Traumatic Brain Injuries – Part 2 of 5
Soldiers, Sports and Ordinary People
Gardening season has arrived and there’s something about uncovering the winter mulch and knowing my roses, wildflowers and perennials will soon be a profusion of color. I love gardening; it brings peace and joy to my otherwise chaotic world.
What I didn’t plan on was that during a six week period while gardening, I would lose my sense of balance and fall three times. I didn’t trip over anything, nor was I bent at a crazy angle or doing something outrageous. Out of nowhere, I went from standing up to being on the ground. The results: another concussion, broken ribs, continual nausea, and my sense of taste is gone and I’m mad. I’m really mad!
This isn’t old age creeping up on me. I have multiple traumatic brain injuries. I used to have a medical history of 3 and now I have 4. Once you have a TBI, research supports that you’re more likely to have additional TBIs. Researchers don’t know why; that’s just the way it is. And, with each additional TBI, medical problems escalate and expand.
A recent Mayo Clinic study of Traumatic Brain Injuries reports that injuries classified as mild may in fact have more severe effects than previously understood.
The study examined medical records from several decades. The researchers found a much higher rate of TBI than the Centers for Disease Control (CDC) estimate. Sixty percent of the injuries were outside the standard categorization for TBI used by the CDC.
The Mayo Clinic warns of: difficulty understanding risky situations or avoiding risky persons, difficulty controlling one’s temper which causes others to get angry, and behavioral problems, such as drinking too much.
The CDC states that seventy-five percent of all TBIs are a result of previous mild TBIs, and the Mayo study indicates that these mild TBIs may not be so benign.
The late NFL star Junior Seau was involved in a risky situation when he drove his jeep over a cliff yet his family didn’t connect this irrational behavior to multiple traumatic injuries on the playing field.
I shudder when I read of retired NFL football players committing suicide. It’s not by coincidence that they shoot themselves in the chest. The players want their brains preserved and most ask that their brains be submitted for study due to the trauma inflicted. These men tell of no longer being who they once were, their personalities have changed so much. It’s not that they now have taken off the uniform and have lost their identity. They have lost so much more due to traumatic brain injuries. The eventual suicide of former NFL icon Junior Seau by just such a gunshot to the chest is a case in point.
Teen sports are legendary: football for boys and soccer comes in at a close second for girls. An investigative report by Kate Snow at RockCenter.NBC dated May 23, 2012 clearly shows the mounting problems teen girls are having.
Professional football players don’t have to choose their lifestyle, teens don’t have to participate in sporting events and I could be more sedentary. But, our soldiers don’t have a choice. They’ve fought in the longest war in which our country has ever been engaged. But these men and women haven’t been deployed once. They’ve endured multiple deployments.
One of the most common wounds troops suffer is brain injuries caused by the concussive force of a nearby blast. Improved battlefield diagnoses lead to a record number of concussions detected among U.S. troops fighting in Afghanistan and Iraq last year, with an average of sixteen inflicted each day.
Blast injuries can result in the full spectrum of closed and penetrating TBIs (mild, moderate, and severe). The mild-to- moderate blast related TBIs are often overlooked in the presence of more severe polytrauma. Blast injuries are defined by four potential mechanism dynamics:
1. Primary Blast: Atmospheric over-pressure followed
by under-pressure or vacuum.
3. Tertiary Blast: Service Member being placed in
motion by the blast.
4. Quaternary Blast: Other injuries from the blast
such as burns, crush injuries, toxic fumes.
All individuals sustaining a traumatic brain injury recover at different rates. As I mentioned in Part 1 of this series, posted on June 18, 1012, I didn’t follow my doctor’s advice and my brain and body didn’t heal properly. Soldiers want to return to combat. They know they are needed. As a rule, they don’t want duty restrictions. Instead, they want to return to the very place that puts them at risk for sustaining another concussion.
Current testing doesn’t tell what the consequences of a head injury will be. Nor can it forecast long term limitations.
A real problem for soldiers is that even if there is some documentation in their medical record of “something in service” without evidence of treatment for the condition with the first year of discharge, service connection injury is difficult to prove.
TBI medical issues will occur from a number of different scenarios. Perhaps most important is that the Department of Defense admits they’ve missed diagnosing thousands of soldiers. There’ll be nothing in the service member’s medical file that he or she was even seen for a possible TBI. Therefore, medical benefits will be more difficult to obtain. Meanwhile, the veteran may have become incapacitated in many aspects of his life. Until such time as a service connected disability is established, thousands of veterans are not allowed access to the VA and thus have no medical care. Often it’s impossible for them to prove they have an injury related to their time in service if they don’t have access to medical care. Most don’t have private insurance. Many are homeless.
Then there’s the problem of not knowing the degree of disability a service member will be awarded and the lengthy appeals process that tragically continues.
As already stated, the many medical issues that come from having a TBI may not show up until years later and symptoms come and go with lightning speed. It’s easy to think you are losing your mind.
Tricare would have you believe that sunglasses will take care of eyes hurting from the light. Referring to the investigative report by Kate Snow of NBC again, it’s clear that this is not the case. Light can be enemy number one. I have days when I cannot go outside or even open the blinds.
That said, one positive outcome has been the Defense and Veterans Brain Injury Center (DVBIC). In its efforts to assess and manage TBIs at all levels of care, DVBIC has brought military and civilian head injury and sports medicine together to facilitate a dialogue on TBI.
The $1.03 billion DVBIC provides services among itself (located at Fort Belvoir, VA) and Walter Reed-Bethesda in Maryland. Fort Belvoir Community Hospital is looking to be a leader in comprehensive behavioral and physiological health throughout the National Capital Region and DoD.
Service members with TBIs are scattered across the US. Only the most severe cases will receive treatment at DVBIC. Family members will be further harmed emotionally and financially. They’ll want to be with their service member at DVBIC but will that be possible? It’s reported the DC area DVBIC will deliver care to the most severely wounded TBI related service members. Fortunately, other facilities are now located around the country.
My concern, will the DVBIV at Fort Belvoir become an expensive think tank at the expense of our veterans?
Please join me for part 3 on July 2, 2012 when I continue this conversation of traumatic brain injuries. I’ll be discussing how a man, my husband, had 55 years of his memory erased, all in the name of a medical procedure paid for by our insurance company, ECT. He sustained a severe traumatic brain injury during the procedure.