A Year To Remember

Reprinted from PN/Paraplegia News December 2018

From medical advancements to sports achievements, 2018 was filled with noteworthy moments.

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Time sure does fly, and this year was no exception. As 2018 winds down, it’s time once again to pause and review the happenings and highlights of the year. It was a year that came with plenty of advancements, changes and surprises. For Paralyzed Veterans of America (PVA), there were occasions to celebrate, such as Congress passing and U.S. President Donald Trump signing the VA (Department of Veterans Affairs) Mission Act, but there also were events to mourn, such as the passing of a longtime PVA sports director. To wrap things up and prepare for the year ahead, here’s a look back at some of the significant moments that dotted the calendar.

Caregiver Program Expansion

Legislation involving one of PVA’s top priorities, expansion of the VA’s Comprehensive Assistance for Family Caregivers Program to veterans of all eras, took a monumental step forward this year. On June 6, Trump signed the VA Mission Act into law. Officially titled The John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act, the VA Mission Act will reform care in the community, require the VA to assess its infrastructure and expand eligibility for the VA Caregiver Program. The legislation was an overwhelmingly bipartisan product that sailed through the Senate with a 92-5 vote and the House of Representatives with a 347-70 vote. As a result of the VA Mission Act, veterans who were catastrophically injured before Sept. 11, 2001, and their caregivers will soon be eligible to access services such as respite care, beneficiary travel and a monthly caregiver stipend. An estimated 70,000 veterans will be able to receive care in their homes from family members. A phased roll-out is expected to begin early next year. Pre-9/11 veterans’ caregivers, many of whom have sacrificed their own health and employment opportunities  some for half a century  will have desperately needed support and be acknowledged for the decades of service given and billions of taxpayer dollars saved. Another key component of the VA Mission Act is the creation of a new VA Community Care Program. All seven VA community care programs, including the Veterans Choice Program, will be consolidated into a single program. Now that the VA Mission Act is law, the VA will face the daunting task of implementing its requirements. PVA has already begun the process of working with the VA to ensure that the needs of veterans with catastrophic disabilities and their caregivers are part of the VA’s decision-making processes. 

Rocky Mountain Regional VA 

Another long-awaited project that has the potential to help hundreds of veterans with spinal-cord injury and disease (SCI/D) was finally unveiled in August. The suburban Denver area welcomed the state-of-the-art Rocky Mountain Regional VA Medical Center in Aurora, Colo., which includes the VA’s first SCI/D unit since 2013. The 30-bed SCI/D unit is equipped with modern comforts and technology but also an amazing attention to detail. Patient rooms include lowered and longer windows to let in more daylight and private bathrooms for each patient to prevent the spread of infection. Outside the rooms, the unit features several outdoor courtyards for both recreation and therapy, as well as side-by-side indoor therapy pools, each with its own temperature control. PVA first supported creating a SCI/D center in the region in 1980 and unanimously approved a resolution to advocate for a facility during its 2001 convention in Long Beach, Calif. Construction on the medical center got underway in 2012 but stalled in 2014 because of various disagreements and cost overruns. This led to litigation, investigations, intense media scrutiny and the eventual need for Congressional action. The United States Army Corp of Engineers (USACE) was eventually brought in to advise on the construction and on the overall management. The USACE helped get construction back on track in late 2015. The USACE puts the price tag for the 12-building, 1.2-million-square-foot facility at $1.7 billion.

Dental Pulp Research

Clinicians at the new Rocky Mountain Regional VA medical center aren’t the only medical professionals who are helping people with SCI/D. Researchers at Craig Center for Regenerative Research at Craig Hospital in Englewood, Colo., are looking at ways to extract and preserve dental pulp stem cells that could be used to improve grip strength, enhance hand function and even help restore the ability to walk in people with SCI.

“There’s been a lot of focus on obtaining stem cells from elsewhere, like bone marrow, which is a painful procedure, and they haven’t been effective in recovery for spinal-cord injuries,” says Leslie Morse, DO, co-founder of the research center and endowed director of SCI research at Craig Hospital.

Dental pulp, however, is relatively plentiful and relatively easy to access from any healthy teeth: discarded baby teeth, extracted wisdom teeth or, potentially, during root canal procedures.

“We know that the dental pulp stem cells do improve strength in paralyzed rats,” Morse says. “Now we want to make sure the cells stay in the cord and don’t go into other tissues or cause tumors.”

The next step will be to determine if there is similar improvement if the injection is done one week post-injury.

“After spinal-cord injury, the hope is that we would be able to obtain dental pulp from an individual and be in a position to inject the necessary cells a month or six weeks after injury,” Morse says.

The pathway to clinical trials is long, with safety and efficacy proven in the clinical domain before human patients can get involved. Morse and her Craig team continue forging ahead with enthusiasm and high hopes.

“Realistically, we are very excited to move to clinical trial in two to three years,” Morse says. “We hope these cells will have a big impact. There’s currently no treatment that restores strength that would translate to functional improvements. Even improving grip strength would be a tremendous improvement for people with spinal-cord injury.”

A Helping Hand

Improving grip strength also happens to be the idea behind a new prototype glove that debuted at January’s annual Consumer Electronics Show (CES) technology trade show in Las Vegas. There were tons of accessible technology featured at CES this year, but the NeoMano from Neofect could have a major impact on daily activities for high-functioning quadriplegics and others with limited hand dexterity. Mainly targeted to those with a SCI between C5 and C7, the glove fits over the user’s index finger, middle finger and thumb to form what is technically called the “three-jaw chuck,” or power grip. A small battery-operated motor attached near the thumb is controlled with a remote by the user’s other hand to grip and/or release an object. Neofect began a Kickstarter campaign with the device on Oct. 30 and hopes to have it out on the market by the end of this year or in early 2019.

Paralympians In Spotlight

While CES is always an eye-opening experience, all eyes were on Team USA during the 2018 PyeongChang Winter Paralympics in South Korea in March. Military members were in the spotlight as the U.S. led the medal count for the first time in more than 25 years. Team USA men’s para ice hockey captured its third straight Paralympic gold medal  an unprecedented feat. Military team members included Ralph DeQuebec (Marine Corps), Travis Dodson (Marine Corps), Jen Lee (Army), Luke McDermott (Marine Corps), Josh Misiewicz (Marine Corps) and Rico Roman (Army). Navy SEAL veteran Dan Cnossen brought home the gold as well, in addition to five other medals, and became the first American man to win a biathlon gold medal in Olympic and Paralympic history. And Army veteran Andy Soule earned his gold hardware in a photo finish in the men’s 1.1-kilometer sitting sprint.

Great Games

The Winter Paralympics was just one memorable sporting event that showcased veteran athletes with disabilities. More than 600 participants from across the United States, Great Britain and Puerto Rico took part in the 38th National Veterans Wheelchair Games in Orlando, Fla., from July 30–Aug. 4. Among the 19 sports, the outdoor team challenge made its debut. The team challenge included a 200-yard freestyle swim, bench press (which consisted of a 2-minute maximum in two divisions), 5K handcycling and 200-meter dash events. Nine teams, comprising four people each, competed in the relay, which honored former PVA Sports Director Ernie Butler who passed away in July.  Butler’s daughter, Tia Butler, and wife, Vicki, were in attendance.  

“I think this has been the most cathartic moment because it’s been the culmination of everything he worked towards. He loved the PVA and the Wheelchair Games. I mean, it was second only to mom and me in his life,” says Tia. “And to have an award named after him for a new event because that’s what Dad believed in — innovation — and bringing new events. He brought boccia [ball] five years ago when it first started and now this. And so I just hope it motivates whoever wins it to see that you can create new events and make a really amazing footprint on the world just by showing people that you can do anything you want to do, and that’s what he believed.”


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