Wednesday, March 10, 2010

Brain collector shows injuries

After a lifetime of multiple brain injuries (along with three broken necks and one broken back related to them) I worry about and show the signs of long term consequences as noted in the article below. But as always I desire to educate those around about this for there are many others who's injuries are not recognized and could use help.


NFL Brain Collector Shows Violence in Slices of Gray Matter

Bloomberg

Businessweek

March 10, 2010, 12:28 AM EST

By Tom Moroney

March 10 (Bloomberg) -- Five years of hell ended in a hard death. Those are the widow's words.

Her husband, Lou Creekmur, suffered 13 broken noses and 16 concussions as a Hall-of-Fame lineman for the National Football League's Detroit Lions, and in retirement saw 14 doctors who couldn't explain his anger and forgetfulness. Toward the end he would chase his wife in rages, apologizing later. He died at 82 on July 5, 2009, on a bed three inches too short, in a hospice eight miles from home. Then Chris Nowinski called.

His voice was soft like her husband's when his mind was right, the widow recalled. Nowinski, with his own concussion history in football and wrestling, introduced himself as a co- founder of the Boston University School of Medicine Center for the Study of Traumatic Encephalopathy. He wanted a donation: Lou Creekmur's brain.

"My husband died a hard death, and I did not know what was wrong," Caroline Creekmur, 67, said in an interview from her home in Plantation, Florida, 30 miles north of Miami. After consulting with the family, she consented to Nowinski's request.

"I wanted to know why this happened."

So did Nowinski. The 31-year-old Harvard University graduate -- who as "Chris Harvard" taunted World Wrestling Entertainment fans with his Ivy-League smarts -- is on a quest: to prove that brain damage is widespread in men, women and children who engage in sports involving repeated collisions, and to persuade professional leagues, colleges and high schools to change their rules to save lives.

Donating Their Brains

Nowinski is amassing what he thinks is the first brain bank in the U.S. dedicated to the study of head trauma.

Three times a week or more, he calls the wife, parent or child of a former athlete who has died in the past 48 hours and asks for the brain. He also contacts retirees from the NFL and other sports to request they commit their brains to research after they die, and 270 have so far agreed to do so.

Nowinski, author of the 2006 book "Head Games: Football's Concussion Crisis from the NFL to Youth Leagues," (Drummond Publishing Group, 195 pages), is the public face of the Boston University brain center. The other principals are Dr. Robert Cantu, 71, chief of neurosurgery at Emerson Hospital in Concord, Massachusetts; Dr. Ann McKee, 56, a neuropathologist who directs the Neuropathology Service for the New England Veterans Administration Medical Centers; and Robert Stern, 51, a Ph.D. clinical researcher and co-director of Boston University's Alzheimer's Disease Clinical and Research Program.

Seeing Orange

The U.S. House Judiciary Committee explored the center's findings -- that head injuries have cumulative effects -- at hearings last October at which Nowinski, Cantu and McKee testified, along with NFL Commissioner Roger Goodell. In December, Goodell told the league's 32 clubs that players with concussion symptoms can't play or practice until cleared by a neurologist. That same month, the NFL, acknowledging that head trauma can have long-term consequences, pledged $1 million to the brain center. The move came after the New York Times published articles about brain damage in NFL players.

At the NFL pre-draft camp on Feb. 24, all 329 college players who attended were given brain-wave tests and grilled about their concussion histories -- both NFL firsts. The tests were conducted so the league would have baselines.

A concussion, an injury that occurs when gray matter bumps against the skull, can result in symptoms including loss of consciousness, fogginess, blurred vision, or, as the expression goes, having your bell rung.

During one of his, Nowinski said he saw orange.

Punch-Drunk Boxers

For decades, medical professionals connected head trauma in sports to cognitive trouble later in life only in so-called punch-drunk boxers. The diagnosis: dementia pugilistica.

Other athletes' cerebral damage was routinely mistaken for Alzheimer's or other diseases, Stern said. They may have had chronic traumatic encephalopathy, or CTE; the center has found a protein deformity that is a sign of CTE in the brains of 19 athletes, Nowinski said.

The work by Nowinski and his colleagues has helped expand awareness of head injury, especially for parents whose children play sports, according to Dr. Douglas Smith, director of the Center for Brain Injury and Repair at the University of Pennsylvania in Philadelphia.

"This group has really underscored that what happens with punch-drunk boxers can occur in other contact sports," Smith said in an interview.

About 135,000 children 5 to 18 years old are treated in U.S. hospital emergency rooms every year for sports-related traumatic brain injury, a 2007 study by the Centers for Disease Control and Prevention showed.

Banging Heads

The concussion rate among kids who play soccer, lacrosse and hockey is about 10 percent, according to Cantu, basing his estimate on 35 years as a neurosurgeon treating young athletes. In football, the reported concussion rate is 6 to 9 percent and the actual rate six or seven times more, he said.

"The recognized rate of concussion is increasing due to better diagnosis or bigger, faster, stronger people banging heads -- nobody knows which," he said.

A law in Texas requires youth coaches be educated about concussions, and in Oregon and Washington young players suspected of having a concussion have to be cleared by a doctor before they can return to the sports field, Nowinski said. Similar legislation is pending in 20 states, and rules limiting helmet-to-helmet contact and full-force hits during practice are being discussed on the college and high school levels, he said. A helmet doesn't always safeguard against injury, he said.

Tangles of Yarn

"This is personal," Nowinski said, alluding to his fears concussions will come back to haunt him. "It doesn't get any more personal than this."

Nowinski -- six-foot-five, 250 pounds -- had two concussions in college football and four in pro wrestling, the last one bringing on headaches and dizziness that lasted five years. He worries his brain will show alteration of the protein called tau, a sign of CTE.

Healthy tau helps strengthen the neurons in the brain, like steel reinforcements in a concrete bridge. Repetitive trauma can lead to a change in tau, making it clump like tangles of yarn. The more tangles, the more the communication between cells is hampered. Functions such as memory and anger control can disappear; dementia and death can follow.

CTE is a unique pathological condition, according to Stern. The postmortem diagnosis of Alzheimer's requires the presence of deformed tau and another protein, beta amyloid. The diagnosis of CTE requires only the presence of deformed tau.

The only way to confirm a diagnosis is in an autopsy.

15 Football Players

The center has so far studied the brains of 23 deceased athletes: a hockey player, two pro wrestlers, five boxers and 15 football players, eight from the pros, four from college and three from high school. Nineteen showed abnormal amounts of deformed tau in a pattern consistent with CTE, Nowinski said. The center published its findings on three cases last year in the Journal of Neuropathology and Experimental Neurology.

Nowinski is now consulting with the U.S. Department of Defense to reach another susceptible group: soldiers in combat.

Established in 2008, the center has been funded with $200,000 in grant money from the National Institutes of Health in Bethesda, Maryland, and $250,000 from the National Operating Committee on Standards in Athletic Equipment, a trade group of manufacturers, athletic trainers and coaches.

Nowinski never knows when he'll be picking up the phone to ask the hard question. His computer will flash an alert that an athlete has died, or he'll get a call from someone in the network of the center's roughly 500 supporters, including retired athletes and relatives who have donated.

'How Dare You'

"You just have to be respectful but persistent," he said, and if he senses resistance, he politely hangs up.

Some families are harder to persuade than others.

"They don't want the deceased's body to be mutilated any further," he said. "Is their soul still in there? Is it not? Those are the questions people are asking."

Survivors will sometimes have already given away other organs, "and they'll tell me that was tough enough," he said.

The mother of one deceased teenager agreed to Nowinski's request -- and then handed the phone to her angry husband.

"It was the one time I had someone say 'How dare you call us?'" Nowinski said.

When the answer is yes, he hires a doctor to retrieve the brain and ships it, in plastic on ice, via World Courier of Stamford, Connecticut. The package goes to McKee's office at the Veterans Administration Hospital in Bedford, Massachusetts, or, if it's at night or on a weekend, to her home.

Bottle of Champagne

In June 2008, Nowinski flew to Houston with autopsy images on a DVD that showed yarn-like tau lacing the brain of John Grimsley, a former Houston Oilers linebacker who accidentally shot himself 19 days before his 46th birthday. He had grown forgetful and volatile in the years before his death -- once launching a tirade because his wife didn't take out the trash, his widow, Virginia Grimsley, 48, said.

When she saw the DVD she understood.

"It basically broke my heart," she said.

In December, when the NFL acknowledged the long-term effects of head injuries, Grimsley sent Nowinski a bottle of Dom Perignon Champagne.

The middle child between two girls, Nowinski grew up in suburban Chicago playing multiple sports. He didn't go out for football until he was 13 because of his safety-conscious mother.

Crimson Shorts

He captained his freshman team and eventually the varsity team at John Hersey High School in Arlington Heights, Illinois, where as a middle linebacker he drew the attention of college scouts. He played football at Harvard, graduating cum laude in 2000 with a sociology degree.

Nowinski's brain mission began after his sixth concussion caused headaches, dizziness and sensitivity to light. He was coming off a sensational rookie year in 2002 for World Wrestling Entertainment, performing with a big "H" emblazoned on the backside of his skin-tight crimson shorts. During a tag-team match in June 2003, an errant kick by 300-pound Bubba Ray Dudley landed full-force on Nowinski's chin.

An attempted comeback ended in an Indianapolis hotel room, with Nowinski lying face-down in shattered glass and his girlfriend screaming, "Chris, Chris, are you OK?" He'd been trying to climb the wall in his sleep and had fallen onto a glass-topped nightstand, he said.

"I knew it was time to get some help," he said.

Help for Headaches

He retired from wrestling, and went to the Harvard library to read everything he could find about head injuries. He said he visited seven doctors before the eighth, Cantu, was able to help, and sent him to a headache specialist. Nowinski and Cantu in 2007 co-founded the Boston-based Sports Legacy Institute, which promotes the treatment of concussions.

Nowinski also met Dr. Bennet Omalu, the first to write about CTE in pro football players, Nowinski said. As a Pittsburgh pathologist, Omalu diagnosed the late Steelers linemen Mike Webster and Terry Long. Webster died in 2002 at age 50, having been homeless and hospitalized for heart problems, and Long, 45, killed himself in 2005 by drinking antifreeze.

Then, in November 2006, Nowinski read about Andre Waters, a former Philadelphia Eagles defensive back who committed suicide in November 2006 at age 44. What struck Nowinski was something Waters had told an interviewer: He had lost count of his concussions after 15. Omalu found extensive evidence of CTE.

The 88 Plan

Another brain Nowinski delivered to Omalu was that of WWE wrestler Chris Benoit, known as "The Canadian Crippler," who killed his wife, his seven-year-old son and himself in June 2007. Nowinski said Benoit had told him about his concussions over his 22-year performing career, and Benoit's father gave permission to examine the brain for CTE. The diagnosis was confirmed by Omalu, now chief medical examiner for San Joaquin County, California, and Dr. Julian Bailes, chairman of neurosurgery at West Virginia University in Morgantown.

The NFL is the first major sports organization to make changes regarding concussions, issuing guidelines in 2007 and updating them in 2009, said league spokesman Greg Aiello. With $8 billion in annual revenue and 225 million television viewers in the 2008-2009 season, according to Nielsen Media Research, the league is the most popular of U.S. sports and the world's richest by revenue.

The NFL's 88 Plan, established in February 2007, grants former players with brain disease $88,000 a year if they live in a facility and $55,000 if they're home, and 100 men receive the benefits, Aiello said. The plan is named for the number worn by ex-Baltimore Colts receiver John Mackey, 68, who has dementia.

'He Loved Football'

World Wrestling Entertainment Inc., based in Stamford, Connecticut, hired Dr. Joseph Maroon, a concussion expert and the Pittsburgh Steelers' team neurosurgeon, as its medical director in 2008, according to spokesman Robert Zimmerman. WWE tests wrestlers' brain waves for comparison after a concussion and, as of December, fines or suspends performers who deliberately hit opponents in the head, Zimmerman said.

The brain center applied in February for a $9 million grant from the National Institutes of Health to find ways of diagnosing CTE in living athletes, what Stern called "the next big step." If the money comes through, the center will recruit hundreds of former NFL players, giving them spinal taps to measure CTE-associated proteins in their bodies and scanning their brains with imaging devices.

Caroline Creekmur is supportive. She had had her suspicions that the game that helped define her husband and gave him so much joy probably destroyed him.

"He loved football so much; you can't fault him for that," she said. "I don't want to see somebody else die like Lou did."

---

--With reporting assistance from Aaron Kuriloff in New York. Editors: Peter Waldman, Anne Reifenberg

To contact the reporter on this story: Tom Moroney in Boston at tmorrone@bloomberg.net

To contact the editors responsible for this story: Robert Blau in Washington at rblau1@bloomberg.net; John McCorry in New York at jmc@bloomberg.net

©2010 Bloomberg L.P


NFL Brain Collector Shows Violence in Slices of Gray Matter - BusinessWeek (10 March 2010)

http://www.businessweek.com/news/2010-03-10/nfl-brain-collector-shows-violence-in-slices-
of-gray-matter.html

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