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Therapist explores links between TBI and Alzheimer's

Although most people associate Alzheimer’s disease solely with memory loss, its earliest symptoms often are difficult to recognize because they don’t appear to have anything to do with forgetfulness.

Hailey Damrow, a recent addition to staff at Hastings Physical Therapy Spine, Sport, and Extremity Center, is a physical therapist who specializes in working with patients with traumatic brain injury (TBI), including patients with neurological conditions including Alzheimer’s. Damrow said that while memory deficit obviously is the biggest qualifier for diagnosing Alzheimer’s disease, it is more likely to see a patient exhibit abnormal movements as an early symptom of the disease rather than anything typically associated with memory loss.

“Actually, the very first symptom to look for is that they have abnormal movement patterns,” she said. “Going up and down stairs, they may think there’s another stair there, but there is not. Or stepping over a line on the carpet that’s not there because of depth perception (issues). Or they may go for a cup of coffee and overshoot it and tip it over, or grab at it and it’s not there yet.”

Another common symptom of brain injury is the loss of sense of smell. This occurrence is commonplace among those interviewed, Damrow said.

lbeahm / Laura Beahm/Tribune  

Physical therapist Hailey Damrow smiles Monday while working with a patient at Hastings Physical Therapy.

“Almost everyone says they’d eat but that the food didn’t smell like it used to,” she said. “Then a couple years later they notice the memory loss.”

While Alzheimer’s is described as a progressive disease that destroys memory and other important mental functions, traumatic brain injury occurs as the result of a blow to the head that disrupts normal brain function.

Certain types of traumatic brain injury may increase the risk of developing Alzheimer’s or another type of dementia years after the injury takes place.

A key study cited on the Alzheimer’s Association homepage indicates that older adults with a history of moderate traumatic brain injury are 2.3 times more likely to develop Alzheimer’s than seniors with no history of head injury, and that those with a history of severe traumatic brain injury had a 4.5 times greater risk.

And while there is no evidence that a single mild traumatic brain injury increases dementia risk, emerging evidence suggests that repeated mild traumatic brain injuries, such as those that occur in sports like football, boxing, hockey, and soccer, may be linked to a greater risk of chronic traumatic encephalopathy (CTE), a form of dementia.

In states where snow and ice are present, slip and fall injuries are among the more common causes of TBI, Damrow said.

A large percentage of cases she sees involve patients who have fallen in the shower, on stairs, or on ice. Falls from putting up Christmas lights and other holiday decorations tend to make winter an especially vulnerable time for injury, especially among the senior population.

At HPTSSEC, brain injury patients already are vamping up for the winter months by working on balance issues that will challenge them as extreme winter temperatures turn sidewalks into ice rinks. By using foam or uneven surfaces to simulate conditions that will arise, patients are better prepared to tackle potential fall risks and avoid them.

lbeahm / Laura Beahm/Tribune  

Physical therapist Hailey Damrow works with Kim Schiefelbein at Hastings Physical Therapy Monday.

“Some things we work on addressing are uptraining other balance systems,” Damrow said. “Vision is the No. 1 thing that helps you keep your balance, so when it’s dark out, training inner ear and muscle strength can help them react faster if they do lose their balance.”

An estimated 775,000 seniors are living with TBI, according to statistics released by the Centers for Disease Control and Prevention.

Each year, 56,000 seniors are hospitalized as a result of head injuries sustained in falls. About 8,000 will succumb to their injuries, while many others will suffer long-term cognitive changes, including the reduced ability to function and changes in emotional health.

Suggested measures to reduce the risk of falls include: Using a walker to compensate for mobility problems, muscle weakness or poor balance. Other useful remedies suggested by Damrow include use of a cane, grab bars, ice cleats, and in extreme cases, wheelchair.

Strategies for helping those dealing with brain injury memory issues include having them write down appointments on a cell phone or specific place consistently, and placing items such as keys and shoes, in the same place each time to strengthen the memory.

Soliciting outside services from groups such as Meals on Wheels, church groups, and public transportation outlets can be of benefit by creating a safer environment for a patient, Damrow said.

Incorporating memory exercises into treatment plans can enable patients to stay sharper longer, she said.

“We try to incorporate memory and getting them to not only uptrain their balance and muscles but also their brain,” she said. “We may ask them to recall five things they would like to do, what they had for breakfast, where they were born...

“With Alzheimer’s, it’s a degenerative disease and it’s going to keep getting worse. You just want to start compensating with different memory strategies that can be really hopeful in early stages.”

Woman pleads guilty to obstruction in 2017 killing

A Lincoln woman involved in covering up the 2017 slaying of a 19-year-old Hastings man pleaded guilty to a misdemeanor charge pursuant to a plea deal on Thursday in Adams County Court.

Katherine Creigh, 23, of Lincoln entered the plea to one count of obstructing government operations, a Class 1 misdemeanor punishable by up to one year in jail and a $1,000 fine.

In exchange for her plea, prosecutors reduced the charge from accessory to first-degree murder, a Class 2A felony punishable by up to 20 years in prison. Another part of the agreement was that Creigh would testify in the cases of any co-defendants brought to trial.

Creigh’s boyfriend at the time, Deante Mullen, 21, and Daniel Harden, 23, were both charged with first-degree murder and use of a deadly weapon to commit a crime.

Prosecutors added a charge of conspiracy to commit robbery against Harden, whose jury trial concluded Monday in Adams County District Court. A jury found Harden not guilty of the murder and weapon charges, but convicted him of the conspiracy charge.

Creigh testified in the case, fulfilling her end of the bargain and paving the way for the plea deal to continue.

Adams County Judge Michael Burns accepted the plea and ordered a pre-sentencing investigation to be completed. He scheduled a sentencing date for Jan. 8, 2020, at 1 p.m.

Mullen made a deal similar to Creigh’s with prosecutors and he also testified during Harden’s trial. His case is set for a pre-trial hearing on Nov. 12 at 11 a.m. Mullen also requested Thursday a reduction in his $1 million bond at that time.

Prosecutors say Mullen and Harden planned to rob Jose “Joey” Hansen in the early morning hours of Sept. 11, 2017. The attempted robbery led to Hansen’s death in 700 block of West G Street. Hansen was killed by a single gunshot wound to the back.

During his trial, Harden said he was at home at the time of the shooting.

After the shooting, Creigh said she went back to the scene with Mullen to retrieve a dropped cellphone and package of cigarettes. Creigh also lied to police when questioned about the whereabouts of herself and Mullen at the time of the shooting.

First-degree murder is a Class 1 or Class 1A felony punishable by life in prison. Use of a firearm to commit a felony is a Class 1C felony punishable by five to 50 years in prison. Conspiracy to commit robbery is a Class 2 felony punishable by up to 50 years in prison. Accessory to first-degree murder is a Class 2A felony punishable by up to 20 years in prison.

County offices collaborate with other entities on need for hygiene products

Several local agencies are working together to address a need and provide individuals in the probation system with hygiene products.

RuAnn Root, executive director of Court Appointed Special Advocates, shared this need with members of the Adams County Board of Supervisors at the board’s meeting Tuesday.

Root said adults within the probation system are in need of hygiene products. She has worked with Sue Kissinger, chief deputy of the District 10 Probation Office, on the issue.

Root said members of the Hastings Community Foundation expressed interest in providing a $1,000 emergency grant to buy a variety of hygiene products. Root hasn’t yet written the grant application.

“We’re just making sure we can do this before we write the grant,” she said.

Because the Hastings Community Foundation wanted to be able to track the grant funds, the supervisors voted 6-0 at their meeting to accept the funds on the county’s behalf.

Should the Community Foundation approve the grant application, the funds would go into the county’s general fund. The products would be purchased using the County Attorney’s Office credit card, with the products stored at the probation office at the Adams County Office Building, 300 N. St. Joseph Ave., and given to those in need.

“The county’s not going to be out any money. This is not something my office would generally purchase. I don’t want the auditor coming back later saying, ‘You bought $1,000 worth of what?’ ” County Attorney Donna Fegler-Daiss said of why the issue was brought to the supervisors.

Kissinger said individuals on probation sometimes are in a precarious financial situation where they must pick between buying hygiene items or buying food.

“If we can give them some positive reinforcement and help them remain clean, they have a better chance of having a good self-image and getting a job and all those other things,” Root said. “It’s a good thing to do.”

Officials review city's quiet zone plan

Hastings is one step closer to getting quiet crossings along the BNSF Railway between Marian Road and Elm Avenue.

Representatives from several city departments as well as from the Nebraska Department of Transportation met Thursday with David Huntley, grade crossing inspector for the Federal Railroad Administration office of safety, and toured those nine crossings as part of the city’s quiet crossing diagnostic review.

Huntley also reviewed designs for potential approaches to each of those nine crossings, with medians either three or four feet wide and 60 to 100 feet long.

There were designs for both one-way and two-way intersections on the downtown streets.

“What we went through today, if they do everything they’ve got here I see no issues, but they’ve got to work with the railroad to get it accomplished,” Huntley said.

To receive approval from the Federal Railroad Administration, Hastings must achieve a certain score on a pair of FRA risk assessment scales.

The city achieves that score through supplemental safety measures such as one way streets, crossings closed, medians and automatic horn system with the horn stationed on the mast with the lights and gates instead of on the train.

“It’s not really a quiet zone then, but the train will quit blowing the horn,” Huntley said.

BNSF was noticeably absent from the diagnostic review, choosing not to participate.

The next step will be to state a notice of intent to establish quiet crossings.

The notice of intent will be followed by a 60-day comment period. Huntley said the city should expect to hear from the railroad then.

Provided the city gets approval from the Federal Railroad Administration and cooperation from BNSF, construction could then begin maybe as soon as 2020.

Huntley will do another inspection as part of the construction process.

“If I find issues, I’ve got to take away your quiet zone until it’s fixed,” he said. “I like to come before the date of establishment that way if we’ve got an issue we can fix it.”

therrman / Tony Herrman/therrman@hastingstribune.com  

Hastings City Engineer Dave Wacker (right) reviews his notes at the Pine Avenue BNSF Railway crossing during the quiet crossing diagnostic review Thursday as Jesus Guerrero, engineering assistant for the city of Hastings (center) and David Huntley, grade crossing inspector for the Federal Railroad Administration office of safety, look on.

The city provided cost estimates for each of the quiet crossings, the total for all nine of which range from $2.4 million for the lowest alternate costs and no pad replacement to about $3.6 million for the highest alternate costs and pad replacement.

However, even those estimates are low because they don’t include new arms at the crossing gates, which Huntley said BNSF will require.

He said BNSF will make upgrades to the railroad equipment and bill the city.

The quiet crossings are being paid for as part of the city’s half cent sales tax, which was renewed in September 2017. Collection began in April 2018.

There is $350,000 set aside for engineering or construction work on quiet crossings in the 2019-2020 fiscal year. That amount is based on what has been collected so far.

In approving the city’s one- and six-year street improvement plan, members of the Hastings Planning Commission and Hastings City Council both identified 2020 as the year for work to begin on quiet crossings.

The city would like to keep all nine of those crossings open, but there is an understanding that is not likely as part of negotiations with the railroad.

The crossings discussed during the diagnostic review most likely to be closed were at Laird and Lincoln avenues. That is based on traffic counts and cost for improvements.

The Department of Transportation representatives said the city would receive at least $22,000 to close a crossing. The railroad may offer more.

BNSF crossings in southwest Hastings, further east and the Union Pacific crossing on Baltimore Avenue aren’t yet included in quiet crossing plans.

“We decided the southwest intersections didn’t merit something at this time, or further east than Elm, like Showboat, with CPI out there and the Highway 6 project that’s coming, we thought that’s better left alone,” City Administrator Dave Ptak said.