There’s a lot to learn about brain injuries

The tragic circumstances surrounding the incident in Tucson, Ariz., on Jan. 8, 2011, when Rep. Gabrielle Giffords was shot in the head has significantly increased awareness of traumatic brain injury.

I believe her decision to resign Wednesday from her congressional seat was the right thing to do. Rather than go through the rigors of a re-election campaign, she has chosen to continue to go through the rigors of rehabilitation. This is a good choice, not only for herself and her constituents, but also for the 5.4 million other Americans who live with the consequences of a TBI.

In the United States, it is estimated there are 1.7 million new cases of TBI per year and many more go unreported. In contrast, there are estimated to be 10,000-11,000 new cases of multiple sclerosis and about 40,000 new cases of Parkinson’s disease each year.

Fortunately, most TBIs are considered mild. However, a concussion, which is considered a mild brain injury, once was thought to have little to no residual effects.

We are just now learning about the long-term effects on cognition and behavior. Post-mortem studies of professional football players are finding multiple hits to the head result in changes in the brain that resemble Alzheimer’s disease.

There have been tremendous advances in the surgical and acute care treatment of TBI, but we still have a long way to go in the area of post-acute and long-term rehabilitation.

At the University of Texas Medical Branch, we are trying to better understand all aspects of the recovery process after a TBI from the physical, cognitive and hormonal impairments survivors are dealing with.

It’s been more than a year since Rep. Giffords was injured, and she’s fortunate to have the resources available that enable her to continue her rehabilitation. If you watched the YouTube video on her website where she announced her resignation, you can see she still has challenges that hopefully she will be able to overcome.

Rep. Giffords is fortunate her costs are covered by the workers’ compensation plan available to all federal employees. Unfortunately, not everyone is going to receive the kind of care Giffords has and will continue to receive.

If we assume you are covered by Medicare (total coverage is capped at $1,880 per year for physical and speech therapy combined), your number of one-hour sessions would be significantly less than what the congresswoman is receiving. Additional sessions would have to be paid for by other third-party payers or out of pocket.

The bottom line is, the kind of care the average American can expect is dependent on the insurance plan (if any), state of residence and, probably most importantly, how strongly they or family members/caregivers advocate for their continuing needs.

Rep. Giffords’ office has made it known not everyone has been as fortunate as she is in receiving the full spectrum of treatment. Our biggest challenges are funding for research and access to high-quality treatment.

As she continues her therapy, Rep. Giffords will teach us about the potential for improvement long after the initial event. Her world changed in an instant and it could happen to anyone.

Dr. Kurt A. Mossberg is a brain injury expert and the Fannie Kempner Adoue Distinguished Professor in the department of physical therapy and rehabilitation sciences at the University of Texas Medical Branch at Galveston.