Brain Injuries – No Fault Of Their Own

Traumatic Brain Injuries – Part 5 of 5 
Chronic Traumatic Encephalopathy (C.T.E.)
and Conclusion

Thomas Insel, Director of the National Institute of Mental Health (NIMH) wrote in his director’s report on May 28, 2012, that “NIMH was established nearly 65 years ago to help the nation address the mental health issues of veterans after World War II.”

I’ve been affiliated with NIMH for many years and hadn’t realized the original mission of the organization involved helping combat veterans of WWII reintegrate into society. My immediate thought, is that if the ‘greatest generation’ needed assistance with mental health issues, why do we still have the stigma we have today when a brain goes bad?

A brain can go bad for many reasons. It can be physically injured as is the case with a Traumatic Brain Injury (TBI). The brain can additionally be injured because the individual witnessed or experienced a traumatic event too encompassing to process. Finally, there are chemical and physiological reasons as to why a brain goes bad: bipolar disorder, personality disorders, schizophrenia, etc. For the purposes of this discussion I’ve elected to focus on traumatic brain injury and discoveries resulting in lingering healthcare questions for veterans in the decades to come.

In the report by Director Thomas Insel of NIMH, he brings to attention the following relevant facts: 2.7 million men and women have served in Iraq and Afghanistan over the past decade; most were under age 25, many had never traveled before, and all are volunteers. Additionally, for many the wars have translated into so-called invisible wounds (TBI and PTSD). While improvements in body armor have protected limbs and lives, the brains and minds of our returning soldiers have not escaped the modern battlefield unscathed.

Patrick Kennedy, co-founder of One Mind for Research, has stressed the urgency of these injuries, calling these soldiers “medical prisoners of war.”

Today more soldiers are dying from suicide than combat. Conclusive evidence is not yet available but cumulative evidence is presenting itself at an alarming rate.

Statistics are unavailable for the exact number of TBIs and PTSD cases as a result of the dual wars. It wasn’t until National Public Radio (NPR) and ProPublica began intense reporting that a number of issues were brought to light. These included: no guidelines for testing or treating soldiers and no reporting mechanism. Furthermore, while the Defense Department spent close to $3 billion between 2003 and 2012 to treat and study traumatic brain injuries and post traumatic stress disorder (the leading injuries suffered by US military in Iraq and Afghanistan), a federal investigation found that the department’s programs were so disorganized it couldn’t figure out how the money had been spent.

Fortunately, as a result of the development of the Defense and Veterans Brain Injury Center (DVBIC) referenced in Part 2 of this discussion, all divisions of the military now have a central location for the collection of data, accountability of expenditures, and policies for guidelines and treatment modalities.

On May 16, 2012, the New York Times reported that scientists had discovered an organic structural problem in the brain associated with blast exposure.

The paper provides the strongest evidence that perhaps many combat veterans with invisible brain injuries caused by explosions are at risk of developing long-term neurological disease—a finding that, if confirmed, will have profound implications for military policy, veterans programs, and future research.

Fox News reported on the comparisons of professional football players and combat soldiers with traumatic brain injuries. Their report of May 17, 2012, suggests that brain injuries suffered by thousands of soldiers may be at risk of developing the same degenerative brain disease as some retired football players.

Autopsies of four young veterans found the earliest signs of chronic traumatic encephalopathy, or C.T.E., in their brain tissue.

Dr. Lee Goldstein of Boston University leads the comparative study along with Dr. Ann McKee of the VA New England Healthcare System.

C.T.E. is a progressive disease linked to multiple concussions. Unfortunately only an autopsy can confirm a diagnosis.

The four young veterans, ages 22 – 45, lived for a year or longer after their military TBIs, but complained of problems with memory, irritability, sleep and other issues before dying of suicide or other causes. Drs. Goldstein and McKee found the veterans’ brains contained broken axons, the nerve fibers that act as the brain’s telephone system.

C.T.E. is a close relative of Alzheimer’s disease. Despite the fact that C.T.E. can only be diagnosed posthumously, it does show itself in symptoms like memory loss, impulsiveness, mood swings, and addictions.

Additionally, it’s as though the individual’s personality leaves them and they are always flat or one-dimensional. Unlike TBI wherein there are problems with sleep, the individual with C.T.E. often falls asleep in the middle of an activity.

In the case of professional hockey player, Derek Boogaard, diagnosed with C.T.E., he died of a drug and alcohol overdose at 28. It was reported that he lived in a fog of post-concussion syndrome and that he slid into a hazy shade of loneliness. He grew desperate for company and his memory lapses grew more severe.

Additional signs of Boogaard’s brain gone bad was that he would go days without showering and would make grandiose and scattered plans.

Derek Boogaard’s symptoms are similar to many of our returning combat soldiers.

In closing, as I stated in my first blog of this series, I take the position, ‘don’t send a soldier back into combat after receiving a traumatic brain injury.’

My reasoning might best be summed up by referring to the suicide numbers being higher than our actual combat casualties. Never in the history of our nation have we asked so much from so few.

An article in USA Today on May 14, 2012, caught my eye and I instantly thought it could possibly be the best outcome for any service member separating from the military and facing an immediate need for medical care. We know the wait time for processing into the VA is lengthy and the USA Today article titled ‘Studies up as War Winding Down’ from page 2A speaks of medical studies being conducted as a result of combat. My suggestion to combat veterans: run, don’t walk to the head of any line where volunteers are being accepted and sign-up. Most studies will last for decades and you’ll be in the system for medical care for the duration.

For anyone with a traumatic brain injury or any other brain injury—I wish you the best. It’s not easy living day-to-day with a brain injury. I discover new concessions I must make on a regular basis. Click to view April and Tom Marcum’s experiences.

Thank you for reading with me. I welcome your comments about brain injuries: experiences you might have had (good or bad), treatment that has worked or not, what you might have done differently, or anything else you might like to add.

About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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19 Responses to Brain Injuries – No Fault Of Their Own

  1. This is a very important post. People need to be aware of the dangers that veterans face, after leaving the military.
    It is very sad to me that people so young have to be subject to this kind of suffering. There needs to be a much better support system for them.
    Annie ❤

  2. Reblogged this on Gentle Kindness and commented:
    This is an important post about traumatic brain injuries sustained by veterans when they were in the military.

    Being exposed to blasts nearby over and over again can cause brain injury, even if the rest of their body is not hit by the explosion.

    There is a bar graph statistic in the middle of this post. Please read the original post to see the graph. There are about the same number of soldiers who commit suicide as soldiers who die in combat.

    So, once the soldiers are out of the war zone, they still are in as much danger of death, as they were before leaving the war.

    Annie ❤

  3. Sheri, this morning I was on line at the supermarket and caught the cover story in Time Magazine … One a Day … each day one member of the military commits suicide. It is a thought provoking article that speaks to the heart of what you have been talking about. Such a sad testament to our boys in uniform that now more die at their own hands than in combat );

  4. Sheri – my experience is quite different, in that I didn’t have a brain injury but I did have brain surgery of a sort. I had a benign tumor on my auditory nerve (which is right next to – touching – the facial nerve). Having it removed took 11 hours. I had the finest of surgeons. I got lucky, the tumor was completely removed, and my facial nerve came through with flying colors.

    But even such a minor – and when dealing with brain/nerve issues, this was minor – surgery has taken me over a year to recover on the mental side. On the physical side, I still lose my balance, I have lost my hearing entirely (as they ended up going through my Eustachian tube instead of my skull) and am still learning to cope with the lack of triangulation of sounds.

    My experience is nothing when it comes to a traumatic brain injury. But I have enough insight to know how desperately these people need some sort of lifeline, some sort of help to get them through their darkness to whatever balance they can achieve. Your series of articles will, I devoutly hope, bring a bright light to these issues and encourage even more research and study groups in this area.

    Thank you.

    • Christine – You’ve been through a harrowing experience and again, ‘though no fault of your own.’ Thankfully, you’ve had a medical team who knew what they were doing and they gave you the best medical care. It sounds to me that your experience is one I and many others like me with TBI consider ourselves fortunate to not have experienced. Thanks for sharing your story and I’ll be thinking of you as you continue your recovery.

  5. You do indeed speak well for those who can’t speak for themselves. Keep it up, Sheri.

  6. As everyone else has written, you have taught us so much with this series. I certainly plan to Tweet and RT whenever I can to help get the word out.

  7. I couldn’t agree more with your commentors. You’ve absolutely opened my eyes and are an incredible voice to those who need an advocate most! Here’s to continued visibility to this most distressing topic!
    Great series!

  8. I agree with Florence, Sheri. This has been an extraordinarily enlightening read for me. The five posts you’ve written about TBI’s, your personal experience, your husband’s experience, and what you’ve learned and told us, is meant for a book. Can you imagine how helpful this would be for people who have suffered what you’ve written about? I am going to be forwarding your article to my sister-in-law and also my nephew. He fought in Afghanistan and though he didn’t suffer a TBI as far as he knows, perhaps he has buddies who did.
    Thank you so much for sharing your knowledge. I know I learned a heck of a lot from this series.

    • Thank you, Patti. My goal in writing this series was to get the word out about brain injuries in general but most importantly, what’s happening to our soldiers as they return home and are not receiving the care they need. It’s not just the immediate care, but the on-going care that will more than likely affect the remainder of their lives.

  9. Sheri, this has been an amazing series and one that should be reprinted in magazines or in a book of your own. You are a true soldier and shine a beacon of hope for those who still live in the shadows of our system in a desperate need of care and understanding. You have brought many issues out of the darkness and into the light. Bless you !!

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