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Archive for the ‘Personal Injury Lawyers North York’ Category

Perspectives on Chronic Pain

Tuesday, January 29th, 2013

One in every five people in Canada suffers from chronic pain.

Chronic pain sufferers may find and do find relief with prescription medication. Often strong medications, such as opoids are prescribed, but many physicians are hesitant to prescribe them, or are unable to prescribe them and only specialists can prescribe them.

There is a polarization between pain and addiction. Doctors do not want to prescribe medication for pain, because of fears that patients will become addicted to the medication.

Chronic pain can develop as a result of injuries from a motor vehicle accident and can lead to the short term disability claims and long term disability claims.

Many people in Ontario who suffer from chronic pain are left floundering, struggling to find someone who will help them to manage their chronic pain. Pain specialists are in short supply in Ontario. Chronic pain sufferers are facing an uphill battle: there is a lack of understanding with respect to chronic pain among doctors and health professionals, and a growing stigma with respect to opoid medications, which the government has cracked down on- making treatment less available to those in need.

The Canadian Pain Coalition recognizes that strong medications such as Oxycodone and morphine need to be carefully monitored, but the opoids are an important part of pain management. Having a pain specialist or physician who can prescribe the medication and monitor its use is an important part to treating chronic pain, especially when physiotherapy and/or massage therapy is not an available option. When medication is difficult to get, chronic pain patients are out of luck.

Both the government of Ontario and the federal government have taken steps to oversee how painkillers such as Oxycontin, Oxycodone, morphine, methadone and codeine are dispersed in the wake of the rising number of accidental deaths. Ontario has introduced a tracking system to monitor these narcotics to identify patients who are getting multiple prescriptions, the doctors prescribing them and the pharmacists dispersing them.

Chronic pain affects not just the individual in pain, but his or her family.

 

 

A Depression Gene, Stigma, Psychotherapy, Relationship between Concussions and Depression

Monday, January 21st, 2013

The search for a depression gene came up empty. A group of 86 researchers were hoping to discover genetic influences linked to depression while studying approximately 34,500 volunteers. Since depression runs in families, many experts believe that there must be a genetic connection. Research failed to demonstrate any specific genes that cause depression. After raising the number of study subjects to over 51,000, only one spot in the whole genome was tied to depression, but it was not close to any genes. The study had focused on patients with symptoms of depression. The study’s authors are considering trying again on a larger scale, this time focusing on patients who have a confirmed diagnosis of depression.

What prevents people from seeking treatment for depression and mental health treatment? Psychotherapy takes time and effort. There is stigma attached to seeking treatment for mental illness. People are hesitant to admit that they attend therapy sessions. Society places illogical taboos and stigmas around mental illness, therefore many people feel ashamed about their diagnoses or symptoms. Another factor that can prevent someone from seeking treatment is severity- he or she may not realize how severe the symptoms are and may feel that therapy is not warranted. The will to get started and knowing how and when to start is another factor.

Research has shown that, in some instances, there are legitimate biological scenarios that cause secondary illnesses that would not exist in individuals otherwise. Researchers in Denmark at the University of Copenhagen were able to isolate an enzyme called C-Reactive Protein (CPR), that when present in high concentrations can cause depression, using a blood test to isolate a specific protein in the bloodstream. It was through this line of research that they found a relationship between depression and arthritis. It was noted in the past patients with inflammation or arthritis may have been simply “written off” by their doctors as upset due to the physical pain and limitations.

This new research has showed that those patients with higher levels of the CPR protein (which is released by inflammation/inflammatory conditions), were 2-3 times more likely to develop depression. It is not clear though, whether inflammation causes depression or the other way around.

An article released on the Time.Com website concerning the link between concussions and depression explains how sustaining a concussion can make one more vulnerable to depression. Two studies were conducted on  retired NFL players.  The first study, which has already been released found that the former players who are depressed or cognitively impaired have abnormal findings in a specific area of the white matter of their brains.  White matter is critical for transmitting signals. The American Academy of Neurology reports that a higher number of concussions equates to a higher likelihood of depression. Neurologist, Dr. John Hart, who was active in both studies, said that these studies apply to everyone who is affected by concussions, not just professional sports players. He said anyone who has suffered a concussion should be monitored for signs of depression. Depression is manageable, but only if doctors know how to diagnose and treat it properly.

 

Aaron Waxman and Associates is a Toronto Personal Injury Law Firm that focuses solely on the rights of injured persons. We advocate for your rights. We provide a free initial consultation.

 

Developments in the field of Brain Injury Awareness

Monday, January 14th, 2013

When a brain injury occurs, it is crucial to go to a hospital or diagnostic imaging clinic to have a CT Scan or MRI test completed right away to assess what has happened.

A recent study found that , however, that CT scans can miss minor bleeds on the brain. Individuals with mild traumatic brain injuries may have normal CT Scans. It may take more sophisticated scans to see abnormalities. MRIs are of course, more expensive.

The study tracked patients with mild TBI for 3 months. Researchers found that over a quarter of patients with normal CT Scans on the day of injury had positive findings on their MRIs when tested a week later. Further testing showed that full recovery had not taken place after 3 months.

An MRI study is a more comprehensive study and is better able to show a comprehensive picture of damage.

This is why it is so important for patients to tell their doctors exactly how they are feeling and if they are experiencing any problems after a head injury.

The study showed that MRIs are able to show focal lesions, which are areas of microscopic bleeding in the brain.Researchers can use the presence of focal lesions to predict which patients are more likely to have ongoing neurological problems.

MRIs are better indicators of the course of injury and recovery.

A brain injury can cause long term damage to the brain. A traumatic brain injury can lead to inflammation and slow regeneration of brain cells. A study from the University of South Florida, found that even at the most chronic stage of injury, therapeutic intervention can help with the regeneration of brain cells. The study examined brain injuries to different areas of the brain and found that TBIs caused a second wave of cell death that impairs cell proliferation and impedes that brain’s ability to regenerate cells.

The study’s researchers found that microglia cells at the injury site and distant sites were activated around 8 weeks after injury. The researchers feel that therapeutic intervention may help prevent some long term damage to the brain.

According to the Centre for Disease Control and Prevention (CDC), 1.7 people sustain a traumatic brain injury per year and of that number, 75% are concussions or some other form of mild TBI.

Aaron Waxman & Associates is a Toronto Personal Injury Firm that advocates for the rights of its clients. Contact us today for a free consultation.

Global Study Reveals People Worldwide are Living Longer, but with Disabilities and Diseases of Modern World

Saturday, December 22nd, 2012

Nearly everywhere around the world, people are living longer. Increasingly, however, people are living with chronic diseases and disabilities of modern life.

The last comprehensive global study took place in the year 1990. Back in 1990, the top health problem globally was the death of children under age 5.

Currently, the biggest contributors to the global health burden is chronic diseases, injuries, mental health conditions, and bone and joint diseases. In developed countries, these account for more than half of the health problems in the population.

The research appeared in the online journal, Lancet, more than 480 researchers in 50 countries collaborated, gathering data from 1990-2010. The series of information was paid for by the Bill & Melinda Gates Foundation.

Globally, the leading causes of death are heart disease, stroke, lung cancer, liver cancer, stomach cancer, colon cancer and AIDS.

People are living longer in chronic pain and with physical and mental disabilities.

It is a time for people to consider long term disability insurance and critical illness insurance.

Critical illness insurance assists with any costs associated with facing a critical or long term illness. Critical illness insurance provides you with a one time lump sum payment upon survival of a designated waiting period (survival period) of one of several specific condition ( cancer, stroke, Alzheimer’s etc).

If you encounter a denial of your long term disability claim or critical illness claim, the lawyers at Aaron Waxman and Associates can assist you with your claim. We are a Toronto Personal Injury Law Firm that practices personal injury law. We only represent the rights of injured people.

Cars with Wifi, Beware of Wildlife and Road Rage: An Update on the Wonderful World of Driving

Tuesday, November 20th, 2012

In-car technology has come a very long way in recent years. Auto makers have installed radar devices and cameras to help drivers maintain safe distances from other cars, keep vehicles in their lane and even alert drivers of impending accidents. There is in-car technology that even goes as far as automatically breaking and stopping the car as necessary.

How about if your car could have a bird’s eye view of the road, and see other vehicles, pedestrians and bicyclists? A special form of Wi-Fi is being developed that will allow cars to communicate with each other through special sensors. It would be vehicle to vehicle Wi-Fi.

This system is being piloted by the University of Michigan, eight automakers and the Department of Transportation. It is being tested on 3,000 vehicles in Michigan with sensors. Participating automakers include GM, Ford, Toyota, Honda, Nissan, VW, Hyundai/Kia and Mercedes. Data from the trial will ultimately help determine whether or not the National Highway Traffic Safety Administration should pursue this technology.

Collisions between wildlife and vehicles are often unpredictable. Collisions tend to spike during the fall, when it is breeding season for deer. In general, due to the earlier dusk and poorer visibility, more accidents are likely to occur. Drivers must obey wildlife signs and traffic signs.

It is better to think about and learn how to avoid an encounter with wildlife, than have to react to a dangerous situation when you are unprepared. Drivers and passengers should be on the lookout for wildlife on the road, in the ditch, on the shoulder. Driving at a slower speed may reduce the chances of having to swerve at all. Always reduce your speed in signed areas. The danger of swerving is that it can take you into the path of a ditch and take you off course.

However, if you are about to collide with a moose, experts say you should swerve as a collision with a moose carries a significant risk of injury or death to motorists and passengers.

Another threat on the roadway is distracted drivers. The popularity of smartphones and internet use while driving has made drivers even more distracted than ever.

State Farm conducted its annual research report on distracted driving, surveying 1000 US motorists. Texting and driving remains a concern, but there has been a noticeable increase in “webbing” while driving (internet use).

The study found that it is not just youth who are committing these distracted driving offenses, but motorists of all ages.

While the distracted driving focus has traditionally been on young people, the data indicate that motorists of all ages are using the mobile web while driving.

Another study says that young drivers are more likely to drive while tired. The AAA Foundation for Traffic Safety surved drivers aged 16-24 and found that 1 in 7 licensed drivers have admitted to falling asleep behind the wheel at least once in the past year.

Research shows that fatigue impairs a person’s driving ability, and causes them to behave in similar ways a person does while intoxicated. Most drivers underestimate the dangers of driving while fatigued. Driving fatigued can cause a person to miss exits and traffic signs,  drifting from your lanes and daydreaming.

A Canadian Study shows that 80% of Canadian drivers admit to road rage behaviour.   The poll, completed by Leger Marketing, suggests that about 80% of Canadians admit to aggressive behaviour such as using profanity, yelling or following other vehicles too closely. The most commonly reported aggressive behaviour was speeding.

Distracted drivers (including the use of mobile phones) were the most common trigger for road rage-like behaviour. Being cut off by other drivers, as well as tailgating behaviour were also causes of road rage. Other reasons for road rage included running behind schedule and having a bad day.

Aaron Waxman and Associates is a personal injury law firm located in Toronto. We handle various types of personal injury claims including automobile accident claims and disability claims.

 

Chronic Pain in the News

Monday, November 19th, 2012

A small British study has shown that laughter can increase your tolerance of pain. The study, called ” Social laughter is correlated with an elevated pain threshold”, confirmed that social laughter, laughter in the presence of others release endorphins, the same feel-good brain chemicals that are released during exercise.

Laughter is useful and helpful when you are hurting because it is work for the body. The release of endorphins through the body masks pain. It is a work out for the chest and lungs. The study was led by Robin Dunbar, PhD, a professor of evolutionary psychology at Oxford University.

The Scientific American recently posted an article entitled “How Chronic Pain Affects Memory and Mood”.  Sufferers of chronic pain also experience faulty memory, depression and anxiety. According to new research from Northwestern University, the reasons for these symptoms could be that people who experience chronic pain suffer from an impaired hippocampus. The hippocampus is the region of the brain responsible for learning, memory and emotional processing.

Researchers at Northwestern University used anatomical brain scans to study the brains of people suffering from chronic back pain or complex regional pain syndrome and found that they had a smaller hippocampus than healthy people. The study turned to mice for more clues about how the hippocampus worked. Mice in chronic pain displayed greater anxiety like behaviours. The mice were unable to produce new neurons in the hippocampus, which is one of the few brain areas where adult mice and humans can grow new neurons.

The lead study researcher suspects that the hippocampal size difference seen in humans could be a reflection of the lack of neuron growth and other problems that were seen in the mice. Without the formation of new neurons, memory and emotional processes would also become impaired.

The study author believes that the study underlines the importance of treating chronic pain as a brain based disorder, in addition to targeting its perceived source in the body.

In technology news, an iPhone/iPad App called My Pain Diary has won awards and has found to be beneficial to those who suffer with chronic pain.

The app was originally released for iPhones, and is now avaialable for iPads, called My Pain Diary HD. It was created by a chronic pain sufferer. It helps patients and chronic pain sufferers track their pain and easily report it to caregivers and doctors. Features include an automatic weather tracker, the ability to attach photos, and the ability to track and compare multiple chronic conditions within one app.

Other features include the ability to create custom PDF doctor’s report to share with doctors, or to store in the app, private entries, which can be flagged as private so as not to be shared, a reminders feature, and a passcode option. There is also a Dropbox Backup option to back up data as well as iCloud syncing between devices.

 

 

 

 

 

 

Halloween Safety Tips 2012

Tuesday, October 30th, 2012

Children anxiously await the end of October, waiting for Halloween to come. This year, with the unpredictable weather we’ve had over the past few days, everyone, should take some extra precautions when trick or treating and if driving in residential areas during the peak of trick or treating.

Regardless of the weather, there are certain safety recommendations that should not go ignored when it comes to ensuring the safety of trick or treators.

Safety Tips for Trick or Treating:

1. Make yourself seen: Costumes should be light coloured or have reflective strips so that children are seen more easily at night (put reflective strips on accessories too).

2. Be careful of costume length – make sure costumes aren’t dragging so that children don’t trip over their costumes.

3. Use face pain rather than masks or something that covers the eyes – keep childrens’ line of sight clear.

4. Travel in Groups. Young children should be accompanied by an adult.

5. Cross safely, walk safely: Remind children to walk on sidewalks on not on the streets, and to cross at intersections or crosswalks. Remind them to look both ways before crossing the street and to check for cars.

6. Stay in well-lit areas: Visit homes that have the porch light on, or other lights on. Carry a flashlight or make sure your child is carrying a flashlight.

7. Tell your trick or treator to stay away from candles and open flames.

8. Teach your children to only accept treats at the door, not to get into cars with strangers, or enter anyone’s house that they don’t know.

 

Drivers, too have to take extra care and be extra vigilant.

Safety Tips for Drivers:

1.  Watch out for children and other pedestrians crossing the street in residential areas- they may not be crossing at intersections.

2. Expect large groups of people to be crossing; be patient and let them finish crossing.

3. Be aware of increased pedestrian traffic.

4. Look out for signs of moving objects like debris, or it could be people in dark costumes.

5. Drive slowly, don’t be in a hurry.

 

Aaron Waxman & Associates is a personal injury law firm in Toronto handling various types of personal injury claims. We offer a free no obligation consultation.

Pastore v. Aviva Canada Inc. – Definition of Catastrophic Impairment broadens, victory for the plaintiff’s bar

Thursday, October 11th, 2012

The Ontario Court of Appeal finally released its decision in Pastore v. Aviva Canada Inc. It’s been referred to as a “landmark decision on chronic pain”.

The OCA ruled that chronic pain is a psychological condition that can produce a catastrophic impairment, thereby entitling accident victims to enhanced medical benefits.

The unanimous decision of the Court means will allow claimants with severe psychological impairments to access much-needed benefits beyond standard accident benefits.

The Court of Appeal overturned the lower court’s decision that would have denied the plaintiff, Anna Pastore access to extended benefits.

Pastore v. Aviva concerns a woman who was struck as a pedestrian in November 2002 and injured and broke her left ankle, which never healed properly, leading to numerous surgeries and an eventual knee replacement.

Prior to the accident, she was the primary caregiver to her husband of over 35 years, who was receiving chemo-dialysis.  The decision states that she is almost completely dependent on others for her most basis personal care needs.

Pastore applied for catastrophic determination in May 2005.

Pastore was assessed by a team of medical assessors to determine if she was catastrophically impaired. It was found that she had catastrophic impairment due to mental or behavioural disorder. She had class 4 or ‘marked impairment’ in terms of her activities of daily living and assigned her a class 3 (moderate impairment) with respect to social functioning, concentration, persistence and pace and deterioration or decompensation in work or work-like settings.

Aviva did not accept the findings of the assessment centre and this led to mediation and arbitration.

One major issue was whether marked impairment in one category was enough to lead to a catastrophic designation.

The arbitrator and the Director’s Delegate upheld the decision of the assessment centre and found that Pastore was catastrophically impaired. Aviva appealed this decision and the Divisional Court sided with Aviva, stating that the Guides portion of the Statutory Accident Benefits Schedule (SABS)  requires all four categories to be considered as marked impairments in order for a person to be deemed as catastrophically impaired.

The Ontario Court of Appeal disagreed and overturned the Divisional Court’s decision, siding with the original decision, stating that the American Medical Association’s Guides to the Evaluation of Permanent Impairment language did not specifically require all four categories to be considered marked impairments for a catastrophic impairment designation.

The role of pain was addressed within the context of the marked impairment test. The OCA concluded that a cumulative approach should be taken where it is not possible to factor out the impact of discrete physical impairment and associated pain limitations.

What the court is saying, is that pain can be considered within the marked test in cases where the pain is not cleared related to physical causes, but may be related to a mental disorder.

Aaron Waxman & Associates is a Toronto Personal Injury Law Firm that handles personal injury claims, including catastrophic cases.

Ontario Coroner’s Report on Pedestrian Deaths: No Jaywalking and Reduce Speed Limits

Thursday, September 20th, 2012

Ontario’s Deputy Chief Coroner, Dr. Bert Lauwers issued his report on pedestrian deaths on Wednesday, September 19, 2012, in collaboration with the Office of the Coroner.

The Report reminds us that we are all pedestrians.

According to the Coroner’s office, approximately 113 Ontarians die annually from pedestrian accidents.

The Coroner’s office suggested the following:

  1. Pedestrian deaths are more likely to occur during the months when daylight is shorter. (e.g. November to March).
  2. Pedestrian deaths are more likely to occur when a pedestrian and/or driver is using a mobile entertainment/communication device. (e.g. cell phone, ipod, etc.).
  3. Pedestrian deaths are more likely to occur when one or more persons involved in the collision are under the influence of alcohol and/or drugs.
  4. The vast majority of pedestrian deaths are preventable.

According to the Review on Pedestrian Deaths, in Canada, characteristics of pedestrian traffic are as follows:

  • 75% of pedestrian traffic fatalities occurred on urban roads;
  • 60% of pedestrians killed in traffic crashes were trying to cross the road;
  • 35% of fatally injured pedestrians were aged 65 or older even though they represent only 13% of the population;
  • 63% of pedestrians killed at intersections were 65 or older;
  • 6% of fatally injured pedestrians were under the age of 16 and of these, 20% ran out into the street;
  • 33% of fatally injured pedestrians acted in a manner which caused or contributed to the crash;
  • 33% of fatally injured pedestrians were struck by a driver who had committed a traffic infraction prior to the crash;
  • 60% of pedestrians were killed at night or during dim light conditions when they were not seen by drivers; and
  • 40% of fatally injured pedestrians had been drinking

The Coroner’s Office made 26 recommendations in the Report. Highlights of the recommendations include:

  • lowering speed limits in residential areas to 40 km/h
  • installing side guards on heavy trucks to help prevent people from falling beneath and getting crushed by the rear wheels
  • implementing a complete streets approach to guide the development of new communities and redevelopment of existing ones
  • creating an educational program for senior citizens and other adult pedestrians
  • creating an educational program for drivers

The Coroner found that 67% of pedestrian fatalities occurred on streets with a posted speed limit of above 50km/h.

Other significant factors for pedestrian deaths included jaywalking, inattentive motorists and distracted walkers.

It was found that nearly one third of pedestrians died while jaywalking.

The Report notes that in 14% of the deaths, driver inattention was noted.

Pedestrian distractions including dogs, smartphones and cellphones may have contributed to 20% of the fatalities.

Canada has a Road Safety Strategy according to the Report. The vision of the Strategy is to make Canada’s roads the safest in the world. Currently, Canada is ranked 10th in terms of fatalities per billion vehicle kilometers travelled compared to other member countries of the Organization for Economic Cooperation and Development.

The key elements of the Strategy are:

  • a downward directional trend in fatality and serious injury rates over the 2011 to 2015 period;
  • jurisdictions will adopt a holistic (Safer System) approach addressing the vehicle, the road infrastructure, and road users based on the primary risk groups;
  • an evidence-based Best Practice Framework will be adopted in choosing interventions;
  • a fluid and flexible approach will allow jurisdictions to adopt best practices appropriate to their situation; and
  • jurisdictions will own their road safety plans.

To achieve this, the Strategy seeks to target:

  • young drivers (16 to 24);
  • medically-at-risk drivers (e.g. those with heart disease or cognitive disorders such as Alzheimer’s Disease);
  • vulnerable road users (i.e. pedestrians, motorcyclists, bicyclists);
  • motor carriers (e.g. managers of carrier operations, truck and bus drivers);
  • high risk drivers (e.g. those who don’t wear seat belts or who speed, drive impaired, or drive without a valid license) and the general population.

Dr. Andrew McCallum, Chief Coroner for Ontario stated “A road safety paradigm shift will be necessary”, acknowledging that the rising cost of fuel will result in an increase in cyclists and pedestrians.

 

Aaron Waxman and Associates is a Toronto personal injury law firm. We handle various types of personal injury claims including motor vehicle accident, pedestrian, long term disability and critical illness claims.

Slip and Fall outside of Car not an accident according to FSCO- Reversal of controversal slip and fall case

Tuesday, September 18th, 2012

Webb and Wawanesa involves the case of a woman, Daphna Webb who slipped on ice outside of her car. She parked her vehicle in a residential neighbourhood, near a snow bank where access points had been cleared. When she exited her vehicle, and walked around the front of her car, she fell backwards and broke 4 bones in her foot.

A May 2011 decision from Arbitrator Joyce Miller found that Webb was still in the process of exiting her vehicle when she fell, therefore the incident constituted an “accident” under the Statutory Accident Benefits Schedule (SABS).

The SABS defines “accident” is defined in section 2 of SABS as: “An incident in which the use or operation of an automobile directly causes an impairment or directly causes damage to any prescription eyewear, denture, hearing aid, prosthesis or other medical or dental device.”

Arbitrator Miller found that that the use of a motor vehicle caused an uninterrupted chain of events ending in Webb’s injuries.

Wawanesa appealed the decision, stating that the use or operation of an automobile did not cause Webb’s injuries.

The July 18, 2012 decision of Director Delegate Lawrence Blackman rescinded the decision of Arbitrator Miller and found in favour of Wawanesa, holding that the chain of causation was broken. There was an independent source, the ice and snow at a pedestrian access point resulting from the weather conditions.

Director Delegate concluded that Webb’s injury falls outside of the scope of the applicable definition of accident.

Aaron Waxman and Associates is a Toronto Personal Injury Law Firm. We handle disability claims, automobile accident claims, long-term disability claims and other types of personal injury claims.