Archive for May, 2008

Triathlon Trial Lawyer Doug Landau a volunteer for Reston Interfaith

Trial lawyer triathlete Landau will be a volunteer at the Reston Sprint Triathlon.

Volunteer Doug Landau giving Aquathlon Champion Beth Baker her registration packet
Volunteer Doug Landau giving Aquathlon Champion Beth Baker her registration packet
He won his age group with a top-10 finish last year, en route to becoming an Virginia Triathlon Series Age Group Winner and competing in the SouthEastern Olympic Distance Triathlon Invitational Championship. The second annual Reston Sprint Triathlon will be held in Reston, Virginia on June 1st, 2008. The proceeds from the event will again be donated to one of Reston’s oldest, and Northern Virginia’s most successful, non-profit organizations, Reston Interfaith. Reston Interfaith promotes self-sufficiency through support and advocacy for those in need of food, shelter, affordable housing, quality childcare, and other services. The CORE Foundation, in cooperation with Reston Association, presents the event.

How does Diffuse Axonal Injury occur ?

What has happened is that rotational and other movements of the brain during trauma has resulted in injury to numerous axons in both cerebrum and brain stem. Brain injury trial attorney Doug Landau explains that this can happen as the result of a sharp, fast back-and-forth movement of the skull, or a rapid twisting of the head from an impact, or a high-velocity combination of straight and curvilinear motions of the body above the neck. This type of injury has been seen at autopsy following many days after the traumatic injury. In other words, the movement of the head during an accident causes the string-like nerve cells (axons) to stretch, tear or rupture. These specialized cells may not be able to repair or regenerate themselves. There may be swelling, inflammation or disruption of the electrical impulses that make up our “wiring.”

The brain is the “command and control center” of our “wiring system” points out brain injury lawyer Doug Landau. And when the wires are severed or damaged, the signals do not work as intended, with short, and sometimes long term consequences. If you or someone you know has been suffered a brain injury or has symptoms of a head injury, it is critical that they get proper medical attention and seek experienced legal assistance. At ABRAMS LANDAU, Ltd., we help adults and children from around the world with brain injury and head trauma cases.

WHAT IS “DIFFUSE AXONAL INJURY” ?

This important concept explains both short and long term neurologic deficits in patients whose trauma did not produce either contusions, hemorrhages or lacerations sufficient to account for the deficits. Frequently, the latter lesions are minimal but the deficit is severe. Sometimes, notes Herndon Reston brain injury lawyer Doug Landau, there is a minimal laceration (cut) or not cut at all, but the neurological damage is significant. This is often harder on the innocent crash victim because they have no “Red Badge of Courage” to display to friends, family or their physicians to buttress their claims of disability, deficit and suffering. This, in turn can cause anxiety, depression and fear, especially in cases in the long and trying litigation process adds Landau.

When to see a Doctor for Low Back Pain

The American College of Physicians (”ACP”) recommends that you see a doctor IF:

1. Pain runs down the leg below the knee
2. The leg, foot, groin or rectal area feels numb
3. Fever, nausea or vomiting, stomachache, weakness, or sweating occurs
4. Bowel or bladder control is lost
5. Pain was caused by an injury
6 Pain is so bad you cannot move around
7. Pain does not seem to be getting better after 2-3 weeks.

The ACP and the American Pain Society published guidelines on the diagnosis and treatment of low back pain in December, 2007.  For a “Summary for Patients” of these guidelines, go to www.annals.org/cgi/reprint/147/7/

Triathlon Trial Lawyer Doug Landau looks at LOW BACK PAIN

Many people have low back pain at some time in their lives. It can become chronic, meaning that it comes and goes over months to years.

In the “ANNALS OF INTERNAL MEDICINE” it is suggested that

IF YOU HAVE LOW BACK PAIN:
*Do not lift heavy things or do strenuous work
*Try to keep doing everyday activities an walking, even if it hurts
*Do not stay in bed longer than 1-2 days, because it can make your recovery slower

Dr. Allen Delaney of Commonwealth Orthopedics has treated many patients with traumatic and chronic back pain
Dr. Allen Delaney of Commonwealth Orthopedics has treated many patients with traumatic and chronic back pain
These recommendations, published by the American College of Physicians (”ACP”) in the May 6, 2008 volume, also contain this advice:

TO HELP YOU FEEL BETTER, TRY SOME OF THESE THINGS AT HOME:
*Medicines from the drug store to reduce pain, (acetaminophen, ibruprofen - read the labels !)
*Heating Pads or hot showers
*Massage

See tomorrow’s post for suggestions from the ACP as to when you should see a doctor. For more information, in English and Spanish. try the American Academy of Family Physicians (http://familydoctor.org/online/famdoces/home/common/pain/treatment/117.html)

Secondary Effects of Brain Injury and Head Trauma

In the previous posting, brain injury lawyer Doug Landau listed Direct Effects of head trauma and brain injuries.  In addition to those sometimes permanently disabling effects of an impact or blow involving the skull and brain, the Herndon Reston trial attorney notes that there are “Secondary Effect” which can also be quite devastating to the innocent victim of a bike or car crash.  Listed below are Secondary Effects of brain injury and head trauma:

B. SECONDARY EFFECTS

1. Cerebral edema or swelling

2. Herniations of brain tissue

3. Infection

4. As a result of traumatic brain damage, there may be permanent localizing neurologic defects or post-traumatic epilepsy.

www.pathology.vcu.edu/WirSelfInst/trauma.html

Direct and Secondary Effects of head trauma and brain injuries

Doug Landau gives swim star Beth Baker a noogie, which will not result in brain damage or a closed head injury
Doug Landau gives swim star Beth Baker a noogie, which will not result in brain damage or a closed head injury
Traumatic lesions, whether they are the product of closed or penetrating injuries, and whether they are coup or contra-coup, may be said to have direct effects, and secondary effects. Brain injury lawyer Doug Landau notes that it is important to have an experienced specialist examine and test for the subtle effects of a closed head injury and brain trauma. Direct Effects of head trauma and brain injury are listed below:

A. DIRECT EFFECTS

1. Skull fracture

2. Hemorrhages–epidural, subdural, subarachnoid or parenchymal

3. Lesions to brain–contusion, laceration [ the most minor “lesion” has no identifiable gross or microscopic counterpart in human material and is the concussion which produces unconsciousness].

4. Diffuse axonal injury [DAI]

The Brain Can Move Independently of the Skull

When the head is struck, it often moves until it is abruptly brought to a stop against a solid object. At this moment, the brain continues moving for a brief instant until it hits the bony prominences inside the now stationary skull.  The skull does not give with this impact.   The brain does.  This is often accompanied by a stretch of the nerve endings.  Sometimes this “stretch” goes beyond the nerve’s limit, and microscopic nerve (axonal) tears occur.   These are not detected by regular x-rays.  Sometimes, the injury to the moving brain takes place at a site opposite the point at which the skull was initially struck. This type of injury is called “contra-coup,” as opposed to a “coup” injury occurring on the same side as the initial impact (coup = blow, French; contra-coup = opposite the blow).  Traumatic lesions, whether they are the product of closed or penetrating injuries, and whether they are coup or contra-coup, may be said to have direct effects, and secondary effects.  Direct Effects and Secondary Effects will be addressed in the next post.

http://www.pathology.vcu.edu/WirSelfInst/trauma.html

How can I have a brain injury to the side OPPOSITE where my head struck the interior of my car ?

TriathlonTrialLawyer Doug Landau will cover brain injury issues in the posts that follow
TriathlonTrialLawyer Doug Landau will cover brain injury issues in the posts that follow
Herndon-Reston area Brain injury lawyer Doug Landau studied neurology and neurophysiology before attending law school. He recognized that it was important to understand how his clients’ bodies functioned. This Virginia trial lawyer also realized that he needed to have more than just a passing understanding of the medical terminology used in his clients’ records and experts’ reports.

Landau is fond of pointing out that the human body is a miraculous machine. It is resilient, and often able to recover from horrific and traumatic injury. The ABRAMS LANDAU trial team has seen a number of clients heal from terrible injuries and bounce back from enormous impact. This is especially true of our younger clients. Children, even those who sustain fractured skulls and subdural hematoma, seem to make better recoveries than their adult counterparts.

Part of the resiliency of the human body is found in the flexibility and elasticity of many of its parts. Tendons, ligaments, muscles and other connective tissues are often able to withstand and absorb significant impact and blows. There may be bruising and pain, but the body’s natural healing ability is often up to the task of repair and replacement of damaged cells and tissues. In the following posts we will discuss how one can have a brain injury on the side OPPOSITE the impact to the skull, bike helmet and/or ear.

Doug Landau’s 2008 Triathlon debut at Virginia Run Sprint Triathlon

In an event that raises funds for the Special Olympics, put on by the wonderful crew of “FinsWheelsand Feet” Doug Landau, the “TriathlonTrialLawyer,” began his 2008 Triathlon Season.

Doug Landau is a prizewinner at the 2008 Virginia Run Sprint Triathlon.  He is shown here with the mascot shark and Race Director Shandra Richardson
Doug Landau is a prizewinner at the 2008 Virginia Run Sprint Triathlon. He is shown here with the mascot shark and Race Director Shandra Richardson
After several days of rain and cold weather, some participants were in wetsuits for the short outdoor pool swim ! The race began with a 250 meter serpentine swim. Passed repeatedly in the frigid pool, Landau managed a pedestrian 4:55.39 for 63rd. After his “pokey” swim, The Athletes Lawyer passed many of those who swam faster in the first transition in a blistering 00:41.70. Next, the racers biked 20km., completing 2 laps through the rolling Virginia Run Community located across the street from Bull Run Elementary School in Centreville, VA. 33:38.9 for an average speed of 22.1 mph, for 10th best bike split. T-2 was on frozen feet and took 1:06.45. Running on what felt like stilts was difficult, but Landau managed 6:22 pace for the last 2 miles and a 20:30.45 5km. to post the 15th fastest split. With a total time of 1:00:52.8, the Triathlon Trial Lawyer was 8th overall against some 400 other athletes. The Herndon Reston area personal injury and disability lawyer was also 2nd in his age group, in his first Triathlon of 2008. Having finished 10th in 2005 and 8th in 2006, Landau was pleased with his performance, if not his time and age group placing.

Douglas K.W. Landau is admitted to practice in DC, VA, CT, FL, and NJ. Abrams Landau services clients in Washington DC, Pennsylvania, PA, Maryland, MD, Virginia, VA (including Northern Virginia, Fairfax county, Loudoun county, Herndon, Reston, and more), Connecticut, CT, Georgia, GA, Florida, FL, New Hampshire, NH, New York, NY, New Jersey, NJ, Maine, Massachusetts, MA, Rhode Island, RI, North Carolina, NC, and South Carolina, SC.

Information disseminated on this website is intended for informational purposes only and is not legal advice. This information is not intended to create an attorney-client or similar relationship. Please do not send us confidential information. Past successes cannot be an assurance of future success. Whether you need legal services and which lawyer you select are important decisions that should not be based solely upon this website. Please contact: Abrams Landau Ltd. at (703) 796-9555.