long-term survival.

If you or someone you know has suffered a spinal cord injury as a result of an accident or medical error do not hesitate to contact us. Our office has successfully managed cases involving spinal cord injuries. You can reach our office, ChurchWyble, at (888) 227-4770.

Originally posted at InjuryBoard by David Mittleman

Surprising Facts about Spinal Cord Injuries

Jim Lewis — Wed, 11 Nov 2009 00:10:00 GMT

According to www.sci-info-pages.com, a website of caregivers centred on spinal cord injuries, about 250,000 Americans have a spinal cord injury. A little over half, or 52% of spinal cord injured are paraplegic; an impairment in motor and sensory function of the lower extremities. 47% of the injured are quadriplegic; which is paralysis caused by illness or injury which results in partial or total loss of use of all the limbs and torso.

Vehicular accidents make up for 37% of the cause of spinal cord injury (SCI), followed by violent assault at 28%, falls are at 21%, and sports-related injuries amount to 6% of total spinal injuries. The majority of spinal cord injuries typically occur between the ages of 16-30 when an individual is usually the most physically active. This spinal trauma results in morbidity and also includes respiratory deficiency, bladder and bowel dysfunction and loss of motor and sensory functions. With the advent of these secondary complications from the initial spinal injury requires the patient to undergo physical and medical care for a longer period time.

Since motor vehicle accidents are the primary cause of spinal cord injury, the CDC has come up with safety measures to help prevent the occurrence of SCI. Also, it should be noted that you should never drive under the influence of drugs or alcohol for the obvious impairment issues related to such activity.

About the Editors: Shapiro, Cooper, Lewis & Appleton personal injury law firm (VA-NC law offices ) edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard, and Northeast North Carolina Injuryboard as a pro bono service to consumers.

Originally posted at InjuryBoard by Jim Lewis

What's more dangerous, cheerleading? ... Or foolish coaches?

Steve Lombardi — Fri, 06 Nov 2009 12:01:00 GMT

Is Cheerleading too dangerous? Does it need to be changed? Or does the coaching system simply need to be tweaked to provide a more safety minded mindset?

A Wall Street Journal article on September 17, 2009 addressed the increasingly popular sport of cheerleading and the dangers it presents to girls across America. More news coverage of the injuries incurred by cheerleaders is causing debate on whether certain aspects of the sport should be banned or at least changed. With cheerleading being the cause of “65% of all female catastrophic injuries in high school and college…according to the University of North Carolina's National Center for Catastrophic Sport Injury Research.” There is no wonder why people are upset that this high risk sport does not have the same quality of medical assistance present at all times, as with other sports such as football. To help decrease the risk factor different levels of cheerleading are taking preventive measures such as, “College teams are no longer allowed to perform three-person-high pyramids and do double flips from them. High school teams can't perform flipping basket tosses and last year, twisting dismounts were banned on basketball courts.” Some states (like Wisconsin) view cheerleading as a high risk sport and called it a “contact sport” which the Wisconsin's Supreme Court’s decision “prevents injured cheerleaders from suing their schools or teammates.”

If cheerleading is such a high risk sport as to be considered a contact sport, should not the association which regulates it, make changes to protect the participants or change the way the sport is performed all together. To truly estimate the risk of cheerleading first the sport must attempt to account for all participants across the country. The Wall Street Journal says that “estimates say there are about 400,000 public high school cheerleaders, but the NCAA doesn't track participation (it's not considered a sport) and the number of cheerleaders on private teams isn't known.” The number of cheerleaders all together is hard to pinpoint, but “if you go by the consensus estimate -- that there are about 4 million cheerleaders across the country -- the activity looks about as risky as women's soccer.”

What was the original purpose of cheerleading: to get the crowd’s energy up and to support and “cheer” on the team. There is no doubt that the ways of cheerleading have shifted with regular stunts in routines consisting of split jumps called the “Herkie”, flipping basket tosses, and twisting dismounts. If the stunts of cheerleading of today remain, maybe the activity should be reconsidered an organized sport, instead of just a “girly athletic activity.”

There have been motions set in place to attempt in helping injured cheerleaders. Kimberly Archie founded the National Cheer Safety Foundation in 2008, created this program as a parent of a cheerleader who broke her arm during a practice. She hopes this program will help parents be more aware of the injuries and ultimately help reduce the risks that cheerleaders face constantly. Archie’s organization has been in the forefront of cheerleader safety issues and advocating for positive changes. She’s a positive force that has successfully resisted the headwinds pushing against change.

Should this highly dangerous but popular activity be changed all together, have tighter regulations, or continue to victimize America’s young girls of today. As a parent it’s your choice to accept the status quo or push for changes that may protect your child from a life of misery. All coaches need to get on the safety band wagon for the sake of the cheerleaders. It’s a terrific sport.

Video Library | Lombardi Law Firm

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Originally posted at InjuryBoard by Steve Lombardi

Crashing Into A Sheriff Deputy is a Bad Night

Steve Lombardi — Tue, 03 Nov 2009 12:01:00 GMT

What caused 21 year old Travis Scott to veer straight into oncoming traffic? That is the question Council Bluffs police are asking after the accident in the late hours of October 9th 2009 between Mr. Scott and Pottawattamie County Deputy Jahn Kirlin left Mr. Scott, his two passengers and the deputy injured. The accident happened on 23rd St.; the driver Travis Scott and passenger Leah Wenninghoff were in serious condition, another passenger Anthony Biggert was listed in stable condition, and the Deputy was treated for hand and arm injuries. The case remains open for investigation.

This is one of those types of crashes we are seeing more and more of on the Interstate highways: I-80, I35, I235, I380 and all the other parts of Iowa's interstate highway system. As the accident causes accumulate distracted driving is the number one, two or three cause. It's got to be right behind drunken driving or speeding. Many that we see are by drivers distracted with cell phones, either because of talking or tweeting or texting. I wonder what this one was about. What was the distraction that caused this young man to run right into a police car?

Yesterday as I was driving by an elementary school where parents must have been attending a school activity the function ended and we all drove off together in a line. As we turned onto the main drag, University Avenue, I got in the left lane to pass them. I passed six cars in a row and every one of the drivers was a parent with a cell phone glued to their ear. With the cell phone being held to your left ear the driver's hand creates an added blind spot by the hand and arm. You can see how the driver is required to turn their entire body to see the left side if they want to see what's coming to the left. These are all distracted drivers who can cause an accident, and injure others or kill pedestrians.

And that's why personal injury lawyers aren't going anywhere. This is why people will continue to need more personal injury lawyers who care about their clients and understand the business of personal injury legal work. There will always be those who want us gone or who work through large advertising campaigns to convince people the problems are all the lawyers' fault. And people can choose to believe that, at least until it's them that are struck by a distracted or drunk driver. And then they need Lombardi Law Firm and alll the other law firms that make up the InjuryBoard, because when you come right down to it, we aren't the problem we are a part of the solution. When you're in an accident, call us at the Lombardi Law Firm and we'll use our 30 plus years of experienced trial work to assist you with your fight against distracted drivers. For more information about the types of distracted drivers read the other blogs at the Des Moines InjuryBoard site.

Welcome Mr. Scott you're now a member of the distracted drivers' club.

Originally posted at InjuryBoard by Steve Lombardi

Iowa Cheerleader Bibliography of Safety Titles

Steve Lombardi — Tue, 27 Oct 2009 17:32:00 GMT

Cheerleading Blog Title Bibliography

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Let's work to keep Cheerleading Safe

Steve Lombardi — Tue, 27 Oct 2009 10:23:00 GMT

Canadian cheerleader coaches comment on the safety of the rising popularity of cheerleading in the U.S. and Canada, in an article of Times and Transcript online news source on October 3, 2009. Though there are reported catastrophic injuries from cheerleading in America, Leanne Livingston from Canada’s Alberta Cheerleading Association says, "Injuries do happen, it's just like any other sport. But in my experience in cheerleading for over 25 years, there has never been any kind of catastrophic injury." Another Canadian, Deanna Mason from the Ontario Cheerleading Federation, “also said she couldn't think of such a disaster north of the border.” She was bothered by the American media coverage of accidents in cheerleading saying, "‘It's really unfortunate. I know there are a lot of coaches and programs that are really safe and never had severe injuries. But it can happen in any sport.’"

At Edmonton's Harry Ainlay High School the cheerleading “team is the reigning provincial champion.” The coaches are Chelsey Harris and Meagan Tracey and are said to “start with safety and a focus on the fundamentals.” They also make sure the students are able to perform what is asked of them by evaluating their performance. Tracey suggestes parents “check out the coach's credentials and visit the gym, ask about the training regimen, make sure the mats are good quality.” She also commented that “when things go wrong, it's usually a case of the coach not knowing their athletes, pushing the athlete beyond a skill they're capable of.’”

Club teams of cheerleading have changed the dynamic of the activity in the U.S. and Canada. Mason said in Ontario, “We've seen a huge decline in school cheerleading programs in the last five to 10 years. We're seeing a lot of experienced and successful coaches move into the club environment." Will this result in a lack of qualified coaches being provided at the school level?

See other blog on 2009.10.08 Is Cheerleading too dangerous? Does it need to be changed?

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Originally posted at InjuryBoard by Steve Lombardi

Medicare Is Delaying My Settlement

Mike Bryant — Sun, 18 Oct 2009 16:08:00 GMT

There have been new and old issues that have come up with recent changes in the Medicare rules. In July of 2009 a number of reporting requirements were added. Basically, in each settlement it must be determined if the plaintiff is Medicare eligible. If they are, then there are additional reporting requirements at the time of settlement. There also is a pay back requirement for money that was expended by the system that was caused by the defendant.

The concern has been if there is a requirement for a future set aside. In workers compensation claims, when there is a settlement that included future medicals, some of the money needs to be set aside so that the Medicare system doesn't pay for those items. The fear that was being pushed by some defendants was that the new rules require a set aside in all cases.

The American Association for Justice followed through on this issue and provided the following information:

... statements from CMS, and other federal entities, make clear that the agency does not require set-asides for liability claims. Since the MMSEA’s passage, CMS has held several Town Hall teleconferences to discuss the Section 111 requirements. During the March 24, 2009 call, Barbara Wright, CMS’ Acting Director of the Division of Medicare Debt Management, made several statements reiterating that Section 111 has no impact on liability MSAs.(2) For example:

In response to a question as to whether liability set-asides will be required under Section 111, she said “the point is the set-aside process is totally separate from the Section 111 reporting process. As we’ve said in more than one call we don’t anticipate changing our routine recovery process.” (Transcript, pg. 24)

When explaining that worker’s compensation agreements use a formal review process which makes set-asides recommended, she said that was in contrast to liability agreements. Liability “does not have the same formal review process although our regional offices will consider review of proposed liability set-aside amounts depending on their particular work load and whether or not they believe significant dollars are at issue.”
(Transcript, pg. 24).

In addition, CMS also has released several Alerts explaining Section 111, which do not indicate any intent to require MSAs for liability claims. For example:

“Unless you are a business entity which qualifies as [a required reporting entity (RRE)] for purposes of Section 111, you do not need to initiate any specific actions in connection with Section 111.” (CMS Alert, 2/23/09).(3)

“The new Section 111 requirements do not change or eliminate any existing obligations under the MSP statutory provisions or regulations.” (CMS Alert, 2/23/09).

Moreover, the Congressional Research Service (CRS) provided Congress with an “objective and non-partisan analysis” analysis of the MMSEA. As there was no legislative history regarding the bill, the CRS research report is the most reliable analysis of the MMSEA, including the Section 111 reporting requirements.

CRS’ analysis of the Section 111 reiterates that it is a reporting requirement, and makes no mention of the need for set-asides in liability cases. The Section 111 analysis states, in part:

This provision requires an insurer or third-party administrator for a group health plan (and in the case of a group health plan that is self-insured and self-administered, a plan administrator or fiduciary) to (1) secure from the plan sponsor and participants information required by the Secretary for the purpose of identifying situations where the group health plan is or has been a primary plan to Medicare, and (2) submit information specified by the Secretary. If an insurer or third-party administrator for a group health plan fails to comply, then a $1,000 per day civil monetary penalty will be imposed for each individual for which information should have been submitted.(4)

If CRS believed that the legislative language implies any Congressional endorsement of liability set-asides, it would have been included in this analysis.

It is still expected that with the reporting requirements many cases will be delayed if an amount needs to be determined for the payback. Early recognition of the claim and making sure all of the reporting is done right will make the biggest difference. Experienced attorneys are getting through the system as fast as possible, and will make a difference to clients who need to know their future Medicare coverage will not be put in jeopardy.

Originally posted at InjuryBoard by Mike Bryant

A True Story

Joe Crumley — Sat, 19 Sep 2009 18:48:00 GMT

A crisp and bright October Sunday morning. The kind of morning that inspires drives out of the city seeking clear air and crimson and amber leaves by roads and rivers.

First things first, though. Mom teaches Sunday School and starts her class prep an hour before. Dad is in charge of the kids until class starts, and when the weather is good, a nature walk along the creek fills the time. Today, however, something different.

It's the morning of the marathon. Dad has been drafted by best friend James to handle snack, first-aid, and petroleum jelly for socks at Milepost 18, which James won't reach for a couple hours. There will be plenty of time to reach Milepost 18 after Sunday School. The church is near Milepost 4, and a check of his watch tells Dad the race is just starting, a few miles away.

Dad shepherds the kids to a bridge where the marathon route crosses the creek. Beyond, the parkway is a broad, sweeping curve. Dad has done this before, and remembers the joy of clapping and cheering on the runners. But always in the middle of the course, arriving only in time to see the middle speed runners, like James. For once, he wants to see the first runners, and taste the excitement of the leaders. Dad has told the kids about this. But Dad has forgotten who usually leads the marathon.

The kids began to get bored after a few minutes, as the runners don't appear right away. They cavort and roll in leaves. A few more minutes and a whisper of clapping and cheering is heard in the distance, then builds. At Dad’s yell, the kids come running back to the bridge. They huddle by him at the curb, all leaning out over the pavement, squinting into the distance.

The clapping gets ever closer, as do indistinct yells of encouragement. My eight-year-old boy looks intently down the road. He often does not care or pay much interest in sport, and his attention span may again soon wander.

Suddenly, a small, low-to-the-ground form comes sweeping past the trees through the beginning of the curve. There is a moment of confusion, then recognition. Not a runner, but a man in a wheelchair ... and he's going fast.

Another man in a wheelchair is coming up the outside, gaining on him. They're almost neck and neck as they sweep through the turn, across the bridge toward us.

I look at my son and note the gradual recognition of what he's seeing. His eyes grow big. It’s a wheelchair. Eyes grow bigger.

His legs are really tiny. Atrophied, tucked almost like an afterthought into a pouch on the racing wheelchair beneath a paradoxically strong, rippling, upper body. He really can't walk or run.

My son is a sensitive boy, and his face begins to screw up at the immensity of what he's seeing. A man who cannot walk; a man who cannot run … is … flying. My boy’s eyes gleam and tears form at the corners of his eyes. Enviably large churning biceps, sweating forearms, and gloved hands literally beat power into the spinning rear wheels.

Men who cannot walk are going to win this marathon.

Misreading his expression, I move to comfort him but he brushes me back and responds quickly, almost as quick as the two men now sweeping by us tucked into their machines.

"Go, Wheelchair Guy, Go!” at the top of his lungs, his voice just cracking. I don’t know which of the two racers he is cheering, but it doesn’t matter. Both racers react immediately to the childish sincerity of that yell, which easily pierces the cheers of the other onlookers. The strain of their Herculean duel notwithstanding; both faces break into broad grins at the cheer.

In a moment they have swept around another corner, still neck and neck. Many more wheelchaired racers sweep by; men and women. Tears are streaming down my face, my son’s face, and his older sister.

A quiet interval, and the running men arrive. All their muscles are lean, and their strides rhythmic and effortless. They are some of the most impressive athletes in the world; some have crossed oceans to run and ‘win’ this race. But they are not so impressive as they might have been just a moment before.

The effort, the striving, indeed the full and complete meaning of sport, encapsulated in one innocent, sincere and robust cheer of an eight year old child. A simple expression of what we often struggle to explain in our closing arguments; the value of strength, the value of physical effort and competition. Not tears of sympathy for them, but a shout of encouragement and tears of joy and wonder.

The 2009 Twin Cities Marathon will be run October 4.

Go, wheelchair guy, go.

Originally posted at InjuryBoard by Joe Crumley

Goals of Rehabilitation Following a Spinal Cord Injury

Sach Oliver — Wed, 09 Sep 2009 08:41:33 GMT

Goals of Rehabilitation Following a Spinal Cord Injury

Change should be expected following a spinal cord injury. One of the most important things that a person can do is setting goals for rehabilitation following a spinal injury. Setting goals allows a person to “facilitate [his/her] return to performance of accustomed tasks and roles in [his/her] family and in society.”[1] Of course, accomplishing goals requires a person who suffers from a spinal injury to make adjustments, acquire certain skills, possess necessary equipment, adapt their physical environment, and maintain their health.[2]

Adjustment

First of all, one who suffers a spinal cord injury must make psychosocial adjustments including coming to terms with their loss.[3] Furthermore, a person must make adjustments to their vocation and recreation activities since many of the activities possible before injury are now impractical.[4] Adapting these two areas of one’s life will likely require significant changes, but are necessary to developing a well adjusted life.

Functional Skills

Perhaps most affected by spinal cord injuries are a person’s physical capabilities. Learning to function despite altered capabilities will require one to take up functional training.[5] The goals set in this area are critical, as accomplishing them will allow a person to become more independent and mobile.[6]

Necessary Equipment

Acquiring the necessary equipment following spinal injury is interconnected with developing functional skills that allow a person to maintain their independence. Often, as part of an overall plan for recovery, the right equipment enhances one’s health and performance of socially defined roles.[7]

Adapting the Physical Environment

The architectural environment of most places is not well suited to those with spinal cord injuries. The most adaptable place is often the home environment, and adequate adaptation should take place in order to promote independence.[8]

Maintaining Health

Following a spinal cord injury, a host of health maintenance issues will arise that one probably did not consider prior to injury. “Virtually constant vigilance is required to avoid complications such as pressure sores and urinary tract infections.”[9] Avoiding health deteriorations requires one to “learn how [his/her] body works, how to prevent and detect complications, and what to do when complications occur.”[10]

Setting practical goals in these areas will help a person’s rehabilitation following spinal cord injury.

[1] Martha Somers, Spinal Cord Injuries: Functional Rehabilitation (New Jersey: Prentice-Hall, 2001), 2.

[2] Id. at 2-3.

[3] Id. at 3.

[4] Id.

[5] Id.

[6] Id.

[7] Id. at 4.

[8] Id.

[9] Id.

[10] Id.

Originally posted at InjuryBoard by Sach Oliver