By Tracey-Jean SantoroMarch 4, 2018
Fort Huachuca, Arizona -- March is designated as Brain Injury Awareness Month and demonstrates the commitment of the Department of Defense and Department of Veterans Affairs to raise awareness about traumatic brain injury and educate service members, veterans, family members and health care professionals about brain injuries.
DOD's definition of traumatic brain injury, or TBI, is a disruption of brain function resulting from a blow or jolt to the head or a penetrating head injury indicated by new onset or worsening of at least one of the following: loss of consciousness, alteration of consciousness, post-traumatic amnesia, neurological deficits, or a intracranial lesion. However, not all blows or jolts to the head result in a TBI.
The Defense and Veterans Brain Injury Center's campaign, A Head for the Future, encourages you to protect your brain and protect your future. Think about what you are doing and how you can be safe to avoid getting a TBI (for example, always wear a helmet when riding a bicycle or motorcycle). More information on the campaign is available at http://dvbic.dcoe.mil/aheadforthefuture/stories.
Make smart decisions. A TBI can happen to anyone, so it is important to learn the signs and symptoms of TBI/concussion and when to get checked out. See your Primary Care Provider or nearest emergency room as soon as possible after a head injury, and follow your provider's recommendations for rehabilitation to ensure optimal recovery.
Fort Huachuca is home to a Level 4 TBI Program, providing outpatient care to service members with mild traumatic brain injuries occurring while deployed and in garrison. Raymond W. Bliss Army Health Center TBI team members consist of Dr. Richard LaMacchia, treating neuropsychologist; Tracey-Jean Santoro, psychology technician; and Philip Sloss, registered nurse case manager.
The mission of the TBI Team is to assess and evaluate physical, cognitive, emotional and behavioral symptoms in order to optimize care, improve outcomes and reduce disability using a patient-centered approach to promote recovery. Early identification of symptoms and treatment are important in preventing long-term consequences of concussion/TBI.
Service members can self-refer, or be referred to the TBI Program by their primary care manager or another health care provider. An accurate history is then obtained by detailing the injury event(s), and reviewing the service member's medical history and symptoms.
One of the most important steps in the treatment of an acute brain injury is rest. This allows the brain to physically and mentally recover, and removes the risk of sustaining another concussion while the brain is healing. Multiple concussions within a short timeframe may increase symptoms and long-term effects.
TBI is a major cause of death and disability within the United States. The Centers for Disease Control and Prevention, estimate that each year 1.7 million people are diagnosed with a brain injury. The leading causes of TBI are: falls, unintentional blunt trauma, motor vehicle accidents and assaults. Males tend to have higher rates of TBI compared to females. Young children and older adults have the highest risk of sustaining fall-related TBIs. Adolescents and young adults (ages 15 to 24 years) have the highest rates of motor vehicle-related TBIs.
TBI has been called the "signature wound" of the wars in Iraq and Afghanistan. Injuries the service members receive downrange can originate from improvised explosive devices, rocket-propelled grenades, mortars, gun blasts, falls and equipment failure. Many military personnel have experienced multiple deployments due to the length of war, translating into multiple exposures to potential TBI events. However, more than 80 percent of TBIs occur in garrison. Common causes of a TBI can include a blow to the head during sports and recreational activities, combatives and other military training, as well as vehicle/motorcycle accidents, and falls.
The Defense and Veterans Brain Injury Center continues to track the total number of service members throughout DOD who have been diagnosed with a TBI. From 2000-2017 (Q1-Q3), there have been 375,230 service members diagnosed with a TBI within garrison and the deployed setting. Soldiers account for 59 percent of all these service members diagnosed with a TBI. Most of these cases (82.3 percent) have been classified as a mild TBI, which is also known as a concussion.
The majority of these service members are expected to have a full recovery within a few days up to a few months. Symptoms presenting outside of this timeframe may also be associated with inadequate sleep, chronic pain, or other behavioral health issues that share common symptoms of mild TBI. Evaluations seek to identify and treat symptoms with the expectation that service members will fully recover and continue to work within their MOS. Early detection and treatment of brain injuries are essential to unit readiness.
Here at Fort Huachuca, although a few of these service members may be referred immediately following a potentially concussive event, most present to the RWBAHC TBI Program after continuing to experience symptoms possibly related to a traumatic brain injury that occurred in the past. Typical symptoms include headaches, short-term memory problems, irritability, difficulty sleeping, problems with balance, vision or hearing, reduced attention and concentration, and other cognitive problems. Service members may also have post-traumatic stress disorder, or PTSD, which has many overlapping symptoms with TBI. This often requires both conditions to be addressed simultaneously.
The TBI team develops an individual plan of care for each service member that ensures he or she will receive the highest quality care in a timely and efficient manner. The plan of care developed is unique to each individual, and the process of achieving goals set forth in the plan of care may take a few months or a longer period of time.
Typical treatment goals include reduction of headache frequency and intensity, improved onset and length of sleep, improved short-term memory and cognitive functioning, improved balance, vision, hearing, and reduction of PTSD symptoms. The TBI team works with a variety of disciplines both within RWBAHC as well as in the community setting, including physical therapy, occupational therapy, speech therapy, optometry, behavioral health, neurology, sleep assessments and audiology.
The RWBAHC TBI team is available 7:30 a.m.-4:30 p.m., Monday through Friday. For more information, call 520.533.5756.