Traumatic Brain Injury Center: Blows to the head an injury, not a mental illness

FORT HOOD, Texas (March 27, 2009) -- While serving with the 1st Cavalry Division in Iraq during Operation Iraqi Freedom 06-08, Spc. Kevin Williams was in three blasts from improvised explosive devices. The first two, he said, were minor. The third was so severe it damaged the Bradley Fighting Vehicle in which he was riding.

Though not physically injured significantly in those explosions, Williams still is under treatment for the injuries to his brain.

The former 1st Cav. Div. medic is one of an estimated 10-20 percent of servicemembers returning from a combat deployment with a mild traumatic brain injury.

For these servicemembers, a roadside explosion or hard fall are two of the most common incidents that cause injury to the brain.

Better known as a concussion, a mild case of TBI can cause various physical and mental problems for an individual. Concussions can result from a blow to the head causing ringing in the ears, headaches, dizziness, memory gaps, disorientation, balance difficulties and blurred vision.

Aca,!A"Traumatic brain injury results in problems that werenAca,!a,,ct there before and are due to some sort of damage to the brain,Aca,!A? said Maj. Alan Hopewell, chief and office-in-charge of Carl R. Darnall Army Medical CenterAca,!a,,cs Traumatic Brain Injury complex at Fort Hood.

Williams suffers from Aca,!A"constant headaches,Aca,!A? dizziness and memory issues. Aca,!A"I have trouble finding words,Aca,!A? he said. Aca,!A"I forget things. I get lost.Aca,!A?

After spending more than three years as an Army medic helping his fellow Soldiers, Williams now is facing a reversal of roles. Aca,!A"I gave a class in Iraq about TBI and didnAca,!a,,ct realize I had symptoms myself,Aca,!A? he said. Aca,!A"I just wanted to get home.Aca,!A?

Shortly after Williams got home, his wife urged him to seek help.

He was experiencing memory loss, difficulty concentrating and the ever-present headaches. The headaches caused him to be irritable, something his 7-year-old son noticed.

Diagnosed last March with a mild case of TBI, Williams sought treatment at Fort HoodAca,!a,,cs TBI center.

Providers as the TBI complex, located in Bldg. 42005 on Battalion Avenue on Fort Hood, treat active-duty and reserve servicemembers with brain injuries. Services include outpatient psychological, medical, and consultation services.

The TBI team began services in 2007 from various buildings and offices on the installation, making it difficult to treat servicemembers effectively.

In November 2008, the first building in the complex opened with consolidated services.

Aca,!A"In addition to treatment, our current mission is to develop the complex into an integrated team and continue to build on the progress that has been made; weAca,!a,,cre developing a fully functional rehabilitation program and expanding on what we are able to do for the Soldiers,Aca,!A? Hopewell said.

The ultimate goal is improve the health of personnel who have experienced a brain injury and to ensure the Soldier returns to duty in good physical and mental shape, Hopewell added.

Williams visits the center three or four times a week for cognitive rehabilitation groups, post-traumatic stress group and individual counseling and treatment.

During the cognitive rehab, servicemembers work on life skills, memory games, puzzles and other activities to exercise their minds. Aca,!A"We learn new ways to access information,Aca,!A? Williams said.

In addition to receiving assistance and treatment, Williams has found others who are experiencing the same things. Aca,!A"It took me a while to realize how many people have issues,Aca,!A? he said.

He said the level of care at the center is great, especially considering the newness of TBI. Aca,!A"It (the treatment) changes all the time,Aca,!A? Williams said. Aca,!A"I think it is wonderful.Aca,!A?

The center is comprised of a professional military and civilian staff that includes one psychiatrist, two psychiatric nurse practitioners, three neuron-psychologists, six licensed clinical social worker care managers, two physician assistants, an occupational therapist and three registered nurse case managers.

Aca,!A"We are a team dedicated to the rehabilitation of servicemembers who have suffered a TBI and have persistent symptoms,Aca,!A? Hopewell said.

Emergency evaluations, medication assessment and management, individual and group counseling are just a few of the services available at the TBI Center.

When a servicemember is referred to the TBI center, the first assessment is to determine the intensity of the patientAca,!a,,cs condition. Hopewell said many Soldiers do not seek help for fear of appearing weak, or that there is somehow a stigma in getting health care.

Aca,!A"Many times they deny the injury or think itAca,!a,,cs not as bad or they are afraid that someone will think that they have mental problems,Aca,!A? Hopewell said. Aca,!A"The truth is people suffering from TBI donAca,!a,,ct understand how the injury affects them.Aca,!A?

Williams said at first, it was difficult for him to seek help. Aca,!A"A little bit of it was pride and how IAca,!a,,cd be perceived,Aca,!A? he said. The specialist said he does not regret seeking help from the TBI center for his injury.

In much the same way a bullet invades your body causing bleeding and pain, an injury to the head causes reactions in the brain.

It is not something that you caused, it is something that happened to you, Hopewell said.

Aca,!A"In addition to treating TBI as an injury, we want to emphasize to Soldiers that because it involves the brain, you can have emotional and psychological reactions,Aca,!A? Hopewell said. Aca,!A"We want to emphasize this is not a psychiatric illness. ItAca,!a,,cs an injury that affects the body and affects the nervous system.Aca,!A?

For Williams, the TBI affects his balance. He attends occupational therapy in Austin to work on his balance problems. Williams knows his physical condition is not as severe as some others.

Aca,!A"A lot of guys have worse physical injuries,Aca,!A? Williams said.

The former medic said, for him, the worst symptom of the TBI is the headaches that travel from the back to the front of his head.

Aca,!A"The overwhelming primary symptom is headache,Aca,!A? he said. Aca,!A"Other symptoms that seem much more prevalent are sleep disruptions, feeling tired, and having trouble concentrating.Aca,!A?

Other frequent symptoms caused by TBI include loss of coordination and trouble processing or retaining information.

Anyone who has experienced a concussion can suffer from an alteration of his or her mental status. Other symptoms such as confusion, dizziness or physical disabilities are also signs of a possible brain injury.

After the initial assessment, clinic staff identifies the level of injury a Soldier is suffering. The symptoms are divided into three categories: physical symptoms, cognitive symptoms and emotional effects.

Aca,!A"Level one is primarily supporting the soldier to management symptoms: Level two is referral to CRDAMC for more extensive examinations such as CAT scans, MRIs, ear, nose and throat exams and balance exams; Level three is helping a servicemember with medical board separation for medical disabilities,Aca,!A? Hopewell said.

When required, patients might be referred to physicians at CRDAMC for additional health care.

Neurology services, the Resilience and Restoration Center, chaplain services, garrison Battlemind program, and command consultation are just a few of the services available at Fort Hood.

The TBI Center coordinates with CRDAMC and garrison services to ensure all patients receive the entire spectrum of care needed to assist with their injury.

Married servicemembers undergoing treatment at the TBI Center are encouraged to invite their spouse for a weekly evening discussion at the complex. Aca,!A"ItAca,!a,,cs an educational support system to help spouses understand what the Soldier is going through after an injury and during treatment,Aca,!A? Hopewell said.

The TBI complex is still growing to meet the healthcare needs of Fort Hood Soldiers. A new state-of-the-art facility under construction across from the TBI Center will help reintegrate Soldiers back to their units.

Aca,!A"The new facility will include a living apartment where we can teach people who are having trouble cooking for example,Aca,!A? said Hopewell. They are also working on a car and motorcycle simulator that will help evaluate patientsAca,!a,,c driving ability after suffering a TBI.

Other amenities include a whirlpool and more physical therapy equipment.

(Heather Graham, Sentinel News Editor, contributed to this story.)

Page last updated Fri March 27th, 2009 at 17:07