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Always believe in the dream 

After brain injury forced Sean Dolan to give up the teaching job he had always wanted only weeks after it began, he resolved he would never give up on his ambition. Ten years later, he has returned to his role as a teacher and is preparing to mark the anniversary of that life- changing moment with an extreme fitness challenge to raise money for the hospital that saved his life. NR Times speaks to the inspirational survivor, who discusses his journey, the impact of exercise, and why he struggles to acknowledge his recovery is ‘a big deal’

On October 25, 2013, Sean Dolan’s life changed forever.

A newly-qualified teacher, having just completed his first half term in his new role, he was playing indoor five-a-side football when he fell into a wall.

From playing football with friends as he had done countless times before, he was left unconscious, with a fractured skull and bleed on the brain.

Sean was rushed to James Cook University Hospital on Teesside, placed in an induced coma and forced to undergo a craniectomy.

One minute a 25-year-old man in the prime of his life, pursuing his dream career, and the next fighting for survival and facing a recovery where his parents were warned would probably see him lose the use of his left side, and he may not regain full independence.

But from that utter devastation for him and his family has come a recovery his consultant at James Cook has described as a “miracle”.

Ten years on, Sean is a teacher at a Teesside primary school, having resumed the career he loved and always aspired to, through a sheer determination to never give up on his dream.

And having become a prolific fundraiser for the intensive care and specialist neuro wards at James Cook - which he credits with saving and rebuilding his life - Sean is now about to embark on his toughest challenge yet.

From the anniversary and for the following ten days, he will complete his Ten for Ten challenge - a series of gruelling physical challenges, from a marathon to a ten-hour football match, all of which have deep personal meaning attached to them.

“Exercise has been really important for my recovery, for both my mental and physical health, and now it has given me a way of raising money for the hospital that enabled me to rebuild my life,” says Sean, from Billingham.

"There has been a lot of proving myself worthy on this journey, both to myself and to the people who have helped me in my recovery - so fundraising gives me a way to give back, and show what I can do.”

The journey back into teaching For Sean, being a teacher was his dream. Having graduated from Durham University, he secured a job at a primary school in his native Teesside.

After an enjoyable first half term made him realise this was the career for him, everything changed in an instant during a game of five-a-side.

Having been in a coma, and needing part of his skull replaced with a titanium plate, Sean spent 59 days in hospital in total - but while his recovery was only just beginning, he was desperate to defy the odds and return to the classroom.

“In hospital, I was told that I may need to prepare for life where I might not work again,” recalls Sean. “And that was a really bad time. In my head, I was only prepared to accept that I had recovered successfully when I was teaching again. I had to go back to it.

“But, as with recovery from brain injury in general, it has been a journey. It’s been very much backwards and forwards. It has been a big learning experience.

“When I did feel ready to go back into school, I had to spend time as a teaching assistant, doing staggered periods of work. When I was cleared to go back into teaching, I took the first job possible, and it was too soon.

“Then you have to take a step back - and you feel everything is going backwards. It has been a journey with some difficult times along the way.”

However, having taken the step back he needed, Sean found himself ready to move forwards again - and took a role with his current school, where he has been for three years.

“It took me six years to find the right school, but it’s all going well so far and I’m happy here,” he says.

“Things aren’t always as straightforward and as you’d hoped they would be. But you have to keep going, and you can get there.”

As well as returning to the career he loved and everything he had worked so hard for, Sean also sees his resumption of teaching as a debt of gratitude to those who saved his life and have supported him since.

“I felt almost like I owed it to the people who saved me to get a life that was worth of the recovery I’d made, of the recovery they had helped me with,” says Sean.

“There has been a lot of proving along the way, and a lot of proving that I’m worthy. I have suffered a lot with imposter syndrome over the years, and survivor guilt too. A lot of my fundraising is about proving myself worthy of my recovery, as well as the fact I am teaching again.

“But although I am teaching, I’m still not sure I can ever fully accept what happened. There are peaks and troughs. I look at the friends I had at the time of the accident, and where they are now compared to me. I do feel I have fallen behind everyone else.”

Sean has now reached a point where he is comfortable in discussing his story, and in sharing it for the good of others - although he can never see a time where he is able to be seen as an ‘inspiration’.

“I have been through times where I hated talking about what happened, but now I’m quite happy to share it, as hopefully it can be a positive for somebody else - but I’ll never volunteer myself to do that,” he says.

“I don’t really view it as a big deal. I think that if I got through it, then most people could have done the same. It’s probably a defence mechanism, but I really struggle to take any compliments of any form. I don’t see what I have done as being anything different to what anyone else could have done.

“I do tend to play it down, but if it helps someone else, then I’m happy to discuss it.

“I’m from a small community where everyone knows everyone else, which does bring its own problems because everyone knows what has happened to you already. But I have been lucky with the support I’ve had, particularly around the fundraising and people wanting to help with that.

“When I’ve done fundraising events in the past, like a 24-hour football match I organised, there were probably 80 people taking part in that. I’ve got people from the community joining me in some of my latest challenges.

“It does show that support is there, and that’s great to know.” 

Giving back and proving what’s possible - the Ten for Ten challenge Having organised four anniversary fundraising events in the ten years since his accident, and taken part in many more initiatives to raise money for South Tees Hospitals Charity - collectively raising well in excess of £10,000 - Sean’s Ten for Ten fundraiser is a hugely ambitious ten-day physical challenge to celebrate his recovery.

All ten challenges, to be completed over ten consecutive days from October 25, have personal meanings to Sean.

From the marathon - which covers the route the ambulance took from the site of the accident, to North Tees and then James Cook hospitals - to the 59k cycling challenge, which will take place ten years to the day of his injury in James Cook hospital where fought for life, to two football matches to bring in his love of the game he was injured playing, everything is tailored specifically around the milestone anniversary.

As the date falls within term time - often the half term holiday has begun by October 25, as it had in 2013 - children from Sean’s class and others within the school are being sponsored to take part in a Joe Wicks-a-thon. Other local schools are also set to join in.

While delivering an ideal fundraising opportunity, the physical activity has been chosen to mark its significance in Sean’s ongoing recovery.

“Pre-accident I was always sporty, but I’ve never been in the shape I’m in now. It has been a journey, which has probably been as important for my mental health as for my physical health,” says Sean.

“I was in hospital for 59 days and I lost muscle through being bedbound. Then I went home and adopted the approach of ‘Well, I did nearly die, so I will have that takeaway, I will have that chocolate bar’. But then I ballooned.

“Exercise has been really important. The fundraising has been great, but when I entered my first Olympic length triathlon a year after the accident, it was probably as much to show that I could do it, having been warned a year earlier that I might lose the use of my left side.

“That first triathlon was my way of proving that I could do it. And from there I started doing the Great North Run, which I’ve done every year since. It’s about showing what I can do, and knowing that I can do it. Exercise is something you can measure, and I like seeing improvement.”

One of the sponsors of his ten for ten fundraiser is Tees Neuro Physiotherapy, a specialist neurophysio which supports patients in their recoveries across the North East, Teesside and North Yorkshire regions, combining expertise with the latest in technology and robotic equipment to deliver life-changing progress.

Coincidentally, Sean’s physiotherapist from neuro Ward 26 at James Cook, Rahilla Pearson, now works at Tees Neuro Physiotherapy, giving a connection he never expected to find - and making the neurophysio practice an ideal partner for his challenge. Rahilla will join Sean on the 10k leg of his triathlon, and physio Rosie Warnett is planning to join the marathon.

“It’s fantastic I have met one of the people who taught me to walk again, and it comes back to that proving myself worthy of recovery and thanking those who helped me in that,” says Sean.

“I remember being told off when I was in hospital by my physios for trying to be too active - I’ve always wanted to get back to a point where I was doing the things I wanted to, and now I feel I am there. Their support in those early days has enabled me to get here.”

Victoria MacGregor, clinical director of Tees Neuro Physiotherapy, says: “Sean is so inspirational and shows what can be achieved, even when at times the outlook can seem really difficult. Returning to his job as a primary school teacher is such a massive achievement, and this Ten for Ten challenge is incredible.

“He has raised so much money over the years for James Cook, and this latest challenge is really taking that to the next level. It has taken so much organising and all of the events have such a personal reason behind them, and we are so pleased to be able to support him. “Sean is an example to our clients here, and to other brain injury survivors, of what can be possible. With the right rehab and the commitment to overcome the obstacles, it just shows what can be done.”

To support Sean’s Ten for Ten challenge, click here.

‘Give adaptive athletes a level playing field’

A former soldier who has become a world-leading adaptive athlete after being paralysed during a charity bike ride has called for greater fairness and transparency in adaptive sport, after a rule change in a recent tournament saw him robbed of first place.

Tom Green won his category in the recent Wodcelona event, which attracts adaptive athletes from around the world, and follows his fourth-place finish in last year’s WheelWod Games - hailed as the pinnacle event globally for adaptive fitness.

But although Tom won his Seated 2 Male category - a category medics argue he should not be in, due to his lack of hip function - low numbers in the equivalent female category meant the male and female results were combined.

That meant Tom - a former physical training instructor (PTI) in the Royal Regiment of Fusiliers - was awarded a second-place finish, and one of his fellow competitors, who finished third in the male category, was no longer entitled to a podium finish.

In protest, Tom handed back his medal to Wodcelona organisers. While they have since assured him they have learnt from this situation, Tom believes that it must be seen to be an open and fair competition to encourage others into adaptive fitness.

“Adaptive sport is a growing area and I really want to see more people compete - but I don’t think things like this will inspire them at all,” says Tom, who was paralysed from the waist down after being hit from behind by a truck during a 100-mile charity cycle ride.

“I was in first place at Wodcelona and was watching the leaderboard all weekend, and I finished in first place. But because there were only two competitors in the Seated 2 Female category, they decided to join it together with the male category.

“Clearly, a female will have less points as they have different workouts and theirs is a totally different category - and then the results have a knock-on effect for everyone in the male category. Not just for me, but for my fellow competitor who finished third, but then was told he no longer had a podium finish.

“They deserve their recognition; they have earned it. I handed back my medal for that reason, because they have worked hard for this, and it has been taken away.

“Another competitor in my category is someone I train, and he has come on so much. He just missed out on a podium in the end - but for someone like him, who is so close to getting a top three place, rule changes like what happened at Wodcelona are not going to motivate him at all.

“If they are low on numbers, it would make more sense to combine the female Seated 1 and Seated 2 categories, rather than combine it with the male category.

“They should be kept completely separate.”

Tom, who has been supported by Breakthrough Case Management since his spinal cord injury in summer 2020, was told he would never be able to walk again - but has continued to surpass all expectations, with his rehab team continually amazed at the progress he is making.

“What happened with the placings at Wodcelona was clearly unfair,” says Annabelle Lofthouse, Tom’s case manager at Breakthrough.

“However, I was unsurprised by Tom’s decision to hand back his medal. As well as being a completely dedicated athlete, Tom is an incredibly principled man, and this is just so characteristic of him. He really is raising the profile of adaptive fitness in every way he can.”

His venture into adaptive sport has been hailed as “superhuman”, and Tom now has his sights set on the CrossFit Games 2024 in Texas, which combine both mainstream and adaptive competitions to name the world’s top athletes in their respective fields.

“Next year, they’ve promised to try and get all the adaptive categories into the Games, so my focus has shifted to that. I’m not going to compete in anything else this year, I’m concentrating on the qualifying rounds and then hopefully the actual Games,” he says.

“That is the biggest challenge there is, it’s the Mecca for me as an adaptive athlete, so that’s what my sights are set on.”

Meet the MS game-changers

NR Times reports on seven innovative projects changing the outlook for multiple sclerosis.

MS is a complex and unpredictable autoimmune disease of the central nervous system, affecting millions of people worldwide.

The condition was previously deemed untreatable but over the last 20 years huge strides have been made in understanding MS, its causes and potential treatments.

In recent months, ongoing efforts continue to deepen our comprehension of the condition, from EBV vaccine breakthroughs to the discovery of genetic variants responsible for speeding up MS progression.

Unlocking the genetic clue to faster MS progression

Researchers have discovered a genetic variant that hastens the progression of MS, offering fresh insights into the debilitating condition.

This study, encompassing over 22,000 people living with MS, has identified a genetic variation nestled between two genes typically active within the brain and spinal cord. One of these genes plays a pivotal role in repairing damaged cells, while the other is crucial in controlling viral infections.

Published in Nature in late June, the research was the outcome of a vast international collaboration involving over 70 institutions worldwide, spearheaded by researchers from UCSF and the University of Cambridge.

Dr. Sergio Baranzini, a neurology professor at UCSF and co-senior author of the study, notes that inheriting this genetic variant from both parents accelerates the need for a walking aid by nearly four years.

The study amalgamates data from over 12,000 MS patients in a genome-wide association study, pinpointing a genetic variant associated with an expedited disease progression.

Given its proximity to genes involved in nervous system repair and viral infection control, it underscores the pivotal connection between the nervous system and MS progression.

Vaccine breakthrough could protect against EBV virus

Researchers at QIMR Berghofer have developed an innovative vaccine candidate that shows potent and enduring immune protection against Epstein–Barr virus (EBV) in pre-clinical models.

EBV, part of the herpes virus family, is linked to diseases like multiple sclerosis (MS) and various cancers. This vaccine approach targets EBV during both acute and latent infections, potentially complementing ATA188, an advanced Phase 2 clinical therapy for MS.

The study's findings indicate the vaccine's potential to provide long-term EBV protection, which could be a crucial step in preventing MS and other EBV-related diseases.

Further work in EBV and MS

Meanwhile, an EU-funded research project is set to uncover the role of the Epstein-Barr virus MS development and progression.

Led by Professor Kjell-Morten Myhr and Professor Øivind Torkildsen, the team aims to understand why only a minority of EBV-infected individuals develop MS and to define the underlying mechanisms.

They will also explore the potential of antiviral treatments to improve MS outcomes and potentially halt disease progression, with the ultimate goal of developing preventive strategies like vaccination.

The project involves clinical trials, blood and saliva sample analysis, and registry-based research, drawing on a multidisciplinary team of experts. It holds the potential to advance MS treatments, identify high-risk individuals, and provide mechanistic evidence for EBV's role in MS development.

EBV infection significantly increases the MS risk, and this research offers hope for a better understanding and potential prevention of the disease.

Bringing AI into the treatment journey

Another EU initiative, Clinical Impact Through AI-assisted MS Care (CLAIMS), is set to receive nearly €10 million to develop an artificial intelligence (AI)-based platform for predicting the course of multiple sclerosis (MS) in individual patients.

The project will offer a holistic overview of MS patients, from diagnosis to treatment recommendations.

By leveraging diverse patient data, including test results and other health information, the platform will predict how a patient's MS might progress with different treatments.

The initiative aims to personalise MS treatment by developing predictive models and involving patients in their care. CLAIMS will utilise algorithms trained on clinical data, including MRI scans and blood tests, and plans to factor in comorbidities and patient-reported data.

Ultimately, the project seeks to improve the quality of life and prognosis for people with MS.

Reversing autoimmune diseases with groundbreaking "inverse vaccine"

Researchers at the University of Chicago's Pritzker School of Molecular Engineering have developed a groundbreaking "inverse vaccine" that could potentially reverse autoimmune diseases such as MS and type 1 diabetes.

Unlike traditional vaccines, this novel approach erases the immune system's memory of specific molecules instead of teaching it to attack them.

By mimicking the liver's natural process of marking molecules with "do not attack" flags, the vaccine prevents autoimmune reactions to cells that die naturally.

This innovative method successfully halted autoimmune reactions in a multiple-sclerosis-like disease in animal models. Phase I trials are already underway for multiple sclerosis.

Motion Detection Tool Boosts Progressive MS Research

Clinicians and researchers at Leeds Teaching Hospitals NHS Trust have developed an innovative motion detection tool to advance treatments for progressive MS and other neurodegenerative diseases.

In collaboration with the University of Leeds, the tool employs 3D motion technology to monitor upper limb function in patients as they interact with objects.

An evaluation led by Linford Fernandes, a clinical research fellow at Leeds Teaching Hospitals NHS Trust, demonstrated the tool's ability to detect dysfunction progression earlier than current clinical methods.

The tool offers applications in research trials and clinical settings, providing insights into arm function for rehabilitation and benefiting various neurodegenerative conditions like motor neurone disease and Parkinson's.

It will be utilised in the Octopus trial, aimed at expediting the testing of new progressive MS treatments.

The new world of cerebral organoids

A relatively recent development in the field, cerebral organoids have redefined MS research.

Dr. Nicolas Daviaud from the Tisch Multiple Sclerosis Research Center in New York is at the forefront of this work.

By crafting cerebral organoids from patient cells, researchers can delve into patient-specific genetics.

These organoids mirror early human brain development, enabling the exploration of genetic factors in MS onset, including interactions with environmental triggers like viral infections, promising new therapeutic avenues.

Cerebral organoids offer a superior representation of the human brain compared to traditional cultures.

They house various organ-specific cell types, mimicking the brain's structure and function. This makes them invaluable for studying MS and other neurological disorders.

Despite challenges like variability and the absence of immune cells, organoid research is progressing rapidly.

Over the last decade, organoid applications have expanded to various organs and even transplantation experiments, offering exciting possibilities for biomedical research and personalised treatments.

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On the trail of rehab funding foes and threats

Financial compensation is intended to help brain injury survivors manage their condition for the rest of their lives. But what happens when the money is lost through mismanagement, fraud or exploitation?

NR Times spoke to Liesel Annible - a forensic director at accountancy, financial and business advisory firm Armstrong Watson, to find out more about the financial investigation process.

Tell us a bit about your role and where it fits in the brain injury rehab journey.

I deal with cases where an individual is given a large amount of money as part of a settlement.

We regularly see situations where the family has submitted the account and somebody at the Court of Protection has said, hang on a minute, these accounts aren't right, so a new deputy is appointed.

We get brought in to look at where that money has gone.

How does the process work?

We’ll usually start by looking through bank transactions and asking questions about things that don’t look right.

Why is there a bill for a Porsche when the child with the injury wouldn’t even be able to get in such a car? Or why is it necessary to pay for the whole family to go to Disneyland?

Often, a large settlement can be like Christmas for families. There’s all this temptation.

Or it could be that there’s no money left to fund the recipient’s care because it’s all been spent.

Is the legal framework adequate for dealing with this misuse of funds?

Nine times out of 10, if you've got a professional deputy in place, you’re fine because they know what they’re doing and they’re regulated. The problems often start with the families.

We dealt with one family with three children and one was severely disabled.

The family argued that because they spent a lot of time looking after the disabled child at the expense of the other two, they had the right to take them to Disneyland.

So they paid for the trip with the disabled child’s funds.

While I can understand the rationale, that’s just not acceptable.

They were given the funds to look after their disabled child’s needs, pay for medical expenses and the likes of adaptations to the home.

We also often have cases where children live a lot longer than expected due to developments in medical care.

In one case, a young girl who wasn’t expected to live beyond her teens was in her mid-20s and the money was starting to run out.

The Deputy believed some of the money may not have been spent properly.

Our investigation indicated that there had perhaps been some unwise spending, but it wasn’t anything that could be claimed on insurance or recovered from the family.

But the solicitors I was working with managed to handle the money in such a way that she was going to get care.

In that instance, it was also agreed that she could have a better and more independent life living in sheltered housing with some assistance.

What are some other examples?

There are many things that people can justify in their own minds. That's when you get the grey areas.

We had one case where the family had a child who needed rehabilitation and a lot of exercise equipment.

They built a swimming pool in the garden, which was approved of and agreed.

But then when somebody visited the house, they found the pool neglected and full of leaves.

They’d spent all that money but it was a total waste. She was also supposed to be taken to the local pool, but that wasn’t happening either.

When you find that this misuse has happened, how soon can you address it? And how do you work with other professionals in the sector?

I'm often brought in by solicitors to help them investigate.

I also do a lot of work with the police. Not just on this, but all sorts of criminal matters, from murder to drug trafficking to money laundering.

Are there any changes that you’d like to see to make this process more efficient?

I'm working with the police on a case where an individual sustained a serious head injury from a car crash. He was awarded a sum of money and half of it was spent on buying a house.

The other half was there to provide his care for the rest of his life but he had control of the funds.

Unfortunately for him, two individuals moved into the house and it is alleged they have spent all his money.

That’s taken a considerable amount of time to get to the point where a full financial investigation is being undertaken.

At the moment, it can take three or four years to get to that point.

Even then there is no certainty that we can prove who has utilised the funds or that the Crown Prosecution Service will take the case forward for prosecution.

In my opinion there needs to be more financial protection for vulnerable individuals and reports of suspicious activity need to be acted on more quickly by the police.

What technologies do you use to improve efficiency in the work that you do?

We use specialist bank statement-scanning software that puts statements into Excel and allows us to analyse them.

But a lot of what we do is still quite manual, actually looking at items of expenditure, assessing whether they are reasonable and seeing where the money has gone.

What are some of the common scenarios that you come across? People often mention cases of funds being wasted on expensive cars. Do you see that a lot?

Unfortunately, I’ve dealt with quite a few cases where the person who has been looking after the money has decided they want a nice new car.

And then there’s a situation where third parties take advantage.

Quite often, the person with a brain injury doesn’t see the risks and ends up throwing around money to get friends: buying people gifts and drinks and so on.

Then someone latches onto them because they see the opportunity to take advantage.

In years gone by, neighbours might have intervened, but we’ve lost a lot of that community spirit.

People are living quite lonely lives on their own and they become victims.

Do you find that the funds sometimes go missing due to cybercrime?

Not so much cybercrime because that’s usually easy to see and can be dealt with by the police on their own.

We see more cases of individuals moving into the person’s house or persuading them to buy a car or other items for them.

This is clear to see in bank account statements.

The first thing we ask is, has the individual got a car that someone drives for them?

If not, why are there car parts on the statement? If the individual is not allowed to drive, who’s driving a car that these parts have gone to?

It can be really difficult, because how do we know they aren’t paying for their mum, for example?

The same goes for petrol costs. There are a lot of grey areas when it’s an adult.

It could be that the person is spending this money for their own benefit.

But when you have lots of cash withdrawals or money going backward and forward to different people’s accounts, it looks like a scam.

How do you stop inappropriate people being deputised?

If a child is born and there’s a settlement from medical negligence, the parents are often appointed to look after the money right from the start.

But in some cases, they’ll ask for professional deputies to be put in place or the Court of Protection will step in.

A professional deputy is often a solicitor or an accountant.

Every year, they have to draft a report for the Court of Protection detailing how the money has been spent.

When you look at some of the forms that families submit, they’re written in pencil, some of the things don’t add up or aren’t explained properly.

Then, at the extreme end, you have families who are actively looking to take advantage.

But then you have some incredibly good families looking after the funds who wouldn’t dream of doing anything wrong or are just doing the best they can.

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