Golf injury left man with little-known disorder

By Al TaysApril 3, 2013, 5:20 pm

Ever since the accident, John Wynne’s memory hasn’t been so good. But “one funny thing I do remember,” Wynne says. “I remember the center for head injuries’ website said, ‘Play golf, not football.’ That always struck me as funny.”

No wonder. The Cherry Hill, N.J., resident suffered a traumatic brain injury (TBI) 12 years ago while playing golf. Struck on the left side of his head by a golf club, Wynne, 41, was fortunate not to have been killed. But the TBI affected his ability to walk and talk and remember things, and left him with headaches, tremors and a loss of feeling in his right hand.

There was another effect of the injury, one that baffled and frustrated Wynne until fate finally identified it to him when he picked up a brochure in his doctor’s office.

It's called pseudobulbar affect - PBA. (The A refers to “affect,” as in “affectation,” and is not a misspelling of “effect.”) It’s a neurological disorder often caused by a TBI. In layman’s terms, PBA causes a person’s emotions to go haywire – crying or laughing uncontrollably, sometimes far out of proportion to the sadness or levity of a situation and sometimes in complete contrast to what the person is actually feeling.

“It’s a complete mismatch between your inner feelings and your outward expression of emotion,” Wynne says.

“It’s the most under-diagnosed, under-treated, under-recognized condition around, in my opinion,” says Dr. Jonathan Fellus, a neurologist and chief medical officer of the International Brain Research Foundation, who has treated Wynne for several years. “For that reason, it’s almost like a perverse version of don’t ask, don’t tell. Doctors don’t ask, patients don’t tell.”

John Wynne

A 'one-in-a-million shot'

Wynne never saw the broken-off clubhead that was whizzing toward him on that June day in 2001, randomly and improbably locked on target for his skull like some perimeter-weighted missile. He knew his partner was in the woods to his left, dealing with an errant drive, but Wynne was focused on his own ball and his next shot.

“The next thing I knew I was just laying on the ground,” Wynne says. “It came out awhile later that he had wrapped his club around a tree and the clubhead came off. It was such a freak thing. Such a one-in-a-million shot. I was over 50 feet away from him and it hit me a glancing blow. It hit the left side of my head and knocked a pretty good dent in my head.”

Wynne doesn’t remember whether he lost consciousness, but other details remain clear. He recalls that he and his partner were on the ninth hole at Tamarack Golf Course in East Brunswick, N.J., and that “I had hit a pretty good tee shot.” He remembers that there was an off-duty policeman in the group behind them, who came and stabilized him while waiting for an ambulance to arrive. He remembers that other players behind his group were instructed to move ahead and play the hole as a par 3 until he could be removed.

He remembers “just screwing up everyone’s golf game. I remember feeling embarrassed, of all things.”

The last thing Wynne would want to do is spoil someone else’s golf experience. Growing up in a family of golfers, he inevitably caught the bug himself. “The more I played, the more I loved the game,” he says. It didn’t matter if he couldn’t find anyone else to play with – he wouldn’t hesitate to go out as a single. He’d play before going to his job as a restaurant manager. “I’d already have my sticks in my car.”

Today he belongs to an informal group of about 16 buddies who frequently play together. “We always honor the integrity of the game,” he says. “The more we play, the more we find guys calling penalties on themselves, just respecting the game.”

On the day of the accident, Wynne was playing with a close friend. He prefers not to identify him and doesn’t blame him for what happened, saying, “It was such a freak thing.” They no longer play together, he says, “but not because of what happened.” Wynne says he has tried to call on several occasions, but has gotten no response. He thinks his friend simply does not want to deal with the extreme awkwardness of the incident and its aftermath. “He was probably scared; he probably felt really guilty for almost killing his best friend,” Wynne says.

The road to recovery

Wynne was admitted to nearby Robert Wood Johnson University Hospital. He remembers being there less than a week, “and then they told me that I could go. They just had to make sure that my brain didn’t swell to a point where they had to do surgery.”

Although doctors told him full recovery would take a year, he went back to work in 4 ½ months. “And I played golf before then,” he said.

He was still participating in occupational and physical therapy to help with his gait (the left-side brain injury had affected his right side) and his speech. He didn’t even realize it had been affected, but people close to him did.

There was another issue as well – a strange one. He would find himself crying or laughing for no reason. At first he brushed it off as a possible side effect of a medication he had been prescribed for depression. Besides, he had other problems that seemed more pressing.

“The worst one was remembering anything,” he says. “I would literally get off a 45-minute phone call and if I didn’t cross that person off my list, I would hang up the phone and call them right back.”

The PBA became more of an issue when he began a relationship with his now-wife, Amie. “We’d be in an argument and he’d be kind of smirking at me, and I was getting really angry because I thought he was not taking it seriously,” Amie says. “So I would get mad at him.

“It took me saying ‘Why are you smirking at me? Why are you laughing at me? It’s not funny.’”

A 'eureka' moment

At the suggestion of one of his sisters, Wynne had begun seeing Fellus, an expert on brain injuries, and doing his own Internet research to try to discover if his laughing/crying condition had a name.

During one visit to Fellus’ office, Wynne happened to pick up a medical brochure. The subject: PBA. It was a “eureka” moment.

“I said, 'You know, I have this.’

“We kind of laughed it off a little bit, and I don’t think until the next visit did he give me the full diagnostic on it.”

Fellus asked Wynne a series of “screening” questions designed to indicate the probability of his having PBA. “And lo and behold, he scored in the range that is highly suggestive for having PBA,” Fellus says.

“And that was really a lesson for me. … I thought I knew him pretty well.”

PBA, Fellus says, is often confused for depression. “Why? Because it occurs in all these neurologic conditions where we could all imagine that the people who have (them), it would be reasonable for them to be depressed.

“I’ve even had many patients who told me that their doctors said, ‘You’re depressed and you don’t know it.’ That’s disturbing to me.”

PBA is little known, Fellus says.

“We used to think it was quite rare. The old statistics in brain trauma quoted it as low as 5 percent. And yet newer studies, better-done studies with a better kind of screening tool, put it at over 50 percent. So it’s not rare. It’s hiding in plain sight. Patients hide it, doctors overlook it or ignore it, they downplay it. Even families downplay it," Fellus says.

“And then patients learn to avoid situations that trigger it, so they become recluses, they become withdrawn, and it becomes a major impact on the quality of life.”

PBA is treatable, but not curable, Fellus adds. Wynne says the medication he takes – neither he nor Fellus wishes to identify it because of privacy considerations – keeps it in check.

"This is a remarkably effective treatment,” Fellus says. “It is rapidly effective. Over half the people who are treated for PBA have a complete remission of their episodes. And it’s a well-tolerated treatment.

“Is it a cure? There are very few cures in all of medicine, and there are even fewer cures in neurology. There’s management of a disease.”

'Hindsight is 20-20'

Wynne can’t help but wonder if his PBA, before he knew what it was, held him back at work, perhaps costing him promotions. “Hindsight is 20-20,” he says, “but there are certain instances where I can go back, glancing at an executive meeting and things like that, (having had reactions) that aren’t appropriate at all.

“I know that I would have felt leery about putting someone like that in charge or giving them more responsibility if they’re not taking something serious.”

He would prefer to look forward, however. He hasn’t lost any of his enthusiasm for golf. His handicap, once as low as 15, ballooned after the accident, but it’s back down in the 18 range now. He can’t hit his driver as far as he used to, but his irons have remained consistent. The loss of feeling in his right hand affects his short game, but he makes do.

He gets “absolutely” as much enjoyment from the game as he did before, “if not more.” He’s passing along his passion to his 4-year-old son, Aeden, who’s already on his second set of clubs, having outgrown the first one. He and Amie also have a 1-year-old daughter, Kaelyn.

“He’s a highly motivated guy,” Fellus says. “He built a family after this, he continued to work and succeed at his job, against the odds.”

“I think the entire thing,” Wynne says, “has helped me to put everything in perspective.”


More information on PBA is available at PBAfacts.com.

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Minjee Lee co-leads Walmart NW Arkansas Championship

By Associated PressJune 24, 2018, 12:25 am

ROGERS, Ark. - Minjee Lee wasn't all that concerned when she missed her first cut of the year this month at the ShopRite LPGA Classic.

The ninth-ranked Australian has certainly looked at ease and back in form at Pinnacle Country Club in her first event since then.

Lee and Japan's Nasa Hataoka each shot 6-under 65 on Saturday to share the second-round lead in the NW Arkansas Championship 13-under 129. Lee is chasing her fifth victory since turning pro three years ago. It's also an opportunity to put any lingering frustration over that missed cut two weeks ago behind her for good.

''I didn't particularly hit it bad, even though I missed the cut at ShopRite, I just didn't really hole any putts,'' Lee said. ''I'd been hitting it pretty solid going into that tournament and even into this tournament, too. Just to see a couple putts roll in has been nice.''

The 22-year-old Lee needed only 24 putts during her opening 64 on Friday, helping her to match the low round of her career. Despite needing 28 putts Saturday, she still briefly took the outright lead after reaching as low as 14 under after a birdie on the par-5 seventh.


Full-field scores from the Walmart Arkansas Championship


Lee missed the green on the par-4 ninth soon thereafter to lead to her only bogey of the day and a tie with the 19-year-old Hataoka, who is in pursuit of her first career win.

Hataoka birdied six of eight holes midway through her bogey-free round on Saturday. It was yet another stellar performance from the Japanese teenager, who has finished in the top 10 in four of her last five tournaments and will be a part of Sunday's final pairing.

''I try to make birdies and try to be under par, that's really the key for me to get a top ten,'' Hataoka said. ''Golf is just trying to be in the top 10 every single week, so that's the key.''

Third-ranked Lexi Thompson matched the low round of the day with a 64 to get to 11 under. She hit 17 of 18 fairways and shot a 5-under 30 on her opening nine, The American is in search of her first win since September in the Indy Women in Tech Championship.

Ariya Jutanugarn and Celine Boutier were 10 under.

First-round leader Gaby Lopez followed her opening 63 with a 75 to drop to 4 under. Fellow former Arkansas star Stacy Lewis also was 4 under after a 72.

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Henley will try to put heat on Casey in final round

By Will GrayJune 23, 2018, 11:55 pm

CROMWELL, Conn. – While it will be a tall task for anyone to catch Paul Casey at the Travelers Championship, the man who will start the round most within reach of the Englishman is Russell Henley.

Henley was in the penultimate group at TPC River Highlands on Saturday, but he’ll now anchor things during the final round as he looks to overcome a four-shot deficit behind Casey. After a 3-under 67, Henley sits at 12 under through 54 holes and one shot clear of the three players tied for third.

Henley closed his third round with a run of five straight pars, then became the beneficiary of a pair of late bogeys from Brian Harman that left Henley alone in second place.


Full-field scores from the Travelers Championship

Travelers Championship: Articles, photos and videos


“Could have made a couple more putts, but to end with two up-and-downs like that was nice,” Henley said. “I felt a little bit weird over the shots coming in, put me in some bad spots. But it was nice to have the short game to back me up.”

Henley has won three times on Tour, most recently at the 2017 Houston Open, and he cracked the top 25 at both the Masters and U.S. Open. But with Casey riding a wave of confidence and coming off an 8-under 62 that marked the best round of the week, he knows he’ll have his work cut out for him in order to nab trophy No. 4.

“I think I can shoot a low number on this course. You’ve got to make the putts,” Henley said. “I’m definitely hitting it well enough, and if I can get a couple putts to fall, that would be good. But I can’t control what he’s doing. I can just try to keep playing solid.”

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Back from back injury, Casey eyeing another win

By Will GrayJune 23, 2018, 11:36 pm

CROMWELL, Conn. – Given his four-shot cushion at the Travelers Championship and his recent victory at the Valspar Championship, it’s easy to forget that Paul Casey hit the disabled list in between.

Casey had to withdraw from The Players Championship because of a bad back, becoming the only player in the top 50 in the world rankings to miss the PGA Tour’s flagship event. He flew back to England to get treatment, and Casey admitted that his T-20 finish at last month’s BMW PGA Championship came while he was still on the mend.

“I wasn’t 100 percent fit with the back injury, which was L-4, L-5, S-1 (vertebrae) all out of place,” Casey said. “Big inflammation, nerve pain down the leg and up the back. I didn’t know what was going on.”


Full-field scores from the Travelers Championship

Travelers Championship: Articles, photos and videos


Thanks in large part to a combination of MRIs, back adjustments and anti-inflammatories, Casey finally turned the corner. His T-16 finish at last week’s U.S. Open was the first event for which he felt fully healthy since before the Players, and he’s on the cusp of a second title since March after successfully battling through the injury.

“We thought we were fixing it, but we weren’t. We were kind of hitting the effects rather than the cause,” Casey said. “Eventually we figured out the cause, which was structural.”

Casey started the third round at TPC River Highlands two shots off the lead, but he’s now four clear of Russell Henley after firing an 8-under 62 that marked the low round of the week.

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Bubba thinks he'll need a Sunday 60 to scare Casey

By Will GrayJune 23, 2018, 11:15 pm

CROMWELL, Conn. – Perhaps moreso than at most PGA Tour venues, a low score is never really out of reach at TPC River Highlands. Positioned as a welcome change of pace after the U.S. Open, the Travelers Championship offers a lush layout that often pushes the balance much closer to reward than risk.

This is where Jim Furyk shot a 58 on the par-70 layout two years ago – and he didn’t even win that week. So even though Paul Casey enters the final round with a commanding four-shot lead, there’s still plenty of hope for the chase pack that something special could be in store.

Count Bubba Watson among the group who still believe the title is up for grabs – even if it might require a Herculean effort, even by his standards.


Full-field scores from the Travelers Championship

Travelers Championship: Articles, photos and videos


Watson has won the Travelers twice, including in a 2015 playoff over Casey. But starting the final round in a large tie for sixth at 10 under, six shots behind Casey, he estimates that he’ll need to flirt with golf’s magic number to give the Englishman something to worry about.

“My 7 under yesterday, I need to do better than that. I’m going to have to get to like 10 [under],” Watson said. “The only beauty is, getting out in front, you have a chance to put a number up and maybe scare them. But to scare them, you’re going to have to shoot 10 under at worst, where I’m at anyway.”

Watson started the third round three shots off the lead, and he made an early move with birdies on Nos. 1 and 2 en route to an outward 32. The southpaw couldn’t sustain that momentum, as bogeys on Nos. 16 and 17 turned a potential 65 into a relatively disappointing 67.

“Bad decision on the par-3, and then a very tough tee shot for me on 17, and it just creeped into the bunker,” Watson said. “Just, that’s golf. You have mistakes every once in a while.”