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Steve Reimers HBOT & football-related brain injury

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Steve Reimers of Reimers Systems presents more information and statistics on hyperbaric oxygen therapy (HBOT) for treating brain injuries.

Steve Reimers of Reimers Systems presents more information and statistics on hyperbaric oxygen therapy (HBOT) for treating brain injuries.

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  • 1. IHMA & IHMF: Sister Organizations Translating Science into Medical Practice and Public Policy to Create Healthcare Solutions for the 21st Century
    Hyperbaric Oxygen Therapy for Acquired Brain Injury: How To Bring It to the Football World?
    Stephen D. Reimers, MS, PE
    Chief Financial Officer, IHMF & IHMA
  • 2. What is HBOT?
    Typical Multiplace Hyperbaric Chamber
    Typical Monoplace Hyperbaric Chamber
    HBOT is the simple act of breathing pure oxygen at pressures greater than 1 ATA.
    It comfortable, painless and has an exceptional safety record.
    As with any medical intervention, there are risks (primarily ear barotrauma). However, those risks are well understood and readily managed.
  • 3. What is IHMF Goal?
    HBOT is NOT new. “Standard of care” for neurologic decompression sickness in divers for 80+ years and acute CO poisoning for 30+ years . Those are forms of acute brain injury.
    What IS new is the spreading understanding that with a different protocol (different Tx pressure, Tx time and no. of Tx), HBOT can also be used effectively in chronic brain injuries, such as blast injury, concussion CTE, chronic CO poisoning, etc.
    NOT yet considered “proven” in chronic apps. Our goal it to generate the “evidence” req’d to unlock third-party reimbursement.
  • 4. Retired NFL Player: Age 58Pre-Post HBOT 1.54 NFL Players now treated with similar results
    Source: MicroCog Assessment-- Independent Evaluation by Amen Clinic.
  • 5. How Big is the Overall Problem: Public Health Cost of Untreated Brain Insults
    CDC reports 1.7 million new civilian injuries per year with 275,000 hospitalizations and 52,000 deaths. Est. costs of medical costs and lost productivity: $2 billion/week.
    Veterans:33%+ of all deployed, approx. 600,000 total to date
    Overall, an estimated 30-40 million working age Americans are estimated to be living with an untreated brain injury.
    Lost Productivity: mTBI patients have approx ½ of the life-time income of their non-injured counterparts, matched for education, intelligence, etc.
    Incarceration:61% County/56% State/45% Fed have some form of
    Mental illness (usually w/ underlying untreated brain insult)
    If could halve population, est. savings in 10 years = $30B.
    Typical symptoms of brain injury = poor executive function, irritability, poor impulse control, headaches.
  • 6. How Big is the Overall Problem: Public Health Cost of Untreated Brain Insults
    Education (IDEA Children): 50%+ have brain injury. If 20% were brought to normal, savings would be $18 billion per year.
    Welfare:AvgIQ = 85, brain injury effect ??
    Homelessness:67+% overall Vets homeless at 4x rate of non-vets.
    Mental Illness: Brain injury known to have risk of psychological sequelae
    Trafficked & Battered Women & Children: Brain injury is frequent
    _______________________________________________________
    This effort goes far beyond football.
    What football can do here to help its own,
    will lead to help for many others as well.
  • 7. Veteran Casualty Crisis
    Military Med Confused: PTSD shares symptoms with Mild-TBI!
    sleep cycle disruption, impulse control, irritability, and difficulty concentrating
    About 600,000 IEF/IOF war veterans blast/concussion casualties
    MOST DO NOT RECOGNIZE THEY HAVE A BIOLOGICAL INJURY!
    • This is not because they were not “STRONG” enough to take it!
    • 8. It is not a moral weakness!
    Each Untreated Casualty Costs up to $60,000 per year in safety net, substance abuse & Incarceration Costs
    Each Casualty that Returns to Work
    Is a $10,000 minimum Annual Revenue Source to Federal,
    State and Local governments
    Reduced Need for Services
    HBOT (biological repair) Treatment is paid for within 14 months
    Each Active Duty Rescued-$2.6 million per veteran over lifetime
  • 9. NBIRR-01: Principles
    1,000 patient observational multi-center study of Military or Civilian subjects with an Independent diagnosis of mild-moderate TBI/PTSD.(Patients MUST be >6 months post injury in the “chronic” stage, and ages 18-65.)
    Bayesian data analysis (Level 1 Evidence)
    IRB-Oversight
    Patient is their own control
    Methodology of “Coverage with Evidence” at CMS
    Multiple objective measures: ANAM, CNS-Vital Signs, Post- Concussion Syndrome Scale, PTSD Scale, Depression Scale
    All Participants get Real Services (No Placebo)
    Third Party Payment is, therefore, made possible (takes some effort, need more result to get administrators to chg their practices. Our aim = provide the necessary results)
    Therefore, cost of “research” is (hopefully) limited to the administrative overhead costs necessary in addition to the treatment costs, about 10% of treatment cost.
    John Eisenberg Treatment Registry
    Integrated Software with built-in metrics
    Secure & Web Based
    Low Cost Research ($25,000 per patient = $25 million w/ $1.6 million Admin)
  • 10. HBOT For Brain Injury: Where Are We re Football?
    4+ Former NFL players with TBI/CTEhave completed NBIRR Protocol. All have received benefit. (Note: NBOT is not a “magic bullet”, but to date everyone with TBI has achieved significant benefit.)
    Several more in various stages of treatment
    120+ evaluated by Amen Clinic-Newport Beach
    All above efforts predominantly pro bono.
    The task is huge. To move forward with any reasonable speed, support from within the football community is needed.
  • 11. HBOT For Brain Injury: Possible Pathways for Football?
    Acute brain injuries are difficult to study. Many variables, consensus on a protocol will take some time.
    Chronic brain injuries (> 6 months since injury) are remarkably stable, therefore study design is simpler, easier & less costly.
    NBIRR-01 study is underway& inclusion criteria include football-related injuries. Tx can start quickly----limited only by funds.
  • 12. HBOT for Football Brain Injury: A Workable Plan for Action
    Goal is to treat ~50 players already screened by Amen Clinic-Newport who live close (transit time < 1 hour) to NBIRR sites
    Approx Cost is $25,000 each ($20,000 HBOT, $5,000 diagnostics & study costs)
    All req’d resources are in place except the funds
    Each person completes ~5 months after funding
  • 13. HBOT for Football Brain Injury: A Workable Plan for Action
    Overall, need is $1,250,000
    However, 1st patient can start as soon as first $25K is on hand, and so on.
    Pace of study determined by pace of funds.
    Could complete all 50 by end of 2011 if funds available.
    Funds from sources outside football community unlikely. Too many competing needs.
  • 14. HBOT for Football Brain Injury: How to Raise the Funds????
    Individual contributions?
    Facebook pages for players w/visible names
    Facebook pages by friends of players
    Reach out to “football moms”, universities, etc.
    Fund raisers (celebrities, etc.)?
    Grants?
    NFL and NFLPA?
    Insurance plan payments?
    Support from other sports orgs?
  • 15. Retired NFL Players:How You Can Help
    Best way to get started quickly.
    Direct personal contribution, if able
    Solicit help from others
    Set up Facebook pages
    Important
    This is an ongoing study under IRB supervision. ALL public “advertisements” for participants MUST be in a form approved by the IHMF and the study IRB.
  • 16. HBOT for Football Brain Injury: Donation Pathways
    www.nbirrfund.org(Easiest way. Click the “Add a Designation” box and then enter “NFL Vets” in the window that opens)
    Direct contribution to IHMF www.hyperbaricmedicalfoundation.org(“Friends Donor” page, select button for Support Research to Help Veterans & Others with TBI or PTSD)
    Individual FaceBook Pages (requires some IT skill, IHMF will help)
  • 17. IHMF Stands Ready to Help
    Our Team Leaders have decades of experience with Hyperbaric Medicine
    Our Team Leaders have over 20 years of experience treating Brain Injury with this protocol
    The NBIRR-01 Study is IRB-approved
    The Study is Listed at www.ClinicalTrials.gov
    The National Call Center Number is: (800) 288-9328
    Numerous participating clinics throughout the nation
    We Are Helping to Solve the Real Problems of Brain Injured Persons with Biological Repair for their Injury
  • 18. Sponsor: International Hyperbaric Medical FoundationLocations for N-BIRR HBOT 1.5 Study N=1,000
    Sites with Confirmed Investigators
    Sites Being Planned
    Sites Being Planned as Mobile
    Units Under an Investigator
    Investigators with Capacity for 2,000 Treatments per Day
    Anticipate 1,000 veterans or service personnel being able to return to full duty status every 150 days. 90 total sites have sufficient
    equipment, training and skill to join the effort and
    treat these casualties. 1,000 could be brought on line.
    NBIRR Study Sponsored by Int’l Hyperbaric Medical Foundation
  • 19. HBOT for Football-Related
    Brain Injury.
    It can start here.
    Thank you.

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