March 3, 2025 • 40 mins
Brain injuries are more common than most of us realize, and this episode sheds light on the critical issue of traumatic brain injury (TBI) awareness. Join host Larry Zilliox, along with Donna Meltzer, CEO of Brain Injury Services, and Dr. Juliet Haarbauer-Krupa, adjunct faculty in the Department of Pediatrics, Emory School of Medicine, as they explore the far-reaching effects of TBIs on both children and adults. With insights into the varying types of brain injuries and the unique care programs available, this episode offers listeners valuable information on the significance of early intervention and the resources accessible to individuals affected by these injuries.
Tune in for a compelling discussion that emphasizes how critical it is to recognize the symptoms of brain injury and seek help. You'll learn about the vital work being done in the realm of brain health, including programs designed to support those living with TBIs and their families. As we delve into various narratives, we uncover the power of community support and the importance of raising awareness during Brain Injury Awareness Month. With an urgent call to action, we encourage listeners to take the necessary steps to educate themselves and get involved in helping others. Don't miss this important conversation that blends expertise with personal stories—tune in and help us spread the word about brain injuries and their impact on our lives.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Larry Zilliox (00:00):
Good morning.
I'm your host, Larry Zilliox,Director of Culinary Services
here at the Warrior Retreat atBull Run, and this week our
guests are Donna Meltzer.
She's the CEO of Brain InjuryServices.
It's a nonprofit leader indeveloping community-based
services addressing the needs ofamazing people with traumatic
(00:21):
brain injury, and they are basedout of Springfield, Virginia.
The Adapt Clubhouse, which is areally cool place that I had
the good fortune of being therefor the ribbon cutting recently,
is in Fairfax.
There is a Leesburg office inLeesburg, Virginia, a
Fredericksburg office inFredericksburg, Virginia and a
(00:43):
Winchester office in you guessedit Winchester Virginia.
And joining us by phone is DrJuliet Haarbauer-Krupa.
She's adjunct of faculty in theDepartment of Pediatrics at
Emory School of Medicine.
So welcome to both of you.
I'm just so happy that you'rehere and this episode really is
(01:08):
because of brain injuryAwareness Month.
Donna, welcome, and dr Julie,thanks for joining us well.
Donna Meltzer (01:15):
Thank you so much , larry.
It is it's an honor and apleasure to be back here with
you again yes, that's.
Larry Zilliox (01:22):
One thing I should point out is that Donna
is one of our very rare repeatguests, and I'm really happy to
be able to do this episodebecause it's so important and
it's an important issue for ushere at the Warrior Retreat at
Bull Run, and I'll talk a littlebit about how we see traumatic
brain injury manifest itselfhere with our warrior guests,
(01:43):
and then we'll just talk alittle bit about the different
programs that Brain InjuryServices hosts as well, as we'll
get Dr Julie to talk about theissue as it relates to children
too, which I think is the mostimportant thing.
But so, donna, tell us just alittle bit about what Brain
Injury Services does for thepeople of Northern Virginia.
Donna Meltzer (02:08):
I'm happy to Larry.
Thank you.
So.
Brain Injury Services is, asyou mentioned before, a
nonprofit organization.
We are primarily funded throughthe Virginia State Legislature.
That funding goes to the StateDepartment of Aging and
Rehabilitative Services and wehave been around since 1989 and
(02:30):
we are here to serve people withboth acquired and traumatic
brain injuries of all ages, allstages so could you explain the
difference to our listenersbetween acquired and traumatic
brain?
yes, so we so we typically thinkof.
I think most people are morefamiliar with traumatic brain
injury.
Right Especially in your work,larry, with Wounded Warriors.
(02:54):
Right A blast to the head, aconcussion, which I'd like to
talk a bit more about today afall, a car accident?
You know.
Day a fall, a car accident, youknow when something has either
landed on you or slammed intoyou or you have taken a dramatic
fall.
Acquired brain injury istypically through some kind of
health incident.
(03:14):
So, for example, a stroke is areally great example of acquired
brain injury.
So we serve all kinds of folks.
The greatest thing, and whatmakes us so unique, is that we
provide our services for free,again, because we are funded
through the state government,through several county
(03:35):
governments, as well as privatedonations and corporate entities
, et cetera.
We have some amazing folks onour team who really work to
create this full portfolio offunding opportunities so that we
can do everything that we wantto do and need to do, because so
many people, unfortunately,have brain injury.
(03:56):
You know, as I said, it canhappen at any time during life,
and so we really work withfamilies.
We work to support children.
You mentioned that.
You know we care so much aboutkids who are growing up with
brain injury, who may struggleat school, who may feel othered
and really need that help alongthe way.
(04:18):
And it's not just the child, ofcourse.
It impacts the entire family.
So, we have a whole departmentthat supports families.
You know, something that Ithink is really incredible that
we do is any of our staff in ourpediatric department will go
with the family to the schoolwhen they have a big meeting, an
important discussion abouttheir kid's education plan,
(04:41):
their individualized educationplan, an IEP as it's it's
commonly known.
It's really scary as a parentto go to a meeting like that on
their own.
Sometimes they might feel, youknow, pushed to the side and the
the folks from the school say,well, we know what your kid
needs, but let's face it, theparent always knows what their
kid needs, right, so we can bethere to help, you know, ease
(05:04):
that stress and make sure, fromour very professional knowledge,
that the family walks awayfeeling good about the
conversation, that their childis getting what they need.
We serve adults, we do casemanagement, which means when
people come to us, we're goingto sit down and have this
one-on-one conversation, justlike you and I are having here
(05:25):
today, to talk about what aretheir needs, what are their
goals.
Each of our clients actuallydesigns their own goals.
We are very person-focused,centered.
You know.
It's really about what everyclient needs, because no two
people want or need the samething in their recovery plan for
their life.
So we individualize everythingand we work with that individual
(05:47):
to meet their goals and to makethe progress that they would
like to make in their recoveryjourney.
I certainly want to mentiontoday, of course, while I'm
sitting here at your place outhere in Bull Run, that we serve
veterans, we serve all veteransand we work in concert with the
(06:08):
VA, so we're not taking theplace of or pulling people away
from getting their support aftera brain injury through military
service.
We're here to support, maybeadd-on, layer on extras that the
veteran might not have gottenor just needs longer right,
(06:30):
everybody's recovery journey isa different length of time.
For some it might be fairlyshort, for others maybe a number
of months or a couple of years,and for some it's forever.
It is forever and it mightinvolve the rest of the family
as well, and so we are here todo that.
We have a veterans case managerwho is highly trained.
(06:51):
She actually is from a militaryfamily herself, she's from
Virginia, so she gets it, sheknows it, she is deeply steeped
in the language and theunderstanding, the unique needs
of a military individual orfamily.
Larry Zilliox (07:09):
So right there I would say to listeners if you're
a veteran or you know a veteranthat needs assistance with this
issue and you've beenconsidering the VA for that kind
of help, what a lot of peopledon't understand is that while
the VA looks close to us in DC,it's not close to us.
(07:32):
When you talk about the timethat it takes to get there, I
personally go to West Virginiafor my care because it's three
times the distance but it's thesame amount of time to get there
and it's a prettier drive.
So consider brain injuryservices as a possible
replacement for the VA in thisparticular area, because this is
(07:55):
a tough area.
It's sort of a wasteland for VAservices out here in the
country of Western PrinceWilliam County and northwestern
Virginia.
So it's an option for you.
So don't think that you have tofind a ride to Martinsburg,
west Virginia, or somebody who'swilling to battle the traffic
(08:15):
to get into DC.
Brain Injury Services in yourcommunity Fairfax, winchester,
fredericksburg is there toprovide you with services and
they will either supplement theVA or just you may want to check
them out first that is reallygreat.
Donna Meltzer (08:32):
Thank you for for sharing that.
But I also want your listenersto know a lot of our case
management can be done virtuallyright having a conversation
like we're having today.
It can be done over zoom, itcan be done in a phone call.
So, while some of our programsor opportunities are in person,
some of these basics that aveteran may need can be done out
(08:54):
of their own home.
We also have case managers whowill go to the homes of those
who need, so nobody should everfeel pressured to have to get to
one of our locations.
Larry Zilliox (09:05):
And that was sort of my next question, because
when you talk about elderlyveterans, many of them have
mobility issues andtransportation can be an issue
as well.
I think it would be extremelyvaluable for family members or
veterans who have buddies thatmay need some assistance to say
hey, can you come to the houseand evaluate grandpa?
(09:26):
And is this traumatic braininjury or is this something else
?
Is this Alzheimer's or is this?
What is this?
And that's amazing.
Donna Meltzer (09:35):
So one thing I do want to note is we're not there
to do diagnosis, but we willcome evaluate if the individual
says my doctor has said I havebrain injury.
It doesn't necessarily need tobe service connected.
Larry Zilliox (09:51):
Right.
Donna Meltzer (09:51):
As long as the individual was in the military,
any branch of the military, anyera of the military Right.
We're not just serving thosewho have recently come out or
those long ago, it does notmatter.
Ok serving those who haverecently come out or those long
ago, it does not matter.
But you need a diagnosis ofbrain injury for us to be able
to document and serve.
Larry Zilliox (10:10):
Okay, good, that clears that up.
Let me ask Dr Julie a question.
Sure, and since you specializein pediatrics, if you would
could you tell us about, from aclinical standpoint, how TBI
manifests itself in a child, afour-year-old as opposed to a
(10:33):
40-year-old?
Dr. Juliet Haarbauer-Kru (10:34):
That's a great question and thank you.
So, preschoolers?
So when I started in the field40 years ago, there was zero
research on kids and everybodyused to say, oh, their brains
will be fine because they'reyoung.
And what we've learned overtime?
That even with a mild braininjury, kids can have long term
(10:56):
effects because it affects howthe brain works and it can also
impact their development.
So in that way kids are verydifferent than adults because
they're in the process ofdevelopment and injuries start
as infants.
They can start having an injurythen and over time have more
than one.
So yes, it's very different forkids than adults.
Larry Zilliox (11:18):
Yeah, they're not just small people and in young
children.
Dr. Juliet Haarbauer-Krupa (11:21):
yes, that's a good point.
And then kids younger than fiveyes, that's a good point.
And then kids younger than five.
(11:41):
Recent research, including someI've done, has shown that
symptoms may be different theirchild's having a headache at
four.
They may observe theirpersonality changes, their
increased crying.
They're having increasedmeltdowns.
They're not eating as much andthey might have been toilet
trained and that might havechanged.
So young kids have differentsymptoms than even older kids
(12:04):
and adults because we'reobserving them.
They're not necessarilyreporting them.
Larry Zilliox (12:09):
Just so our listeners are clear when we talk
about pediatrics, it's not justyoung children.
Pediatrics covers up to age 21,.
I believe.
Donna Meltzer (12:20):
In our definition at Brain Injury Services.
Larry Zilliox (12:23):
It goes through college, oh okay, all right.
At brain injury services.
It goes through college, ohokay, all right.
So I'm guessing that a lot ofyour work is around concussive
injuries based on sports.
Dr. Juliet Haarbauer-Krupa (12:32):
True , that's a great point.
Sports are one of the and thankgoodness to the sports
community for bringing this allinto the foreground.
Sports is a common mechanism ofTBI, but it mostly starts when
kids are a little older, likewhen they're 9, 10, and they're
starting to participate insports more and the sports are
(12:54):
more competitive, and especiallyin high school that is.
The highest number of injuriesin high school is sports and
motor vehicle crashes.
With young kids it's mostlyfalls.
Larry Zilliox (13:08):
And the concussive injuries very similar
to what we see here at thewarrior retreat.
Many of our warriors sufferfrom TBI.
We actually train our staff,our guest stay coordinators.
They're volunteers but part oftheir training is to recognize
TBI symptoms the biggest one andthe way we encourage them to
(13:32):
contact the warrior and talkabout their upcoming stay.
But then we also encourage themto contact the warrior again
three days later and discusswhat they discussed, because
very, very often because of theTBI, they have no memory of
their conversation and beforethey go lining up all sorts of
(13:52):
things that the warrior won'tremember, they kind of gently
ask maybe I can talk to yourspouse or your you know
significant other caregiver,whatever.
So that's one of the ways we seeit manifest itself here and we
recognize that for our guests,when you see somebody who's a
(14:13):
below the knee amputee, you arealso looking at somebody who has
TBI and post-traumatic stress.
So rarely do you do.
Our guests come with just oneissue, and I think that can also
be true in a community when,donna, you're dealing with a
person who was in an autoaccident and maybe a near-death
(14:34):
experience.
Now you're talking about TBIbut also PTS, you know, I just
think the concussive injuriesand the blast injuries that we
see warriors with are so similarto what you deal with in sports
and in auto accidents.
So, donna, what percentage ofyour guests are auto accidents
(14:58):
or sports related, or how doesit break down for you?
Donna Meltzer (15:01):
That's a great question.
I would say majority of what wesee are either auto accidents
or false, as Julie mentioned.
But I want to take a step backfor a moment, just share a
little story.
We have a program at BrainInjury Services that we call the
Human Library Project.
It's very unique and it'sabsolutely fascinating and it's
(15:24):
changing the breadth and scopeof knowledge of the average
person about what brain injuryis.
As you could probably guess byits title, we are actually using
humans, people who have braininjury, to almost be like a book
.
So it's a two-pronged approachin this program approach in this
(15:47):
program Number one they'reworking with professionals to
learn how to tell their story,create it in writing and learn
how to express it orally as well.
And then we do these eventswhere other people from the
community can come to ourlibrary I'm putting that in air
quotes from those who can't seethat and check out a book, which
means you come and you sit withthis individual for a while and
(16:10):
hear their story.
The reason I'm sharing this isbecause I went to a fairly
recent human library event and Ichecked out a book of my own.
My book was a woman who at thispoint is in her mid to late 60s
.
As a child she had her firstbrain injury when she was, if my
(16:32):
memory's correct, around 10.
Or it might have been five, andher second one was at 10.
She had two.
The first was she was playingwith her friends.
She lived kind of in a ruralarea.
She fell out of a tree and backthen nobody knew.
We didn't know TBI, we didn'treally talk about concussion,
(16:52):
she didn't know what was wrongand her parents didn't even
necessarily think it wasimportant to take her to see a
doctor because that was going tocost them money and it might be
an embarrassment or you knowsomething about the reputation.
So this poor child suffered formuch of her life.
It wasn't until she was an adultthat she learned really she had
(17:16):
had a major concussion, endedup, as I said, having two, and
to that point, about crossover.
It wasn't just a head injury,but it impacted everything about
her life how she felt aboutherself, her struggle with
memory issues, her ability to dowell in school, her ability to
(17:38):
hold down relationships and toreally share about herself.
It wasn't until she found braininjury services as an older
adult that she really understoodterminology, about what this
was, that she could understandthe roots, the genesis of what
she was going through, and thatshe wasn't alone.
(17:59):
And that she now has copingmechanisms and can really look
at her life very differently.
And she is repairingrelationships from the past and
learning how to forgive herparents who just didn't know
better.
Right Today, you know, as wewere talking about pediatrics
and the fact that we look atpediatrics as all the way up
(18:21):
through college, it's because wedo know better.
We know that the earlier we canrepair something and gives an
individual the tools and theskills to learn what they need
to learn to be successful inthis world, the better off they
will be.
Larry Zilliox (18:39):
Dr Julie, can you tell us a little bit about the
research that you all are doingthere at Emory and the work that
your department does?
Dr. Juliet Haarbauer-Krupa (18:50):
Oh, thank you.
Well, my field.
I've always been interested inyoung children because I had a
federal longitudinal study ofchildren's where we were
studying kids who were injuredbefore age five, but they were
in early elementary school andit was mind blowing.
First of all, many parents cameto us whose children had a
(19:10):
concussion or a mild injurybecause they said nobody was
listening to them, and then welearned that these kids actually
test within normal limits.
That's one of the issues withkids.
This is an unexpected event andparents don't always understand
what to do, whether to take themto get care, as Donna mentioned
, or not.
(19:31):
In the early years they wouldjust say, okay, you'll be fine
if they had a mild injury.
But now we're reallyencouraging parents to really at
least take them to theirpediatrician or somewhere to get
them evaluated, because it canreally impact them.
So I've done work on outcomes,I've done work on overall the
(19:54):
theories about brain injury, andchildren are different from
adults because they have twomodels of care.
They have the healthcaresetting and the school setting,
and all kids are in schoolsomewhere.
And so what I've learned fromtalking with educators over time
is kids might come back andtheir behavior has totally
(20:17):
changed, but they weren't toldthey had a brain injury.
They'll ask the parents.
Some schools now have somethingcalled a guided credible
history where if the parent, ifthey ask the parent, and the
parent says, oh yeah, my childhit their head but we didn't get
, they can still take care ofthem at school because they've
changed their requirements.
But most schools require amedical diagnosis and to qualify
(20:40):
for school services you need tonot test.
Well, you know that's part ofthe reason why it's hard to
serve children.
So over time we have learnedthat A this early childhood or
any injury in childhood canreally affect the kids, in part
because imaging has advanced.
(21:00):
It showed us that.
You know, their brains lookdifferent and if a child has an
injury at a young age, as Donnamentioned, they could have
multiple injuries over time,like that story Donna told us.
Nobody knew at 10 what to do orrealized it, and you know she
probably had a few.
(21:20):
She might have had a few more.
But also what we've learned toois past and current health
history means something.
So if you have a concussion andlet's say you had a learning
disorder, you might have moreissues than if you did not.
Or if you had a developmentaldelay or hearing problems or
(21:40):
ADHD, you might have moreeffects because of them and
there's heterogeneity inoutcomes due to many factors in
kids the injury, what happened,as Donna mentioned some kinds of
injury types like abusive headtrauma or if somebody was
affected by violence.
That's going to add to theissue, in addition to the
(22:05):
child's past and current healthhistory and the child's
environment.
So if a child lives in ruralareas, they may not get care, if
parents don't have insurance orthey don't have the means to
pay for care a child may not getcare, or we've also learned
that sometimes parents don'trealize there's effects of those
(22:26):
things killed and I thinkthat's part of the story that we
really need to educate everyoneoverall that if you hit your
head, here's what to watch forand here's what to do.
Larry Zilliox (22:37):
So I want to just take a moment to point our
listeners towards the BrainInjury Services webpage, because
you're going to find atremendous amount of resources
Services webpage.
Because you're going to find atremendous amount of resources.
It's just, it's your firststarting place really when you
(22:59):
think you have an issue or youhave a friend or relative who
may have an issue, but it'sbraininjurysvcsorg, so
braininjurysvcsorg.
So go there, take a look, findresources, reach out if you're
not sure.
And what I always tell ourlisteners is, when you go to a
(23:24):
webpage for an organization thatoffers services, look it over
and then contact theorganization.
Don't make assumptions based onwhat you see, because most of
the time you're going to bewrong.
You're going to think, oh, Ididn't see that service, so they
don't offer it.
When they do, or once theyunderstand your situation, these
(23:47):
are trained professionals whocan make recommendations for a
treatment protocol or some sortof case management that you
hadn't even thought of.
Don't just assume anything.
Look it over, get anunderstanding of the
organization.
You can trust the organization,I guarantee that.
But reach out to them and sayhere's my situation, what do you
(24:13):
think?
Can you help me?
And straight up.
If they can't help you.
They will tell you they can'thelp you and then they'll find
some other resources for you.
They'll say you know what, youmight be better off with the VA
if you're a veteran or you don'tlive in Virginia.
You know, thanks for looking atour webpage, but you don't live
(24:34):
in Virginia.
You live in Iowa.
But maybe there's a similarorganization in Iowa and I'm
sure Donna is just hooked upwith all these brain injury
people around the country andthe world.
So don't give up.
Make sure you reach out.
For sure, donna, you guys havea webinar coming up.
(24:54):
Can you tell our listeners alittle bit about that?
Donna Meltzer (24:56):
I would be delighted to Thank you.
So, as you mentioned at thebeginning of our conversation,
today it's Brain InjuryAwareness Month.
I want to go back briefly.
A year ago at this time, as wewere preparing for brain injury
awareness month, we did a littlepoll that we sent out to over
300 northern virginias just toget a little information from
(25:18):
folks about what do they knowabout brain injury and what
don't they know.
And one of the facts thatreally struck us was how little
people knew or understoodconcussion and related
concussion as brain injury.
Right, julie made that point.
Brain injury is excuse me,concussion is brain injury, and
(25:41):
so we have spent a lot of timethis year focusing in on
concussion.
50% of people with braininjuries don't get it checked
out, because often what theyhear is oh, you had a concussion
, you're OK, maybe take a day ortwo off.
You know school protocols aredifferent depending on what
school system you're in.
(26:03):
Some will tell you go see yourdoctor or take your kid to the
pediatrician.
Others will just say rest for awhile and you'll be fine, but
it's really important to see amedical professional because,
none of us can see inside thatbrain and know exactly what is
going on.
So we've been studying this.
We've been talking with a wholelot of specialists and very
(26:26):
highly educated people likeJulie, like Dr Greg O'Shanick
from Richmond, virginia, whohave expertise around concussion
.
In September, we did what wecalled a concussion summit,
where we brought together agroup of professionals from a
variety of different parts ofsociety right so, employers,
(26:49):
educators, people in the sportscommunity, physicians, people
who are in technology and we hadthis amazing half-day
conversation.
We had a great panel Julie waspart of that where our experts
got to talk about what they knowabout concussion.
And then we had some deeperconversation and what we're
(27:13):
doing this year in March, onMarch 25th at 9 am Eastern Time,
we're going to be releasing ourreport through a webinar format
of what we've learned over thispast year.
Julie will be part of that, drGreg O'Shanick, who I mentioned,
will be part of that along withmyself, and so we do encourage
(27:36):
all of the listeners here tojoin us for that event.
So some of it will be ussharing some of the information
we've learned, and then therewill be opportunity for
questions and answers as well.
Larry Zilliox (27:47):
So I've registered for that.
It's pretty painless.
You put your name in your emailaddress and boom, you're there.
Donna Meltzer (27:52):
Boom, you're there.
Larry Zilliox (27:53):
So definitely go to the webpage.
You'll find it there.
I think it's under events,right, so you know, click on
that.
Dr Julia, one question for youwhat is your take on the current
state of research done byfederally supported universities
(28:15):
, private organizations today,especially when it comes to
concussive injuries, whetherthey're in children, in auto
accidents, in sports or whetherthey're involving veterans and
their service?
So what do you think the stateof research is?
Dr. Juliet Haarbauer-Krupa (28:34):
Well , first of all, what I've been
pleased about over the years isthere's multiple areas of
research.
There's research on kids, onadults, on service members.
There's research on biomarkers.
People are looking more intothe brain, physiology and what a
head injury can do, and they'realso looking at the effects.
(28:56):
There have been even somepapers although we can't study
kids clear to adulthood, that'stoo expensive but people will
write a paper about individualswho had a childhood history
they're now adults and how it'simpacting them.
So the state of the researchhas been unbelievable because
it's expanded so much.
(29:17):
It covers concussion and mildinjury.
It covers severe injury,disorders of consciousness.
There's so much out there rightnow.
Now some of it's been put onhold for a month or so, but I'm
hoping that it opens up andcontinues.
Larry Zilliox (29:33):
Donna, what can our listeners do to support
brain injury services as far asfrom a funding standpoint?
Now, normally I tell them to goclick on a donate button and
give five bucks.
But who can they reach out toon a state level here in the
Commonwealth and say we knowthat there might be funding
(29:54):
issues from the federalgovernment to the state as far
as transferring funds, but whenall said and done, brain injury
services needs to be funded.
This is too important to justsort of push to the side.
So what do you recommend ourlisteners do who want to help
(30:14):
you continue to do the amazingwork that you do?
Donna Meltzer (30:18):
thank you so much for for opening up that
conversation.
We are not federally funded, sowe are fortunately at this
moment, while, as Julie said,some grants are on hold.
Larry Zilliox (30:31):
We don't have that direct impact, but I'm
guessing some of that moneycomes from the feds to the state
so our money is from the state,but you're right in that
there's always going to be atrickle down.
Yeah.
Donna Meltzer (30:42):
Right.
It's going to hit us innumerous ways, some that we
can't even anticipate quite yet.
I will say that I have a verystrong feeling that where we
will see some impacts is fromour county grants.
Fairfax County is one of ourlargest funders.
They're going to be strugglingin numerous ways either.
(31:04):
Because they have federalgrants, For example, they run
some amazing programs thatsupport people with all kinds of
disabilities, including braininjury, to get a leg up on
employment.
A lot of people withdisabilities struggle to get
into good, meaningful employmentopportunities.
Larry Zilliox (31:22):
Sure.
Donna Meltzer (31:22):
And they have some very strong programs in
Fairfax County that they've metwith us about.
They want to see our folks withbrain injury enter those
programs.
Those are federally fundedprograms, so we're waiting to
find out if they're still inexistence or if their funding
has been cut, so we'll feel someof that trickle down, if you
will.
Fortunately for us, as I said,most of our programs are not
(31:44):
currently impacted.
In fact, we have just finisheddoing our advocacy work at the
Statehouse in Richmond and wegot very good news this past
week that the General Assemblyhas approved Now the governor
has not yet signed the bill, butwe anticipate he will that we
(32:09):
have been approved for someincreases to support our staff
so that our staff, who arerelatively low paid, can get at
least a small bump up, becauseall costs are going up right
Every nonprofit, every nonprofit.
So we're happy about that andwe've gotten some expansion
money as well.
One of the unique things aboutthe state of Virginia is we are
(32:30):
one of the only states in thenation that has brain injury
service provider agencies acrossthe state.
Some have none.
District of Columbia hasnothing.
Maryland has a brain injuryAssociation of Maryland, but
they're kind of up in Baltimoreso they're not able to provide
the kind of supports we do yeahand with funding support a year
(32:53):
ago we were able to cover everyinch of Virginia.
So every single person inVirginia who has a brain injury
has an opportunity to be served.
So we are getting a little bitmore expansion money so we can
maybe grow our staff.
So, for example, where we arereally in need of increasing our
staff capacity, this is notgoing to shock you mental health
(33:15):
services.
Sure Right.
Larry Zilliox (33:17):
Yeah.
Donna Meltzer (33:17):
We have waiting lists, so we are very excited
about that, but it doesn't meanthat we're just fine and dandy.
Sure, we need more help.
We recently had an annualcampaign.
We have Giving Tuesday.
We have, if you feel socompelled that you want to say,
brain Injury Awareness Month isa great time for me to make a
donation.
(33:37):
Please do so.
You can do it very easilythrough our website.
If you struggle to find theright way or time or place to do
that, give me a call or callAndrew Walensky, who is our
Director of Development.
We have so many different waysthroughout the year for
individuals to give, and it'snot just dollars.
If you would prefer to givesome of your time in a
(34:01):
particular way, let us know thatwe can utilize volunteers.
We are always in need of avariety of kinds of supports
that can be helpful.
So, it's not just dollars.
We like people who care aboutbrain injury to join us in
learning more about what itmeans and how to advocate for
(34:22):
our funding for programs, forall these other things that help
us do what we do.
So please take a look at ourwebsite.
If it's not leaping out at youas to what they're, the right
path is for you, just give us acall and we'll we'll have a
conversation and guide youthrough and so the website again
(34:43):
is braininjurysvcsorg and it'sBrain Injury Awareness Month
this month.
Larry Zilliox (34:52):
So share that webpage on your social media.
Please Send it out to everybodyyou know.
Listen, the folks that they seeover there at Brain Injury
Services, the wounded warriorsthat we host here at the Retreat
many of their injuries came tothem in a second.
Their life changed, theirfamily's life changed in just a
(35:18):
second.
So you might think this isn'tfor me, I don't know anybody,
but you need to familiarizeyourself with this issue, these
resources, and promote the workthat they do, because things can
change for you or someone youlove or know a relative, a
(35:39):
friend in an instant.
You love or know a relative, afriend, in an instant, and that
is not the time to try andfigure out what's going on.
So, for sure, check out thewebpage and spread the word.
This is Brain Injury AwarenessMonth and that's why we're doing
this episode and that's why wewant all of our listeners to get
(36:00):
the word out.
We're over.
We don't usually go this long,but this has been fascinating.
And, dr Julie, I just have onelast question for you and I
asked this of a number of guests, but considering, thinking
about the work that you do, how?
Donna Meltzer (36:17):
do you?
Larry Zilliox (36:18):
think that artificial intelligence and AI
is going to impact the work thatyou do.
Dr. Juliet Haarbauer-Krupa (36:25):
Oh, that's a great question and
that's really up for debateright now.
Right, I think some physiciansare using it to help verify, you
know, diagnosis.
I've seen that done, but I'mhoping it doesn't take over for
healthcare providers anddiagnosis, but that it assists
(36:45):
them and that's what I've seenpeople using right now something
to assist them.
So hopefully it will assist butnot take over for healthcare.
Larry Zilliox (36:56):
Yeah, I know that UVA was involved in a recent
study of their physicians and Ithink their diagnosis were about
69% of them were better whenthey were using AI as a
supplement to their ownknowledge and clearly I think
that's just, that's great andI'm happy to hear that from you
(37:18):
because I think I'd hate to seepeople resist using it really.
I also want to direct ourlisteners to a previous episode
that I did with Dr Stone fromUVA, who's doing research on
blast injuries small blastinjuries over a short period of
time.
So where a lot of times peoplethink of soldiers being in close
(37:44):
proximity to large explosions,it turns out that during their
study they found that explosiveordnance disposal instructors
who were subject to a series ofsmall explosions during the time
that they're instructing othersoldiers, that they actually had
more of an impact on theirbrain than those soldiers who
(38:09):
were just one-off largeexplosions here and there.
So it's a great episode.
It was last season, season two,you can look it up.
I just really wanted to kind ofwind up here and say thank you
to you both.
Dr Julie, thank you for thework that you do.
It's amazing because it's soimportant, especially with kids
(38:32):
and pediatrics, because itreally does change the
trajectory of their life if theysuffer this sort of injury and
it's unattended and it reallycan impact so many people.
So thank you very much foreverything that you do.
Dr. Juliet Haarbauer-Krupa (38:51):
Oh, thank you, and I want to make a
special comment of support forwhat Donna does, and the Brain
Injury Services of Virginia is avery unique state-run agency or
nonprofit.
And, donna, thank you, you'redoing great work.
Thank you.
Larry Zilliox (39:09):
So, donna, yeah, thanks for coming out and
joining us again as a repeatcustomer.
Donna Meltzer (39:14):
Well, I'm honored and it's always a pleasure If I
can just say one thing as well.
You know, as we've, we talkedabout spending this year really
looking at concussion.
It's for.
The message for everybody is ifyou or someone you know has had
a fall, a car accident, bumpedtheir head on a beam, whatever
(39:38):
it might be, don't just say Ithink I'll be okay, go get it
checked out.
Larry Zilliox (39:44):
Yeah, yeah.
Get medical support soimportant, yep.
And so here we are Brain InjuryAwareness Month.
Get the word out, spread theword.
Thanks for listening.
We really appreciate it For ourlisteners.
We will have another episodenext Monday morning.
If you have any questions orsuggestions, you can reach us at
podcast at willingwarriorsorg.
(40:05):
Until next week.
Thanks for listening.
Good morning.
I'm your host, Larry Zilliox,Director of Culinary Services
here at the Warrior Retreat atBull Run, and this week our
guests are Donna Meltzer.
She's the CEO of Brain InjuryServices.
It's a nonprofit leader indeveloping community-based
services addressing the needs ofamazing people with traumatic
(00:21):
brain injury, and they are basedout of Springfield, Virginia.
The Adapt Clubhouse, which is areally cool place that I had
the good fortune of being therefor the ribbon cutting recently,
is in Fairfax.
There is a Leesburg office inLeesburg, Virginia, a
Fredericksburg office inFredericksburg, Virginia and a
(00:43):
Winchester office in you guessedit Winchester Virginia.
And joining us by phone is DrJuliet Haarbauer-Krupa.
She's adjunct of faculty in theDepartment of Pediatrics at
Emory School of Medicine.
So welcome to both of you.
I'm just so happy that you'rehere and this episode really is
(01:08):
because of brain injuryAwareness Month.
Donna, welcome, and dr Julie,thanks for joining us well.
Donna Meltzer (01:15):
Thank you so much , larry.
It is it's an honor and apleasure to be back here with
you again yes, that's.
Larry Zilliox (01:22):
One thing I should point out is that Donna
is one of our very rare repeatguests, and I'm really happy to
be able to do this episodebecause it's so important and
it's an important issue for ushere at the Warrior Retreat at
Bull Run, and I'll talk a littlebit about how we see traumatic
brain injury manifest itselfhere with our warrior guests,
(01:43):
and then we'll just talk alittle bit about the different
programs that Brain InjuryServices hosts as well, as we'll
get Dr Julie to talk about theissue as it relates to children
too, which I think is the mostimportant thing.
But so, donna, tell us just alittle bit about what Brain
Injury Services does for thepeople of Northern Virginia.
Donna Meltzer (02:08):
I'm happy to Larry.
Thank you.
So.
Brain Injury Services is, asyou mentioned before, a
nonprofit organization.
We are primarily funded throughthe Virginia State Legislature.
That funding goes to the StateDepartment of Aging and
Rehabilitative Services and wehave been around since 1989 and
(02:30):
we are here to serve people withboth acquired and traumatic
brain injuries of all ages, allstages so could you explain the
difference to our listenersbetween acquired and traumatic
brain?
yes, so we so we typically thinkof.
I think most people are morefamiliar with traumatic brain
injury.
Right Especially in your work,larry, with Wounded Warriors.
(02:54):
Right A blast to the head, aconcussion, which I'd like to
talk a bit more about today afall, a car accident?
You know.
Day a fall, a car accident, youknow when something has either
landed on you or slammed intoyou or you have taken a dramatic
fall.
Acquired brain injury istypically through some kind of
health incident.
(03:14):
So, for example, a stroke is areally great example of acquired
brain injury.
So we serve all kinds of folks.
The greatest thing, and whatmakes us so unique, is that we
provide our services for free,again, because we are funded
through the state government,through several county
(03:35):
governments, as well as privatedonations and corporate entities
, et cetera.
We have some amazing folks onour team who really work to
create this full portfolio offunding opportunities so that we
can do everything that we wantto do and need to do, because so
many people, unfortunately,have brain injury.
(03:56):
You know, as I said, it canhappen at any time during life,
and so we really work withfamilies.
We work to support children.
You mentioned that.
You know we care so much aboutkids who are growing up with
brain injury, who may struggleat school, who may feel othered
and really need that help alongthe way.
(04:18):
And it's not just the child, ofcourse.
It impacts the entire family.
So, we have a whole departmentthat supports families.
You know, something that Ithink is really incredible that
we do is any of our staff in ourpediatric department will go
with the family to the schoolwhen they have a big meeting, an
important discussion abouttheir kid's education plan,
(04:41):
their individualized educationplan, an IEP as it's it's
commonly known.
It's really scary as a parentto go to a meeting like that on
their own.
Sometimes they might feel, youknow, pushed to the side and the
the folks from the school say,well, we know what your kid
needs, but let's face it, theparent always knows what their
kid needs, right, so we can bethere to help, you know, ease
(05:04):
that stress and make sure, fromour very professional knowledge,
that the family walks awayfeeling good about the
conversation, that their childis getting what they need.
We serve adults, we do casemanagement, which means when
people come to us, we're goingto sit down and have this
one-on-one conversation, justlike you and I are having here
(05:25):
today, to talk about what aretheir needs, what are their
goals.
Each of our clients actuallydesigns their own goals.
We are very person-focused,centered.
You know.
It's really about what everyclient needs, because no two
people want or need the samething in their recovery plan for
their life.
So we individualize everythingand we work with that individual
(05:47):
to meet their goals and to makethe progress that they would
like to make in their recoveryjourney.
I certainly want to mentiontoday, of course, while I'm
sitting here at your place outhere in Bull Run, that we serve
veterans, we serve all veteransand we work in concert with the
(06:08):
VA, so we're not taking theplace of or pulling people away
from getting their support aftera brain injury through military
service.
We're here to support, maybeadd-on, layer on extras that the
veteran might not have gottenor just needs longer right,
(06:30):
everybody's recovery journey isa different length of time.
For some it might be fairlyshort, for others maybe a number
of months or a couple of years,and for some it's forever.
It is forever and it mightinvolve the rest of the family
as well, and so we are here todo that.
We have a veterans case managerwho is highly trained.
(06:51):
She actually is from a militaryfamily herself, she's from
Virginia, so she gets it, sheknows it, she is deeply steeped
in the language and theunderstanding, the unique needs
of a military individual orfamily.
Larry Zilliox (07:09):
So right there I would say to listeners if you're
a veteran or you know a veteranthat needs assistance with this
issue and you've beenconsidering the VA for that kind
of help, what a lot of peopledon't understand is that while
the VA looks close to us in DC,it's not close to us.
(07:32):
When you talk about the timethat it takes to get there, I
personally go to West Virginiafor my care because it's three
times the distance but it's thesame amount of time to get there
and it's a prettier drive.
So consider brain injuryservices as a possible
replacement for the VA in thisparticular area, because this is
(07:55):
a tough area.
It's sort of a wasteland for VAservices out here in the
country of Western PrinceWilliam County and northwestern
Virginia.
So it's an option for you.
So don't think that you have tofind a ride to Martinsburg,
west Virginia, or somebody who'swilling to battle the traffic
(08:15):
to get into DC.
Brain Injury Services in yourcommunity Fairfax, winchester,
fredericksburg is there toprovide you with services and
they will either supplement theVA or just you may want to check
them out first that is reallygreat.
Donna Meltzer (08:32):
Thank you for for sharing that.
But I also want your listenersto know a lot of our case
management can be done virtuallyright having a conversation
like we're having today.
It can be done over zoom, itcan be done in a phone call.
So, while some of our programsor opportunities are in person,
some of these basics that aveteran may need can be done out
(08:54):
of their own home.
We also have case managers whowill go to the homes of those
who need, so nobody should everfeel pressured to have to get to
one of our locations.
Larry Zilliox (09:05):
And that was sort of my next question, because
when you talk about elderlyveterans, many of them have
mobility issues andtransportation can be an issue
as well.
I think it would be extremelyvaluable for family members or
veterans who have buddies thatmay need some assistance to say
hey, can you come to the houseand evaluate grandpa?
(09:26):
And is this traumatic braininjury or is this something else
?
Is this Alzheimer's or is this?
What is this?
And that's amazing.
Donna Meltzer (09:35):
So one thing I do want to note is we're not there
to do diagnosis, but we willcome evaluate if the individual
says my doctor has said I havebrain injury.
It doesn't necessarily need tobe service connected.
Larry Zilliox (09:51):
Right.
Donna Meltzer (09:51):
As long as the individual was in the military,
any branch of the military, anyera of the military Right.
We're not just serving thosewho have recently come out or
those long ago, it does notmatter.
Ok serving those who haverecently come out or those long
ago, it does not matter.
But you need a diagnosis ofbrain injury for us to be able
to document and serve.
Larry Zilliox (10:10):
Okay, good, that clears that up.
Let me ask Dr Julie a question.
Sure, and since you specializein pediatrics, if you would
could you tell us about, from aclinical standpoint, how TBI
manifests itself in a child, afour-year-old as opposed to a
(10:33):
40-year-old?
Dr. Juliet Haarbauer-Kru (10:34):
That's a great question and thank you.
So, preschoolers?
So when I started in the field40 years ago, there was zero
research on kids and everybodyused to say, oh, their brains
will be fine because they'reyoung.
And what we've learned overtime?
That even with a mild braininjury, kids can have long term
(10:56):
effects because it affects howthe brain works and it can also
impact their development.
So in that way kids are verydifferent than adults because
they're in the process ofdevelopment and injuries start
as infants.
They can start having an injurythen and over time have more
than one.
So yes, it's very different forkids than adults.
Larry Zilliox (11:18):
Yeah, they're not just small people and in young
children.
Dr. Juliet Haarbauer-Krupa (11:21):
yes, that's a good point.
And then kids younger than fiveyes, that's a good point.
And then kids younger than five.
(11:41):
Recent research, including someI've done, has shown that
symptoms may be different theirchild's having a headache at
four.
They may observe theirpersonality changes, their
increased crying.
They're having increasedmeltdowns.
They're not eating as much andthey might have been toilet
trained and that might havechanged.
So young kids have differentsymptoms than even older kids
(12:04):
and adults because we'reobserving them.
They're not necessarilyreporting them.
Larry Zilliox (12:09):
Just so our listeners are clear when we talk
about pediatrics, it's not justyoung children.
Pediatrics covers up to age 21,.
I believe.
Donna Meltzer (12:20):
In our definition at Brain Injury Services.
Larry Zilliox (12:23):
It goes through college, oh okay, all right.
At brain injury services.
It goes through college, ohokay, all right.
So I'm guessing that a lot ofyour work is around concussive
injuries based on sports.
Dr. Juliet Haarbauer-Krupa (12:32):
True , that's a great point.
Sports are one of the and thankgoodness to the sports
community for bringing this allinto the foreground.
Sports is a common mechanism ofTBI, but it mostly starts when
kids are a little older, likewhen they're 9, 10, and they're
starting to participate insports more and the sports are
(12:54):
more competitive, and especiallyin high school that is.
The highest number of injuriesin high school is sports and
motor vehicle crashes.
With young kids it's mostlyfalls.
Larry Zilliox (13:08):
And the concussive injuries very similar
to what we see here at thewarrior retreat.
Many of our warriors sufferfrom TBI.
We actually train our staff,our guest stay coordinators.
They're volunteers but part oftheir training is to recognize
TBI symptoms the biggest one andthe way we encourage them to
(13:32):
contact the warrior and talkabout their upcoming stay.
But then we also encourage themto contact the warrior again
three days later and discusswhat they discussed, because
very, very often because of theTBI, they have no memory of
their conversation and beforethey go lining up all sorts of
(13:52):
things that the warrior won'tremember, they kind of gently
ask maybe I can talk to yourspouse or your you know
significant other caregiver,whatever.
So that's one of the ways we seeit manifest itself here and we
recognize that for our guests,when you see somebody who's a
(14:13):
below the knee amputee, you arealso looking at somebody who has
TBI and post-traumatic stress.
So rarely do you do.
Our guests come with just oneissue, and I think that can also
be true in a community when,donna, you're dealing with a
person who was in an autoaccident and maybe a near-death
(14:34):
experience.
Now you're talking about TBIbut also PTS, you know, I just
think the concussive injuriesand the blast injuries that we
see warriors with are so similarto what you deal with in sports
and in auto accidents.
So, donna, what percentage ofyour guests are auto accidents
(14:58):
or sports related, or how doesit break down for you?
Donna Meltzer (15:01):
That's a great question.
I would say majority of what wesee are either auto accidents
or false, as Julie mentioned.
But I want to take a step backfor a moment, just share a
little story.
We have a program at BrainInjury Services that we call the
Human Library Project.
It's very unique and it'sabsolutely fascinating and it's
(15:24):
changing the breadth and scopeof knowledge of the average
person about what brain injuryis.
As you could probably guess byits title, we are actually using
humans, people who have braininjury, to almost be like a book
.
So it's a two-pronged approachin this program approach in this
(15:47):
program Number one they'reworking with professionals to
learn how to tell their story,create it in writing and learn
how to express it orally as well.
And then we do these eventswhere other people from the
community can come to ourlibrary I'm putting that in air
quotes from those who can't seethat and check out a book, which
means you come and you sit withthis individual for a while and
(16:10):
hear their story.
The reason I'm sharing this isbecause I went to a fairly
recent human library event and Ichecked out a book of my own.
My book was a woman who at thispoint is in her mid to late 60s
.
As a child she had her firstbrain injury when she was, if my
(16:32):
memory's correct, around 10.
Or it might have been five, andher second one was at 10.
She had two.
The first was she was playingwith her friends.
She lived kind of in a ruralarea.
She fell out of a tree and backthen nobody knew.
We didn't know TBI, we didn'treally talk about concussion,
(16:52):
she didn't know what was wrongand her parents didn't even
necessarily think it wasimportant to take her to see a
doctor because that was going tocost them money and it might be
an embarrassment or you knowsomething about the reputation.
So this poor child suffered formuch of her life.
It wasn't until she was an adultthat she learned really she had
(17:16):
had a major concussion, endedup, as I said, having two, and
to that point, about crossover.
It wasn't just a head injury,but it impacted everything about
her life how she felt aboutherself, her struggle with
memory issues, her ability to dowell in school, her ability to
(17:38):
hold down relationships and toreally share about herself.
It wasn't until she found braininjury services as an older
adult that she really understoodterminology, about what this
was, that she could understandthe roots, the genesis of what
she was going through, and thatshe wasn't alone.
(17:59):
And that she now has copingmechanisms and can really look
at her life very differently.
And she is repairingrelationships from the past and
learning how to forgive herparents who just didn't know
better.
Right Today, you know, as wewere talking about pediatrics
and the fact that we look atpediatrics as all the way up
(18:21):
through college, it's because wedo know better.
We know that the earlier we canrepair something and gives an
individual the tools and theskills to learn what they need
to learn to be successful inthis world, the better off they
will be.
Larry Zilliox (18:39):
Dr Julie, can you tell us a little bit about the
research that you all are doingthere at Emory and the work that
your department does?
Dr. Juliet Haarbauer-Krupa (18:50):
Oh, thank you.
Well, my field.
I've always been interested inyoung children because I had a
federal longitudinal study ofchildren's where we were
studying kids who were injuredbefore age five, but they were
in early elementary school andit was mind blowing.
First of all, many parents cameto us whose children had a
(19:10):
concussion or a mild injurybecause they said nobody was
listening to them, and then welearned that these kids actually
test within normal limits.
That's one of the issues withkids.
This is an unexpected event andparents don't always understand
what to do, whether to take themto get care, as Donna mentioned
, or not.
(19:31):
In the early years they wouldjust say, okay, you'll be fine
if they had a mild injury.
But now we're reallyencouraging parents to really at
least take them to theirpediatrician or somewhere to get
them evaluated, because it canreally impact them.
So I've done work on outcomes,I've done work on overall the
(19:54):
theories about brain injury, andchildren are different from
adults because they have twomodels of care.
They have the healthcaresetting and the school setting,
and all kids are in schoolsomewhere.
And so what I've learned fromtalking with educators over time
is kids might come back andtheir behavior has totally
(20:17):
changed, but they weren't toldthey had a brain injury.
They'll ask the parents.
Some schools now have somethingcalled a guided credible
history where if the parent, ifthey ask the parent, and the
parent says, oh yeah, my childhit their head but we didn't get
, they can still take care ofthem at school because they've
changed their requirements.
But most schools require amedical diagnosis and to qualify
(20:40):
for school services you need tonot test.
Well, you know that's part ofthe reason why it's hard to
serve children.
So over time we have learnedthat A this early childhood or
any injury in childhood canreally affect the kids, in part
because imaging has advanced.
(21:00):
It showed us that.
You know, their brains lookdifferent and if a child has an
injury at a young age, as Donnamentioned, they could have
multiple injuries over time,like that story Donna told us.
Nobody knew at 10 what to do orrealized it, and you know she
probably had a few.
(21:20):
She might have had a few more.
But also what we've learned toois past and current health
history means something.
So if you have a concussion andlet's say you had a learning
disorder, you might have moreissues than if you did not.
Or if you had a developmentaldelay or hearing problems or
(21:40):
ADHD, you might have moreeffects because of them and
there's heterogeneity inoutcomes due to many factors in
kids the injury, what happened,as Donna mentioned some kinds of
injury types like abusive headtrauma or if somebody was
affected by violence.
That's going to add to theissue, in addition to the
(22:05):
child's past and current healthhistory and the child's
environment.
So if a child lives in ruralareas, they may not get care, if
parents don't have insurance orthey don't have the means to
pay for care a child may not getcare, or we've also learned
that sometimes parents don'trealize there's effects of those
(22:26):
things killed and I thinkthat's part of the story that we
really need to educate everyoneoverall that if you hit your
head, here's what to watch forand here's what to do.
Larry Zilliox (22:37):
So I want to just take a moment to point our
listeners towards the BrainInjury Services webpage, because
you're going to find atremendous amount of resources
Services webpage.
Because you're going to find atremendous amount of resources.
It's just, it's your firststarting place really when you
(22:59):
think you have an issue or youhave a friend or relative who
may have an issue, but it'sbraininjurysvcsorg, so
braininjurysvcsorg.
So go there, take a look, findresources, reach out if you're
not sure.
And what I always tell ourlisteners is, when you go to a
(23:24):
webpage for an organization thatoffers services, look it over
and then contact theorganization.
Don't make assumptions based onwhat you see, because most of
the time you're going to bewrong.
You're going to think, oh, Ididn't see that service, so they
don't offer it.
When they do, or once theyunderstand your situation, these
(23:47):
are trained professionals whocan make recommendations for a
treatment protocol or some sortof case management that you
hadn't even thought of.
Don't just assume anything.
Look it over, get anunderstanding of the
organization.
You can trust the organization,I guarantee that.
But reach out to them and sayhere's my situation, what do you
(24:13):
think?
Can you help me?
And straight up.
If they can't help you.
They will tell you they can'thelp you and then they'll find
some other resources for you.
They'll say you know what, youmight be better off with the VA
if you're a veteran or you don'tlive in Virginia.
You know, thanks for looking atour webpage, but you don't live
(24:34):
in Virginia.
You live in Iowa.
But maybe there's a similarorganization in Iowa and I'm
sure Donna is just hooked upwith all these brain injury
people around the country andthe world.
So don't give up.
Make sure you reach out.
For sure, donna, you guys havea webinar coming up.
(24:54):
Can you tell our listeners alittle bit about that?
Donna Meltzer (24:56):
I would be delighted to Thank you.
So, as you mentioned at thebeginning of our conversation,
today it's Brain InjuryAwareness Month.
I want to go back briefly.
A year ago at this time, as wewere preparing for brain injury
awareness month, we did a littlepoll that we sent out to over
300 northern virginias just toget a little information from
(25:18):
folks about what do they knowabout brain injury and what
don't they know.
And one of the facts thatreally struck us was how little
people knew or understoodconcussion and related
concussion as brain injury.
Right, julie made that point.
Brain injury is excuse me,concussion is brain injury, and
(25:41):
so we have spent a lot of timethis year focusing in on
concussion.
50% of people with braininjuries don't get it checked
out, because often what theyhear is oh, you had a concussion
, you're OK, maybe take a day ortwo off.
You know school protocols aredifferent depending on what
school system you're in.
(26:03):
Some will tell you go see yourdoctor or take your kid to the
pediatrician.
Others will just say rest for awhile and you'll be fine, but
it's really important to see amedical professional because,
none of us can see inside thatbrain and know exactly what is
going on.
So we've been studying this.
We've been talking with a wholelot of specialists and very
(26:26):
highly educated people likeJulie, like Dr Greg O'Shanick
from Richmond, virginia, whohave expertise around concussion
.
In September, we did what wecalled a concussion summit,
where we brought together agroup of professionals from a
variety of different parts ofsociety right so, employers,
(26:49):
educators, people in the sportscommunity, physicians, people
who are in technology and we hadthis amazing half-day
conversation.
We had a great panel Julie waspart of that where our experts
got to talk about what they knowabout concussion.
And then we had some deeperconversation and what we're
(27:13):
doing this year in March, onMarch 25th at 9 am Eastern Time,
we're going to be releasing ourreport through a webinar format
of what we've learned over thispast year.
Julie will be part of that, drGreg O'Shanick, who I mentioned,
will be part of that along withmyself, and so we do encourage
(27:36):
all of the listeners here tojoin us for that event.
So some of it will be ussharing some of the information
we've learned, and then therewill be opportunity for
questions and answers as well.
Larry Zilliox (27:47):
So I've registered for that.
It's pretty painless.
You put your name in your emailaddress and boom, you're there.
Donna Meltzer (27:52):
Boom, you're there.
Larry Zilliox (27:53):
So definitely go to the webpage.
You'll find it there.
I think it's under events,right, so you know, click on
that.
Dr Julia, one question for youwhat is your take on the current
state of research done byfederally supported universities
(28:15):
, private organizations today,especially when it comes to
concussive injuries, whetherthey're in children, in auto
accidents, in sports or whetherthey're involving veterans and
their service?
So what do you think the stateof research is?
Dr. Juliet Haarbauer-Krupa (28:34):
Well , first of all, what I've been
pleased about over the years isthere's multiple areas of
research.
There's research on kids, onadults, on service members.
There's research on biomarkers.
People are looking more intothe brain, physiology and what a
head injury can do, and they'realso looking at the effects.
(28:56):
There have been even somepapers although we can't study
kids clear to adulthood, that'stoo expensive but people will
write a paper about individualswho had a childhood history
they're now adults and how it'simpacting them.
So the state of the researchhas been unbelievable because
it's expanded so much.
(29:17):
It covers concussion and mildinjury.
It covers severe injury,disorders of consciousness.
There's so much out there rightnow.
Now some of it's been put onhold for a month or so, but I'm
hoping that it opens up andcontinues.
Larry Zilliox (29:33):
Donna, what can our listeners do to support
brain injury services as far asfrom a funding standpoint?
Now, normally I tell them to goclick on a donate button and
give five bucks.
But who can they reach out toon a state level here in the
Commonwealth and say we knowthat there might be funding
(29:54):
issues from the federalgovernment to the state as far
as transferring funds, but whenall said and done, brain injury
services needs to be funded.
This is too important to justsort of push to the side.
So what do you recommend ourlisteners do who want to help
(30:14):
you continue to do the amazingwork that you do?
Donna Meltzer (30:18):
thank you so much for for opening up that
conversation.
We are not federally funded, sowe are fortunately at this
moment, while, as Julie said,some grants are on hold.
Larry Zilliox (30:31):
We don't have that direct impact, but I'm
guessing some of that moneycomes from the feds to the state
so our money is from the state,but you're right in that
there's always going to be atrickle down.
Yeah.
Donna Meltzer (30:42):
Right.
It's going to hit us innumerous ways, some that we
can't even anticipate quite yet.
I will say that I have a verystrong feeling that where we
will see some impacts is fromour county grants.
Fairfax County is one of ourlargest funders.
They're going to be strugglingin numerous ways either.
(31:04):
Because they have federalgrants, For example, they run
some amazing programs thatsupport people with all kinds of
disabilities, including braininjury, to get a leg up on
employment.
A lot of people withdisabilities struggle to get
into good, meaningful employmentopportunities.
Larry Zilliox (31:22):
Sure.
Donna Meltzer (31:22):
And they have some very strong programs in
Fairfax County that they've metwith us about.
They want to see our folks withbrain injury enter those
programs.
Those are federally fundedprograms, so we're waiting to
find out if they're still inexistence or if their funding
has been cut, so we'll feel someof that trickle down, if you
will.
Fortunately for us, as I said,most of our programs are not
(31:44):
currently impacted.
In fact, we have just finisheddoing our advocacy work at the
Statehouse in Richmond and wegot very good news this past
week that the General Assemblyhas approved Now the governor
has not yet signed the bill, butwe anticipate he will that we
(32:09):
have been approved for someincreases to support our staff
so that our staff, who arerelatively low paid, can get at
least a small bump up, becauseall costs are going up right
Every nonprofit, every nonprofit.
So we're happy about that andwe've gotten some expansion
money as well.
One of the unique things aboutthe state of Virginia is we are
(32:30):
one of the only states in thenation that has brain injury
service provider agencies acrossthe state.
Some have none.
District of Columbia hasnothing.
Maryland has a brain injuryAssociation of Maryland, but
they're kind of up in Baltimoreso they're not able to provide
the kind of supports we do yeahand with funding support a year
(32:53):
ago we were able to cover everyinch of Virginia.
So every single person inVirginia who has a brain injury
has an opportunity to be served.
So we are getting a little bitmore expansion money so we can
maybe grow our staff.
So, for example, where we arereally in need of increasing our
staff capacity, this is notgoing to shock you mental health
(33:15):
services.
Sure Right.
Larry Zilliox (33:17):
Yeah.
Donna Meltzer (33:17):
We have waiting lists, so we are very excited
about that, but it doesn't meanthat we're just fine and dandy.
Sure, we need more help.
We recently had an annualcampaign.
We have Giving Tuesday.
We have, if you feel socompelled that you want to say,
brain Injury Awareness Month isa great time for me to make a
donation.
(33:37):
Please do so.
You can do it very easilythrough our website.
If you struggle to find theright way or time or place to do
that, give me a call or callAndrew Walensky, who is our
Director of Development.
We have so many different waysthroughout the year for
individuals to give, and it'snot just dollars.
If you would prefer to givesome of your time in a
(34:01):
particular way, let us know thatwe can utilize volunteers.
We are always in need of avariety of kinds of supports
that can be helpful.
So, it's not just dollars.
We like people who care aboutbrain injury to join us in
learning more about what itmeans and how to advocate for
(34:22):
our funding for programs, forall these other things that help
us do what we do.
So please take a look at ourwebsite.
If it's not leaping out at youas to what they're, the right
path is for you, just give us acall and we'll we'll have a
conversation and guide youthrough and so the website again
(34:43):
is braininjurysvcsorg and it'sBrain Injury Awareness Month
this month.
Larry Zilliox (34:52):
So share that webpage on your social media.
Please Send it out to everybodyyou know.
Listen, the folks that they seeover there at Brain Injury
Services, the wounded warriorsthat we host here at the Retreat
many of their injuries came tothem in a second.
Their life changed, theirfamily's life changed in just a
(35:18):
second.
So you might think this isn'tfor me, I don't know anybody,
but you need to familiarizeyourself with this issue, these
resources, and promote the workthat they do, because things can
change for you or someone youlove or know a relative, a
(35:39):
friend in an instant.
You love or know a relative, afriend, in an instant, and that
is not the time to try andfigure out what's going on.
So, for sure, check out thewebpage and spread the word.
This is Brain Injury AwarenessMonth and that's why we're doing
this episode and that's why wewant all of our listeners to get
(36:00):
the word out.
We're over.
We don't usually go this long,but this has been fascinating.
And, dr Julie, I just have onelast question for you and I
asked this of a number of guests, but considering, thinking
about the work that you do, how?
Donna Meltzer (36:17):
do you?
Larry Zilliox (36:18):
think that artificial intelligence and AI
is going to impact the work thatyou do.
Dr. Juliet Haarbauer-Krupa (36:25):
Oh, that's a great question and
that's really up for debateright now.
Right, I think some physiciansare using it to help verify, you
know, diagnosis.
I've seen that done, but I'mhoping it doesn't take over for
healthcare providers anddiagnosis, but that it assists
(36:45):
them and that's what I've seenpeople using right now something
to assist them.
So hopefully it will assist butnot take over for healthcare.
Larry Zilliox (36:56):
Yeah, I know that UVA was involved in a recent
study of their physicians and Ithink their diagnosis were about
69% of them were better whenthey were using AI as a
supplement to their ownknowledge and clearly I think
that's just, that's great andI'm happy to hear that from you
(37:18):
because I think I'd hate to seepeople resist using it really.
I also want to direct ourlisteners to a previous episode
that I did with Dr Stone fromUVA, who's doing research on
blast injuries small blastinjuries over a short period of
time.
So where a lot of times peoplethink of soldiers being in close
(37:44):
proximity to large explosions,it turns out that during their
study they found that explosiveordnance disposal instructors
who were subject to a series ofsmall explosions during the time
that they're instructing othersoldiers, that they actually had
more of an impact on theirbrain than those soldiers who
(38:09):
were just one-off largeexplosions here and there.
So it's a great episode.
It was last season, season two,you can look it up.
I just really wanted to kind ofwind up here and say thank you
to you both.
Dr Julie, thank you for thework that you do.
It's amazing because it's soimportant, especially with kids
(38:32):
and pediatrics, because itreally does change the
trajectory of their life if theysuffer this sort of injury and
it's unattended and it reallycan impact so many people.
So thank you very much foreverything that you do.
Dr. Juliet Haarbauer-Krupa (38:51):
Oh, thank you, and I want to make a
special comment of support forwhat Donna does, and the Brain
Injury Services of Virginia is avery unique state-run agency or
nonprofit.
And, donna, thank you, you'redoing great work.
Thank you.
Larry Zilliox (39:09):
So, donna, yeah, thanks for coming out and
joining us again as a repeatcustomer.
Donna Meltzer (39:14):
Well, I'm honored and it's always a pleasure If I
can just say one thing as well.
You know, as we've, we talkedabout spending this year really
looking at concussion.
It's for.
The message for everybody is ifyou or someone you know has had
a fall, a car accident, bumpedtheir head on a beam, whatever
(39:38):
it might be, don't just say Ithink I'll be okay, go get it
checked out.
Larry Zilliox (39:44):
Yeah, yeah.
Get medical support soimportant, yep.
And so here we are Brain InjuryAwareness Month.
Get the word out, spread theword.
Thanks for listening.
We really appreciate it For ourlisteners.
We will have another episodenext Monday morning.
If you have any questions orsuggestions, you can reach us at
podcast at willingwarriorsorg.
(40:05):
Until next week.
Thanks for listening.
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