Saturday, July 24, 2010

Traumatic Brain Injury: Setting the Record Straight: There's More To Be Done

Let's face it no Traumatic Brain Injury is easy. You can search online for thousands of stories, videos, science articles, news stories, etc. Brain Injuries range from mild to severe. According to my medical record, doctors at the beginning diagnosed a moderate traumatic brain injury (contusion), and later after initial diagnosis it was documented as mild traumatic brain injury (concussion). The difference between my case and the case of many others is that my head injury was diagnosed within an hour from the EFP blast by a doctor at the Joint Security Station. The aid station were I had to be taken to was a very small but I was referred for observation to an Emergency Room at a larger Forward Operating Base. There I was dismissed quickly apparently because of the lack of visible wounds even though the head injury was documented. I was dismissed very quickly, regardless of the symptoms presented. I always tried to remain in country with my troops, making that the reason for me to try to lay low and pretend like nothing was wrong with me. At the time I didn't know what traumatic brain injury or mTBI. I did everything within my power to stay in Iraq. Regardless what I tried there was visible signs that I wouldn't notice but everybody around me could tell that something was wrong. I was a top notch NCO, not because I'm saying so but rather because all my military documents state so. On my last evaluation, one of the comments was "the best Staff Sergeant in the Company" written by CPT Norman Lockhart. Many times the clinical notes on my record don't reflect what actually took place in the visit and don't accurate represent what was wrong with me. It is because the involvement of the commonly called "line unit" leadership that I'm better today. They pushed for what they thought was more beneficial for me. I do appreciate the efforts of the following individuals: 1SG Paul Crow, CPT Norman Lockhart, CPT Erika Porter, CPT Patricia Watkins, CSM Roger Yuraska, LTC James Gallivan, CSM Mustafa, and LTC Wilson.
As you all know in the present I have lingering effect for the traumatic brain injury. There is always one question in my mind: will I be like this today if prompt action would have been taken? This is a question that will never be able to be answer.
As the Army's medical system tries to move forward and make progress in this area. Honestly I do believe that that top level Army’s leadership is taking this seriously. But I also see that there are philosophy issues within the system as some believe that TBI is just a headache and some other attribute everything to Post Traumatic Stress Disorder or PTSD (now they call it Post Traumatic Stress or PTS). These philosophies I have heard and read. What makes my case so unique is that the PTSD in me have resolved. On the other hand, when I arrived to Ft Bliss from Iraq I had many emotional issues. The root of these issues in my opinion was the fact that I didn't want to be here. I wanted to be in Iraq with my Soldiers. As I came to accept the fact that I had to take care of myself the emotional issues started to resolve. Today, I have my doubts in regard to ever having PTSD, this proven as the Neuropsychological test deferred the axis I and II because no behavioral issues were found.
Even with all the documented issues on my record I still faced challenges in getting proper care. The neurologist at the time even wrote on my medical notes "I am concerned this soldier is slipping into a cycle of playing the sick role". That crushed me as I was having all this cognitive issues, tremors, headaches, fluency issues, etc. That crushed my values, the values I live for.
To know more from my story click on the links at the bottom of the screen.

Why I'm I telling you all this?

Today I had the opportunity to watch the PBS video on Traumatic Brain Injury. This video can be found on http://www.pbs.org/wnet/need-to-know/video/need-to-know-june-25-2010/1821/
This is the story of Army Ranger, Scott Nos, US Navy Medic Anthony Thompson, and SPC Eric Edmunds. Its shocking to see the price paid by the family, from coming back to an unprepared hospital to taking care of a wounded service member full time. These families have dropped everything in life to care for their loved one. I commend them for doing that. But this raises a question in me: are we doing enough? Is the system we are part of, doing enough? I recognize many are doing more of what they are asked because they care and like in everything there got to be those that are in this to see how famous their name can become. Research has to be done but at the same time with a brain injury we can run out of time if proper intervention is not given promptly.
My personal opinion is: the system should do research parallel to giving the care Wounded Service members and their families deserve. As I recognize the struggles and bureaucracy we face as Wounded Soldiers, I also recognize the struggles and bureaucracy our medical professionals have too. I don't think nobody should be blamed as historically our system has been reactive and not proactive. Since is such a huge system I see that it takes time to change. But as us the ground troops in combat we have to quickly adapt to situations, our medical system should be like that too.
I'm not writing this out of anger. We shouldn't be looking for who's at fault. We (medical professionals, patients, and family members) should be working together in order improve the system.
My message to the higher leadership is: try to see your operation from the patient’s eyes. As we have a lot to learn from all of you, you all have a lot to learn from us. Our feedback should be priceless to the operation.
Thank you.

2 comments:

  1. Victor, hooray for you for being persistent and for speaking out and fighting for the proper care and recognition of TBI in other veterans.

    Because it does not present a visible wound, brain injuries are all too over looked, underestimated, and not treated. I know, I oftentimes wish I had a big bandage on my head. There is also a stigma that goes with such an injury especially in the military.

    The number of people coming home with brain injuries is going to be staggering. Keep being their voice and raising awareness and fighting for adequate treatment. For yourself and for them.

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  2. Wow,.. you are a very good speaker and writer. Its amazing what experience and passion can bring forth. I like your approach on not placing blame, but working together to bring accountability and needed changes in the medical system. As if you haven't given enough allready, I'm truely amazed and inspired by your dedication to advocate for the many guys and gals thats facing the issues that goes with having invisable wounds. Hopefully you will be able to help educate the public that isn't effected by TBI themselves or one of their family members,.. that just because your nolonger in theater, doesnt necessarliy mean your battle is over.

    As for the research I have done, it is very clear that the symptoms of TBI and PTSD are very alike and often mis diagnosed, which in turn results in wrong treatments. Also I have learned,.. one can be injured with a TBI just by being near the sounds of the blasts from I.E.D's and also from the repeated jarring of the brain from riding in the vehicals. Heres a couple of videos that I refer people to often.
    Medical Animation: TBI Part I
    http://www.youtube.com/watch?v=gCMS8aOmK1M
    Medical Animation: TBI Part 2
    http://www.youtube.com/watch?v=AmAML1-F2LE

    As for the note that doctor put into your record, "I am concerned this soldier is slipping into a cycle of playing the sick role". It's sad and unfortantly not uncommon,.. when one doesnt understand on a personal level, one can be ignorant. But the bright side is, through advacating and educating as you are,by sharing your story,.. perhaps the next soldier who is seen, won't recive that same note in his or her record.

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