We are pleased to announce that our Trainee Supported Brain Injury Research fundraiser was a rousing success! After all was said and done, we raised $8,427 from 71 donors! Dr. Wagner thanks every last one of our generous supporters. Your donations will keep our trainees working and focused on lab work and education throughout the summer, as well as help pay the costs associated with research conferences and presentation of their hard work. We will continue to give periodic updates on this site of our trainees presenting their research so you can see your donations hard at work.
Again, a giant THANK YOU from Dr. Wagner and all of us here at the TBI research labs!
Only one day left in our campaign, and we are so close to our goal! We wanted to share one more trainee story with you - thank you for supporting our project!
Stephanie Ferimer, MD: PGY4 Department of Physical Medicine and Rehabilitation Class of 2018
It was a combination of my personal experience with concussion and prior exposure to research that sparked my interest to continue to learn more about brain injury. Through a year-long position supporting brain injury research, I was able to help design a project to study the markers of sepsis in traumatic brain injury. As part of this research project, I worked within an interdisciplinary team to develop a protocol to capture specific items of patient data in order to characterize sepsis.
Through this project, I was able to grow professionally, because it provided me the opportunity to think critically about a research question and to apply my medical knowledge toward the creation of the research protocol. I also grew personally through the opportunity to mentor undergraduate and medical students that were working in the laboratory. I provided them advice as they navigated various aspects of their career or graduate school planning process.
I hope that my work would change the way we monitor and manage sepsis occurring among individuals with traumatic brain injury. As I continue my training next year as a pediatric rehabilitation fellow, I plan to apply my previous scholarly work on markers of sepsis to clinical encounters with this population and determine if/how similar monitoring is applicable to the pediatric patients I will care for as a pediatric rehabilitation physician.
My research experience was a unique opportunity to work within an interdisciplinary team, and I feel that early exposure to collaborative research would be greatly beneficial to the career development of other physicians in training who strive, like myself, to become a young clinical rehabilitation researcher.
At over 75% of our fundraising goal and only two days left in our campaign, we wanted to share a student profile that comes full circle. Thank you to everyone who has generously supported our campaign thus far. We truly appreciate it!
Shaun Darrah, MD Department of Physical Medicine and Rehabilitation Class of 2016
I began Brain Injury Research in Department of Physical Medicine and Rehabilitation (PM&R) when I was a 19 year old undergraduate sophomore at the University of Pittsburgh. At the time, I had not yet developed a research or career focus. However, my research mentor introduced me to the world of academic research, and more specifically, the traumatic brain injury community.
My years as a Trainee Supported Brain Injury Researcher during undergraduate and medical school led me to a fruitful research career as a trainee, including three peer reviewed journal articles and multiple national scientific presentations. Perhaps more importantly, my mentored research experiences also provided many important insights into what it means to be a physiatrist and a health care provider focused on function. My eyes were opened to the clinical aspects of PM&R, and these experiences encouraged me to explore the field as I entered medical school. From that point on my passion for PM&R grew, and I have since completed medical school at the University of Pittsburgh and a PM&R residency with the University of Pittsburgh’s Medical Center (UPMC).
I am now a Medical Director for a 24 bed inpatient rehabilitation unit within UPMC where I routinely care for individuals with significant impairments due to neurological injury. I attribute my passion and dedication to caring for these people to the opportunities, experiences, and mentorship I received as a trainee conducting brain injury research. I am privileged to say that I joined the University of Pittsburgh’s PM&R Department and now work alongside my mentors as colleagues. The scientific and human impact of trainee supported brain injury research continues to be an invaluable resource to the brain injury and rehabilitation communities, UPMC, and trainees at the University of Pittsburgh.
In December of 2010, Michael McNally, a senior student at St. Edward’s University in Austin, decided to take a break from studying for finals. Exercising was one of Michael’s favorite hobbies, so he got on his bicycle for a short ride.
On his way back to his house, Michael was struck by an intoxicated driver of an SUV travelling about 50-mph in a 35-mph speed limit. Having suffered a traumatic brain injury, Michael was on a ventilator and was unconscious with the neurosurgeon offering no hope for a recovery.
With prayers, support of family and friends, and an outstanding medical staff, Michael began to make a slow, yet steady recovery. On Christmas Day, we were surprised to see the ventilator disconnected and moved to a corner of the ICU room. Michael was breathing on his own; a miracle in the making that gave all of us hope and a sense of appreciation for each day going forward.
In March of 2011, Michael was flown to Pittsburgh to begin Inpatient Rehabilitation at UPMC Mercy Hospital. Dr. Gary Galang and his staff were very attentive to the needs of Michael and our family. After 3 months of daily rehabilitation, and Intrathecal Baclofen Pump surgery, Michael began his journey to move his limbs and regain strength to continue to work hard.
Today, Michael is able to walk with a walker and assistance. His baclofen pump has served a valuable purpose in giving him mobility, but now no longer needs it due to the expertise of medical staff, therapists and support of family and friends. He knows he was given a second chance at life for a reason, and he is grateful for the progress he has made.
Michael enjoys going to concerts, reading, exercising on his adaptable trike, and he participated and won two medals in the local Texas Special Olympics for Equestrian events in April.
UPMC Research is needed in order to improve the quality of life for individuals like Michael who would not have made the progress possible without the knowledge and advanced techniques provided by the research; in learning more about brain function, injuries and techniques to make advancements in living a life with hope and continual room for growth.
Our thanks and gratitude to UPMC for giving Michael a second chance at “Life”!
This summer I will begin my career as a psychiatrist, but in 2010, when I first began working as a brain injury research assistant in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh, I had just graduated college with limited clinical or research experience. I began to hear the stories of many individuals with TBI who were willing to be a part of our research efforts. As I listened, I learned of their struggles and was especially struck by the emotional sequelae that accompanied the physical and cognitive effects of their injuries. These patients and their stories had a huge influence on my decision to pursue my chosen specialty. Over time, I also developed an understanding of the scientific background, as well as a foundation in data interpretation and statistical analysis, which afforded me the opportunity to contribute to various clinical research projects, including one examining the role of neuro-inflammation on outcome after traumatic brain injury. It was only in this way, by going through the struggles and challenges inherent in scientific inquiry, where I was able to gain a true appreciation of what research entails. Importantly, the work environment, shaped in large part by the amazing people there, fueled a deep passion and curiosity for the brain and all its mysteries, and for searching for a better understanding on how to facilitate repair, recovery, and function after a brain injury. Going forward, I envision incorporating my past research experience into my future role as a psychiatrist and potentially explore the role of neuro-inflammation in mental health disorders. Lastly, my time as a brain injury research assistant at the University of Pittsburgh has shaped the way I view patient care. My lab group aims to utilize a personalized approach to rehabilitation care that emphasizes the uniqueness of each patient or group of patients. This philosophy will continue to influence every one of my patient encounters as a future physician.
As a Senior Student in Neuroscience, I am in the process of writing about the research I began working on in August 2016. My project involves the assessment of patient care trends and outcomes among those who have developed infections after suffering a traumatic brain injury. After months of analysis, I am extremely excited for the implications this research can have for helping future patients. While a lot of our discussions are about the research I have been conducting, my research mentor is always open to discussing topics in medicine, career paths, and much more. Ultimately, my time as an undergraduate research assistant has taught me about medicine, but it has also provided me skills and information that will help me in my future career as a healthcare provider. What I have learned here is invaluable, and I appreciate such a fantastic opportunity.
My personal connection to brain injury and brain injury research stems back to my time in high school. When I was 16, I suffered a severe concussion while playing soccer that kept me out of all physical activity for 10 months. As I went through therapy for that, I became fascinated with the research that went into all of my treatment, and I knew I wanted to become a part of it once I went to college. My brain injury research experiences over the past year include data entry and abstraction for several projects, and I have recently started running cortisol ELISA experiments to learn more about the stress response to brain injury. Since beginning my work here, I have grown a lot professionally, as I have learned how to work with other people and manage my time on different projects. I enjoy all of the work I do here because I know that everything we are working on is leading to better clinical treatment of patients who suffer from traumatic brain injury; that is all I have wanted to do with my career once I came to college.
On March 28, 2010, my family and I were in the Cleveland area celebrating our daughter’s 1st birthday. Early that morning I felt a sharp pinch in my right temple. It felt like a migraine but nothing would alleviate the discomfort. My focus was shifted with the party and the discomfort did not become noticeable again until everyone left. My wife had to make the 2-hour drive to Pittsburgh as I was in too much pain.
No over-the-counter medications seemed to help, but I continued my normal routine. Finally, on April 2, 2010 I ended up at an Urgent Care. Much to my surprise, the physician scheduled a CT scan to be performed immediately. After the CT scan, a nurse informed me the scan revealed two ruptured brain arteriovenous malformations (AVMs) and indicated I had to be taken to a hospital immediately. On the EMT’s recommendation, I was taken to UPMC Presbyterian via ambulance.
In the Hospital:
Once at UPMC Presbyterian, an MRI was performed to confirm the diagnosis, and a 3rd ruptured AVM was found. After this, I was advised emergency procedures had to be conducted immediately and my options were to either undergo open-brain surgery or treat the AVMs with embolization. We choose the latter and a couple of hours later I was taken to the operating room.
I was in an induced coma for the next 6 weeks, as the AVM ruptures were larger than expected and the embolization would not repair them. My life was hanging by a thread. First, I contracted pneumonia, which later turned into Acute Respiratory Distress Syndrome. Both of my lungs collapsed and my heart was beginning to fail.
Miraculously, I began to improve and after 6 weeks was transferred to UPMC Montefiore. I slowly regained consciousness in mid-June 2010. I was still sedated and could not perform the most basic functions let alone grasp the severity of what I’d just gone through. I also began to move my extremities and practice to sit upright. These were painful tasks, but thanks to the vision, courage and strong will of one of my physicians, Dr. Gary Galang, I was transferred to UPMC Mercy Hospital, where I began inpatient rehabilitation at its Center for Brain Injury Rehabilitation for another 6 weeks. At the completion of this program, I was released on July 21, 2010 and continued my recovery at home. I had spent 110 days in 3 different UPMC hospitals.
After returning home, I began weekly sessions of physical and occupational therapies. Because I was in a wheelchair, a nurse came by a couple of times a week to help me shower and get dressed, as I could not do many tasks without assistance. During this challenging time, my wife Hari had been the pillar to my recovery. I am 100% certain that I would not be where I am today without her in my life.
After several weeks I began outpatient physical and occupational therapies at UPMC Passavant for 6 months. I slowly transitioned from a wheelchair to walker, to quad cane and ultimately to single cane.
In January 2011, my condition had stabilized and I underwent a Gamma Knife procedure at UPMC Presbyterian to repair the remaining brain AVM. Over the next couple of years, the AVM became smaller, which was the desired result by all parties involved in this journey.
We are now U.S. citizens and I work for a reputable law firm in downtown Chicago. Despite everything we have been through, we never gave up and I am now pursuing my licensure as a U.S. attorney. I owe my success to my faith, as well as the relentless work of the UPMC physicians and nurses that gave their everything to see me get better.
Why I will always support Pitt brain injury research:
I am blessed to have been at the right place at the right time when my AVMs ruptured. Research being conducted at the University of Pittsburgh led to the effective and successful treatment of the many conditions that resulted from my initial brain injury. Words aren’t enough to express my appreciation for everything everyone at UPMC has done for my family and me.
Why YOU should support Pitt brain injury research:
Thanks to cutting-edge medical research at Pitt, I was given a second chance at life. I was in my early 30s, in excellent physical condition and suddenly had less than 1% chance of survival. What happened to me can happen to anyone. Having access to the best care is only made possible through an elite research program. Research saves lives; I am proof of this.
Working as an EMT, I interact with patients who have a variety of medical needs. Among the more tense moments of my job is encountering patients with severe head trauma. As an EMT in the prehospital setting, my capabilities and interventions are limited, and my work ends upon entering the doors to the Emergency Department. One of the most frustrating aspects of any medical professional’s career is knowing there is nothing more they can do for a patient because the capabilities of the field and the interventions known are limited. One day I aspire to be the attending physician receiving these patients on the other side of the Emergency Department doors. Like all medical personnel, I hope that treatment limitations will never negatively affect any patient. The brain injury research being conducted at UPMC’s department of Physical Medicine and Rehabilitation is invaluable to medical professionals and is shaping the way patients are treated globally. The desire to never have to tell a patient’s family that there is nothing more I can do is what drives me to continue my involvement in and dedication to this type of research. Patient care can always be enhanced, and this improvement comes through the research being conducted in labs with Undergraduate Assistants supporting these efforts. I am proud to work in a lab that is directly affecting patient care in and forever shaping the field of my future career.
I began work on brain injury research in Fall of 2015 as a research assistant because the work really resonated with me. My job focuses on overseeing the pre-clinical research carried out in the lab. Working at this position for over two years now has yielded tremendous growth from myself both as a scientist and as a person, allowing me to oversee several different projects. While working these last few years on important brain injury research topics, I came to realize that an additional avenue of learning would help improve my work. As of January 2018, I am continuing my full-time efforts for my lab while also pursuing a Master’s degree in Neuroscience from the University of Pittsburgh. Supplementing lab research with the rigorous neuroscience coursework puts me in a unique position to take concepts I’ve grasped in one arena and apply them to the other. Doing so has really immersed me in these topics, and I feel myself growing like I never have before. I did not, however, take on this position solely for personal growth. The brain injury research projects that I support are incredibly relevant to individuals dealing with brain injury related disability day in and day out, and I believe my work will have a significant impact on many lives in the future. Traumatic brain injury affects millions of people in the United States, and so elucidating the mechanisms of learning and memory after injury will help support treatments for this population that help optimize functional recovery. I believe my work unraveling the mechanisms of dopamine dysfunction after brain injury also has tremendous implications for a large population who has survived a TBI or cardiac arrest.
I am a third-year PhD student in Neuroepidemiology at the University of Pittsburgh Graduate School of Public Health. I began working as a research coordinator in the Traumatic Brain Injury Model Systems study. Working as a research coordinator, I had the chance to speak firsthand with patients with brain injury and their families, and gained an intimate understanding of how brain injury is a debilitating condition that affects entire families for months to years. In my five years conducting trainee supported research, my primary focus has been to understand how proteins in the blood and brain influence how a patient with brain injury recovers from their injury. I have learned a tremendous amount of knowledge from this experience, and have had the opportunity to attend local and national conferences to present my research, as well as learn more about the latest clinical and research advances. My research mentors here at the University of Pittsburgh helped foster my strong passion for brain injury research, and it is now my unwavering career goal to devote my life to studying this condition to improve the quality of life of patients with brain injury.
September 4, 2017 Labor Day: The day started off normal. I went to work in my retail sales job and said goodbye to my husband Bill. He went to the grocery store to get something to grill for a holiday meal around 11:00 am.
At 12:30 he called me and said he was having chest pains. I told him he needed to go to the hospital and seconds later I just heard gurgling on the other end. I hung up and called 911 and said, “I think my husband is having a heart attack!” We believe he was without oxygen up to 10 minutes before the firemen broke into the house.
Someone suggested we go to UPMC Presbyterian because they have a specialized post-cardiac arrest service there. Once at UPMC Presbyterian, two stents were placed in his heart and was admitted in to cardiac ICU. They kept him at low temperatures for two days to keep his brain from swelling. After the two-day low temperature treatment, the plan was to wake Bill up. Unfortunately, he started having pulmonary issues and things were looking very grim. The next two weeks were very scary because his lungs got very sick. At one point the brain doctors told me they didn’t think there was much brain activity but they were going to do a test to see if there was any hope for recovery. A few hours later they came back with great news! There was brain activity! Bill’s lungs started to get better and miracles were happening every day.
Bill spent a total of 31 days in the cardiac ICU. During the final weeks of his stay, Dr. Amy Wagner started coming to visit him on Tuesdays and Thursdays. At first, I had no idea what she was looking for, as Bill was still unconscious and on a ventilator. She explained to me that she was from the Traumatic Brain Injury Unit at UPMC Mercy and was trying to figure out if Bill would be a good candidate for their rehabilitation program. I had no idea what she could possibly be looking for, and I would get so nervous because I so desperately wanted him to be accepted to get the best possible outcome. Eventually Dr. Wagner came to me and told me that he was accepted into the rehab program! I was so thrilled! Bill was transferred to UPMC Mercy Hospital and admitted into the Traumatic Brain Injury Rehabilitation floor.
From the first day I was amazed at the therapists, doctors and nurses on the sixth floor. The therapy was intense, and I understood why Dr. Wagner had to be sure that Bill could tolerate the amount of therapy that went on every single day. The physical therapist had him out of his wheelchair the day after we arrived. A lot of support was needed to help him up, as he had been in the bed over a month. All of the therapists were outstanding.
I did not know anything about anoxic brain injury until we arrived and I started learning about what Bill was going to have to endure to get back to as close to normal as possible. From early on, all he wanted was his life back! Even on the days he didn’t feel good he never quit. At one point we realized he couldn’t see and we found out he was experiencing cortical blindness. A few weeks later he got his vision back! More miracles! He was discharged two days before Thanksgiving. When we got home he did not remember our house. He had many new things to learn, but he learned them!
We immediately started outpatient therapy doing speech, physical therapy, and occupational therapy at UPMC Southside Hospital. The progress we have seen in the past seven months has been absolutely outstanding! I owe so much thanks to so many doctors; especially those in the Traumatic Brain Injury rehab program who knew what to look for in saying that Bill had a great chance at recovery. I support Traumatic Brain Injury Research because without them I may never have gotten my husband back. I believe it is because of their research that they knew what to look for in deciding he was a good candidate for the rehab program. You should support their program because you never know what could happen to you or a loved one. We had no idea how our lives were going to change on Labor Day. We are so thankful for these hard-working doctors who never quit and never gave up on my husband.
Growing up, I had numerous family members who were affected by strokes or TBI, and the variability of their injury and recovery was always of interest to me. When I entered Pitt as an undergraduate, I was interested in studying Neuroscience to understand the complexities of cognition and the brain. One thing I quickly learned was that there was much we did not know about these systems. A great resource that Pitt can offer students is the opportunity to get involved in research with some of the leading researchers in the field. When I explained my interests, my research mentor invited me into her lab where I continue to conduct research, now as a medical student, 5 years later. My experiences in the lab have allowed me to spend time on a wide variety of projects allowing me to grow both professionally and personally. I have been able to help conduct and publish research pushing the field forward in understanding the relationship between genetics and cognition. In addition, I have been able to attend conferences across the United States to present my work to others in the field. It is very important to me that other students like myself have the opportunity to pursue their dreams of a career in research while helping to find the next breakthrough in the treatment and care for persons with brain injury.
My training at the University of Pittsburgh was instrumental to my career and has continued to shape how I conduct research. Working in brain injury research helped me understand how individual differences in patients can actively shape clinical care. Everything from genetics to our own personal activity level can influence how individuals might recover from a traumatic brain injury. During my training, we worked to develop personalized algorithms that might inform how someone's care after injury might be managed in order to maximize their recovery and minimize risk for other adverse outcomes. It is incredibly rewarding to know that our research could lead to better managed care for these individuals and to help tailor their treatment. I believe that some of the findings I have uncovered contribute to a reduction in patient suffering and could eventually prevent outcomes like depression in some individuals. Even though I now work in a different area of brain research, the training I had in brain injury, precision medicine, and the Rehabilomics research model has forever influenced how I view medical research. Now, I continue to emphasize how individual differences play a role in medical research and in my current research focus area of Autism.
In searching for research opportunities related to my Neuroscience major, I became interested in traumatic brain injuries because of the disproportionate underfunding of brain injury related research and poor post-injury recovery in severe cases. As a student researcher, I have had the opportunity to help lead a multi-center project, along with another graduate student. Together, we drafted a manuscript that is currently under review for publication. I served as the primary author and as the leader of over a dozen collaborators from across the country. My project identified factors that can be targeted to help individuals maintain stable employment following a brain injury. Through this research program, I have been able to present my work at multiple conferences, and I have developed both technical skills in data management and analysis and professional skills in managing a research collaboration and in presenting my results in small and large settings. Because of these experiences, I will be pursuing a graduate degree in epidemiology to continue similar research for under-represented, underfunded populations. I hope to improve rehabilitative outcome for individuals following brain injuries, and my brain injury research experience has provided me with opportunities unlike any of my undergraduate peers involved in research. I have developed not only technical skills for my career in epidemiology but professional skills that have translated outside of my research work.
On June 22, 1987, my life changed forever. Suffering – and surviving – a traumatic brain injury does that. Even if it does not appear that way to anyone else.
The day of the accident was a walk in the park, literally. I spent the morning and early afternoon rock climbing for the very first time with a good friend, then a hurried drive back to Green Tree on the way to a dentist appointment. I was running late. While driving by Station Square, I asked my friend to stop so I could run to the Metro Train Station and use the pay telephone to call my dentist.
Why on earth did I insist on calling my dentist just to let his office know that I was going to be a few minutes late? I wanted to be thoughtful. I like being thoughtful. But my compulsion to inform my dentist I’d be a few minutes late irrevocably changed my life.
Running across four lanes of traffic on East Carson Street, two lanes going in opposite directions, must have appeared easy to accomplish. I have no recollection. After successfully crossing the two westbound lanes, there was, I am told, a large truck in the eastbound left lane. The truck had stopped to let me cross. The truck’s girth apparently blocked the right lane eastbound driver’s view. I collided with her car and was thrown 150 feet, my head crashing to the concrete pavement.
Doctors and nurses at UPMC Mercy Hospital, where I spent the next 3 months, saved my life. Another contributing factor: I’d run and completed the Pittsburgh marathon seven weeks earlier. My body’s excellent physical condition and fifty-five beats per minute resting heart rate surely played a role in my survival.
Not many understand – or believe – that TBI causes permanent damage and lifelong cognitive, psychological and physiological deficits. The left and right frontal lobe and parietal brain contusions and hemorrhaging I suffered forevermore affected my brain’s executive management functioning and visual-spatial capabilities.
My 30+ year “road to recovery” continues to this day. Dramatic improvements? Yes. Full recovery, ever? No.
Given the bone fractures to my right pelvis, left tibia and left leg peroneal nerve damage (which resulted in foot drop – I wore a brace for many months after hospital discharge), I was unable to run. In fact, my left leg (below the knee) was nearly amputated. But a fasciotomy – incisions made on either side of my calf – relieved the compartment swelling. Mercy Hospital doctors saved my leg.
In addition to retraining my brain on how to take in, process, and respond to each and every life transaction – which included repeatedly reading through the dictionary to re-learn words I used to know but now would not come to mind – I believe exercise and music played a significant role in my brain’s healing. I could not run, but I could cycle. And I spent hundreds of hours in physical therapy on a Lifecycle bike, peddling away the anger, frustration, agitation and other “not me” thoughts, feelings and emotions which now inhabited my injured, but healing, brain.
The cognitive retraining that I participated in – both while a patient at Mercy and after discharge – had a huge positive impact. These vocational programs helped me to organize my thoughts and improve the circumlocution and other expressive verbal challenges I suffered after my TBI.
I support the University of Pittsburgh brain injury research programs because – if it weren’t for the extraordinary medical care, nursing, pharmacological, physical and cognitive rehabilitation services I received after the ambulance found me unconscious at the scene of the accident – I would not be alive today.
It is vital that we all contribute whatever we can and support Pitt’s brain injury research programs.
I will bet that everyone in the world is just one step removed from knowing a TBI survivor. Just because your sister, cousin, stepson, best friend or co-worker has not shared the details of his or her brain trauma – or one of his relative’s or friend’s experience with TBI – does not change the reality. These people in your life may be reluctant to share. Unfortunately, there is still a stigma attached to TBI.
Please, support Pitt’s TBI programs and help us change that.
I am a second year medical student at the University of Pittsburgh’s School of Medicine involved in brain injury research. As an undergraduate, I studied neuroscience and was fascinated by the complexity of the brain; in medical school, I sought to further learn about the brain’s pathological processes outside of our curriculum, and research involving traumatic brain injury and epilepsy development really appealed to me. It’s exciting to not only help manage data collection for this piece of the research program, but also be part of a team thinking of new ideas for future projects that can directly impact patient care. Currently, our project involves creating a prognostic model for predicting post-traumatic epilepsy development at two years following traumatic brain injury. Since post-traumatic epilepsy is a major cause of death in the traumatic brain injury population, being able to accurately assess risk could be very beneficial, and hopefully our model will be a tool to help guide physicians in management of traumatic brain injury. As a medical student, much of my time is dedicated to course studying, so participating in this research group helps me not only gain perspective of the bigger picture, but it is also an opportunity to think more clinically and appreciate that the basis of treatment comes from extensive investigation.
I first heard about traumatic brain injury as a teenager, in the context of members of the armed forces returning from duty in Iraq and Afghanistan. I knew immediately that I wanted to help those that had sacrificed so much for our nation. One opportunity has come to fruition in the form of traumatic brain injury research at the University of Pittsburgh. When I joined my brain injury research team I joined a family of sorts, all dedicated to the pursuit of new knowledge intended to help individuals with brain injury from trauma and cardiac arrest. From day one, I was immersed in our work, and hands-on learning rapidly developed into genuine contributions to our progress. Whenever we complete a study or have a breakthrough, I feel like I am truly a part of it, not just a student tagging along for the ride. Not only do I get to have an impact on our work, but our work impacts me as well. I’ve learned immense amounts not just about neuroscience, but about study design, teamwork, and how to conduct impactful research of any kind. My research experience has broadened my horizons and encouraged me to incorporate an element of research into my future career as a physician, and I want every other student who wishes to have the same chance to feel what it’s like to shape the frontiers of medicine.
Not only is it a privilege to participate in brain injury research in Pittsburgh with the wealth of resources and collaborations; it is a privilege to personally contribute to the ongoing efforts to treat traumatic brain injury. Just recently, two high-school classmates of mine suffered blast injuries from improvised explosive devices in Afghanistan, stripping them of the cognitive and social abilities they once had. At the same age as these young men, I have had the opportunity to work with Dr. Amy Wagner for nearly three years striving to address the complexities of this injury and the complications that individuals with traumatic brain injury endure. Thankfully, PITT has graciously provided an avenue for young individuals to become involved. My time spent here at PITT through my undergraduate years at W&J and now post-college, I have assumed a role similar to a ‘mathematical ambassador’ in a traumatic brain injury lab. I have pursued interdisciplinary work that incorporates mathematics and medicine. My research has encouraged those in the traumatic brain injury field to open-mindedly approach new techniques that represent biological phenomenon in a mathematical framework. I plan to continue my research and education in such a way that I can facilitate collaborations across disciplines to advance brain injury research. It is important to me that willing students have the early opportunity to make personal contributions to research aimed at the global and clinically challenging issue of traumatic brain injuries.
Zachary Behm was the Chef De Cuisine at Cure restaurant prior to his accident. Last summer, on his way home from work, Zachary lost control of his car striking a guard rail then a utility pole. As Zachary exited his car to assess the damage, another car became entangled in the electrical wires from the utility pole causing it to fall. The falling pole struck Zachary on the right side of his head, and the utility lines electrocuted the left side of his body.
The initial prognosis was grim. Zachary sustained a brain injury to the right side of his brain and to his brain stem. His recovery was complicated by seizures and several infections including MRSA, C-Diff, pneumonia and a UTI. Zachary was inpatient at a local hospital for over one month until he was first admitted to the UPMC Mercy Brain Injury Unit for recovery. His first rehab stay was short as Zachary required a surgical procedure to aid his recovery.
Shortly after his surgical procedure Zachary was air lifted from a local hospital to the UPMC Mercy ICU unit where he continued to recover. The physicians on the UPMC Mercy Brain Injury Unit were instrumental in convincing Zachary’s insurance to allow him to be readmitted to the rehabilitation program. Once readmitted, the rehabilitation physicians at UPMC Mercy put Zachary through a regimented program: Zachary had occupational therapy to help restore his fine motor skills and to enhance his cognitive reasoning, physical therapy to help regain the use of his left leg, and speech therapy to help relearn how to eat, speak and write.
The rehabilitation physicians provided weekly updates on Zachary’s progress, and finally after two months agreed it was time to discharge him home. The team of therapists at UPMC Mercy were instrumental in preparing both Zachary and his family for this transition. Zachary’s parents were educated on how to properly care for their son, and therapists visited Zachary’s home to ensure all the necessary equipment needed was in place. UPMC assigned at home physical, occupational and speech therapists so Zachary could continue his therapy. In addition to the therapy Zachary received from therapists, Zachary’s parents worked with him each day.
Zachary made significant cognitive and physical progress after his discharge. After six weeks he began to speak more, drink fluids on his own, and gained use of his left arm and leg. After three months he began eating solid food and could stand with assistance. After six months Zachary could walk with the use of his cane and the physicians at UPMC Mercy felt he would benefit from additional inpatient rehab. During inpatient therapy Zachary improved his fine motor skills, gained the ability to climb stairs unassisted, and could walk with the use of a cane for longer periods of time. Zachary received additional outpatient therapy at UPMC’s Lemieux center for the next 4 months. Today Zachary can care for himself without assistance, operate a motor vehicle, and has gone back to work at his restaurant a few days per month.
Without the physicians at UPMC Mercy Zachary would not have made such an incredible recovery. All the therapists and physicians at UPMC Mercy treated Zachary with respect and dignity and most importantly never gave up on him. The continued therapy Zachary received both in and outpatient has been crucial in his recovery. Zachary went from being fully dependent without the ability to speak, to living a fully independent life again. We are forever grateful to UPMC’s Traumatic Brain Injury Rehabilitation Unit.
My initial interest in brain injury stems back to when I was 10 years old. My mother was hit by a car and suffered a mild head injury. As I watched her rehabilitate, my fascination with the complexities of the brain grew. When I began my college education at Pitt, I was thrilled at the numerous opportunities available for students like myself to get involved in research. Over the past 3 years, I have had the opportunity to participate in brain injury research, where I have learned to appreciate the nuances of the brain. While studying the adaptive immune system and related biological markers, I have seen that learning about the brain at an individual and biological level is important for understanding outcomes post-injury and advancing personalized care in the future. In having the opportunity to present at and attend various conferences over the years, I am always fascinated by the impactful work of people around the world who are committed to understanding the complexity of the brain after trauma. It is humbling to think my work may make a small dent in this endeavor and will help change patient care for the better.
Brain injury is a tremendous burden on our society, on families, and on individuals that continue to live with its long-term effects after trauma and cardiac arrest. Unfortunately, there isn't a rational set of guidelines for managing symptoms like impaired attention, motivation, and cognition, which often persist for a very long time. To address this problem, we examined and demonstrated what goes awry in the dopamine system, on a physiological level, after brain injury from trauma and cardiac arrest and how to restore function through pharmacological treatments. Working in this lab during both my undergraduate and graduate student career was a privilege because I knew that the impact of our research may ultimately be seen by the many patients that suffer from brain injury due to trauma and cardiac arrest today and in the future. Important also is the lab environment where I developed as a scientist by learning about the process that paves the way for meaningful discovery. Continuing to have a place for students to conduct meaningful brain injury research, and to grow as individuals and scientists, is an important priority for me as a Pitt neuroscience graduate alumnus.
My experience conducting brain injury research was one of the most challenging and rewarding components of my undergraduate education. In my laboratory every trainee, from a first-year undergraduate to a post-doctoral fellow, is given the education, respect, mentoring, and support necessary to tackle some of the most important questions in the field of traumatic brain injury rehabilitation. Over the course of four years, I was encouraged to pursue research topics that interested me, given progressively more responsibility within the lab, and afforded opportunities typically reserved for graduate students or healthcare professionals. The Wagner Lab’s unique access to a large repository of biological samples from individuals with traumatic brain injury enabled me to conduct original research on genomic and proteomic biomarkers for post-traumatic epilepsy, a new and important area of study. This work was well received by the scientific community and lead to the publication of three peer-reviewed manuscripts, one of which was awarded an international research prize, which I accepted on the behalf of the lab at the International Epilepsy Congress in Istanbul, Turkey. As a part of receiving the award, I also had the honor of presenting one of the keynote lectures at the conference. These experiences continue to differentiate me from other job and professional school candidates, and I cannot be more thankful for having these unique opportunities during my undergraduate education.
June 2015: I was in Aruba on vacation when I began to have chest pains. A local ER suspected I was having a heart attack and began treatment with anticoagulants and thrombolytics. The combination of medication resulted in a cerebellum brain bleed complicated by fluid and pressure build up on my brain. I had emergency brain surgery to relieve the pressure and was flown to Florida for additional treatment.
My initial prognosis was poor. My wife was told I had multiple brain stem and cerebellar strokes, and that my brain stem was herniated beyond repair. Comatose, I was transferred to UPMC Presbyterian Intensive Care Unit. After four weeks in the ICU I was transferred to an acute care facility where I began to emerge from the coma. As I began to emerge, I was diagnosed with a degree of Locked-in-Syndrome, a rare neurological condition that can result from a brain stem injury. Locked-in-Syndrome left me cognitively intact but completely paralyzed, except for vertical eye movement. My recovery was complicated by several infections and a stage 4 pressure ulcer. I was inpatient at the acute care facility for over one month until I was admitted to the UPMC Mercy Brain Injury Rehabilitation Unit for recovery. It was there I began the long, hard road to recovery.
Road to Recovery: I was discharged home after four months on the UPMC Mercy Brain Injury Rehabilitation Unit, just in time for Christmas. Immediately following the holiday, I began in-home therapy three days a week and received Botox therapy for muscle spasticity. My recovery regimen also included outpatient physical therapy, yoga, acupuncture, cranial-sacral treatments and massage therapy. After four months I returned to work part-time using a special seat and an electric wheelchair, and after eight months I was back to work full-time. One year after discharge I re-learned how to drive at the UPMC Adaptive Driving Center. I currently participate in outpatient physical therapy 2-3 days per week and complete about 15 hours of weekly at-home therapy on my own. I still have remaining deficits including problems with muscle control, balance and coordination, but I continue to improve each day. I will soon be obtaining a mobility service dog, a Labradane named Groot. This will allow me greater support while I continue working towards walking independently.
Why I support University of Pittsburgh Brain Injury Research: As many as 5.3 million people in the United States are estimated to be living with the challenges of long-term brain injury-related disability. As my family and I learned, every Traumatic Brain Injury is different. My injury was complex, and although the road to recovery continues to present challenges, the physicians at UPMC Mercy worked with my family and me to develop an effective treatment plan. Through advances in medicine developed from research my rehabilitation physicians, they understood how to treat my conditions and ultimately support my recovery. Research is the key and backbone to continued success in medical care. It is through continued research that someday we might live in a world where the long-term effects of a brain injury may no longer exist.
Why YOU should consider supporting University of Pittsburgh Brain Injury Research:
By supporting brain injury research, you are helping people just like me: people who suddenly and inexplicably find themselves leading a very different life than expected. You are helping families that have been instantly changed, and forced to accept a new, sometimes confusing reality. Helping to push forward promising, cutting edge research in the field of brain injury treatment and rehabilitation will help generations to come. Great progress has been made over the past years, substantially increasing survival from severe brain injuries, including strokes, but there is a lot more progress to be made. Research has expanded from a singular focus on severe brain injury to a greater awareness about potential long-term consequences and the need to find better ways to diagnose, treat, and prevent all forms of brain injury. Many questions remain unanswered regarding the impact of brain injury, the best treatments, and the most effective methods for promoting recovery of brain function. Please consider supporting the University of Pittsburgh brain injury research today, so others, like me, can have a tomorrow.
As freshman undergraduate new to health research and the field of medicine, I came upon a Brain Injury Research opportunity available to undergraduate students interested in biomedical sciences. The research team eagerly took me under their wings to nurture and facilitate this budding interest.
Over the course of those next four years, I received training on laboratory techniques and how to dissect scientific literature, and ultimately this experience showed me how to bring bench work to the bedside. The most important lesson for me through this process was seeing how the resilience of brain injury survivors can defy research statistics pushing us to reach for higher standards. With the help of the entire research team, we analyzed and developed a model that used biomarkers to predict mortality and outcomes among individuals with severe traumatic brain injury – a study that has led to numerous national presentations and well-cited manuscripts.
The ability to work with such an experienced team so early in my career energized me to pursue medical school at the University of Pittsburgh’s School of Medicine, and carry on my training at Duke University where I am currently completing residency in Internal Medicine as an aspiring physician-scientist. The Wagner Lab’s commitment to me is undoubtedly the defining experience in my growth as an undergraduate student, researcher, and clinician which to this day continue to be invaluable.
I am a medical student at the University of Pittsburgh’s School of Medicine, working on brain injury research. I was interested in neuroscience and cognition during my undergraduate career, where I worked on research relating to Multiple Sclerosis rehabilitation and cognition. I was especially impacted by seeing the consequences of cognitive impairment on the lives of patients with neurodegenerative disorders. I continued to have these interests through medical school when I started investigating how inflammation adversely impacts cognition after Traumatic Brain Injury. This research is interesting and exciting to me personally, and I believe that understanding the causes of cognitive impairment could be impactful for patient lives and directly inform their treatment and rehabilitation.
Through my research work, my interest in the field of Physical Medicine and Rehabilitation has grown as well. I hope to someday become a rehabilitation physician researcher, who will be motivated by her care of patients with brain injury. Also, the opportunities that I have been afforded to conduct research, shadow rehabilitation providers, and attend conferences have yielded many opportunities to network and present our findings. I want future students to share in this experience and gain a similar passion for rehabilitation medicine and for advancing brain injury care.
For the past three years, I’ve been conducting clinical research on sepsis and the inflammatory responses of individuals who have sustained a traumatic brain injury. I’ve read through hundreds of patients’ medical records and each one has a different story. However, what really amazes me is how these patients’ stories seem to come together. Despite a diverse pool of histories, I’ve discovered patterns and trends both within individual health records and in relationships to other research data that I never would’ve expected. This type of analysis and critical thinking has helped me to develop skills which will be invaluable to me as a future physician.
My brain injury research experience has also further fueled my passions for learning and medicine. I have gained a greater appreciation for the complexities of the human body as well as the importance of comprehensiveness and continuity of care. While physicians, nurses, and other members of the healthcare team may only have the chance to help one patient at a time, this research program provides trainees with the opportunity to help patients and healthcare teams across the entire country. I hope that our findings can both foster our understanding of brain injury medicine and help improve brain injury patient care for years to come.
Compared to the general population, individuals who sustain a traumatic brain injury have 10X greater risk of developing major depression. Our research trainees have helped identify how inflammation and personal biology contribute to this risk.
Of those with moderate to severe traumatic brain injury, our work suggests that 20% will have developed epilepsy within 5 years of their injury. Trainees in our research program have been integrally involved in identifying unique genetic markers associated with seizure risk in a population with severe TBI.
Individuals with traumatic brain injury are 50X more likely than the general population to die from a seizure. Trainee supported research is generating individualized, quantitative seizure prediction algorithms to help practitioners better gauge how to treat and prevent post-traumatic epilepsy.
Trainees participating in the Rehabilomics research program have co-authored over 100 scientific abstracts that were also accepted for presentation at a national conference.
The incidence of traumatic brain injury is calculated to be approximately 200 per 100,000 per year. Your donation helps support young and enthusiastic trainees learn about the latest advances in brain injury rehabilitation research and care.
Student researchers have shown that ~44% of men with severe traumatic brain injury have abnormally low testosterone levels, a vital hormone that impacts energy levels and functional recovery. Your gift will sponsor continued trainee research focusing on potentially relevant treatments for recovery and repair that address this condition.
Recent research from the Henry Kaiser Foundation suggests that only ~60% of the mental health services need is being met in Western Pennsylvania. Other data suggests that mental health problems are the number one reason for hospital readmission after a moderate to severe traumatic brain injury. Your gift will help us continue our trainee supported mental health research efforts that are aimed at screening, prevention, and effective management of mental health disorders after TBI.
Survival from sudden cardiac arrest has risen to 10-12% in recent years. Our trainee supported research has identified unique changes in brain neurotransmitters and inflammation after cardiac arrest. Your donation will aid in additional trainee supported research evaluating the mechanisms underlying these changes and studies on how clinical rehabilitation treatments and therapies can be tailored to optimize recovery in this unique population with acquired brain injury.
Over 2200 Emergency room visits per 100,000 population are made for traumatic brain injury among adults over the age of 75 years. Trainee supported research has made multiple important discoveries on how age at the time of injury influences pathology and recovery. Your donation will continue to support trainees in their work to understand how inflammation and other hormonal signaling molecules influence mortality risk and complications that commonly occur in older individuals with brain injury.