My passion, for better or worse, is brain injury rehabilitation. I have seen what a lack of optimal multi disciplinary rehabilitation can do to a victim. It can and does destroy the fabric of family life. It splits families and marginalises victims. It is still very much the invisible injury, the silent epidemic.

Look at what Professor Mike Barnes, ex-President of the World Federation for Neurorehabilitation says, in his letter about the value of early rehab and the Rehab4Life scheme. Click here to read his letter. It is crucial his message is understood. Not only understood, but acted upon. The Rehab4Life scheme goes some way to doing this, and I am proud of it. But, I wish things were better all around.

Our state care system, here in the UK is wonderful, generally. It has it's problems. Goodness only knows it tries it's best to be all things to all men. The Doctors and nurses who work within it are second to none in my opinion and do us all proud. Oh, there are glitches and every organisation has it's bad bits and things go wrong occasionally. That's life. Life doesn't come with any guarantees. Our National Health Service has only so much money to go around and inevitably there are areas it could be much better at. Brain Injury rehabilitation is one of those areas. The Rehab4Life scheme is also not all things to all men. It fills an important gap and, in appropriate cases, guarantees the much needed early multi disciplinary rehabilitation Professor Barnes so strongly advocates for.

Whatever applies over here in the UK applies equally in the USA, but on a much larger scale. When you have a minute, listen to the young lady speaking about traumatic brain injury facts and figures in the USA - on YouTube - http://www.youtube.com/watch?v=IMBdWl5Dk_U 

My brother David, an established business consultant, based in North Aurora, Chicago, and myself, have set up Rehab4Life Inc, registered out of Delaware. It has been created very much on a suck it and see basis. It is designed around our UK model (see www.rehab4life.co.uk) with a view to hopefully raising awareness of brain injury rehabilitation issues in the USA and finding support for our initiative. It is in it's embryonic form. It has no funders or insurers and no support whatsoever from American lawyers, yet! We will be looking to establish contact with major influences some time soon. Maybe the publication of this blog article will elicit a response from interested prospective Stateside brain injury professionals, who may wish to, at least, explore and debate the Rehab4Life model to see if it can make any difference to brain injury outcome amongst compensatable victims in the USA.

There is nothing more stimulating than debate. I would welcome the opportunity to debate the value of the Rehab4Life rehab model with Stateside brain injury professionals. I would like to know if it is thought that our initiative is dead in the water e.g. because it purports to potentially be able to fix something that doesn't actually need fixing. I would be delighted, and extremely impressed, to know there is no problem facilitating early neurorehabilitation in America, for compensatable victims. My initial enquiries, however, tell me otherwise. One American clinician told me it is a great idea and would be very relevant in America. An Attorney (a commercial lawyer I met recently whilst skiing in France), speaking of his personal injury colleagues, doubted there would be much interest amongst them, i.e. in facilitating early neurorehabilitation, for the benefit of clients. He told me this was because early optimal neurorehabilitation would mean a much better outcome for the client. In turn this would mean a lesser jury award than would otherwise be the case which, also in turn, would affect the amount of the Attorney's contingency fee. I think he was being very cynical and this did not represent the view of responsible and committed brain injury Attorneys.

The cry, amongst American brain injury lawyers, will undoubtedly be "What does he know about our system - who does he think he is?". Well, they will be correct. I know very little about the American system save that I was a member of the old ATLA and have been Stateside many times to Conferences and seminars to listen to the glitterati of Americas legal profession, Howard Nations and Bruce Stern and many others, talk on the subject of personal injury lawsuits, advocacy, trial strategies and tactics, brain injury issues etc etc etc. I do know, however, and this brings me back to my opening point, that brain injury is still an invisible injury, the silent epidemic, wherever you are and I am passionate about making a difference to the lives of those who can be helped. Rehabilitation is accepted at world health and political levels as being a fundamental human right. It is an absolute truth. No apologies, no compromises, no excuses. If the Rehab4Life model of helping people is irrelevant, can somebody over there tell me, so that my brother and myself can get on with other things. Any comments or suggestions by way of stimulating this potential debate, or by way of developing the model, please email me on andrew.lindsay@rehab4life.co.uk.

Last week was a really good and busy week. Everything is going as well as we expected, in fact better at times. This week we’ve been invited to become panel members of Manchester-based national charity, BASIC – Brain and Spinal Injury Centre. They do fantastic work with victims of acquired brain injury. They run entirely on the basis of charitable donations and are a centre of excellence. They offer rehabilitation at all levels. Look at their web site - www.basiccharity.org.uk

BASIC is a specialist resource for people and their families in crisis followinga traumatic brain injury or neurological diagnosis. This includes people recovering from severe head injury, brain haemorrhage, brain tumour and other brain-related conditions such as stroke and brain cancer. It is affiliated to the Greater Manchester Clinical Neuroscience Centre, and works in close collaboration with the staff there to meet needs of patients within the community. I will be writing more about them on this site some time soon so watch this space.

As specialised neuro-solicitors we will offer BASIC a partnership at all levels, from to offering our support and helping those people who get go to BASIC for information and advice.

I also went to see Jo Maudsley, a young Mum who has two brain injured sons. She is also the founder of The Legacy- Rainbow House, based in West Lancashire, another centre of excellence designed to provide therapy and stimulation for brain injured young children. The charity specialises in providing services for children with neurological problems and conditions such as cerebral palsy, genetic and metabolic conditions, and acquired brain injuries. Some of their children have undiagnosed neurological problems. Jo is an absolute inspiration and I will be writing about The Legacy and their work shortly, too. In the meantime take a look at www.thelegacy-rainbowhouse.com

I’ve been interviewed by the Manchester Evening News and by Imagine FM, the press have been great, they have really responded to what Rehab4Life aims to do for people with TBI.

On Saturday I went to Aintree Racecourse, to a Headway Brain Injury Awareness Event, to mark the opening of the Liverpool and North West branch of Headway. I talked to a lot of people who have been affected by brain injury and their carers and case managers. The Rehab4Life scheme received unanimous support.

We’ve also taken the decision to open an office in Manchester because it seems a sensible move to be close to the city, although we are still based in Preston.

This week has been really difficult for family life because I’ve been so busy I have hardly seen them. It’s head down and work and thinking of how and when we are going to launch our Neurolaw Newsletter..It’s going to be a comprehensive newsletter sent to every personal injury lawyer in England and Wales, containing clinical and legal developments about brain injuries from a global to local level. We are looking to have the first one out within a month and I am very pleased to be working in conjunction with a QC, barristers, an educational consultant, case managers, a vocational rehabilitation expert as well as other solicitors.

I’ve been logging onto the Brain blogger website – www.brainblogger.com - which has been sharing thoughts on the peripheral brain. We all use one at times - you know when you have too much going on in your head so you have to make a list - doctors do, especially trainees and so do lawyers to try and get a grip on the sheer volume of information they have to handle but then any busy person like a mum need something external to remind them because there’s so much to remember and that scrappy list is our peripheral brain. Mine happens to be in my phone, and the computer. I couldn’t manage my working life without them and the Sat Nav now, just anything to make life a bit easier when you are busy. I seem to spend more and more of my life online, I check the phone at breakfast then get into work and switch on the computer whereas once I’d pick up a file and work my way through it. Technology helps me keep more things on the go and that suits me at work but not at home, I can’t keep up with the DIY, that’s multi-tasking too far.

I did more than enough work last week, so on Sunday morning I was in the garden (beautiful day up here in the North) and then watched England rugby side romp to victory (in the first half!!) against the French. Then I promptly fell asleep, before turning my thoughts to the Rehab4Life week ahead.

Here goes!

We’ve been working towards the launch of Rehab4Life for more than three years. It’s felt like a long slog from that lightbulb moment in Chicago when I knew I had to get money to help people to fast track rehab. There were times I felt like throwing in the towel and it’s been very difficult to imagine launching such a unique scheme, especially in the present climate but all along I have had a gut feeling it was exactly right.After all the hard graft, we are pleased that insurers and stakeholders see the importance of channelling money to victims of traumatic brain injury before a final compensation deal, to ensure their chances of recovery are maximised.

In the middle of February I chaired the first meeting of the North West Acquired Brain Injury Forum. It’s nationally headed by the renowned global brain injury expert, Professor Mike Barnes, who I’m pleased to say is backing Rehab4Life.We are aiming to get together a lot of like-minded professionals, including solicitors, brain injury clinicians, case managers and social workers from Manchester, Cheshire, Liverpool, Lancashire and Cumbria.This team is going to look at brain injury services and assess how provision can be improved in both the public and private sectors.The forum is not only for those who have suffered traumatic brain injury but those who have an acquired brain injury, for example, a stroke, haemorrhage or meningitis. Teaming up like this is an exciting, positive development for all patients with brain injuries and that’s our main concern.

It feels fantastic to launch Rehab4Life and we’re planning a party in the near future for everyone who has been involved. Dave doesn’t know this yet but I’m going to rope him and his band in to do the entertainment, he’s really good and he’ll enjoy being on the stage.Tracy and Peter will be there because without them we wouldn’t have set up Rehab4Life or even be operating the kind of practice we run, I can’t imagine what route our lives would have gone if they hadn’t been born.When you have a catastrophically brain damaged baby your life is altered forever. There are very black times when you can’t imagine feeling as you used to.We are in a very different place now. Tracy is 27 and Peter is 20 and we have been amazed at how their lives have transformed and, with them, ours.

Tracy is living with her partner, Andy, who also has quadriplegic cerebral palsy. She’s been shopping this week, with her carers, because it’s Andy’s 30th birthday soon. They met when they went to college in Lancaster, when Tracy was 16, and have been together ever since.

At work I’m representing a couple with the aim of getting further interim payments for their eight-year-old son who was massively brain damaged at birth. He was premature and went into distress during premature labour. Unfortunately, there was a significant and unacceptable delay in delivery, which caused the problems. All his limbs are affected and there is a degree of blindness along with hearing problems. His parents sought us out because of our professional expertise and personal experience bringing up children with brain damage. They appreciate our insider knowledge and the fact that we understand what they are going through because we’ve been there ourselves.

Outside work life is very busy. We’ve got builders at Tracys house because the garage is being torn down and an extension built for Andy to move into. It’s going to be state-of-the-art accommodation with a hoist attached to a tracking system in the ceiling so Andy can be transferred from bed to chair easily. Dave’s been doing DIY on a lesser scale at Peter’s home. He’s been drafted in to put up shelves etc and they have both been diverted by watching Simpsons DVDs. I think Dave’s having a bit of break; he’s been having sleepless nights with his eight-month-old son, James. I remember what that was like.

I’ve been missing going out on my Suzuki Bandit 1200 because the weather’s been treacherous. I can’t wait for spring, and a good run out.The Suzuki’s a big, solid touring bike that’s very comfortable to ride and it’s taken me all over the continent. I have a plan - I’d really love to get a group of solicitors who also happen to be bikers interested in Rehab4Life’s scheme, and get them together to ride the Big Sur down the west coast of California and ultimately have a conference at the end of it with biking American lawyers to swap ideas.

I’ve being skiing, not abroad but at the Chill Factor near Manchester’s Trafford Centre. It’s the country’s biggest natural snow ski slope. I’m intermediate and I love it.

When I get the chance I’ve been reading my favourite author, CJ Sanson. It’s his fourth historical thriller ‘Revelation’ and can't put it down. It’s about the internecine goings on at the court of Henry VIII with murder, politics and a great sleuth investigation conducted by a hunchback barrister.

And all the time I’m busy I’m thinking about Rehab4Life, how I want it to work for people who need the help and how coincidences in life shape you - Tracy, Peter, Dave, families I’ve helped. jetlag and lying awake all night in a Chicago hotel room- all that mix of random chances.

I have today posted a news item but since it is so important I am reproducing it in this blog.

It is as follows:-

"The need to objectively measure head injury severity at the scene of a road accident or in Casualty cannot be overstated. Traumatic brain injury (TBI) remains a major health issue with millions of victims affected annually the world over. Yet there are no objective, blood based diagnostic tests for TBI, and no effective pharmacological treatments. The absence of medically validated brain injury diagnostic markers, as an indicator of brain tissue damage, with the ability to measure changes in the brain cells, and biochemistry and molecules after the injury has been identified as a major limitation in diagnostic and therapeutic development for brain injury. However, significant strides have now been made towards solving these problems. Proteomics is the large-scale study of proteins, particularly their structures and functions. Proteins are vital parts of living organisms, as they are the main components of the physiological metabolic pathways of cells. Major research advances in neurotrauma neuroproteomics have identified several markers that are under evaluation as TBI biomarkers. Although there are currently no biomarkers with proven relevance for diagnosis of brain injury, whether it is caused by TBI, stroke, or other acute brain injuries, research has uncovered several candidate markers that have shown some preclinical potential. Clinical validation with human serum samples using these biomarkers is in progress. The Glasgow Coma Scale (GCS), a symptoms-based neurological scale used to assess level of consciousness after a TBI, divides patients into broad categories of mild, moderate, and severe injury. While the GCS has proven its usefulness in the clinical management and prognosis of severe TBI patients, it cannot provide information about the pathophysiological mechanisms responsible for a patient’s neurological deficits. In addition, specific patient populations are difficult to assess with the GCS, particularly those who suffer from mild or moderate TBI, which account for 80 – 90% of all cases. The future of biomarkers to diagnose and guide therapeutic development and treatment of TBI is very promising. As studies continually expand so does knowledge of the internal workings of the brain under pathological conditions and, as more is learned about the proteins that make up the brain, the closer science is to finding a means to diagnose and treat TBI."

Source: IBIA Issue 02 2008

I will be producing some more research news items shortly so watch this space.

Rehab4Life was conceived out of an absolute feeling of helplessness, as a lawyer, whilst acting on behalf of a seriously brain-injured young lady following a road traffic accident. She was medically stabilised following intensive care at her local hospital and was then discharged home to her family. You only have to read our book to know and understand the difficulties she and her family faced in the coming months and years.

The insurance company on the other side denied liability. There was little or no follow up by the medical and therapy professionals in the form of meaningful rehabilitation.

I could not refer her for private rehabilitation because the cost was prohibitive. She therefore had to make do with what the NHS could do for her, which was precious little I regret to say. She suffered badly.  Her productiveness as a human being was marred by the serious difficulties she still encounters because of a lack of any proper rehabilitation. She eventually won her case, but only years later. Money eventually became available to provide rehabilitation but the damage has been done and any future improvement is sadly years too late. She will improve but not to the extent she would have done.

I never want to be in this situation again and I never want a client to be in this situation again. I became determined to do something about it. The Rehab4Life Scheme is the result. It is an excellent solution to the problems faced by brain injury victims who are entitled to make a claim for compensation for their injuries. Sadly, we cannot help victims under the Scheme who are not entitled to make a claim.

We want Rehab4Life to be the start of a sea change of attitude towards this “silent epidemic” – this “invisible injury”. Consequently, we intend to monitor all clients who avail themselves of the Scheme and ultimately, at some point in the future, produce a dossier of evidence to illustrate to the powers that be that the current system is just not good enough and that much more needs to be done to provide optimal rehabilitation for the benefit of all victims.

Our pledge is that we will do everything in our power to challenge the present system in order to try to bring about change, to elevate brain injury rehabilitation at all levels to a more meaningful and effective service, to make it a priority at NHS level and to make it better for all victims. We have set up the Rehab4Life Charitable Trust, with this in mind. Read this blog so that you can keep up to date with our charity's efforts and the responses of those in authority.