TBI clinic uses stressors to create positive change
July 22, 2011
July 22, 2011--Tucked away across the street from the Blanchfield Army Community Hospital, is a small group of some of the newest buildings on Fort Campbell. For service members who need care for a traumatic brain injury beyond what their primary care provider can give them, the Warrior Resiliency and Recovery Center is like a second home, a place where they spend weeks and months getting the treatment they need.
Some aspects of the treatment can frustrate Soldiers, explained Dr. David Twillie, director of the center. It is not meant to discourage them though, it is meant to help.
“What we really do in all of our work here at the clinic is we stress the brain in certain areas to make changes that are more helpful than hurtful,” said Twillie. “Our patients, especially in the early part of what we do, they are pretty frustrated. The reason they’re pretty frustrated is we’re going to ask them to do things that are hard for them and they feel pretty silly because they think they’re things they should be able to do. ‘I could do this before. Why can’t I do this? This is so simple.’ We get them to understand that what we’re asking them to do is right on the edge of what they are able to do.”
Soldiers are evaluated when they first come to the TBI clinic by the various specialists there to create an individualized treatment plan. The treatment is designed to last about 12 weeks, but usually lasts an average of 19 weeks, with Soldiers being re-evaluated every four weeks to be sure the treatment plan is working. Soldiers will see everyone from their primary care doctor at the clinic to physical therapy to behavioral health and neurology and everything in between; with a majority of their appointments all in one building.
“The furthest you can be is one building over,” said Twillie.
This helps those suffering from a TBI decrease their frustration, especially if they have memory issues. A Soldier doesn’t have to worry about trying to remember which day to be at a certain building. The can show up to any of the three buildings and if they are at the wrong one, they will only need a minute or two to end up in the right location.
For some of their appointments, Soldiers will experience things like the quantitative electroencephalogram to map their brainwaves, balance machines, light boards, convoy simulators, a rotary chair and more.
Some of the treatments are much like computer games and other procedures are for diagnostic reasons. The rotary chair is one the things the TBI clinic uses to help diagnose problems.
“This chair is able to determine not only that your ears that the balance is wrong, but which, there are like five different little organelles inside your inner ear, it can tell which one of them is not working properly,” said Twillie.
The chair can make the Soldiers feel off balance and is one way the Soldiers are pushed to their limit. With things like some of the balance boards, the Soldiers not only have to balance, but they have to shake their head and sometimes complete a task like a math or word problem. While it all may be difficult and they continue to push the Soldiers more and more as they get better, it is all for a good reason.
“We’re not asking people to be able to walk again,” said Twillie. “We’re asking them to be able to jump over a wall and chase down a bad guy. We’re training them to a very high level here, a professional athlete level. They’ll be smoked, they’ll be tired from the work we’re doing.”
Twillie explained the clinic actually won’t see most of the Soldiers who are involved in an incident while deployed that causes a concussion. He explained 10 to 20 percent of service members will end up with a concussion while deployed and most will not need the treatment provided by those at the TBI clinic.
“Most of these folks won’t need to come see me,” said Twillie. “Most of them, with good self care and good primary care, will get better and never have any problem.”
Of the 10 to 20 percent who have a concussion, only 10 to 20 percent of that group will need the care provided by specialists like those at the TBI clinic. In Afghanistan, they can have a better idea of who those Soldiers are before they even leave theater. Six concussion clinics have been set up. Soldiers are required to be seen after an event which can cause a concussion.
“It is event driven,” said Twillie. “We can get much better data. Sometimes the Soldier doesn’t know what happened to them because they were knocked unconscious. We’re able to already know some patients before they even arrive.”
With clinics like those in Afghanistan and the one at Fort Campbell, Soldiers are able to get the care they need and many are able to return to duty after their treatment. Twillie appreciates the support the clinic is given to do their job and to help Soldiers.
“The Army sort of lead the way here with the propensity for rehabilitation and reintegration,” said Twillie. “We’ve had great command support. They really supported us and let us do what we needed to really help Soldiers. What the Army is doing is really helping us move forward. Because we’ve seen so many concussions now, we’re helping the science move forward.”
**Editor’s note " This is the second story in a series on TBI. To follow this series, visit www.fortcampbellcourier.com.