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Navigation: SOS Sisson > Traumatic Injury Blog
Jack Sisson's TBI Blog
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Monday, April 12, 2010
Military plans to test brain-injury therapy
We all know by now that Traumatic Brain Injury is the signature wound of the Iraq War. Explosions that would have killed soldiers in previous wars are now less often fatal, due to the improved protective qualities of military helmets. What happens, however, is that the brain is knocked around inside the skull, as the head forcibly hits the helmet during the explosion. The result is less fatalities, but more brain injuries. According to the Defense Department, more than 134,000 service men and women suffered traumatic brain injuries from 2003 through 2009. The military has planned clinical trials using pure oxygen in a pressurized chamber to determine if the technique can help brain-injury sufferers heal.
From The Associated Press:
The U.S. military plans clinical trials next year to see whether breathing pure oxygen in a pressurized chamber might help thousands of Iraq and Afghanistan war veterans suffering from traumatic brain injuries.
Wednesday, February 13, 2008
Florida to be Site of Brain Injury Research
St. Petersburg Times, By William R. Levesque, Times Staff Writer, February 12, 2008 --
Tuesday, January 22, 2008
Army Task Force Finds Problems with Brain Injury Care
USA TODAY, January 18, 2008, WASHINGTON — An Army task force found major gaps in the care of traumatic brain injury last year, but officials say they are moving rapidly to correct the problems.
A task force study — completed last May but not made public until Thursday — found fault with several issues, including efforts to identify and treat soldiers suffering mild traumatic brain injury often resulting from exposure to roadside bomb blasts.
Although victims often show no outward sign of the injury, it can affect brain functions dealing with short-term memory, problem solving and sleep, and cause nausea, dizziness and headaches. Treatment often involves pulling a soldier out of combat temporarily or permanently, and treating the symptoms.
Screening efforts show 10% to 20% of Marines and soldiers returning from Afghanistan and Iraq may have suffered this wound, according to the Army. The task force last May found that "major gaps" in identifying and treating the injury "were created by a lack of coordination and policy-driven approaches."
This was despite the fact that researchers at the Defense and Veterans Brain Injury Center — the Pentagon's premier clinical research office for brain injury — had developed ways of identifying the wound in 2004, the study said.
USA TODAY reported in November that at least 20,000 U.S. service members returning from combat have been diagnosed with, or shown signs of, brain injury.
"There is clearly a problem when the most common injury of the war is the least understood," said Sen. Patty Murray, D-Wash. "This task force is a long-overdue step forward in diagnosing and understanding the signature wound of this war."
Monday, December 03, 2007
Iraq War Leaves Hidden Wounds
Savannah Morning News, Sunday, December 2, 2007 -- Laboran Pickens sits inside the busy Savannah coffeehouse.
He flinches every time the grinders whine so strangers can walk away with frothy, caffeinated beverages.
He looks nervous. He assures his company he's fine.
He's on medication from Georgia Regional Medical Center.
It helps, but not always.
The Iraq nightmares still come, medicine or not.
Sometimes the spell is prompted by a loud noise or errant thought. It makes him space out. He moves like he's in a dream. He often disappears from his Hinesville home, sometimes for hours.
His wife spends those hours frantic, wondering where he is. She worries each time will be his last. That he won't come back to her and their three children.
He returns, but remembers nothing.
At 30, he is a shell of the man he once was.
It is estimated that up to 20 percent of the 1.5 million men and women who have served in Afghanistan and Iraq since America's War on Terror began may suffer from post-traumatic stress disorder or traumatic brain injuries, according to the Defense and Veteran Brain Injury Center, which is part of the Walter Reed Medical Center.
And a 22-month study by Veterans for America of all soldiers returning to Fort Carson, Colo., found more than 17 percent of all servicemen and women who had deployed from the installation had some form of traumatic brain injury.
Veterans organizations fear that thousands of soldiers are living undiagnosed.
Many have left the military. Or, like Pickens, were asked to leave.
They carry invisible scars.
These wounds take the form of honorable discharges, public disturbances, police reports, missing memories, sleepless nights.
And their numbers are only increasing.
Continue reading the article.
Sunday, November 25, 2007
Military Not Finding All Brain Injuries
USA TODAY, Gregg Zoroya, November 22, 2007 --Marine Lance Cpl. Gene Landrus was hurt in a roadside bomb attack outside Abu Ghraib, Iraq, on May 15, 2006, and faces medical separation from the Corps. He's also up for a Purple Heart.
Along with 20,000 other veterans, he's not included in the Pentagon's official count of U.S. troops wounded in Iraq and Afghanistan.
That's because Landrus' wound was to his brain and hidden from view. Landrus, 24, of Clarkston, Wash., says he did not realize the nausea, dizziness, memory loss and headaches he suffered after the blast were signs of a lasting brain injury.
Army medics who examined him in the field didn't find the wound either. "They wanted to know if we had any holes in us, or if we were bleeding. We were in and out of there (the aid station) in 10 to 15 minutes," Landrus remembers.For the balance of his combat tour, he tried to shake off the blast's effects and keep going. Now, "my goal is to get back to a normal life," he says.
A USA TODAY survey of four military installations and the Department of Veterans Affairs, where combat veterans are routinely screened for brain injury, has found that about 20,000 people show signs of damage. They are not counted in the Pentagon's official tally of 30,000 war wounded.
The military lacks "a standardized definition of traumatic injury or a uniform process to report all TBI (traumatic brain injury) cases," Assistant Secretary of Defense Ellen Embrey wrote in a memo last month. As a result, it is hard to determine the scope of the problem, she wrote.Continue reading article.
Sunday, October 14, 2007
TBI and the War in Iraq -- How Many More?
In an article earlier this year, the magazine Discover asked, "What sort of future do brain-injured Iraq veterans face?" Read the following article to find out if they managed to answer that question:
Discover, 02.23.2007 -- In a flash, the blast incinerates air, sprays metal, burns flesh. Milliseconds after an improvised explosive device (IED) detonates, a blink after a mortar shell blows, an overpressurization wave engulfs the human body, and just as quickly, an underpressure wave follows and vanishes. Eardrums burst, bubbles appear in the bloodstream, the heart slows. A soldier—or a civilian—can survive the blast without a single penetrating wound and still receive the worst diagnosis: traumatic brain injury, or TBI, the signature injury of the Iraq War.
But in the same instant that the blast unleashes chaos, it also activates the most organized and sophisticated trauma care in history. Within a matter of hours, a soldier can be medevaced to a state-of-the-art field hospital, placed on a flying intensive care unit, and receive continuous critical care a sea away. (During Vietnam, it took an average of 15 days to receive that level of treatment. Today the military can deliver it in 13 hours.) Heroic measures may be yielding unprecedented survival rates, but they also carry a grim consequence: No other war has created so many seriously disabled veterans. Soldiers are surviving some brain injuries with only their brain stems unimpaired.
While the Pentagon has yet to release hard numbers on brain-injured troops, citing security issues, brain-injury professionals express concern about the range of numbers reported from other military-related sources like the Defense and Veterans Brain Injury Center, the Department of Defense, and the Department of Veterans Affairs (VA). One expert from the VA estimates the number of undiagnosed TBIs at over 7,500. Nearly 2,000 brain-injured soldiers have already received some level of care, but the TBIs—human beings reduced to an abbreviation—keep coming.
Keep reading this article.
Vet's 1-Year War Now Endless for Wife
ROMNEY, W.VA., Sunday, October 14, 2007 -- Michelle Turner's husband sits in the recliner with the shades drawn. He washes down his Zoloft with Mountain Dew. On the phone in the other room, Michelle is pleading with the utility company to keep their power on.
"Can't you tell them I'm a veteran?" asks her husband, Troy, who served as an Army scout in Baghdad and came back with post-traumatic stress disorder.
"Troy, they don't care," Michelle says, her patience stretched.
The government's sweeping list of promises to make wounded Iraq war veterans whole, at least financially, has not reached this small house in the hills of rural West Virginia, where one vehicle has already been repossessed and the answering machine screens for bill collectors. The Turners have not been making it on an $860-a-month disability check from the Department of Veterans Affairs.
After revelations about the poor treatment of outpatient soldiers at Walter Reed Army Medical Center earlier this year, President Bush appointed a commission to study the care of the nation's war-wounded. The panel returned with bold recommendations, including the creation of a national cadre of caseworkers and a complete overhaul of the military's disability system that compensates wounded soldiers.
But so far, little has been done to sort out the mess of bureaucracy or put more money in the hands of newly disabled soldiers who are fending off evictions and foreclosures.
In the Turner house, that leaves an exhausted wife with chipped nail polish to hold up the family's collapsing world. "Stand Together," a banner at a local cafe reminds Michelle. But since Troy came back from Iraq in 2003, the burden of war is now hers.
Michelle has spent hundreds of hours at the library researching complicated VA policies and disability regulations. "You need two college degrees to understand any of it," she says, lacking both. She scavenges information where she can find it. A psychotic Vietnam vet she met in a VA hospital was the one who told her that Troy might be eligible for Social Security benefits.
Meanwhile, there are clothes to wash, meals to cook, kids to get ready for school and a husband who is placidly medicated or randomly explosive. Besides PTSD, Michelle suspects that Troy may have a brain injury, which could explain how a 38-year-old man who used to hunt and fish can lose himself in a three-day "Scooby-Doo" marathon on the Cartoon Network.
Keep reading this article.
Saturday, September 29, 2007
War Brain Injuries -- More Bad News?
Earlier this week, Gregg Zoroya in USA TODAY wrote:
Scientists trying to understand traumatic brain injury from bomb blasts are finding the wound more insidious than they once thought.Continue reading the article.
New Foundation for TBI Patients
On Friday, Sept. 28, 2007, The Brown Daily Herald published the following story about a Brown University alumnus who, after suffering a TBI in 2004, started a foundation for brain injury patients. From the article:
A month after his graduation, Charlie Maddock '04 was hit by a car and suffered an often-fatal traumatic brain injury. Two years later, in 2006, he founded the Charles Maddock Foundation, a nonprofit foundation that supports patients who have suffered brain trauma.The story later notes:
TBI has recently received national media due to the increasing amount of head injuries for soldiers stationed in Iraq. About 10 to 20 percent of the 35,000 screened "health returnees" from Iraq and Afghanistan had "experienced a mild TBI during deployment," the New York Times reported in July.And:
TBI has also made the national news because of the large number of NFL players with head trauma. In June 2007, late Pittsburgh Steelers offensive lineman Justin Strzelczyk was found to have signs of a condition associated with the elderly or boxers with dementia. Strzelczyk is the fourth NFL player to be found with this condition, which is thought to be caused by repeated concussions on the football field.
Read the article.
Wednesday, September 19, 2007
Fighting Brain Injury in Iraq
The war in Iraq is bringing a well-documented but hardly understood battlefield injury into the limelight: traumatic brain injury (TBI). In an effort to learn more about the injury, the U.S. Army awarded Simbex, of Lebanon, NH, a million-dollar contract to develop sensor-studded helmets for combat soldiers. The army is currently testing the helmet technology, which could be deployed as early as December of this year.
DOD, VA medical programs too complex for those with brain-damage
The bureaucracies that are supposed to help brain-injured war veterans are too complex for them to navigate, a panel of military and medical experts concluded at a meeting Tuesday.
Specifically, the departments of Veterans Affairs and Defense need better coordination of their programs, according to the panel, which was part of a daylong Washington Defense Forum sponsored by the U.S. Naval Institute and the Military Officers Association of America.
The panel included two military officers, a doctor, a lobbyist and the chief executive officer of the Brain Injury Association of America.
"The systems in the VA and DOD seem to be against what brain injury can handle," said Susan Connor, chief executive officer the Brain Injury Association. "Because the frontal lobe controls memory, thinking, judgment and processing ... if you shove paperwork in front of someone with sustained brain injury or put them in a large group with scripted instructions, they can't follow it."
Nonfatal TBIs From Sports and Recreation Activities
Each year in the United States, an estimated 38 million children and adolescents participate in organized sports,1 and approximately 170 million adults participate in some type of physical activity not related to work.2 The health benefits of these activities are tempered by the risk for injury, including traumatic brain injury (TBI). CDC estimates that 1.1 million persons with TBIs are treated and released from U.S. hospital emergency departments (EDs) each year, and an additional 235,000 are hospitalized for these injuries.3 TBIs can result in long-term, negative health effects (e.g., memory loss and behavioral changes).3 To characterize sports- and recreation-related (SR-related) TBIs among patients treated in U.S. hospital EDs, CDC analyzed data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP) for the period 2001-2005. This report summarizes the results of that analysis, which indicated that an estimated 207,830 patients with nonfatal SR-related TBIs were treated in EDs each year during this period. The highest rates of SR-related TBI ED visits for both males and females occurred among those aged 10-14 years. Increased awareness of TBI risks, prevention strategies, and the importance of timely identification and management is essential for reducing the incidence, severity, and long-term negative health effects of this type of injury.
Saturday, August 25, 2007
Let's Really Support Our Troops -- Bring Them Safely Home
It's hard to believe that, at this late date, certain people still accuse those of us opposed to the Iraq War of not supporting our troops. How in the world can they construe supporting our troops to mean sending them back into that escalating quagmire for repeated (and extended) tours of duty where over 3,700 have died and approximately 1,800 have suffered traumatic brain injuries (TBIs)?
According to the Washington Post, "...neurologists worry that hundreds of thousands more -- at least 30 percent of the troops who've engaged in active combat for four months or longer in Iraq and Afghanistan -- are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch." A study by researchers at Harvard and Columbia predict that brain injuries from the Iraq war will cost the government at least $14 billion over the next 20 years.
Here's one more recent story:
CAMP WILLIAMS, Utah (ABC 4News)- A voluntary assignment to help the people of Afghanistan develop new agriculture skills turned into a life long sentence for a Utah man, who joins an increasing list of returning soldiers who suffer from traumatic brain injuries caused by roadside bombs.Continue reading.
The photo accompanying this post was honored in The Best of PhotoJournalism 2007. Go here to see this picture and other winners.
Wednesday, August 08, 2007
TBI and War (Today's Edition)
More on TBI and the military...
...is mandatory for all active-duty and reserve-component Soldiers, from the highest to lowest levels in the chain of command.
KELLAR: "Depression, anxiety and all the rest of that stuff. It's bad. They give you Zoloft and they try to monitor it. And all the rest of that."
Saturday, June 23, 2007
War's TBI Numbers Continue to Challenge Government
The number of TBI's caused by injuries in the Iraq War continues to stretch the government's ability to treat them. As the following excellent article points out, no one was prepared for the high number of wounded, kept alive by improved body armor. And no one really knows exactly how many of those wounded are TBI survivors:
Only an estimated 2,000 cases of brain injury have been treated, but doctors think many less obvious cases have gone undetected. One small study found that more than half of one group of wounded troops arriving at Walter Reed Army Medical Center had brain injuries. Around the nation, a new effort is under way to check every returning man and woman for this possibility.Even with the continuing media coverage of the war's injured, and the recent flurry of interest by Congress, I still don't think the average American's knowledge (or even awareness) of TBI has increased by much. I hope I'm wrong. I know that Bob Woodruff got a lot of press, and that he made the rounds of television talk shows. I suppose we just need to be patient. Change takes time, and it will be a while before people's understanding of TBI increases appreciably. Here's an excerpt from the article:
Orangeburg Times Democrat, June 23,2007 -- These are America's war wounded, a toll that has received less attention than the 3,500 troops killed in Iraq. Depending on how you count them, they number between 35,000 and 53,000.Continue here to read the entire article.
Monday, May 28, 2007
Iraq War Continues to be Biggests News on TBIs
ABC30.com, 05/24/2007 - As many as 20% of service members returning from duty in Iraq and Afghanistan will have some level of traumatic brain injury.
This spring the Department of Defense acknowledged traumatic brain injury as a "significant health concern" and vowed to identify it among active duty troops. But many new cases are likely to emerge as troops transition to civilian life as veterans.
Military records show that 60% of the 25,000 war injuries to date resulted from explosive blasts like IED's or roadside bombs. And nearly 3,000 of the wounded are currently being treated for severe traumatic brain injury or TBI.
Fresno V.A. Hospital emergency room doctor James Lindsay says injuries in this war are different from other wars when bullets did the majority of the damage.
Dr. Lindsay, Fresno V.A. E.R. physician, says "there's less ballistic wounding from actual gunfire and more blast injuries and blast injuries typically produce traumatic brain injuries." And those blasts can leave an injury without ever breaking the skin.
Read the article here.
Sunday, May 20, 2007
Iraq TBIs raise public's awareness, but at what cost?
News about brain injuries in Iraq doesn't stop:
Frontline combat troops in the Iraq war have at least a one in five chance of coming home with a brain injury, according to Chris Elia, a Veterans Affairs psychologist who spoke Friday about traumatic brain injuries in veterans at the second annual Black Hills Brain Injury Conference in Rapid City.What a shame that it's literally taken a war to bring TBI front and center. Hardly a day goes by now that TBI is not in the news, and word of advances in TBI research hits the media with unusual frequency. Advocates for brain injury research have wanted this for a long time, but who could have forseen that a war would be necessary to accomplish it? The universe does indeed work in mysterious ways, but I can't imagine anyone who'd have chosen this route to brain-injury awareness.
Read the complete article here.
Monday, May 07, 2007
A Signature in Blood -- and Neurons
No matter your politics, I hope you'd agree that it's a strange world in which wars are said, dispassionately, to have "signature injuries." For the American Civil War, maybe this was battlefield amputations; for World War I, trench mouth or gas-attack symptoms; for Vietnam, I guess, post-traumatic stress; and for the original Gulf War, various Agent Orange-related afflictions.
Here at sossisson.com, we've noted before (recently, for example, here) that traumatic brain injury is widely regarded as the signature wound of the current war in Iraq. This sad state of affairs has at last received Federal attention, in the form of a Congressional ruling that soldiers must be tested for TBI before and after their Iraq deployments. This news came at the end of last week, in a report from USA Today. This comes roughly concurrently with a report from the Defense Department itself, per the Associated Press.
From USA Today:
The Pentagon must use computers to screen troops before and after they go to Iraq or Afghanistan to better determine whether they suffered traumatic brain damage in combat, according to a plan by a congressional brain-injury task force...
And from the Associated Press:
Issuing an urgent warning, the Defense Department's Task Force on Mental Health chaired by Navy Surgeon General Donald Arthur said more than one-third of troops and veterans currently suffer from problems such as traumatic brain injury and post-traumatic stress disorder.There have also been a couple of other recent news items on this issue:
As increasingly elaborate body armour protects the torso, and even the limbs, the brain is still vulnerable to shock waves that helmets cannot deter... And these "closed-head" injuries are harder to treat than even those commonly suffered by motorcyclists.
As an aside, if you -- like I -- were previously unfamiliar with the term "Article 15": It refers to a section of the Universal Code of Military Justice, or UCMJ. Generally, it's one of the UCMJ's "punitive articles." According to Rod Powers, about.com's "Guide to the US Military," Article 15 is one of several proceduresAn MRI later showed that Thurman had lesions on the right parietal lobe of his brain, a condition that led to a “don’t deploy” order — which the Army violated, according to Thurman. Worse, rather than providing compassionate understanding of the symptoms associated with traumatic brain injury, he said leaders at Fort Carson, Colo., have harassed him, refused him medication and pushed for an Article 15.
whereby the commanding officer or officer in charge may:Note that the soldier whose case is covered in the Army Times piece claims about his post-TBI treatment that his superiors have "pushed for an Article 15." I understand that the military code of justice must be different than the civilian. But if this claim is at all true, I hope the military at least stops to reflect on ways in which Article 15 can be abused -- if not outright criminalizes the abuse.
[Updated 2007-05-09 7:56 pm]
Thursday, April 12, 2007
Public Needs to Know That TBI is Still the Signature Wound of Iraq War
The following seems a little "after the fact," because Traumatic Brain Injury was labeled the signature wound of the Iraq War last year. Still, even if the military has been slow to fully address this issue, the following AP article from the "Boston Herald" sounds promising (except for identifying TBI as "military parlance"):
AUGUSTA, Maine - Traumatic brain injuries are common among wounded soldiers returning from Iraq, but they’re also commonly misdiagnosed or undetected, according veterans’ activists and Maine’s congressional delegation.Read the entire article.
Here's more from the "IndyStar":
WASHINGTON -- Sens. Evan Bayh and Hillary Rodham Clinton said Wednesday that soldiers with traumatic brain injuries should get extended treatment through the Defense Department instead of the Veterans Affairs Department, which they argued is less capable of handling such injuries.Read the article.
Wednesday, March 07, 2007
More on Bob Woodruff
Here's a link to a Fox News transcript of Greta Van Susteren interviewing Bob Woodruff. The interview took place last night.
Good article in the Detroit News about Woodruff's growing influence on good medical care for TBI injuries.
Yesterday ABC News reported receiving over 1000 emails from wounded veterans and their families. The emails resulted from ABC's documentary about Woodruff, "To Iraq and Back," "with many claiming they have had problems dealing with the Veteran's Benefits Administration as they seek rehabilitation from injuries sustained in Iraq and Afghanistan." Read the article (and talk to the Woodruff family) here.
Bob Woodruff's Amazing Story
The NY Times cited Bob Woodruff's contribution to public awareness about traumatic brain injury (TBI), called the signature wound of the Iraq War. All those "Support Our Troops" bumper stickers aside, how many people really knew that a number of our wounded will never be the same because they suffered a TBI? There are so many ugly things about this war that have been suppressed or cleaned up for public consumption, but now here is someone whose story no one can question because its truth has been well documented by the media. Maybe some of those wounded veterans will now have a chance at better medical care because of Woodruff. And maybe TBI sufferers everywhere will see improved funding for research because the public is more aware of this epidemic.
Read the entire article.
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