By Tracey-Jean SantoroMarch 13, 2019
FORT HUACHUCA, ARIZONA -- Fort Huachuca joins the Department of Defense and the Military Health System in recognizing March as Brain Injury Awareness Month. This year's theme, "Advancing Warfighter Brain Health," supports the enduring responsibility of the DOD to promote and protect the health and well-being of our nation's warfighters and their families.
The goal is to increase awareness of traumatic brain injury, to educate and provide resources about brain injuries to service members, veterans, family members and health care professionals, and to encourage help-seeking behaviors.
The DOD definition of traumatic brain injury (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 an intracranial lesion. However, not all blows or jolts to the head result in a TBI.
Service members can prevent a concussion by making smart decisions in day-to-day life, such as wearing a helmet when riding a bicycle or motorcycle, being safe when playing sports, and driving responsibly. 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 the nearest emergency room as soon as possible after a head injury, and follow your provider's recommendations for rehabilitation to ensure optimal recovery.
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. A history of multiple concussions may increase symptoms and long-term effects. Service members returning to duty after any brain injury, even a concussion, should take a progressive, stepped approach. Symptoms from the injury may reappear or worsen if a person resumes military training and sports/recreational activities too quickly.
"A Head for the Future" is a national TBI awareness campaign from Defense and Veterans Brain Injury Center (DVBIC) with videos of real service members and veterans, their family members, caregivers, and providers sharing their experiences with TBI. See more at http://dvbic.dcoe.mil/aheadforthefuture/stories.
TBI has been called the "signature wound" of the wars in Iraq and Afghanistan. TBI is a less visible and still poorly understood consequence of these wars. As a result, DOD and DVBIC are leveraging new technologies and leading cutting-edge research in the field of brain injury in order to improve and modernize health care to maximize warfighter brain health.
Injuries that service members receive downrange can originate from improvised explosive devices (IEDs), rocket-propelled grenades (RPGs), mortars, gun blasts, falls, and equipment failure. Many service members have experienced multiple deployments, which translates into the possibility of multiple exposures to potential TBI events.
TBI results not only from concussive impact but also from exposure to blast waves. Blast exposure derives from both the effects of enemy action in combat and from training on weapons and tactics. DOD is reviewing the safety precautions associated with combat and training activities to account for new research on how blast exposure events affect brain health.
However, more than 80 percent of all TBIs occur in garrison. Common causes can include a blow to the head during sports and recreational activities, combatives and other military training, falls, and vehicle/motorcycle accidents.
DVBIC continues to track the total number of service members throughout DOD who have been diagnosed with a TBI. From 2000-2018 (Q1), there have been 383,947 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 (mTBI), 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, and continue to work within their military occupational specialty. 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 mTBI.
Medical evaluations seek to identify and treat these symptoms with the expectation that service members will fully recover. Early identification of symptoms and treatment are essential to the service member's health and in preventing long-term consequences of mTBI/concussion, as well as decreasing the impact on unit readiness.
Fort Huachuca is home to a Level 4 TBI Program, providing outpatient care to service members who have experienced an mTBI/concussion while deployed or in garrison. The Raymond W. Bliss Army Health Center (RWBAHC) TBI team members include: 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 make appropriate referrals for specialty services, optimize care, improve outcomes and reduce disability using a patient-centered approach to promote recovery.
Service members can self-refer, or be referred to the TBI Program by their Primary Care Provider or any other 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.
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 (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 longer. 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 TBI Team is available 7:30 a.m. to 4:30 p.m. Monday through Friday. For more information about the TBI program, call 520-533-5756.