A little-known device invented by a New Mexico man is helping those with brain injuries reclaim their lives

Retired Army Col. Ramon Sanchez has developed a strut.

The 63-year-old from Santa Fe demonstrated his new, more confident gait recently in an office in Albuquerque, where he is getting treatment for a brain injury he suffered following a stroke in 2003. The former mariachi trumpet player walked while holding his hands out to the side. With a smile, he said, “It never used to be like this.”

Only a few months ago, walking was difficult for Sanchez. He had a limp and sometimes lost his balance. He experienced a burning sensation on half of his body that was so painful he sometimes didn’t feel like getting out of bed. Memory loss, fatigue and depression plagued him.

Sanchez went to see several different neurologists, was prescribed a “bazillion” medications and did hundreds of hours of physical therapy. Doctors said his prognosis was bleak.

“I was told by a neurologist to get my paperwork ready. I said, what do you mean paperwork? Am I going to die soon? That didn’t sit too well with me,” Sanchez recalled recently.

A few months ago, Sanchez said he began using a device developed by Diego Guillén, a former computer installer from Alcalde. “Now I am doing everything I was told I wasn’t going to be able to do,” he said.

The Automated Pegboard 2000, a machine that resembles a child’s geometric puzzle, helps brain-injury patients rebuild motor functions. Sanchez’s son-in-law convinced the skeptical colonel to try it after a chance meeting with the inventor several months ago.

Traumatic brain injuries

About 5.3 million Americans are disabled because of a brain injury, according to the U.S. Centers for Disease Control and Prevention.

And thousands of soldiers and Marines returning from Iraq and Afghanistan are seeking treatment for traumatic brain injury ranging from mild to severe. Speedy and more sophisticated medical care for service members injured by improvised explosive devices and other blasts has improved survival rates from head injuries, but pressure is growing on veterans health care facilities to care for them.

The government does not release statistics on the number of brain injuries among returning service members, citing national security. But more than 12,000 men and women who fought in Operation Iraqi Freedom and Operation Enduring Freedom are estimated to have sustained such injuries, according to the Brain Injury Association of America. The Defense and Veterans Brain Injury Center says as many as 20 percent of military personnel have brain injuries.

No statistics are available for how many of them are from New Mexico.

Treating traumatic brain injury, often described as the signature injury of the war in Iraq, is a growing concern for veterans health care organizations.

Many vets from New Mexico, which doesn’t have a brain-injury rehabilitation center, receive care at the Department of Veterans Affairs in Albuquerque. Options there include speech therapy, neuropsychology, physical therapy, drug treatments, psychiatry and occupational therapy.

The protocols don’t currently include the APB 2000, and there is little scientific validation of the device. But in an article published in the Journal of Applied Research in 2003, researchers at Loma Linda University in California who tested the pegboard concluded it “appears to be a highly reliable tool.”

Guillén said he is trying to get one of the machines to Baltimore to be used by a neurologist who treated actor Christopher Reeve, who died in 2004, years after he was paralyzed in a horse-riding incident.

Guillén is also hoping to get funding from the Legislature and said the governor has promised to help him with a pilot project.

Brain-injury experts in the state said they don’t feel comfortable talking about the APB 2000 because they have never seen it in action. But Sanchez said, “I think this has the potential to help a lot of our returning veterans.”

A summit is scheduled for August in Santa Fe to identify and discuss gaps in services to brain-injured veterans coming home to New Mexico. Guillén hopes to attend to talk about the pegboard. Advocates also will be talking about veterans legislative priorities for the 2008 session.

Objective learning

Guillén’s pegboard works by giving the patient a set of instructions to move shapes across a puzzle board and fit them into specified spots. A computer monitors the time it takes for the patient to process the instructions and then execute them.

“At first I watched the DVD and said, ‘That’s just a pegboard! My grandkids could do it.’ Then I watched it again and said, ‘What the heck. I guess it’s worth a try,” Sanchez said. The machine converted him to a believer after one session. Since using it, he said, the burning sensation on his face has lessened, although he is still unable to work.

According to Guillén, the pegboard works because it forces patients to use their mind and body simultaneously, which is how all people learn motor functions as children. It gives patients objective, mathematical information so they can see their time improvements, he said.

“The mind is capable of doing miracles, but it has to have objective information, not someone’s opinion that you are getting better,” he said. “We show them mathematical proof that they are getting better.”

Traumatic brain injury is caused by an external blow to the head that is severe enough to move the brain around inside the skull. Often it leaves no visible scars, but sufferers can experience a loss of memory and motor function, pain such as headaches or a stinging sensation, numbness and unpredictable mood swings, among other symptoms.

These tend to be unique to each person, said Elisabeth Peterson, the director of New Mexico’s Brain Injury Advisory Council. “Because you can’t see it, it’s hard for people to grasp what it is,” Peterson said. “With a broken leg, you see someone walking down the street with crutches. People say, ‘Oh!’ and they open a door for the person. With a brain injury, you can’t see it.”

Guillén is not a neurologist, although he has personal experience with brain injury because his mother, Esperanza Guillén, had a brain tumor. He said he was motivated to create something new to treat brain injury after watching her struggle with several different forms of treatment, none of which seemed to help significantly. Several years ago, he went back to school at ITT Technical Institute, where he earned associate’s degrees in engineering and business and now works promoting the APB 2000.

“The hang-up people have is that I’m not a doctor,” he said. “I say, let’s put the title aside and look at the results. To us, simplicity is the key.”

So far, Guillén has only treated only a handful of patients. Besides Sanchez, he also has had success with Bruce Bayless, a Vietnam veteran who lives in Albuquerque. Bayless suffered a severe brain injury in a car accident more than 20 years ago. He tried several different treatments and hundreds of drug combinations. Still, he couldn’t walk long distances, he slept badly and he couldn’t concentrate. Bayless spent most of his days inside his house, venturing out only when it was absolutely necessary.

After eight sessions on the pegboard, Bayless said he began to sleep better and even started remembering his dreams. He now makes lists of the tasks he wants to complete each day. On a list he carried with him earlier this month, Bayless had written, “Walmart, keys, milk, light bulbs, shower rod.” Each item was checked off. “That’s something I would have done in a month before,” he said.

“I am really thankful to be getting this,” Bayless said. “I wish I would have gotten it right after my accident because it is changing my life.”

Contact Natalie Storey at 986-3026 or nstorey@sfnewmexican.com.

What is a concussion?

A concussion is an injury to the brain that results in temporary loss of normal brain function. It is usually caused by a blow to the head. Cuts or bruises might be present on the head or face, but in many cases there are no signs of trauma. Many people assume concussions involve a loss of consciousness, but that is not true. In most cases, a person with a concussion never loses consciousness.

Source: American Association of Neurological Surgeons.

By the numbers

►12,274
Number of service members who have sustained a traumatic brain injuries in Iraq and Afghanistan as of March 24, 2007

►2,726
Number of severe brain injuries sustained by men and women who have served in Iraq and Afghanistan

►22
Percent of returning service personnel with some form of brain injuries

►83
Percent of wounded Marines and sailors with brain injury in a screening at National Naval Medical Center that began in August

►1.4 million
Number of people in the U.S. who sustain brain injuries annually

Sources: Brain Injury Association of America; March 2007 letter to the House Appropriations Committee from the Congressional Brain Injury Task Force; final report of the President’s Commission on Care for America’s Returning Wounded Warriors issued Wednesday.