FORT BRAGG, N.C. - At 6 feet 4 inches tall, Sgt. Nicholas Lima knows a thing or two about head injuries. He said he has been running into doorways for most of his life and even has an inch-long scar on the top of his to prove this point.

As an artilleryman with 3rd Battalion, 27th Field Artillery Regiment, the 26 year old also knows about the dangers of combat. He survived explosions in Iraq that caused additional damage to his brain. To top it off, Lima was involved in a severe car accident three months ago in which he suffered a concussion, or traumatic brain injury.

Looking at Lima, he appears to be in excellent physical health. However, the damage the Mount Airy, N.C., native has suffered over the years is unseen, but it has led to numerous potentially hazardous changes in Lima's personal and professional life.

These changes affect not only the injured person but also Family members and friends.
Fort Bragg offers TBI awareness classes and support groups to Soldiers and their Families to help those affected by brain injury better cope.

TBI has become the "signature injury" for the wars in Iraq and Afghanistan. Almost 50 percent of head injuries being reported as a result of combat were caused by blasts from events like roadside bombs or mortar attacks. TBI can also be caused by car accidents or other events where the head is jerked forcefully or hit by hard objects.

"When your head is hit or exposed to a blast, your brain is shaken around inside your skull," explained Kathy Bell, education coordinator and registered nurse at the Fort Bragg Defense and Veterans Brain Injury Center. "This has caused your brain to be bruised. Like a bruise on the skin, this will heal with time."

In fact, 76 percent of troops diagnosed with TBI fall within the "mild" category. Most mild TBI can heal within three to six months, with medical treatment and cognitive rehabilitation. However, the injured person may not necessarily act like the person he was prior to the brain damage. Personality changes can accompany TBI, making people more susceptible to depression, irritability, and forgetfulness.

The road to recovery after a brain injury can be a long and difficult journey, explained Herman Martin, a marriage counselor and Family therapist at Womack Army Medical Center's Department of Social Work.

In fact, only about 20 percent of couples remain married following a diagnosis of TBI. It's a staggering statistic, but Martin said it is understandable.

"Think of it this way. You marry one person, and then they get hurt and become someone else," said Martin.

A TBI Family support group meets the second Tuesday of every month from 6:30 to 8 p.m. at a conference room at Womack Army Medical Center's TBI Clinic.

Martin serves as the group's leader and refers to spouses and other Family members taking care of injured Soldiers as the "unsung heroes." He has given them this title because he said he doesn't feel they always get the credit due to them for becoming caregivers.

"It's a tough transition going from husband or wife to caregiver. Spouses don't always feel like they can go to other Family members or friends to talk about how they are feeling or what they are going through," Martin explained.

The class provides support to spouses and other Family members of Soldiers affected by TBI, allowing them to meet and share concerns while providing them with access to various resources.
Additionally, Bell gives TBI awareness classes every Tuesday and Thursday from 8:30 to 9:30 a.m. at the Defense and Veterans Brain Injury Center located in Building 4-2102 on
Longstreet Road.

Martin and Bell agreed that the first step to recovering from TBI is to seek medical treatment. Even if a Soldier did not appear to be physically injured following a bomb or rocket attack in combat, he could have still suffered a closed head injury.

The Soldier might exhibit symptoms like memory loss, irritability, depression, confusion, headaches, and rarely seizures. TBI can also overlap with other mental disorders, such as post-traumatic stress disorder.

"It's hard sometimes to tease out what is PTSD and what is TBI, but there is always a history of physical injury associated with TBI," Bell said. "So a Soldier might think they just have PTSD, but it might also be a brain injury that they didn't know about."

The best advice, she said, is to make an appointment at the WAMC TBI Clinic and Neuro Rehabilitation Center. A Soldier can "self-refer" himself, meaning he does not need permission to make an appointment.

"Don't be afraid to seek treatment. Soldiers need to understand that TBI is a real, physical injury and there is always an event that causes the injury," said Bell. "It is treatable, and the sooner the Soldier seeks treatment, the chances of recovery increase."Aca,!A..

Bell said the majority of cases seen on Fort Bragg are mild to moderate with a 75 percent recovery rate. This is accomplished by the patient following the prescribed treatment plan, including taking his medications, attending education classes and undergoing therapy.

For more information about TBI, contact the DVBIC at 497-5900.