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Jewish World Review Nov. 5, 2009 / 18 Mar-Cheshvan 5770 Getting well, helping others By Kevin Ferris
http://www.JewishWorldReview.com |
"Send the best surgeon there is, someone who knows more than the mechanics of the body, someone who knows how to treat that drifting of the mind into the fizzling lights, how the mind seems to vanish into the skull's stratosphere of bone, untethered, rising to where the world ends, that edge, bring a doctor who can bring them back from there, and quick" — from This is another piece about health care, but not the politics. This is on the daily realities. The life and death decisions. The advances that come when the military and civilians work together. And the miracles. Col. TBIs are one topic on the agenda at the Dr. Armonda's career is a good example. He's steeped in the military, from At Jeff, Armonda worked primarily with stroke patients. The emphasis was on protecting the brain, improving blood flow with catheter-based techniques from inside blood vessels. Today, those lessons help him with follow-up care in TBI cases. "We treat these patients as though they have an evolving stroke," he says. The blood vessels feeding the brain are monitored for spasms that might cut off oxygen. Ultrasound images are taken daily. Brain waves are checked for seizure activity or decreased oxygen flow. "That's something that hadn't been done before," Armonda says. That's one example of civilian practices' enhancing military efforts. But the information flows the other way, too. In cases of severe injury — such as penetrating wounds from IED blasts or car bombs — the brain swells, threatening to crush uninjured parts of the brain or the brain stem, killing the patient. Doctors can prevent such damage by removing part of the skull, giving the brain room to swell. Not so long ago, given that death or a vegetative state was the likely outcome of such wounds, radical skull surgery wasn't the norm. The military's experiences in The skull operation, known as a hemi-craniectomy, alters the equation, Armonda says. "What we're seeing is individuals achieving a higher degree of recovery," he says. "So the lesson learned there is, performing the hemi-craniectomy, doing it early, makes a difference in long-term functionality." Civilian hospitals are paying attention to the results, Armonda says. Surviving such horrific wounds, of course, is just the beginning. Years of physical and cognitive therapy follow. Lifetime care is a given. As this is all new territory, there's no telling if the next day will bring progress or setbacks.
Through it all, Maxwell has continued to improve, and in the process has focused on getting well and helping others. First, of course, are his wife and three children. But he's also helped his fellow Marines. He recommended the Corps start the "The biggest problem is they won't talk about what happened, to their wives or their moms," Maxwell says. "They will talk to other guys who have been there. ... We want to find them, get them into the system, and connect them to the right person." Maxwell will be among the honorees next weekend, a celebration not only of TBI survivors, but of the collaborative efforts that create such miracles and the unwavering dedication of so many to extend those blessings to others. Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.
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Kevin Ferris is commentary page editor of the Philadelphia Inquirer.
© 2008, Philadelphia Inquirer Distributed by McClatchy-Tribune Information Services
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Arnold Ahlert | |||||||||||||