Using Aerospace Medicine in 21 st  Century Medical Practice H.R. 396 - The TBI Treatment Act Using Translational Medicine ...
Dumb Things Said on the Floor of the House of Representatives The Disconnect
Dumb Things Said on the Floor of the House of Representatives “ We Might Have to Do Away with Football”
Translational Medicine <ul><li>Turns Bench Science into Bedside Practice </li></ul><ul><li>Provides Access to Treatment th...
Case Presentation Traumatic Brain Injury and Substance Abuse 23 y. male   Scan #1 Scan #2 top view
Case Presentation Traumatic Brain Injury from Child Abuse 48 y. male Scan #1 Scan #2
Public Health Cost of Untreated Brain Insults <ul><li>Untreated Brain Injury is so Endemic in America, its effects are not...
It’s Just Oxygen! <ul><li>O2 used in 5,769+ cellular processes </li></ul><ul><li>HBOT activates 8,100 Genes! </li></ul><ul...
The Specific Science for HBOT 1.5 <ul><li>1977 Study:  Holbach & Wasserman:  HBOT 1.5 puts the most oxygen into the brain ...
Returning Athletes to Competition <ul><li>U.S. Olympic Team </li></ul><ul><ul><li>Treated at San Diego IHMF-NBIRR Site </l...
Fractures <ul><li>Air Force Research Demonstrated that Fractures heal 30% faster and 30% stronger when Hyperbaric Oxygen i...
Retired NFL Player: Age 58 Pre-Post HBOT 1.5 4 NFL Players now treated with similar results Source:  MicroCog Assessment--...
Non-Healing Wound of the Foot Diabetic Foot Ulcer:  This Wagner Grade III was present for one year and unresponsive to con...
Pre-HBOT 1.5 Post-HBOT 1.5 Non-Healing Wound of the Brain Physical Abuse - 9 years after Injury - 21 y. female No wound wi...
Veteran Casualty Crisis:  Source of Performance Challenges in Veteran Programs <ul><li>Military Med Confused:  PTSD shares...
National Emergency: A War Casualty Crisis <ul><li>Service members in  the All-Volunteer Force  are some of the best and br...
HR 396:  TBI Treatment Act <ul><li>Subject must have TBI or PTSD and be a Veteran under 66 </li></ul><ul><li>Voluntarily T...
HR396:  TBI Treatment Act (Con’t) <ul><li>Changes Focus from “Bureaucratic Decision” on Health Care Coverage to: </li></ul...
IHMF’s National Brain Injury Rescue and Rehabilitation Project NBIRR-01: Mild-Moderate TBI Ages 18-65 <ul><li>1,000 patien...
ANAM Scores -  pre-injury ,  post-injury ,  after HBOT Budget Savings from Restoring 4 Military Personnel to Duty:  $11.2 ...
Personal Health Questionnaire-9  Suicidal  thoughts eliminated Pre-HBOT “ If ANY drug eliminated suicidal thoughts, it sho...
Physical Symptoms Questionnaire
Actions to Take Now <ul><li>If you or a loved one have a history of TBI or PTSD, and are between ages 18-65, enroll in NBI...
Finally Let Us: <ul><li>Crush Brain Injury!  See it Driven from America, and Hear the Rejoicing of our Women! </li></ul><u...
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Bill Duncan saving football with HBOT

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Dr. William Duncan speaks from a background as a legislator in Washington DC working to write and promote legislation regarding HBOT into the medical system in America.

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Bill Duncan saving football with HBOT

  1. 1. Using Aerospace Medicine in 21 st Century Medical Practice H.R. 396 - The TBI Treatment Act Using Translational Medicine to Create Solutions like Saving Football, Youth Sports Programs, and for Restoring Readiness to our Armed Forces, Police Officers and Productive Lives to those who have Served our Nation William A. Duncan, Ph.D. Vice President for Government Affairs, IHMA Vice President of Development, IHMF IHMA & IHMF: Sister Organizations Translating Science into Medical Practice and Public Policy to Create Healthcare Solutions for the 21st Century
  2. 2. Dumb Things Said on the Floor of the House of Representatives The Disconnect
  3. 3. Dumb Things Said on the Floor of the House of Representatives “ We Might Have to Do Away with Football”
  4. 4. Translational Medicine <ul><li>Turns Bench Science into Bedside Practice </li></ul><ul><li>Provides Access to Treatment that Would not Otherwise be Available </li></ul><ul><li>Collects Data to Verify Bench Science Results </li></ul><ul><li>Drives Good Medicine into Medical Practice </li></ul><ul><li>Protects Physicians Providing Innovative Treatment </li></ul>
  5. 5. Case Presentation Traumatic Brain Injury and Substance Abuse 23 y. male Scan #1 Scan #2 top view
  6. 6. Case Presentation Traumatic Brain Injury from Child Abuse 48 y. male Scan #1 Scan #2
  7. 7. Public Health Cost of Untreated Brain Insults <ul><li>Untreated Brain Injury is so Endemic in America, its effects are not even recognized! </li></ul><ul><li>An estimated 30-40 million working age Americans are living with an untreated brain injury. CDC reports 1.7 million new injuries per year and only 50,000 die. </li></ul><ul><li>Lost Tax Revenue & Productivity: mTBI patients have ½ of the life-time income of their non-injured counterparts, matched for education, intelligence, etc. </li></ul><ul><li>Incarceration: 61% County/56% State/45% Fed </li></ul><ul><li>Mental Illness (w/ Underlying untreated brain insult) </li></ul><ul><ul><li>National Prison System Cost: 2.3 mil Jail; 5.1 m Supervision </li></ul></ul><ul><ul><ul><li>$51.7 billion on corrections $29,000 each </li></ul></ul></ul><ul><ul><ul><li>$10.2 billion for supervision @ $2,000 each </li></ul></ul></ul><ul><ul><ul><li>Cut cost in half over 10 years: Savings $30 billion </li></ul></ul></ul><ul><li>Veterans: (33%+ of all deployed) (All with PTSD) </li></ul><ul><ul><li>Cost? Current ineffective treatments $8,000-$32,000/yr </li></ul></ul><ul><li>Education (IDEA Children): 50%+ have brain injury. If 20% were brought to normal, savings would be $18 billion per year. </li></ul><ul><li>Welfare: Almost all women on Welfare (Avg IQ = 85) </li></ul><ul><li>Homelessness: 100% Vets, 72-80% all others </li></ul><ul><li>Disability (Worker’s Comp & Social Security): 61,000 TBI, most mentally retarded </li></ul><ul><li>Nursing Home Residents: Dementia, Stokes </li></ul><ul><li>Mental Illness: Most traceable to an insult </li></ul><ul><li>Trafficked & Battered Women & Children: Traumatic Brain Injury </li></ul><ul><li>Cost to biologically repair and regenerate brain insults: </li></ul><ul><li>Acute: $200 - $1,000 (59% Reduction in Mortality for Severe) or </li></ul><ul><li>chronic one time cost $16,000 (80% return to duty, work or school) </li></ul><ul><li>(CMS Reimbursement Rate) </li></ul>
  8. 8. It’s Just Oxygen! <ul><li>O2 used in 5,769+ cellular processes </li></ul><ul><li>HBOT activates 8,100 Genes! </li></ul><ul><ul><li>Down Regulates Inflammation Processes </li></ul></ul><ul><ul><li>Up Regulates Growth & Repair Processes </li></ul></ul><ul><li>Lack of oxygen is bad </li></ul><ul><li>We know how it works </li></ul><ul><ul><li>Acutely stops swelling/reperfusion injury </li></ul></ul><ul><ul><li>Restarts stunned cellular metabolism </li></ul></ul><ul><ul><li>Regrows Blood Vessels </li></ul></ul><ul><ul><li>Activates Stem Cells 8x Normal </li></ul></ul><ul><li>No wound can heal without oxygen </li></ul><ul><li>Wounds that have not healed do </li></ul><ul><li>Wounds heal 50% faster with less scar tissue </li></ul><ul><li>Broken bones 30% faster & 30% stronger </li></ul>Pressure causes oxygen to saturate tissues at 7x to 12x normal breathing.
  9. 9. The Specific Science for HBOT 1.5 <ul><li>1977 Study: Holbach & Wasserman: HBOT 1.5 puts the most oxygen into the brain because more triggers an autonomic response to keep extra O2 out! Chronic Stroke patients treated at numerous locations. </li></ul><ul><li>1990: Harch treats first demented diver for delayed decompression sickness. Numerous small studies published. (See Memorandum) </li></ul><ul><li>2002: US Army verifies HBOT 1.5 repairs white matter damage in children. </li></ul><ul><li>2007: Rat HBOT 1.5 study for Chronic TBI published in Brain Research. Human protocol in Animals. First improvement of chronic brain injury in animals in the history of science. </li></ul><ul><li>August 14, 2008: Briefing to Surgeon General of the Navy & Deputy Commandant, US Marine Corps: 5 blast injured veterans treated. All five made dramatic improvement. Four of five were able to return to duty or civilian full-time employment! Published April 2009 </li></ul><ul><li>September 2008: US Air Force Hyperbaric Researcher & Special Forces Command Physician treats two airmen. Results verified by ANAM neuropsych test. Both are restored to duty saving the Federal government an estimated $2.6 million each in lifetime costs. They continue their careers. More active duty personnel are treated. Published in January, 2010 in Peer Reviewed Journal (See www.HyperbaricMedicalFoundation.org ) </li></ul><ul><li>March 12, 2010: Report on 15 Blast Injured Veterans under LSU IRB-approved study. Report is clinically and statistically significant and sufficient proof because of dramatic improvement in patients. ½ of protocol given </li></ul><ul><ul><li>15 point IQ jump in 30 days p<0.001 </li></ul></ul><ul><ul><li>40% improvement in Post-concussion Syndrome p=0.002 (np) </li></ul></ul><ul><ul><ul><li>(10% is considered clinically significant enough to warrant approval and payment for HBOT according to DoD researchers in December 2008. </li></ul></ul></ul><ul><ul><li>30% reduction in PTSD p<0.001 </li></ul></ul><ul><ul><li>51% Reduction in Depression p<0.001 </li></ul></ul><ul><li>Multi-site NBIRR-01 Begins Enrolling Patients: All patients have improved verifying above results. </li></ul>
  10. 10. Returning Athletes to Competition <ul><li>U.S. Olympic Team </li></ul><ul><ul><li>Treated at San Diego IHMF-NBIRR Site </li></ul></ul><ul><ul><li>Sports Injuries </li></ul></ul><ul><ul><li>Concussions </li></ul></ul><ul><ul><li>Summer & Winter Sports </li></ul></ul><ul><li>U.S. Navy SEALs & SOCOM Members </li></ul><ul><ul><li>Treated for Fractures </li></ul></ul><ul><ul><li>Treated for Knee Replacement </li></ul></ul><ul><ul><li>Treated for TBI and PTSD </li></ul></ul>
  11. 11. Fractures <ul><li>Air Force Research Demonstrated that Fractures heal 30% faster and 30% stronger when Hyperbaric Oxygen is used. </li></ul><ul><li>Shorter back to work time </li></ul><ul><li>Stronger Fusion </li></ul><ul><li>Cost Effective through reduced down time </li></ul><ul><li>The effect of hyperbaric oxygen on fracture healing in rabbits, completed 2003. J Wright </li></ul>
  12. 12. Retired NFL Player: Age 58 Pre-Post HBOT 1.5 4 NFL Players now treated with similar results Source: MicroCog Assessment-- Independent Evaluation by Amen Clinic.
  13. 13. Non-Healing Wound of the Foot Diabetic Foot Ulcer: This Wagner Grade III was present for one year and unresponsive to conventional therapy. 26 HBOT Treatments 50 HBOT Treatments Hyperbaric Oxygenation prevents 75% of amputations in diabetic patients. Therapy approved by CMS for Medicare upon application by IHMA to CMS for coverage, 2003. These photographs are the property of Kenneth P. Stoller, MD, FAAP Permission given by Dr. Stoller to the IHMA to publish on this CD (2004) 1 Day Prior to Scheduled Amputation Copyright retained: Kenneth Stoller, M.D., 2010 & IHMA
  14. 14. Pre-HBOT 1.5 Post-HBOT 1.5 Non-Healing Wound of the Brain Physical Abuse - 9 years after Injury - 21 y. female No wound will heal without oxygen! What is the difference between the diabetic non-healing foot wound and the non-healing brain injury? Essentially nothing. FDA has already approved HBOT for 3 kinds of non-healing wounds and 3 neurological injuries!
  15. 15. Veteran Casualty Crisis: Source of Performance Challenges in Veteran Programs <ul><li>Military Med Confused: PTSD shares symptoms with Mild-TBI! </li></ul><ul><ul><li>sleep cycle disruption, irritability, and difficulty concentrating </li></ul></ul><ul><li>About 600,000 IEF/IOF war veterans blast/concussion casualties </li></ul><ul><ul><li>MOST DO NOT RECOGNIZE THEY HAVE A BIOLOGICAL INJURY! </li></ul></ul><ul><ul><ul><li>This is not because they were not “STRONG” enough to take it! </li></ul></ul></ul><ul><ul><ul><li>It is not a moral weakness! </li></ul></ul></ul><ul><li>Each Untreated Casualty Costs $60,000 per year in safety net, substance abuse & incarceration costs & lost tax revenue </li></ul><ul><li>Each Casualty that Returns to Work </li></ul><ul><ul><li>Is a $10,000 minimum Annual Revenue Source to Federal, </li></ul></ul><ul><ul><li> State and Local governments </li></ul></ul><ul><ul><li>Reduced Need for Services </li></ul></ul><ul><ul><li>Each Biologically Repaired Person who Goes to Work Pays for Treatment through taxes and economic productivity </li></ul></ul><ul><ul><li>Each Active Duty Rescued-$2.6 million per veteran over lifetime </li></ul></ul>
  16. 16. National Emergency: A War Casualty Crisis <ul><li>Service members in the All-Volunteer Force are some of the best and brightest in the nation; risk-takers, leaders! </li></ul><ul><li>If left untreated, a veteran’s brain injury destroys their life. They are a Casualty of War as much as if they had been left on the battlefield </li></ul><ul><ul><li>Divorce, unemployment, disability, substance abuse, incarceration, homelessness, suicide </li></ul></ul><ul><ul><li>Cascade steep for the first 2 years and continues </li></ul></ul><ul><ul><li>downhill thereafter </li></ul></ul><ul><li>Virtually ALL Homeless Veterans have a brain injury </li></ul><ul><li>It costs society more per war casualty not to treat them </li></ul><ul><li>End of World War II : by 1949 1/3 of all persons in prison </li></ul><ul><li> were combat veterans </li></ul><ul><li>Vietnam : 66% of prisoners today in jail for violent crimes </li></ul><ul><li> “ harmed someone they knew.” </li></ul><ul><li>We Do Not Need to Repeat the Tragedies of Previous Wars! </li></ul>
  17. 17. HR 396: TBI Treatment Act <ul><li>Subject must have TBI or PTSD and be a Veteran under 66 </li></ul><ul><li>Voluntarily Treated by Civilian Physician </li></ul><ul><li>ANY FDA-approved or Cleared Treatment (Any Purpose) </li></ul><ul><li>Must Improve to be Paid </li></ul><ul><ul><li>Neuropsych Testing (IQ, ANAM, CNS Vital Signs, etc.) </li></ul></ul><ul><ul><li>Standardized Instruments (PCS, PTSD, Depression Scales) </li></ul></ul><ul><ul><li>Neurological Imaging (Functional MRI, SPECT, QEEG) </li></ul></ul><ul><ul><li>Clinical Examination (Coma State, Gate & Balance) </li></ul></ul><ul><li>Must be Enrolled in IRB-approved Study </li></ul><ul><li>No Discrimination Against Practitioner for Any Reason </li></ul><ul><li>Paid 30 days after presentation of valid bill to MM or VA </li></ul><ul><li>Other necessary protections for the treated veteran </li></ul>
  18. 18. HR396: TBI Treatment Act (Con’t) <ul><li>Changes Focus from “Bureaucratic Decision” on Health Care Coverage to: </li></ul><ul><ul><li>“ What Actually Worked for the Patient?” </li></ul></ul><ul><ul><li>ALL TREATMENT MODALITIES INCLUDED </li></ul></ul><ul><li>Outlines a “Rational” Way of Determining What Works and What Doesn’t </li></ul><ul><li>HC Provider is ONLY paid if the treatment works (True Pay for Performance) </li></ul><ul><li>All data is collected under OHRP Rules for Patient Protection </li></ul><ul><li>Provides Valid Evidence-based Medicine data very inexpensively! (10% of the cost of Standard NIH-funded Study!) </li></ul><ul><li>As a Principle of Federal Law, the Bill Radically Alters the Ability of Patients to get Effective Treatment! </li></ul>
  19. 19. IHMF’s National Brain Injury Rescue and Rehabilitation Project NBIRR-01: Mild-Moderate TBI Ages 18-65 <ul><li>1,000 patients with mTBI and/or PTSD ANY CAUSE </li></ul><ul><li>17+ centers </li></ul><ul><li>All receive HBOT </li></ul><ul><li>Early results encouraging </li></ul><ul><li>35 participants in treatment (Mar 2011) </li></ul><ul><li>All participants have improved </li></ul><ul><li>Most improved in every measure </li></ul><ul><li>Most improved substantially </li></ul><ul><li>No participants worsened </li></ul><ul><li>Results are durable </li></ul>NBIRR Study, see: http://www.clinicaltrials.gov/ct2/show/NCT01105962 Many are U.S. War Veterans who have had to be treated “for free” by the clinics as charity cases!
  20. 20. ANAM Scores - pre-injury , post-injury , after HBOT Budget Savings from Restoring 4 Military Personnel to Duty: $11.2 million Long Term Additional Savings: $4 million ($15.2 million) Cost? $100,000 100% 50% 0
  21. 21. Personal Health Questionnaire-9 Suicidal thoughts eliminated Pre-HBOT “ If ANY drug eliminated suicidal thoughts, it should be fast-track researched and adopted immediately!” James Wright, M.D. (COL, MC, USAF, Ret.)
  22. 22. Physical Symptoms Questionnaire
  23. 23. Actions to Take Now <ul><li>If you or a loved one have a history of TBI or PTSD, and are between ages 18-65, enroll in NBIRR and get treated NOW! </li></ul><ul><ul><li>$350 million treats all 14,000 living retired players </li></ul></ul><ul><ul><li>Insist HBOT be covered by workers compensation </li></ul></ul><ul><ul><li>Insist HBOT be covered by the “88” Plan </li></ul></ul><ul><ul><li>Provide funds to a charity of your choice who will pay for HBOT for retired football players & others </li></ul></ul><ul><ul><li>The IHMF: Fund for Veterans and Football Players </li></ul></ul><ul><li>Write Congress about HR 396, the TBI Treatment Act, at the IHMA website: </li></ul><ul><li>www.HyperbaricMedicalAssociation.org </li></ul>
  24. 24. Finally Let Us: <ul><li>Crush Brain Injury! See it Driven from America, and Hear the Rejoicing of our Women! </li></ul><ul><li>Save Football, Soccer, Sports for our Youth, and help </li></ul><ul><li>Save the Cheerleaders! </li></ul>

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