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Blast Exposure & Brain Injuries: What Every Service Member Must Know! · Broken Brains with Bruce Parkman

• 0:11
  Speaker 1: Hey folks, welcome back to another edition of Broken Brains with yours truly Bruce Parkman, where we look at the issue of repetitive brain trauma, especially through repetitive head impacts in sports and repetitive blast exposure to our military veterans, and we look at how this exposure has impacted not only their brains but their lives and what we have to do as a society to identify, diagnose and treat these individuals and then do a beta job to make sports and military service safe.
• 0:38
  Speaker 1: We look at researchers and scientists, patients, advocates and people across the spectrum of brain health and brain support and bring them on the show so that you're informed about this, because this is an untouched subject in America right now.
• 0:54
  Speaker 1: It's the largest preventable cause of mental illness in our adult populations and we are not doing enough for it right now.
• 1:01
  Speaker 1: On our guest today, very excited to have Dr James Engel on board.
• 1:06
  Speaker 1: He represents a product called Blast Analytics and Mitigation, or BAM360, and they're focused uniquely right now on the identification, diagnosis and treatment of individuals from the issue of repetitive blast exposure, that is, the exposure of their brain, their body, to the multiplicity of blasts they take with high-caliber weaponry, indirect fire, weapon systems, explosives, yada, yada.
• 1:34
  Speaker 1: Dr Carver earned his PhD from UC Davis, and his research focused on both the structural and functional neuroplasticity of the brain to injury and normal aging process.
• 1:50
  Speaker 1: He was a postdoctoral research fellow at the University of Arizona, where he continued his research on normal and pathological brain aging, and he pivoted from academia to industry as a clinical neuropsychologist to help optimize outcomes for both high-risk brain and spine surgeries, while specializing in microelectrode recordings to facilitate deep brain stimulating electrode placement for the treatment of motor disorders.
• 2:13
  Speaker 1: In 2017, he got the itch to get back into research and joined an ongoing research program that was a collaboration with the Naval Special Warfare Investigating Training Associated Blast, and he was instrumental to the US, the USHUS CONCORPROGRAMS blast monitoring efforts, and I think I met you at the USHUS conference early this year or I we, because I was there talking about that and is the architect of their weapons mapping program.
• 2:42
  Speaker 1: He launched BAM, which is the program we're getting ready to talk about here in 2020, and developed the first comprehensive blast monitoring program called Operation Blue Shield for high-risk operators in the law enforcement community.
• 2:54
  Speaker 1: We have a lot to talk about.
• 2:56
  Speaker 1: Dr Engel, thank you so much for coming on the show.
• 3:00
  Speaker 2: Thank you so much, Bruce, for having me on.
• 3:02
  Speaker 1: Hey, no.
• 3:02
  Speaker 1: So you've been through a lot, man, and we don't find a lot of people that are focused on the issue of repetitive blast exposure.
• 3:08
  Speaker 1: So what got you here and then what are you trying to do about it?
• 3:14
  Speaker 2: Well, what got me here is actually my interest in trying to understand, like normal aging brain and how it degrades over time, either through normal processes or through pathological processes over time.
• 3:24
  Speaker 2: Either through normal processes or through pathological processes.
• 3:27
  Speaker 2: And you know, essentially, when I jumped into this, you know the blast world it was almost by happenstance.
• 3:32
  Speaker 2: The research program was looking for someone who specialized a systems neuroscientist, who specialized in multiple domains, and I fit the bill Down the road.
• 3:41
  Speaker 2: I inevitably led the project before it closed and they shifted over to the CONCRETE program proper where they were doing a lot of pilot blast monitoring, where I essentially helped design a bunch of reports that are currently circulating throughout the DoD.
• 3:58
  Speaker 2: I was also tasked to do some weapon mapping of all the different types of weapon systems that people have been reporting on, everything from small arms to the large caliber shoulder-mounted weapons and howitzers, artillery, etc.
• 4:15
  Speaker 2: And so I'm really excited about talking to you today about our current efforts, what I'm currently doing within the law enforcement community day, about our current efforts, what I'm currently doing within the law enforcement community, because, as you know, they're also exposed to repetitive low-level blast throughout their op tempo, either through full-time or collateral duty.
• 4:33
  Speaker 2: These guys are also taking a bunch of hits throughout their careers.
• 4:37
  Speaker 2: So that's a little bit about me and kind of what we're doing.
• 4:40
  Speaker 2: I'd love to get more into the topic.
• 4:43
  Speaker 1: Yeah, man.
• 4:43
  Speaker 1: No, I love it because we really don't associate blast exposure, repetitive at impacts, with law enforcement.
• 4:50
  Speaker 1: Okay, other than they might get in a fight right.
• 4:53
  Speaker 1: So with that population specifically.
• 4:56
  Speaker 1: Interestingly, where are they getting the most of their impacts from?
• 5:01
  Speaker 2: Okay.
• 5:01
  Speaker 2: So a couple of things.
• 5:02
  Speaker 2: When it comes to law enforcement, depending if they're full-time or collateral duty, most of these guys are again getting most of their blast exposure in training, just like in the military, in fact, I think their blast exposure large caliber rifles you know 338, 50 cal breaching, wall breaching, door breaching and also shotgun breaching.
• 5:23
  Speaker 2: And lastly, from energetics you know just throwing flashbangs and you know clearing rooms, things of that nature.
• 5:42
  Speaker 1: All right, yeah, and a lot of people don't know that our law enforcement, you know our law enforcement officers, are heavily involved in these types of training, just like the military.
• 5:51
  Speaker 1: And, yeah, to your point, they probably don't execute them as much in, say, combat.
• 5:57
  Speaker 1: And really needed that we right now, given the fact that our, you know, wars are kind of declared over, but you know, that's interesting and it's very interesting.
• 6:06
  Speaker 1: So when we talk about blast exposure to our viewer, what are you calling blast exposure?
• 6:12
  Speaker 1: How are these waves are produced and what parts of the body are they impacting and how are they impacting?
• 6:19
  Speaker 2: Sure.
• 6:19
  Speaker 2: So when you think about the source right, like an explosion or from a weapon system going off, you know there's either a high explosive or some type of propellant that's burning right, that suddenly sets off a charge, right, and so you have, like this source, this energy that's rapidly expanding from the source Now within a weapon system.
• 6:40
  Speaker 2: You know if it's inside of a, like a large caliber rifle, it's that you know the, the, the primer, is going to be struck and the bullets going to the projectiles and come out at the end of the barrel.
• 6:52
  Speaker 2: But all of that force that's getting that projectile out of the barrel is what's going to be producing overpressure.
• 6:57
  Speaker 2: Now, that might be.
• 6:58
  Speaker 2: You know, that's just one source.
• 7:00
  Speaker 2: Another source is obviously from, like a door charge breaching a wall, breaching a door charge breaching a wall, breaching a door, making a high explosive or other sources like an energetic, like a flashback.
• 7:09
  Speaker 2: So when we think about the, you know how it's occurring.
• 7:12
  Speaker 2: Again, there's rapid transient change, pressure that's leaving that weapon system or device.
• 7:18
  Speaker 2: Now, what it's doing I think that was your second question as it's expanding from its source right, right, think of it as a bubble, right.
• 7:27
  Speaker 2: And so when you think about, you know, uh, an unadulterated, like waveform.
• 7:32
  Speaker 2: Uh, as it's expanding from its origin, you get like this, like impulse energy, right?
• 7:37
  Speaker 2: Uh, this, what we call incident pressure.
• 7:39
  Speaker 2: Right, that's going everywhere in space.
• 7:41
  Speaker 2: Now, as soon as that uh waveform and starts interacting with the environment either the floor, the walls or the person we can start getting reflections, and so those reflections also lead to exposure as well.
• 7:55
  Speaker 2: So when we talk about blast exposure, we know we're talking about incident pressure, reflective pressures that can impact the person talking about incident pressure, reflective pressures that can impact the person.
• 8:11
  Speaker 1: Okay, and then for our uninformed here, because we're getting ready to start dialing into, what can we do about it is where you come in Now, when that pressure hits the body, sometimes, from our understanding, it could be two or more different ways that hit the body at different times, depending if they've been reflected off something and if the you know, the organs exposed directly to the source of the blast.
• 8:31
  Speaker 1: So what's the concern?
• 8:32
  Speaker 1: I mean, obviously you can't feel these things right.
• 8:35
  Speaker 1: I mean everybody just goes through, you know, thousands of them all the time with supposedly no, you know, impact.
• 8:41
  Speaker 1: So what's happening to our bodies when we're exposed to these waves, when they come out, when they come off the sources?
• 8:49
  Speaker 2: Well, sure.
• 8:49
  Speaker 2: So a couple of things are actually happening.
• 8:51
  Speaker 2: So when you, when you have a person standing in a blast field, right, that blast wave is going to interact with that individual.
• 9:00
  Speaker 2: So as that blast wave starts, you know we're focusing on brain health with that individual.
• 9:06
  Speaker 2: So, as that blast wave starts, you know we're focusing on brain health.
• 9:08
  Speaker 2: So as that blast wave goes through the skull, and if it makes its way and can make its way through the skull, then it interacts with the tissues of the brain.
• 9:15
  Speaker 2: Now, you know there's other ways for that energy to make its way into the brain.
• 9:20
  Speaker 2: So as it interacts with the body and there's, you know, ways for the flow of the energy to go up through into the brain.
• 9:25
  Speaker 2: So, as it's interact cause, it interacts with the body and there's, you know, ways for the uh, for the flow of the energy to go up through into the brain that way as well.
• 9:29
  Speaker 2: And so you know when we think about, uh, different ways to protect ourselves.
• 9:34
  Speaker 2: Obviously PPE is really important, but PPE, in addition to, like helmets and wearing kits, you know chest protectors, side protectors, back plates, all these other things.
• 9:44
  Speaker 2: These are all important mechanisms to help prevent that blast wave from actually impacting the person's brain.
• 9:51
  Speaker 1: And once that you know blast exposure is impacting the organ, what kind of damage is it doing?
• 9:57
  Speaker 2: Well, so you know, when it comes to blast, there are a couple of theories that we're currently working off of on what it's actually doing to the brain, right, and so cavitation is an injury that seems to be leading the forefront on what is actually occurring inside the tissue of the brain, different types of injury mechanisms to the brain.
• 10:27
  Speaker 2: It's not quite known today like what is actually occurring.
• 10:30
  Speaker 2: There's a couple good theories on it, right Cavitation, shear pressures that are occurring between white matter, gray matter, interfaces, things of that nature.
• 10:38
  Speaker 2: But, like we know, we're still kind of early in its infancy and trying to understand like what is actually occurring in the brain.
• 10:47
  Speaker 2: We know the outcome, right, but the mechanism that leads to that outcome is still being explored.
• 10:54
  Speaker 1: Okay, and that was my next question is here we are at 2025, right, we just had a military veteran take his life, blow himself up in a Cybertruck, obviously struggling with PTSD.
• 11:06
  Speaker 1: He's been a, you know, he's been a active duty special operator since 2005.
• 11:11
  Speaker 1: You can't really help but wonder if you know the combat tours, the blast explosion and all that, because everything that he you know has been said about this kid.
• 11:21
  Speaker 1: You know, obviously, to your point, we know what the outcomes are.
• 11:24
  Speaker 1: But here we are in 2025, no fault of yours, I mean, he just got into this part.
• 11:28
  Speaker 1: You know 2020 and we're now.
• 11:30
  Speaker 1: We've known, like CTE or sports industries, that this you just can't do.
• 11:36
  Speaker 1: The what, the what, what we've been doing for, you know, the last 20 something years, especially because I'm, you know, I'm a 1980s soldier.
• 11:42
  Speaker 1: We trained with sticks, right, ronnie Reagan gave us our first money, right?
• 11:46
  Speaker 1: I mean, now these guys and girls have unlimited access to ammunition, to rounds, and they're either training for combat or in combat, which means they've had, you know, the most significant exposure to blast of any veteran population in the history of this country.
• 12:03
  Speaker 1: Right, and I think that corresponds with the mental illness that is driving the studies, the research and the funding that you know that are leading to great programs like yours.
• 12:13
  Speaker 1: So I mean, and you have an opinion as to why it's taken us so long to get to this point?
• 12:19
  Speaker 1: I mean, I don't even think the outcomes are really that known that long ago.
• 12:23
  Speaker 1: To tell you the truth, it's just that we had all these mentally ill patients and veterans.
• 12:29
  Speaker 1: We have suicide rates to all nine yards and it's just like man.
• 12:32
  Speaker 1: Maybe it could be the blast exposure.
• 12:34
  Speaker 1: You know this is a pretty new area of research.
• 12:38
  Speaker 2: Yeah, you know.
• 12:38
  Speaker 2: So, when it comes to like what the problem is, right, I think I think there's, since traumatic brain injury, tbi, it's kind of rooted in like uh, contact sports and other types of mechanisms people falling out of car vehicles, uh, other types of incidents, like sporting incidents that lead to some type of uh, you know, traumatic brain injury.
• 13:03
  Speaker 2: Um, when it comes to understanding what the actual outcome was, I think there was two competing theories and the first one that popped up was obviously the tau hypothesis that it's like an extension of chronic traumatic encephalopathy or CTE.
• 13:17
  Speaker 2: Right, and it wasn't until some work by Dan Pearl at USU, that kind of illustrating that there is something else that's going on here, some of those seminal papers that showed, hey look, this isn't CTE, this is astroglial scarring.
• 13:37
  Speaker 2: And when we think about what that means to a neuroscientist like myself, or even to a physician or a neurosurgeon or neurologist, we're like, oh, these are different mechanisms, they have different structural and functional changes in the brain, how that impacts, like how neurons are communicating, how the brain's communicating, that might be the problem.
• 13:59
  Speaker 2: But how you treat it, how you address it, are different ways.
• 14:04
  Speaker 2: So I think, by understanding and accepting the fact that it's okay.
• 14:07
  Speaker 2: Well, this is a reactive mechanism of astrogliosis, like you know.
• 14:11
  Speaker 2: The natural brain's mechanism to prevent itself from injury, from spreading, could be the path forward for us to understand how to treat it right, and that's on the front end, or left to boom, left to blast, like I like to say, looking for prevention, mitigation techniques, detection techniques, things of that nature.
• 14:33
  Speaker 1: And that's where I think we're getting ready to start talking about what you're doing right now, because I talked to Dr Pearl and he was like, look, we don't find CTE in veteran branch, okay, sorry.
• 14:41
  Speaker 1: He's like we find other damage, and we've, and now we can all agree that there is damage going on, that mental illness is the outcome.
• 14:50
  Speaker 1: That's causing us all this concern, cause if there were no outcomes and our brains could take all this stuff, we just keep training the way we've always done, but we've got a big problem here.
• 14:59
  Speaker 1: So what?
• 14:59
  Speaker 1: Now let's talk about, you know, bam, bam 360.
• 15:03
  Speaker 1: Okay, so what are you focused on?
• 15:05
  Speaker 1: What's different and novel about your approach and unique and where are you at in the journey of trying to help our veterans and our military?
• 15:15
  Speaker 1: You know our veterans become healthier and our military, looking at you know better ways to.
• 15:20
  Speaker 1: You know to assess and compile aggregate blast exposure in order to you know.
• 15:23
  Speaker 1: You know to assess and compile aggregate blast exposure in order to you know, monitor this for the life of the soldier.
• 15:29
  Speaker 2: Sure, yeah.
• 15:30
  Speaker 2: So you know, I had the crazy idea of trying to essentially mirror a program that the DOD was doing for the law enforcement community, right, but I had the opportunities to kind of, before I did that, take a step back and say, ok, these are the things that they're currently doing with the Section 734 working group the highs and the lows and said, ok, what are the best things that they're doing to really get in front of understanding blast overpressure exposure, blast exposure, exposure and you know a lot of this is.
• 16:06
  Speaker 2: You know, it gave me an opportunity to kind of start with like a clean slate and say, okay, well, one of the biggest things that we need to do and do better is educating people, and so we built a comprehensive program.
• 16:16
  Speaker 2: Part of this comprehensive program that we call Operation Blue Shield, phase one, is all about education.
• 16:22
  Speaker 2: That's what we do.
• 16:23
  Speaker 2: We educate, increase awareness about the problem, blast overpressure exposure, how it impacts the brain, um, you know, people who sit through my seminars or my, my, my debriefs, uh, learn about how the brain works, um, and then we sprinkle in this is blast exposure.
• 16:41
  Speaker 2: There's a little bit of black about blast physics and what types of pressures come off of the weapon systems that they're commonly around.
• 16:49
  Speaker 2: So for us, you know, we, when we had that opportunity to create this clean slate, you know we started we wanted to make it a comprehensive program and and really get in front of it.
• 17:01
  Speaker 2: So education, awareness, phase two we do some things where we can go out and understand more about their particular weapon systems and their environments that they're training in.
• 17:12
  Speaker 2: So we do weapon mapping, device mapping in their environments to understand how pressure is interacting in those environments while they're training.
• 17:23
  Speaker 2: Phase two also has a cognitive baseline component to it.
• 17:28
  Speaker 2: So one important component when we think about brain health right, is knowing where we are today.
• 17:35
  Speaker 2: Right, because if you're going to go out into a training environment, either tactically or as an athlete, you should know where you are today, because unfortunately there are risks to your brain health and knowing that your profession is going to pull away from that.
• 17:52
  Speaker 2: It's good to understand where you are today so that in a couple years it's not your partners, it's not your sniffing others, not your teammates who are seeing you drift.
• 18:02
  Speaker 2: It's actually quantified.
• 18:04
  Speaker 2: And so that's phase two.
• 18:07
  Speaker 2: Phase three is uh actually an important component as well.
• 18:10
  Speaker 2: This is where we actually deploy uh blast sensors, wearable blast sensors to the platoons or units, um, and then we track them for about six months we get a good understanding of what they're being exposed to, their op tempo and, you know, try to provide, try to provide reports that are what we call actionable reports throughout the training cycle so that they can make actionable changes following those events, so that they can decrease their exposures over time.
• 18:41
  Speaker 2: And then, importantly, with phase four, um mitigation strategies, um, a post programmatic debrief to kind of pull everything back together so that they get a full, complete picture of the of of the program and how it may benefit them.
• 18:58
  Speaker 2: So for us, we actually launched a operation blue, launched Operation Blue Shield with LAPD, metro, deep Platoon.
• 19:05
  Speaker 2: So their SWAT team and we've had the opportunity to work with some of the most elite units and I have to say their professionalism, the way that they approached it, the way that they took the data and really kind of absorbed what they were getting and then applying it to make their team more resilient really hats off to them for doing that.
• 19:27
  Speaker 2: So, with that being said, you know there's other things that we do as well, some mitigation, prevention, mitigation strategies that we have in the pipeline.
• 19:39
  Speaker 1: But so this would be a great program for you know anybody to have.
• 19:42
  Speaker 1: That then could be used to justify a diagnosis and treatment of a RBE-related disorder or impact to their brain.
• 19:53
  Speaker 1: So for our audience, let's talk about the blast.
• 19:59
  Speaker 1: When we think blast, we think like booms, right, huge concussive blows.
• 20:05
  Speaker 1: Now I think the OSHA level or the Department of somebody said it was like what you can have up to four PSI a day, right, that was considered the level.
• 20:19
  Speaker 1: Yeah, you can.
• 20:20
  Speaker 1: I mean what was like.
• 20:21
  Speaker 1: So say, somebody's got an AR-15 at home and they shoot that thing off and no air pro, what kind of decibel level, what kind of PSI level are you looking at?
• 20:31
  Speaker 1: Or just explain to our viewers how this is?
• 20:33
  Speaker 1: You know, how is it measured?
• 20:36
  Speaker 1: By what's the metrics?
• 20:37
  Speaker 1: And then give them some examples from you know, rifles to .50 cals, to mortars, and what's the corresponding PSI or decibel levels or whatever measurements you're using.
• 20:49
  Speaker 2: Sure, well, it's important to talk about.
• 20:51
  Speaker 2: When we talk about weapons and devices, we'd like to talk about sound as well, right, because you know?
• 21:00
  Speaker 2: Here's the thing like.
• 21:01
  Speaker 2: What blast over pressure is is it's a supersonic wave that's moving faster than the speed of sound, right?
• 21:07
  Speaker 2: The way that I like to talk about it is it moves from something that you hear to something you feel.
• 21:14
  Speaker 2: Okay that's good.
• 21:15
  Speaker 2: So, uh, some simple.
• 21:18
  Speaker 2: You know, right now we're probably talking, you know, when we, when we put things into to reference and how loud things are, um, there's different ways that we can measure it, right.
• 21:28
  Speaker 2: So, uh, dbspl, decibel, sound pressure level, uh, dba, dbb, which are sound levels, decibels, but put in weights for hearing, and then we can expand upon that and say, okay, well, all of this is just pressure, so we can move dBs to pascals, pascals to PSI, okay, okay.
• 21:54
  Speaker 2: So just for reference, we're probably talking about 65 to 70 DBA right now.
• 22:01
  Speaker 2: That's how loud we're speaking, going back and forth.
• 22:03
  Speaker 2: A good common reference point, like especially for within the law enforcement community, is how loud a siren is.
• 22:10
  Speaker 2: So, a siren, again, there's a couple things that change intensity, such as proximity, how close you are to it, but a siren is about approximately 120 dB, okay.
• 22:25
  Speaker 1: Just for loudness, very loud.
• 22:27
  Speaker 2: So very loud, right.
• 22:28
  Speaker 2: Once we start moving above that right, there's some, you know, when we think about hearing, conservation programs at OSHA and other regulatory bodies have pushed forward.
• 22:39
  Speaker 2: You know the amount of the intensity, how loud something is, either measured in DB or or Pascal's, and duration, how how many minutes or hours you could be exposed to it before you started experiencing some type of temporary hearing change, before you started experiencing some type of temporary hearing change.
• 22:55
  Speaker 2: Once you get to 140 dB, something happens.
• 22:59
  Speaker 2: It actually switches over to what we call impulse noise.
• 23:02
  Speaker 2: So firearms and other devices often fall into this category of impulse noise.
• 23:10
  Speaker 2: So when we think about impulse noise itself, it has to be over 140 dB and under duration of about one second.
• 23:19
  Speaker 2: So very short duration.
• 23:20
  Speaker 2: So that you know when we think about firearms and other types of devices, flashbangs or, within the military community, grenades, artillery you know the intensity and duration are going to be two different important factors.
• 23:36
  Speaker 2: So the the, the four PSI component is is is really just kind of in my mind like a placeholder right, that's a line in the sand.
• 23:44
  Speaker 2: There's data that suggests that you know, if you get exposed to four PSI you're going to have some lung trauma At some point you may even you know start experiencing some hearing changes, rupture in eardrum At 4 PSI, at 4 PSI, yeah.
• 23:58
  Speaker 2: But the important part, important part of that is that when we talk about 4 PSI, we're only talking about an intensity measurement.
• 24:06
  Speaker 2: We're not talking about how much energy or the duration of that, because the shorter duration, the longer duration that it is, the more likely you're going to experience injury at lower levels.
• 24:18
  Speaker 2: So so you know, we'll talk about that in a second, but we're moving along the spectrum.
• 24:25
  Speaker 2: So 120 DB is about like a siren.
• 24:29
  Speaker 2: Um, when we think about like, uh, you know, m four, m4, you know we're talking about 163 dB DBA.
• 24:38
  Speaker 2: Now, when you put that into perspective, 163, again, a lot of factors go into that length of the barrel, how much, how much power is in that bullet and range and caliber, all these other things.
• 24:53
  Speaker 2: But for like an M4, it's about 163 with a 16-inch barrel.
• 24:57
  Speaker 2: So as you start to think about that, when you now pivot from dB to pascals, to PSI, you know 163 dB is just under 0.5 PSI.
• 25:12
  Speaker 2: It's like 0.447 PSI.
• 25:15
  Speaker 1: Okay, so half a PSI is one shot from an AR-15.
• 25:21
  Speaker 1: So, you've got a 30-round magazine.
• 25:25
  Speaker 1: You're looking at 15 PSI.
• 25:28
  Speaker 2: Well, you know, you can think of it in different ways, right, I'm just throwing some math out for everybody, right?
• 25:32
  Speaker 1: Yeah, yeah, yeah, I'm from the Massachusetts educational system so I might be slightly challenged on these things.
• 25:38
  Speaker 2: Bruce, you ever shoot a .50?
• 25:40
  Speaker 1: Yeah, so what's that?
• 25:42
  Speaker 1: Have you ever shot a .50 Cal?
• 25:44
  Speaker 2: Oh yeah, I own one.
• 25:45
  Speaker 2: Yeah, yeah, yeah.
• 25:46
  Speaker 2: So bolt action or semi, Is it the M107?
• 25:51
  Speaker 2: Or like a Mark 15 style it's.
• 25:52
  Speaker 1: Is it the M107 or like a Mark 15 style?
• 25:54
  Speaker 1: Yeah, it's a Mark 15.
• 25:55
  Speaker 1: I got well.
• 25:55
  Speaker 1: I've got a 10 round.
• 25:56
  Speaker 1: Well, I mean, it was back in the day, yeah yeah, yeah, so cross-reference that Okay so an.
• 26:05
  Speaker 2: M4, right AR platform, right 55 grain, 65 grains.
• 26:10
  Speaker 2: You know you're looking at about a half a PSI, just a hair under right, right.
• 26:15
  Speaker 2: So with the .50 cal right now you're looking at, you know, 650, 750 grain type bullet projectile and the amount of pressure depends on the length of that barrel.
• 26:28
  Speaker 1: If, whether or not they're Just a 10 machine gun that's on a, not even a sniper rifle.
• 26:34
  Speaker 1: But if you just had a 50 Cal like an army guy would have on top of a trank with that every barrel.
• 26:40
  Speaker 2: Yeah, yeah, crazy.
• 26:42
  Speaker 2: So you know when we think about how much if it's a.
• 26:46
  Speaker 2: So here's the thing.
• 26:47
  Speaker 2: If there's, what type of muzzle, attachment at the end of that is really important, because if it's just bare barrel, yeah.
• 26:57
  Speaker 1: If it's just bare barrel, yeah, yeah, so bare barrel.
• 26:59
  Speaker 2: You know the, the, the flow pattern that's coming out of the, the muzzle there is going to be directed more forward.
• 27:05
  Speaker 2: However, if you put, like, a muzzle brake on, that energy is going to go sideways or back, depending on the type of muzzle brake.
• 27:11
  Speaker 2: You have right.
• 27:12
  Speaker 1: Oh, wow, so and I got one on my right too.
• 27:14
  Speaker 1: Muzzle break, you have Right, oh wow.
• 27:15
  Speaker 2: So yeah, so yeah, yeah, right, you know it makes it comfortable, right, it makes it comfortable to shoot Um, cause you know, I've shot the 50 Cal uh semi and bolt action Um and I have to say, like it's it, it's punishing, unless you have that muzzle break on there, yep.
• 27:32
  Speaker 2: So, but you're looking at, you know, depending on the length of the barrel and type of ammo, three to four PSI exposure to the shooter.
• 27:39
  Speaker 1: All right.
• 27:39
  Speaker 1: So barely a limit.
• 27:40
  Speaker 1: A daily limit is pretty close to one round.
• 27:42
  Speaker 1: And what I'm trying to get the viewers to understand is that you know, in the military and even in law enforcement, we just don't fire one round.
• 27:50
  Speaker 1: I mean, we fire fire hundreds, if not thousands.
• 27:56
  Speaker 1: Because you know, in the army, I know special forces, we ain't bringing that back to the asp.
• 27:59
  Speaker 1: Okay, we're getting rid of all the carl gustav, whatever we got, we're bringing back brass.
• 28:02
  Speaker 1: We're not going to bring back no live rounds.
• 28:04
  Speaker 1: So we shoot until it's gone right.
• 28:07
  Speaker 1: And so and that's what we're trying to hear is just kind of give the viewer the idea of how much a military person, service member, how much of this exposure they could have, because it could be hundreds of times, even thousands of times if you're shooting a lot of .50 caliber.
• 28:27
  Speaker 1: What is recommended just for one day and that's all in one day.
• 28:30
  Speaker 1: You get a lifetime of civilian exposure in one day in one day.
• 28:32
  Speaker 1: You get a lifetime of civilian exposure in one day.
• 28:36
  Speaker 2: You know, bruce, one of the things to kind of think about, because I've just been talking about weapon characteristics length of barrel, muzzle break grains, bullet shooting position right Standing, kneeling, prone, like, if you're.
• 28:50
  Speaker 2: You know, most people shoot the .50 cal in a prone position.
• 29:01
  Speaker 1: You have to.
• 29:02
  Speaker 1: You know most people shoot the 50 cal in a prone position um.
• 29:03
  Speaker 1: I've had the opportunity, you know.
• 29:04
  Speaker 2: Now Navy SEAL he might stand up and try to shoot that thing while I'm standing up.
• 29:06
  Speaker 2: But I I I had the opportunity to uh teach a blast overpressure section at the uh tack flow Academy, who that's run by Mark Lang um and his large caliber uh rifle course, and you know they teach them how to shoot off a tripod.
• 29:18
  Speaker 2: So I had an opportunity to shoot a 50 cow off a tripod.
• 29:21
  Speaker 2: Um, you know, I have to say that, you know it makes it a lot easier when there's a muscle break, but more importantly, when there's when it's suppressed.
• 29:30
  Speaker 2: So you know here.
• 29:32
  Speaker 2: So here's the mitigation thing.
• 29:34
  Speaker 2: We're talking about 50 cows right.
• 29:35
  Speaker 1: Where does GM 360 take all that?
• 29:37
  Speaker 1: Now that our readers understand that, wow, these guys and girls are taking a lot of exposure, now we know that exposure causes damage.
• 29:46
  Speaker 1: Now you've got a program focused on mitigation.
• 29:48
  Speaker 1: So where are we with this?
• 29:50
  Speaker 1: What are you?
• 29:51
  Speaker 1: What are you?
• 29:51
  Speaker 1: What are you doing and where does this need to go?
• 29:55
  Speaker 2: So a couple of things on the prevention, mitigation side.
• 29:57
  Speaker 2: We have a simple tool that we use to teach operators and warfighters about overpressure coming from those weapon systems.
• 30:05
  Speaker 2: So it's a product that we call the Blast Mat, and we have them for the .50 cal, both bolt and semi-auto.
• 30:13
  Speaker 2: We have them for.
• 30:14
  Speaker 2: Let's talk about it.
• 30:17
  Speaker 2: Yeah, here's the thing.
• 30:18
  Speaker 2: It's a great teaching tool, right, because you put the weapon system down on top of the mat and it gives the user the opportunity to interact with the invisible.
• 30:31
  Speaker 2: Right, because now it's a color-coded mat, like showing you where a 4PSI is or you know where higher pressures is and where lower pressures are.
• 30:39
  Speaker 2: And it gives you, gives the operator, the ability to kind of move from one place to another.
• 30:46
  Speaker 1: Just makes little subtle changes little subtle changes to.
• 30:50
  Speaker 1: What's that?
• 30:51
  Speaker 1: I'm sorry.
• 30:52
  Speaker 1: So the mat tells them the level of exposure that they're getting when they fire.
• 30:58
  Speaker 2: Unfortunately, it doesn't actually tell them.
• 30:59
  Speaker 2: It's not an active mat.
• 31:01
  Speaker 2: Okay, we do have something in the works to make something more active, but this is just a simple training tool to teach people about positioning.
• 31:11
  Speaker 2: Oh, okay, so when we think about, when we think about, you know different types of mitigation strategies.
• 31:17
  Speaker 2: There's a lot of different ways to you to buy down your pressure, how much pressure you're taking.
• 31:24
  Speaker 2: Right, first off, you can use simulation simulators and you know things of that nature.
• 31:28
  Speaker 2: You can remove fire in the weapon system.
• 31:31
  Speaker 2: That's not really practical.
• 31:33
  Speaker 2: That don't work.
• 31:35
  Speaker 2: Yeah, but there's some administrative things that you can do.
• 31:38
  Speaker 2: Right, you can limit the number of rounds that they're firing in a day.
• 31:42
  Speaker 2: The ANOR, the ALARA types of principles that can be applied to, you know, help reduce exposures to, you know, try to optimize operator and warfighter brain health.
• 31:54
  Speaker 2: But really, the way that we view the blast mat itself is it's a tool for operators who are in an operationally necessary position.
• 32:04
  Speaker 2: Right, I need to use this weapon system, so I need to be able to know where I should be and shouldn't be, to train smarter, to reduce how much pressure I'm taking.
• 32:12
  Speaker 2: So when we think about, like you know, we've reduce how much pressure I'm taking Um.
• 32:15
  Speaker 2: So when we think about, like you know, we've been talking about the 50 Cal you know it's uh, that's just one, one type of of of math that we have.
• 32:23
  Speaker 2: We have them for all of the artillery, uh, mortar type systems, even the big stuff, uh, you know, like the tanks and the M109 Paladin, so that people know where they need to be and shouldn't be.
• 32:38
  Speaker 2: So you know, for instance, like, if you ever drop mortars in your career, like 60s, 80s 120s, 81s 160s yeah
• 32:46
  Speaker 2: yeah.
• 32:46
  Speaker 2: So, for like, for instance, for the 81 millimeter mortar, we have a blast map for the 81 millimeter mortar system and you know, when you're thinking about learning how to use that weapon system, right, you know really, what the mat helps provide is a graphical training aid or a visual tool to say, okay, I need to do when I drop this mortar in.
• 33:09
  Speaker 2: I need to.
• 33:10
  Speaker 2: You know, drop it, then follow it all the way down, and then you can look around in the field and say, okay, I need to put my head here If I put my head here.
• 33:19
  Speaker 2: I'm going to get one PSI.
• 33:22
  Speaker 2: If I put it here, I'm going to get three PSI.
• 33:25
  Speaker 2: It gives the operator to reinforce that training, to train smarter.
• 33:32
  Speaker 1: It sounds like you might have.
• 33:34
  Speaker 1: Do you get any pushback, like in sports?
• 33:35
  Speaker 1: Like you know, we talk about subcussive trauma and those little hits, you know.
• 33:39
  Speaker 1: Depending on how old the coaches or the players are, it's like, ah, that's, you know.
• 33:43
  Speaker 1: They don't want to hear it right, and so where are you?
• 33:49
  Speaker 1: So the military, are they being?
• 33:51
  Speaker 1: I know that some commands are being very responsive about the blast pressure.
• 33:56
  Speaker 1: Are these?
• 33:56
  Speaker 1: Are the soldiers now starting to understand that this is something that they need to take into consideration as they train, because it does impact their long-term brain health?
• 34:07
  Speaker 2: Yeah, you know, I have to say that, you know, from different perspectives, I think I'm I'm seeing a change, especially guys who are on the back nine of their career, who's been experiencing this stuff for a long time.
• 34:22
  Speaker 1: Right yeah.
• 34:24
  Speaker 2: Right, and they and they, literally they, they, they start to see the effects and feel the effects.
• 34:29
  Speaker 2: And so these are the guys that are now being like, okay, we need to do something for the next generation, who are on the first nine on the front, nine of their career right, and so those have been our advocates so far um, that and that, and those are the guys that have fought these wars.
• 34:47
  Speaker 1: I was talking to, um, a range safety officer for a shoot house, and you know we always want to train like we fight.
• 34:53
  Speaker 1: But sometimes, like I, I've been through countless doors or I've been on the door right waiting, waiting for that crack.
• 34:59
  Speaker 1: You know, number one guy, number two guy, you know, whatever right, I've been in a stack and waiting to go in and then we find out that, instead of being on the door, if you're around the corner, your PSI goes to nothing.
• 35:12
  Speaker 1: Right?
• 35:12
  Speaker 1: Yep, still get the impact of training knowing that, because what we need to focus on in my turn, my opinion, doctor, is most of our exposure is coming from training.
• 35:24
  Speaker 1: It's like in football.
• 35:26
  Speaker 1: You know, if you took all your game days and put them against the amount of days of training and practice you had, that's going to be 80 of your exposure.
• 35:34
  Speaker 1: So we look at training, um, and now in combat, you can't control combat yet in combat We've got to fight, we've got to kill and we've got to come alive, and we still have to train to be as lethal as possible.
• 35:44
  Speaker 1: But if we know that most of this impact is coming from training, then sometimes we don't have to train the way we fight and I know that's going to piss a lot of people off because they're going to want to be on the door.
• 35:55
  Speaker 1: Or you know, I talked to Navy SEAL.
• 35:57
  Speaker 1: He said he used to shoot not only shoot 20, 30.
• 35:59
  Speaker 1: Called Gustavs, he was the range safety officer.
• 36:02
  Speaker 1: At the end of the day he couldn't feel his fingertips and he thought it was cool, it's like I can't do that again.
• 36:13
  Speaker 1: Right, I'm like dude, right he goes, now he goes.
• 36:14
  Speaker 1: Bro, you know I'm having my issues Right and these are all preventable.
• 36:16
  Speaker 1: So I think what you're doing is is really engaging, and I mean it's.
• 36:20
  Speaker 1: You know, how far are you along with DOD?
• 36:23
  Speaker 1: Is your program being adopted or are you working with military entities right now?
• 36:29
  Speaker 1: Because this is this is hugely important, as this generation is ready to fight the next war.
• 36:35
  Speaker 2: Yeah, you know.
• 36:35
  Speaker 2: So, originally, when I formed BAM 360, it was to, you know, to do more weapon mapping, and I literally had a pivoted like a couple months in after a retired operator, swat operator reached out and you know he was explaining the same exact stories that I've heard over and over and over again.
• 36:54
  Speaker 2: No-transcript.
• 37:26
  Speaker 2: We are starting to pivot back because, you know, we do have the abilities to to do a lot of these weapon mapping and facility ma, to be able to help them understand what their uh, what their types of pressures are receiving, to help buy down pressure, cause, at the end of the day, there's there's there's a couple of things that you mentioned I wanted to go back to cause you did.
• 37:50
  Speaker 2: You did ask me a question Like do we, do we get any uh pushback?
• 37:53
  Speaker 2: Um, some of that pushback is you know, we, we, we train like we fight.
• 37:58
  Speaker 2: Um, some of that pushback is you know, we, we, we train like we fight, fight like we train, and we don't want to deviate K 18.
• 38:18
  Speaker 2: So you're going to take more than four PSI, um, if that's operationally necessary, like that's a decision, that's.
• 38:26
  Speaker 2: That's that has to happen.
• 38:27
  Speaker 2: But if it's not operationally necessary, you don't push back beyond K 18, maybe go K 35, k 45 plus two corners.
• 38:35
  Speaker 2: Like you know, understand that that overpressure is a threat to your brain health and if you want to, you know, make it make it in, like into your, wherever your career goal is Right.
• 38:46
  Speaker 2: And that's how I always start, like, I always start off these conversations with operators and whenever I give my, my brief on on the education piece, it's like where do you want to be?
• 38:57
  Speaker 2: Like, where are you in your career?
• 38:59
  Speaker 2: Is this, is this a job?
• 39:00
  Speaker 2: Is this is is going to be a four to seven year stick for you, or is are you going to stay in this for 20, 30 years, right?
• 39:07
  Speaker 2: Um, because knowing that, you know you're in it for the long haul, you might start making some changes in your favor, which is really important to get you to your goal, right, it's like okay, you want to retire with X amount of uh you know money in the bank.
• 39:24
  Speaker 1: Well, you know, in one marriage, not three or four, like all of us, right?
• 39:37
  Speaker 2: I mean, everyone's got to start thinking about their brain or brain health, just like there's.
• 39:39
  Speaker 2: You know, saving money in the bank, like we, you like, you have to be able to build this reserve, like reserve, uh, to be able to, to get to to those goals.
• 39:46
  Speaker 2: Otherwise, you know, every single time you get hit in the head, every single time you take a uh uh, you know some pressure from a weapon system, um, you know I, we, we, we're not diving into the.
• 39:57
  Speaker 2: You know the potential genetic components or prior history of exposure, but all those things like can lead into, like you know, when someone might start experiencing symptoms.
• 40:08
  Speaker 1: And nobody's going to say don't, but you don't have to train like you're going to fight every day.
• 40:14
  Speaker 1: Right, once you're the number man, number one man, that stack and you got, you've all gotten.
• 40:28
  Speaker 1: You know that, that feeling, right, that exposure, you know that's what we're going to do when we're in.
• 40:31
  Speaker 1: When we're in, when it's game time, okay, now can you go around the corner and just practice your flow drills and other things that are just as important as experiencing that shockwave, but also, you know, going in there and dominating your field.
• 40:41
  Speaker 1: You know your sectors of fire to hold everything that you do and go do that particular job.
• 40:46
  Speaker 1: So I think, yeah, to your point, we have to train like we fight, but we don't have to train every day.
• 40:51
  Speaker 1: And I've told a lot of commanders it's like, look, man, we are.
• 40:54
  Speaker 1: You know, you can only be as good.
• 40:56
  Speaker 1: You know, once you're good with a weapon system, right, you're good, right, you got to go at it all the time, you know, and so, and then the other part is, if our special operators you know, if I paid as much attention to my brain health as I did to my physical health all right, running, lifting, diving, swimming, doing everything I could to be, you know I was, you know be a green beret, right?
• 41:21
  Speaker 1: I mean physical fitness, you know, was next to my job.
• 41:25
  Speaker 1: But my job skills, physical fitness, was right there.
• 41:29
  Speaker 1: I mean that was like sex, right, I mean physical fitness, sex, alcohol, they all had.
• 41:34
  Speaker 1: They all encompassed like my entire life when I was a soldier.
• 41:37
  Speaker 1: It's all I cared about, right?
• 41:38
  Speaker 1: Am I fit, can I do my job?
• 41:40
  Speaker 1: And you know where's my beer and I'd like a little bit of love, right, that's how I live and that's how a lot of our guys live.
• 41:46
  Speaker 1: And they are now and I think to your point, they're now starting to understand how valuable this is.
• 41:52
  Speaker 1: And I got to take care of this because otherwise all this other stuff is going to go away and I'm not going to be good at my job, I'm not going to be good at relationships, I'm not going to.
• 41:59
  Speaker 1: My physical fitness is going to go to crap.
• 42:05
  Speaker 1: I mean, we talk to so many veterans right now, dr Engel, that are they don't even get up and they can't even work out because they are just hurting, because they didn't take care of this, because we didn't know.
• 42:13
  Speaker 1: And nobody's pointing any fingers, man, I was talking to some four stars about this stuff.
• 42:19
  Speaker 1: It's like nobody's looking to blame anybody.
• 42:21
  Speaker 1: We're looking like what do we do now?
• 42:22
  Speaker 1: And the now is, yeah, I mean, we've got to train effectively, we've got to train to be lethal, but since 9-11, doc, these guys and girls have been going at it and we're paying the price, whether it's mental illness, whether it's suicidality, broken marriages, broken relationships.
• 42:46
  Speaker 1: This price is being paid.
• 42:46
  Speaker 1: These kids did nothing wrong.
• 42:47
  Speaker 1: They volunteered for the military, they did their job and, unfortunately, they got hurt.
• 42:49
  Speaker 1: Now we've got it, and so talk a little bit about this.
• 42:52
  Speaker 1: We don't have too much more time, but talk about the.
• 42:54
  Speaker 1: Are you doing anything on the diagnosis side to identify people that?
• 42:59
  Speaker 1: I mean?
• 43:00
  Speaker 1: I'm sure you heard about an MBEV or a GBEV.
• 43:02
  Speaker 1: We don't have an idea how much you can have, of course, because the brain is different for everybody.
• 43:09
  Speaker 1: But on the diagnosis side, do you have any like?
• 43:12
  Speaker 1: We have people listening right now that might be some of these folks right now, that might be some of these folks, right?
• 43:21
  Speaker 1: So, from the you know, diagnosis side, what is your program doing to help us identify the folks that might need help, that might not be aware?
• 43:25
  Speaker 2: of?
• 43:25
  Speaker 2: Yeah, so you know the things that we're doing on the diagnosis treatment side.
• 43:30
  Speaker 2: We're forming partnerships with particular companies that are in the diagnostic space, and so you know one of the things that you can kind of think about, right, I always like to say this like proof's in the pudding, right, if you start having symptoms, you're out.
• 43:47
  Speaker 2: You're in your second year, your fourth year, your 10th year, your 15th year.
• 43:50
  Speaker 2: You know symptoms are, you know, unfortunately, are what guiding us.
• 43:56
  Speaker 2: And I'm a firm believer that you know, outside of cognitive changes and behavioral changes, there are little subtle tells that you have had a traumatic brain injury or have currently a traumatic brain injury.
• 44:08
  Speaker 2: And I think, where you know, I'm a really big proponent of eye tracking and measuring people, like cupulometry and eye tracking type of stuff, because really, at the end of the day, like eye tracking, I think is going to be one of those things that help with the diagnosis of a TBI or concussion or non-concussive injury, right, because, at the end of the day, like our eyes there's, when you think about what controls our eyes, the, the circuitry that goes into it in our brain stem, and then you know, uh, helping us pick targets, things that are cortically mediated um, I think eye tracking is is one of those technologies that we're going to see more of in the future.
• 44:52
  Speaker 2: Uh, when we think about the diagnosis of, uh, um, any type of traumatic brain injury as a whole, yeah, I'd like to know more about that.
• 45:05
  Speaker 1: We've been looking for, like a pupilometry app to put on the phone to recommend to parents, because you know the kids will say I had a concussion, like watch this little thing right, or whatever, however they want.
• 45:10
  Speaker 1: So I mean that would be an amazing, you know, ability to help us.
• 45:15
  Speaker 1: And then, of course, to your point.
• 45:17
  Speaker 1: You know we, we have to educate our community that these cognitive, behavioral and psychological changes that your husband or your partner's going through, right, or your wife, you know, could be related to their job and they need help.
• 45:31
  Speaker 1: It's not, it's not their childhood, right, it's not that they might've seen a couple of bodies, it could be right, there's psychological trauma, but it also could be the changes that their jobs cause.
• 45:43
  Speaker 1: So I mean, how?
• 45:44
  Speaker 2: the brain works, neural circuitries that lead to memories, things of that nature, and how brain injury can alter those circuits to really have someone re-experience something in real time that may just be a distant memory.
• 46:14
  Speaker 2: So those are all interesting things that when you think about what potentially traumatic brain injury is doing to how we process information and retrieve information.
• 46:23
  Speaker 1: That's amazing.
• 46:24
  Speaker 1: Well, doc, I really appreciate the time you spent with us today.
• 46:27
  Speaker 1: This is outstanding and I really thank you for the work you've done and we want to know more we're going to we'd love to stay in touch with you.
• 46:34
  Speaker 1: We have a, you know, a community of providers that are that treat, you know, veterans that have been diagnosed with RBN, you know, to include law enforcement officers.
• 46:45
  Speaker 1: There's a lot of beta approaches out there to brain health that you know aren't covered by the FDA and we're working on that with the VA.
• 46:52
  Speaker 1: So love to know more about you, because that program is could be part of some of the recommendations we're making to Congress right now to implement changes instead of just talking about it, you know, and getting off our butts when it comes to these veterans and law enforcement officers that have been impacted by their careers.
• 47:08
  Speaker 1: So, man hats off to you.
• 47:10
  Speaker 1: Please stay in touch with us and before we go, how do people find you?
• 47:15
  Speaker 1: Talk a little bit about yourself and what you have going on and let people know what they can do to stay in touch with you.
• 47:23
  Speaker 2: Sure Well, you can find out more about what we do.
• 47:26
  Speaker 2: Go to our website, wwwbam360.com.
• 47:31
  Speaker 2: B-a-a-m 360.
• 47:33
  Speaker 2: Talks a little bit about what we do and how to get a hold of us.
• 47:38
  Speaker 2: You can reach out to me directly if you have any questions about the program.
• 47:44
  Speaker 2: There are other things you can do as well.
• 47:47
  Speaker 2: If you're curious on different approaches to brain health, I have a bunch of different resources for you guys as well.
• 47:56
  Speaker 2: So if you're interested in understanding more about blast or understanding more about traumatic brain injury, or if you're someone within the law enforcement community or a veteran in the law enforcement community and you're struggling, we do have resources through our partners as well, through Copline and the Ohio State.
• 48:15
  Speaker 2: That, I think, would be really beneficial for you guys.
• 48:17
  Speaker 1: We'll be reaching out, because the one thing that's lacking for our veterans right now is a resource guide to repetitive blast exposure, and we're working on that right now.
• 48:26
  Speaker 1: So we'd love to work with you on it and get something out there for our veterans that would be a more informed book guide, whatever for them to understand what is going on and then what to do.
• 48:39
  Speaker 1: You know, what do I do now?
• 48:40
  Speaker 1: Right, you know I've already left, I'm already suffering.
• 48:42
  Speaker 1: What do I do now?
• 48:43
  Speaker 1: So, yeah, love the work, dr James Engel, bam 360.
• 48:47
  Speaker 1: Thank you so much for what you're doing, your dedication to our service members, and we look forward to seeing you on the show again.
• 48:52
  Speaker 1: Sir, take care.
• 48:53
  Speaker 1: Thanks, bruce.