a grassroots effort to heal - patriot clinic movement · a grassroots effort to heal 1 ... military...

1A Grassroots Effort to Heal

SPRING 2017

The goal of Patriot Clinics is to function as adjunctive evaluation and treatment centers for military veterans with signs and symptoms referable to brain injury con-ditions which include Traumatic Brain Injury (TBI) or post – concussion syndrome; complicated PTSD, Post traumatic stress disorder (PTSD) and other psychiatric and brain injury conditions.

Veterans of recent conflicts have experienced a high level of TBI and many have been diagnosed with PTSD and the current system is not equipped to provide cut-

A Grassroots Effort to Heal

ting edge care for these conditions. Patriot Clinics will fill in the gaps left by the VA Hospital system. A new paradigm for recovery is Hyperbaric Oxygen Therapy, nutrition and a comprehensive alternative approach to healing that does not involve medica-tions.

The goal is to restore our warriors so they can return to the life they fought for and assume leadership roles in our country.

2 A Grassroots Effort to Heal2 A Grassroots Effort to Heal

Why aren’t appropriate

diagnoses of brain injury

being made?

Awareness of concussion injury resulting from military service and playing professional football

and other sports has reached an all-time high. But not all the information that has been presented is true. It is time to correct the “facts” that the military and the NFL have been touting. Even a single blast exposure may cause NFL–like brain trauma. The brain is much more susceptible to injury than was been traditionally believed. Concussion is a real injury and you should NOT “go back into the game” after the injury. It is often a necessity for warfighters to be “back in the game” after blast exposure, and experience blast after blast. Repeated injuries have

a more serious cumulative effect. You don’t need to lose consciousness to have suffered injury to your brain. You don’t need to be within 150 yards of an IED to have experienced a blast force concussive injury. You don’t need to have hit your head against anything to have had a concussion. Symptoms of concussion overlap almost completely with the listed symptoms of PTSD. Supposedly psychiatric symptoms such as poor short-term memory while at the same time having enhanced memory of traumatic moments, mood swings, sudden anger and night terrors actually correlate with underlying brain injury conditions.

You don’t need to be within 150 yards of an IED to have experiences a blast force concussive injury.

What You Need to Know About Warrior TBICarol L. Henricks, MD


Why aren’t appropriate diagnoses of brain injury being made? Brain imaging that is currently being used to study other neurological injuries has proven to be inadequate to assess concussion injury. As awareness of concussion has increased, it has become blear that many of the injured have experienced multiple more subtle concussions and do not have any visible intracranial bleed or other evidence of injury on their brain MRI study. Patients then have a brain MRI reported to be normal – even when clinically there is clearly post-concussion symptoms and opportunities to study those injured brains post-mortem

demonstrate pathology. Newer studies such as brain MRI with DTI (diffusion tensor imaging studies which show the long fiber tracts truncated by injury ) and high quality brain SPECT scans such as Cerescan are able to demonstrate areas of focal injury. This is the standard of care in Israel.

Young military veterans taken out of active duty or medically discharged don’t recover from their concussions even years after their injury and are often never able to re-enter the work force. The American Headache Association presented data at their July 2012 meeting that even 8 years post concussion-injury, the

majority of these injured veterans continued to have persistent headaches, sleep disturbance, cognitive and emotional problems. These problems also have an adverse effect on their interpersonal relationships with their wife and family resulting in divorce, the veteran becoming disenfranchised and in the worst case homeless.

Concussion is not just about the short-term consequences, the link between concussion injury and neurodegenerative conditions in the NFL has recently been acknowledged. Research data has also shown a higher correlation between military service

and ALS, Parkinson’s disease, Alzheimer’s dementia and other neurodegenerative conditions. It is clear that a new approach to post-concussion management is necessary. If you have played sports, particularly football, or been active duty in the military with exposure to explosives do not settle for a psychiatric diagnosis and medication protocol without proper testing to diagnose a brain injury condition. It is time to put together a game plan to save the brain.

www.northstarhbot.com

Concussion is a real injury and you should NOT “go back into the game” after the injury.


Patriot Clinics Inc. was born from the fact that despite the successes and two years of public support from the Oklahoma state government

policy makers for HBOT, veterans with TBI were not being treated. The PC focus has been on delivering treatment to all who need it, rather than discriminating based upon who can arrange for payment. To make treatment available, we set up the PC state non-profit medical clinic and began treating patients in January of 2014. The governor of Oklahoma finally signed a bill into law

To date hundreds of veterans have been treated, with good outcomes.

RESOURCE: www.HyperbaricMedicalFoundation.org

Patriot Clinic Movement:A Grassroots Effort to Heal Our Warriors

authorizing HBOT for veterans in June of 2014, yet only one other HBOT clinic has treated any veterans. Since January of 2014, Patriot Clinic in Oklahoma City has delivered 11,000 hyperbaric treatments, valued at $321 each ($3.25 million) plus 2,050 chiropractic adjustments and 800 acupuncture treatments for PTSD and pain.

All this treatment was done on a budget of $230,000 in charitable donations largely through the International Hyperbaric Medical Foundation, with some civilian payment for treatment. I know that when HBOT becomes the standard of care, society will save billions as lives are restored. This will reverse lost productivity, disability, substance abuse, and family and personal disintegration. The goal is to replicate our work in clinics in every state that operate separately from the VA Healthcare system. At least 16 states are somewhere in the process of considering legislation to develop payment systems that will foster such clinical treatments. This will support many independent HBOT centers around the country who stand ready to help.

Dr. William A. Duncan, Ph.D., IHMA, Patriot Clinics, Inc.

To date hundreds of veterans have been treated, with good outcomes. Experience shows that if you take 100 veterans in a transitional living situation and give them hyperbaric oxygen treatment, half of them will be back to work and resuming their life after 40 treatments and 80% will recover after a full protocol of 60 or more treatments. After years of living with “shattered life” symptoms, they are more than pleased when the headaches disappear, normal sleep returns, the anger issues subside and the ability to think, reason, and have healthier family relationships returns. Support the Patriot Clinic Movement. Find out where your closest treatment center is and get involved!


Israel typically uses cutting edge medical therapies to provide health care for it’s people and particularly it’s military which is critical to their existence. Is-

rael is also considered to be a leader with the applica-tion of hyperbaric oxygen therapy for different types of brain injuries. When a military member is exposed to a blast, they will be assessed and receive the most ad-vanced rehabilitation program suitable for the specific soldier’s injury. Those who are suffering from post con-cussion may have additional evaluation and if needed hyperbaric oxygen treatment at the Sagol Center for Hyperbaric Medicine and Research.

The center headed by Dr. Shai Efrati is the biggest hyper-baric center worldwide treating more than 120 patients a day. Baseline evaluation after exposure to a concus-sive force includes a Brain SPECT scan and Brain perfu-sion MRI with DTI as well as neurological and neurocog-

nitive evaluation. If there are brain areas of metabolic dysfunction identified by SPECT scan / MRI mismatch, then the injured soldier is suitable for hyperbaric oxy-gen therapy and recovery is expected within a 3 month treatment protocol. Their treatment protocol includes 60 x 1 hour daily sessions of hyperbaric oxygen done 5 days a week. Nutrition is optimized. Recovery includes cognitive therapy as well as counseling sessions.

Many patients from all over the world are traveling to Israel for treatment. Chambers can operate around the clock, except on the Sabbath, as needed. Israel is do-ing it right: proactively making the diagnoses and pro-viding a comprehensive treatment plan. That is how it works when the military and the country truly value their warfighters.

Israel is setting the standard for military TBI Carol L. Henricks, MD with

Dr. Shai Efrati

www.assafh.org


TBI cases typically show brain injury of the prefrontal poles and the temporal lobes.

Military families are the backbone of our country’s defense. These hus-bands, wives, children and parents provide the constant support for our men and women in uniform. However, when our soldiers return

home, often injured and hurting, the families they return home to are the ones that bear the brunt. Concussions and psychiatric illnesses often can be the most destructive, as they are not as visible and can devastate their victims as well as the families they leave behind.

The Iraq and Afghanistan conflicts have proven to be very different types of wars, not just with the enemy being fought but the injuries sustained on the front-line. Injuries that were once fatal are now stabilized in the field. Many wounds, such as concussions and traumatic brain injuries (TBI), often from IEDs (Inter-mittent Explosive Devices) haunt soldiers long beyond their tour of duty. As a psychiatrist at the VA, I saw many soldiers from these wars whose psychiatric symptoms were complex and embedded in layers of medical illnesses. Knowing how and when to diagnose Post Traumatic Stress Disorder (PTSD) versus a TBI was difficult, as both diagnoses comprised the same cluster of symptoms. The treatment for TBI versus PTSD is different and if TBI is not identified timely and treated appropriately, precious brain reserve can be lost.

Concussions and SPECT Scanning: Implications for Diagnoses and TreatmentDr. Daniel Amen

Many veterans do not realize they have suffered concussion injury. Injury results in the dissolution of families, alcohol and drug abuse, loss of employment, homelessness and suicide. Misdiagnosis with PTSD typically results in medication being prescribed which aggravates their condition. There is a huge at-risk population of veterans – not only for the immediate consequences of brain injury but for early onset of neurodegenerative disease conditions like Alzheimer’s disease, Parkinson’s disease and ALS.

DID YOU KNOW?


Since the brain’s consistency is of soft butter, any jostling of the brain...will stretch areas...across very sharp ridges of the skull.

Patients with primarily PTSD symptoms show over-activity in the limbic system.

At Amen Clinics, we are the only men-tal health organization in the country that looks at the organ we are treat-ing. We use SPECT imaging to look at the brain (Single-Photon Emitted Computed Tomography), which is different than using a CT or MRI. CTs and MRIs look at structures in the body, screening for masses or bro-ken bones. SPECT is unique in that it examines blood flow patterns of the brain and how certain areas of the brain are functioning. On SPECT scans, traumatic brain injuries and their patterns of blood flow are dif-ferent from the patterns of blood flow and function seen in PTSD. Being able to identify and diagnose these ill-nesses with SPECT is more accurate than simply talking with patients and families, as psychiatrists have done for the last 200 years. SPECT

scans of individuals who have suf-fered brain injury show very specific changes, which are not the same as the changes seen in PTSD. Since the brain’s consistency is of soft butter, any jostling of the brain, be it from a motor vehicle accident, blast impact or football tackle, will stretch areas of the brain across very sharp ridges of the skull. The areas that show dam-age in a TBI are typically the pre-frontal pole and the temporal lobes (Image 1). The temporal lobes sit on either side of the brain and regulate learning, memory and help stabilize mood. The prefrontal pole is involved with regulating attention, focus, ex-ecutive decision-making and im-

pulse control. When I look at a SPECT scan and see decreased blood flow in these areas and the patient gives a history of brain injury, the diagnosis and treatment becomes clearer. However, if I review a scan, which shows over activity in the limbic system, an area of the brain that manages anxiety and emotional trauma, then a diagnosis of PTSD is highly likely (Image 2). The treatment for these illnesses is distinc-tive and requires varied approaches for success. Not uncommonly, we have patients with SPECT scans that show both TBI changes and PTSD over activity. Treatment is then an integrative approach for both ill-nesses.

Without looking at the brain, without evaluating the function of specific areas, diagnosing and treating illnesses is much harder and less suc-cessful. In fact, treatment can harm if not correct. Veterans deserve specific treatment that is thoughtful and data driven. At Amen Clinics, the data collected through imaging provides that best method.

www.amenclinics.com


Repeated head traumas lead to post-concus-sion syndrome, a period of cognitive impair-ment that may last months. Patients with it

have headaches, oversensitivity to light, unsteadi-ness and other problems. In some cases, repeated concussions may lead to Chronic Traumatic En-cephalopathy.

Concussion is caused by the internal movement and distortion of the brain as it bounces around inside the skull after an impact. The bouncing stretches and deforms bundles of axons that connect differ-ent regions of the brain. It also causes abnormal inflows of sodium and calcium ions in damaged ax-ons. These in turn, trigger a process which releases protein-breaking enzymes that can destroy the ax-ons, further disrupting the brain’s internal commu-nications. In recent years, it has become apparent that when axons are damaged certain chemicals get released.

Research at UCLA suggests a characteristic pat-tern of protein deposits in people who have suf-fered repeated concussions. Concussive injury also damages the blood-brain barrier. This is a system of tightly joined cells surrounding the capillar-ies that service the brain. Its purpose is to control what enters and leaves the central nervous system. One consequence of damaging the blood-brain bar-rier is the release into general circulation a brain protein called S100B. The body mounts an immune response against this protein, and the antibodies it generates can find their way back into the brain and harm healthy brain cells. Researchers propose that repeated damage could set the stage for a continu-ous autoimmune-type attack on the brain.

Until quite recently, it was thought that concussion from accidents was a temporary malfunction rather than a permanent injury. This view began to change in 2005, when Dr. Bennet Omalu, a former patholo-gist at the county coroner’s office in Pittsburgh,

Biological Consequences of Traumatic Brain InjuryArsalan Darmal, M.D.

wanted to discover the reasons for the behavioral and cognitive changes subsequent to traumatic brain injury.

Studies show that concussion and concussion-like symp-toms are mostly underreported or unrecognized. This ap-plies to contact sports at all levels of play, not just college and professional leagues. Neither coaches nor athletes tend to be good judges of fitness to play after a head in-jury. It seems likely that many people return to the field long before the brain’s physical healing is complete. Play-ers tend to underreport symptoms.

Brain scanning is one method for obtaining an objective measure of the damage an episode of concussion has caused. The current challenge is to determine whether a particular injury is likely to have long-term conse-quences. Amen Clinics utilizes SPECT scanning which is a functional brain imaging modality that can reveal re-duced blood flow in the brains of subjects who have had concussions—even long after the injury occurred. SPECT scans have been used as a tool to determine the progno-sis and long-term effects of traumatic brain injury.

www.amenclinics.com


“The Oklahoma Veteran Recovery Plan”Part of the National Brain Injury Rescue & Rehabilitation Project: A Care Pathway for Acute & Chronic Brain Insults from All Sources Restoring Lives, Reducing Entitlement Costs, Restoring Readiness by Healing Brains in Real Time

Dr. William A. Duncan, Ph.D., IHMA, Patriot Clinics, Inc.


The Significance of Visual ProblemsDr. Tanya Polec, D.O.

Visual signs and symptoms are very common in patients with brain injury conditions diagnosed in the TBI/PTSD spectrum of disorders.

Cognitive (Mental):

• Difficulty copying from the board• Discomfort when reading• Unable to sustain near work or reading for

periods of time• Loss of place while reading• Easily distracted when reading• Headaches when reading• Decreased attention span• Reduced concentration ability• Difficulty remembering what has been read

Physical:

• Blurred vision for distance viewing• Blurred vision for near viewing• Slow shift of focus from far to near• Pulling or tugging sensation around the eyes• General fatigue while working/reading• Eyes get tired when reading• Loss of balance• Bothered by movement in the environment• Light sensitivity• Dizziness• Sensation of the room spinning• Sensation of not feeling grounded

Visual Dysfunction Symptoms


Debbie Lee founded America’s Might Warriors, after her son Marc was the first Navy SEAL to be killed in Iraq on August 2, 2006. In Marc’s Last

Letter Home, he asked for friends and family to “pass on the love and kindness and precious gift of human life”. Since then, America’s Mighty Warriors has been fighting to support our troops, the fallen and their families and to work with like-minded organizations to do the same.

As our troops continue the fight on multiple fronts, many are experiencing Traumatic Brain Injuries (TBI) and associated Post Traumatic Stress Disorder (PTSD) from combat-related blasts. More than 750,000 of our troops and families are affected and sadly, many are not getting access to the treatment they need to heal the actual brain injury. Instead, symptoms are being addressed with medication while source of the problem goes untreated. The result, our troops are on medication for depression, anxiety, concentration,

sleeplessness and pain. Individuals and families are being torn apart.

America’s Mighty Warriors’ Helping Heroes Program is collaborating with hyperbaric oxygen treatment (HBOT) centers around the country. This evidence-based protocol for hyperbaric oxygen treatment has been helping veterans heal but it is difficult to access and is not covered by insurance. Locating HBOT treatment

centers willing to provide treatment, many times at a reduced rate, is the first step in getting veterans the help they need. America’s Mighty Warriors pays for the treatment and/or assistance with travel costs and lodging costs for the veteran during treatment.

America’s Mighty Warriors continually raises awareness and money to get our warriors access to this beneficial treatment and help our troops, veterans and their families get their lives back after Traumatic Brain Injury.

America’s Mighty Warriors mission is to honor the sacrifices of our troops, the fallen and their families by providing programs that improve quality of life,

resiliency and recovery.

www.americasmightywarriors.org

America’s Mighty Warriors


Battling TBI and PTSD: New Technology Makes All the Difference

PTSD: The Overactive Brain

While a TBI results in reduced brain activity, PTSD causes increased activity or blood flow in different re-gions of the brain. The disorder often leads to over ac-tivity in many areas of the limbic system (the brain’s emotional command center), causing its victims to perceive and respond to stress differently than healthy individuals.

Soldiers have the toughest jobs available. Between time away from home, the experiences of battle and the lasting injuries — both seen and unseen

— they endure, soldiers often find that they’re fighting a new war when they come home.

Traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD) are two of the most common diagnoses soldiers receive after returning from battle. These debilitating ailments are invisible to structural MRI and CT imaging and can’t be seen by the naked eye. Additionally, the symptoms for PTSD and TBI are often the same – anxiety, headaches, memory prob-lems, insomnia, depression, anger – making an accu-rate diagnosis and proper treatment more difficult. For example, if a patient is treated for perceived “PTSD” with a benzodiazepine, such as Xanax, but the veteran actually has a TBI, the medication could cause their symptoms worsen and impede recovery.

That’s where functional brain imaging, such as Cer-eScan’s qSPECT (quantitative single-photon emission computed tomography) technology, can make all the difference. Because TBI and PTSD affect the way the brain functions differently, qSPECT imaging can detect unique patterns and differentiate between the disor-ders.

CereScan’s technology makes invisible injuries visible through the use of functional brain imaging and ad-vanced software. When the brain is scanned, blood flow levels are measured across 160 regions of the brain to pinpoint where blood flow is normal and where it is ab-normal. Combined with clinical assessments and his-tory, the result is a more precise diagnosis and targeted treatment.

With overlapping symptoms, the two brain conditions are often confused for one another, but their treatments are vastly different. Here’s how functional brain imaging

can differentiate between the two to help soldiers start their path to better brain health.

Understanding Traumatic Brain Injury

Ranging from mild to severe, traumatic brain injuries can be caused by blunt head trauma, a direct injury to the head, or even the brain sloshing around in the skull. The damage from a TBI leads to reduced brain activity (decreased blood flow) in certain regions of brain. Typi-cally, the injury affects the frontal lobe, anterior tempo-ral lobes, anterior cerebellum and occipital lobe, which all play part in how we think, communicate and feel.

Traumatic brain injuries can severely impair a soldier’s quality of life. Common symptoms of a TBI may include:

• Loss of coordination• Sleep disturbances• Seizures• Headaches• Confusion• Agitation and emotional disturbances


Common PTSD symptoms may include:

• Sleep disturbances• Staying away from places and things that trigger memories of the event• Emotional disturbances• Increased anxiety• Headaches• Anger problems or irritability• Nightmares• Flashbacks• Panic attacks

Symptoms of PTSD may not develop immediately after the traumatic event. In many cases, they may not appear until several months, possibly even years later. Having PTSD symptoms is not a sign of weakness or a character flaw. The symptoms point to a biological problem in the brain following a significant trauma soldiers experienced.

How CereScan is Changing the Lives of Soldiers

After coming home, many soldiers have difficulty adjusting to civilian life. From re-entering the workforce to managing a family, veterans face a variety of chal-lenges while still coping with the after-math of hostile situations.

While TBI and PTSD affect the brain dif-ferently, many veterans experience both of these debilitating disorders and receiv-ing an accurate diagnosis is a crucial step toward feeling better. The symptoms that result from TBI and PTSD can severely af-fect a veteran’s quality of life and ability to adjust to a non-combat zone living.

Recently, CereScan announced it has partnered with TRICARE military insur-ance to give the nation’s military popula-tion more access to its functional brain imaging technology.

CereScan is based in Littleton, Colorado, and has affiliate clinics in Texas, Louisiana, Florida and Kansas with plans for several new clinics to open later in 2016. For more information, please visit CereScan.com


Healing the Brain and Neurofeedback Assisting With Connection

Tina Buck, Ph.D., LPC

Neuro feedback (EEG biofeedback) is cutting-edge technology that helps the brain to rebalance it-

self from states of under-arousal, over-arousal, trauma-related hyper-arousal, and other imbalances. Neuro feedback software responds to your brain waves with visual and auditory feedback that guides you to a balanced state. You then learn how to repeat the desired patterns. Neurofeedback trainees feel more happy, calm, focused, confident, energetic, agree-able, creative, and present. Completely painless and noninvasive, nothing comes into the brain. Post Traumatic Stress Dis-order causes changes in the limbic sys-tem, causing the system to get stuck in a state of hyperarousal. Neurofeedback trains the brain to relax and focus so that processing these bits of sensory informa-tion is nonthreatening. BrainPaint® uses AlphaTheta protocols that include delta inhibition so that if a traumatic flashback reoccurs, it can be viewed from a neutral emotional state. Two studies of neuro-feedback with combat veterans resulted in 100% of subjects no longer meeting criteria for diagnosis of PTSD (Peniston & Kulkosky, 1991; Peniston, Marrinan, Dem-ing, & Kulkosky, 1993). (http://www.neuro-feedbackhomeuser.com)

Dr. Buck reports neurofeedback offers hope for post-traumatic stress and head injuries in a way that other methods are challenged to match. Two studies with Vietnam veterans who completed neu-rofeedback training resulted in 100% of subjects no longer suffering from PTSD—long term. And among 819 people who self-identified with PTSD, 89% reported their symptoms were better or resolved by the 20th session of BrainPaint® neurofeedback training. Positive re-sults have been found in at least 22 studies of neurofeedback for head injuries. Additional evidence indicates changes in brain waves and deep brain structures leading to a stable, relaxed state of mind, and to stress reduction after only one session of neurofeedback. The obvi-ous question is, why is neurofeedback training not more available? Dr. Buck explains that neurofeedback has historically been expensive and complicated, but that new generation neurofeedback software makes it affordable and simple to use. She believes that a tactical training approach eliminates the stigma of a mental health diagnosis and should result in accessibility for all veterans and those who serve and protect our national security.” (www.prweb.com/releases/2015/11/prweb13075742.htm)

https://biobalance.us


The body and brain have high requirements for certain nutrients. Namely, the ones often in short supply in our diet and environment due a variety of factors (e.g. the overuse of mineral-depleting agents such as glyphosate and fluoride – and living at higher altitudes).

The oxygen concentration at sea level is approximately 21% and at higher altitudes, Aspen CO (7,908 ft) and Mount Everest, (29,029 ft), oxygen concentration falls to 15.4% and 6.9%, respectively; the latter being life-threatening. Ox-ygen is a vital nutrient required for ALL healing processes in the body – as is magnesium, zinc, lithium, selenium, vitamin C, and D – which are often in short supply due to a wide variety of reasons. These nutrients are required for the creation of neural growth “hormones” that stimulate the formation of new neurons (ie. neurogenesis), and help heal and repair damaged areas of the brain and nervous system. If the body and brain doesn’t receive these nutrients in sufficient amounts – healing processes are impaired – but can be reactivated by the addition of specific nutrients such as those above.

Vital Nutrients for Neuronal HealingTimothy M. Marshall, Ph.D.Holistic Neurospecialist / PharmacologistProfessor of Chemistry and Pharmacology www.dr-marshall.com


Hyperbaric is the best thing I’ve ever done...it actually gave me my life back.

Learn more about the work of Patriot Clinics and how you can make a donation. Your donation will give life saving help to a veteran and is

greatly appreciated.

Visit www.patriotclinics.com and click on the “Donate Now” link.

Since he started, Liby has stepped down his pain medication and other prescriptions from seven to three and he credits Hyperbaric Oxygen Therapy. He said his anger issues are gone and he feels more clear in his thinking and his interac-tions with his children.

Tucson Veteran Hopes His Story Will Help Others

http://bit.ly/1cfmRBq

northstarhbot.com/success-stories

“The Oxygen Revolution”Book by Dr. Paul G. Harch and Virginia McCullough

For the millions of Americans suffering from these seemingly “hopeless” diseases, here finally is the handbook of hope. Inspiring and informative, The Oxygen Revo-lution is the definitive guide to the miracle of hyperbaric oxygen therapy, from a pioneer in the field.

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