Traumatic Brain Injury in Veterans

Andrew

Age at interview: 51
Outline: Andrew suffered three significant head traumas during his 28-year military career including one during a tank accident that damaged his cranial nerve and left him in a coma for a week. The multiple injuries to his brain have left Andrew with migraines, memory loss, and balance issues. To cope with his condition and resulting depression, Andrew spent two months in in-patient treatment, has worked with a psychologist, and keeps a daily schedule of tasks and activities.
Background: Military branch: Army

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Andrew was medically retired from a military career that lasted from 1981 to 2009 during which time he was deployed to El Salvador, Panama, Saudi Arabia, Iraq, Bosnia and assisted with disaster relief during Hurricane Katrina. Andrew suffered multiple head traumas, the first occurring in Germany in 1987 when his tank collided with a tree cracking open his skull and rendering him unconscious for seven days. He was hospitalized for weeks with “damage to one of the cranial nerves, my eyes were stuck crossed, and I had a big black gash across my forehead.” This first incident was compounded by two more head traumas, one during a blast injury in 2005 and the other in a rappelling incident in 2006.

Andrew doesn’t recall hearing the term “traumatic brain injury” until he suffered his third head trauma in 2006. “They called it severe brain disease trauma, I think. I still have my old rating decision from the VA in 1994 and they call it something completely different.” The first signs Andrew noticed were severe headaches and migraines. He also grapples with memory and balance issues. In 2008 Andrew was diagnosed with rheumatoid arthritis. That combined with diabetes, TBI, and PTSD diagnoses led him to be medically retired in 2009. “They finally said, “Look you can’t handle a weapon anymore,” and I was like, “Yes, I’m a danger to others. I would be more of a detraction on the battlefield than I would be a positive, so it’s time to be medically retired.”

 

Reintegration was a struggle for Andrew. “I was not happy. I spent the first year after retirement playing Pokémon 24 hours a day.” His mobility was limited because of his arthritis and, unable to exercise, he struggled with his weight and managing his diabetes. Unhappy in retirement and struggling with a host of conditions, Andrew sank into depression. “For a long time, I was very suicidal because I didn’t feel like I was pulling my weight in 2009, 2010, 2011. I just felt like I wasn’t really, I wasn’t doing my share.”

Andrew spent two months in in–patient treatment and started working with a psychologist. It wasn’t until his mother became sick that he says he finally snapped out of it and told himself “no one else is going to take care of her. You got a job to do. That kind of brought me back out of it, and since then things have been improving.” Andrew says keeping a schedule has been a great help to him in coping with his condition.

To those newly diagnosed with a TBI or struggling with a concussion or other brain trauma, Andrew would encourage them to seek out services at the VA or elsewhere that can help them learn more about their condition.

 

Andrew describes what he remembers about the vehicle accident that caused his brain injury.

Andrew describes what he remembers about the vehicle accident that caused his brain injury.

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It was during Reforger, which is a big exercise where they redeploy all the United States forces to Germany in preparation for the Russians coming over the border if it was ever going to happen. There was a vehicle accident. I was a tank commander. I was actually a tank platoon leader, and my tank got hit with a tree, believe it or not, and took me out. Basically, it cracked open my skull, brain exposed to air, blood everywhere, and my crew drove me in a tank to the hospital at about 50 miles an hour with a whole bunch of other people wondering why they were driving so fast and why there was blood all over the top of the tank. I did not regain consciousness for seven days, and when I did - I don’t want to make it sound like it’s really weird, but in high school I had taken German, and I spoke not native German but pretty good. 

When I woke up I was in a German hospital with no one who spoke English, so I spoke German for the first couple of weeks, and I don’t remember speaking a lick of English until my wife showed up at the hospital. But basically, I had damage to one of the cranial nerves; my eyes were stuck crossed, and I had a big black gash across the forehead. The result from it is that this lobe right here is flattened, and then you know how you take a boiled egg and you squeeze it a little hole will appear in the middle? I have one of those nice little holes right about - if you intersect those two lines.

 

Andrew recalls that when he sustained his first injury, there wasn’t yet a term for TBI.

Andrew recalls that when he sustained his first injury, there wasn’t yet a term for TBI.

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They called it severe brain disease trauma, I think. I still have my old rating decision from the VA in 1994, and they called it something completely different. TBI didn’t become a thing - I think the first time I heard it was in 2006 when I fell off the cliff. Of course, my boss told me after that I couldn’t do anything with the wording in it like running, no meteor catching. He actually put no meteorite catching in there.

I: And by the time the third one came along did they have that sort of terminology of TBI?

They called it TBIs, and it didn’t really affect how they treated me, but it was one of the reasons why they said I had to be medically retired, because I had so many things wrong that I finally agreed that yes, you’re not going to be able to send me anywhere with any kind of confidence where I’m not going to get injured again. So, it was a variety of things, but that was one of them.

 

 

After his injury, Andrew was embarrassed when he discovered he could no longer hit a softball.

After his injury, Andrew was embarrassed when he discovered he could no longer hit a softball.

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It shows in embarrassing ways. For instance, after I had my TBI I think it was a couple - it was like 1992 or something - I hadn’t played baseball in years, and all of a sudden, we went out to play softball and I could not hit the ball. I can’t do it anymore. There’s something about the way I perceive it that’s gone, and that was really embarrassing. Everybody’s laughing, “Strike out,” and you’re like - you can’t tell them, “Well I have TBI, and that’s why I screwed up.” You just kind of suck it up and say, “Yes, okay. I’m worthless,” and then you find a different sport to play. Because I used to be pretty good at softball or baseball, but now I’m - I don’t know. You get tired of telling people, “I have TBI,” or, “I have diabetes.”

 

Andrew no longer has color vision in one of his eyes.

Andrew no longer has color vision in one of his eyes.

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I don’t know where different things are in the brain, but one of the results from it is, I’m now color blind in my left eye, because I had perfect color vision in both eyes, and now I only have color vision in one eye. So that’s why every color looks off to me. I can’t pick out what colors I’m going to wear or what to paint something. I have to assume that it’s right because that center - whatever center handles this eye was really banged up. And I didn’t know that until the VA this lady was taking these colors down and said, “What color is that?” And I went, “Well, that’s pink.” And she goes, “What color is this?” I said, “Well that’s red.” “Well, they’re actually the same one. It’s just you’re seeing this with both of your eyes, and you’re seeing this with just your right eye.”

 

Andrew describes not knowing if his symptoms, like feeling disoriented in urban areas, are associated with TBI or PTSD.

Andrew describes not knowing if his symptoms, like feeling disoriented in urban areas, are associated with TBI or PTSD.

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Yes, I don’t think the way that other people do, and I don’t know if it’s a result of the TBI but my creative centers are pretty much gone. It’s funny because the doctor who studies the PTSD said it’s a result of the TBI, and the people who have TBI say it’s a problem with the PTSD. So, I have problems when I come into the city. It’s too much for me. I can’t handle it, and I’m trying to watch everything, and I can’t do it, and I just kind of flip out. So, the TBI guys said no it’s the PTSD. The PTSD guys say no it’s the TBI. Well, somebody take responsibility. I never ever, ever had to use a MapQuest before, and then this last couple of years I’ve had to start using MapQuest because I just - especially if it’s an urban environment. I can’t do it, remembering - because I used to be really - I mean, still if you get me in the back country and you tell me you want to go somewhere I’ll get there without ever looking at a map. I can’t do it in cities anymore.

 

Andrew talks about feeling suicidal when he didn’t feel like he was pulling his weight.

Andrew talks about feeling suicidal when he didn’t feel like he was pulling his weight.

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Yes, that was the psychologist - well, I don’t know what she was, nurse practitioner. It was at the military department when I was having my exam she said, “Look, you’re beat to shit. You’re going to die if you stay here.” But then when I went for my exams to get out of the military up at Fort Lewis the psychologist there said, “Well, you have a 40/60 chance.” And I said, “A 40/60 chance of what?” “Well, you have a 40% chance of having a great life and moving on, and you have a 60% chance of swallowing a gun.”

I: Is that every Vet, or is that you?

No, I think she was talking me, but that’s because I really did and still do have a problem adjusting to, I believe that everybody should pull their own weight and do the responsible thing, and if you can fix it yourself fix it yourself and don’t just, but maybe, I don’t know if that’s my personality because I grew up on a farm, because you always pulled your own weight.

And for a long time I was very suicidal because I didn’t feel like I was pulling my weight in 2009, 2010, 2011. I just felt like I wasn’t really - I wasn’t doing my share. And then when I left the VA it was even worse. I spent two months in Cedar Hills at the Freedom Care for soldiers with PTSD and depression on suicide watch, which I don’t recommend because you lose your shoelaces.  And I had so much anger in me. You know those punching things they have that are about this tall that supposedly can’t fall over? Yes, I knocked it right over.

 

Andrew explains that a lot of Vietnam era Veterans don’t trust the government and perceive the VA as a “place of death.”

Andrew explains that a lot of Vietnam era Veterans don’t trust the government and perceive the VA as a “place of death.”

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Well, some people won’t even go to the Vet Center. Some people will not go to anything that’s related to the government. The whole reason why the Vet Center was invented and created was because Vietnam vets did not trust the VA. The Vet Center does not have to give up any records, they can go, “Up yours. You cannot have it.” Now some Vets still believe that you still pass it on, that “Big Brother” is always watching us. Just because you’re paranoid, doesn’t mean they’re not watching. But I think it would be nice to have more services away from what a lot of Vets perceive as a place of death. I mean, I know that’s how I felt about this place. I’m still convinced that one day I’m going to die here, but I don’t want to. I’d rather take care of it before I get here.

 

Andrew talks about confronting his anxiety about coming to the VA.

Andrew talks about confronting his anxiety about coming to the VA.

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One of the things that, and this was something I got from the guy who’s head of anxiety, he said that you need to start confronting some of the things that cause you stress and get used to them, and one of them is coming up here, because every time I’ve come up here it’s been stressful. So, if I come up here and have positive experiences - I used to have to sedate myself to come up here. I would have to take - oh, what do they call it - hydroxyzine. I think it’s hydroxyzine. It’s an antihistamine that they give us Veterans to calm us down. I’d always have to take hydroxyzine to come up here, and now I don’t have to anymore, and I don’t have anxiety attacks here anymore because I’m coming up and doing positive things. 

Moving to the East clinic for some of my care was actually mandated by the VA because they’re like, “You’re freaking out when you come up here, and you’re not dealing with it.” It’s kind of hard to see all these veterans that are suffering, and you just want to march into the office and say, “I don’t give a shit that you want your coffee break. You still have 100 people in line. Shut the fuck up and move out. I don’t care that it’s your union or whatever.” So just having to learn to deal with that and just go - okay, so this is the parameters we have to work within, and just deal with it. Because just like the other day I got frustrated when I went to the pay cage and they’re closed, and I’m like, “You know what, we never left in the military until every last person was taken care of.” We don’t say, “Oh I’m sorry. It’s five o’clock. I don’t care that you’re in line.”

 

Andrew would like to know more about which parts of his brain are damaged and why he doesn’t think the way he used to.

Andrew would like to know more about which parts of his brain are damaged and why he doesn’t think the way he used to.

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I would like to have had explained to me what parts of the brain I damaged, because I know it’s damaged. I know it’s there. And it’s funny because depending on whose reading it some people say, “Oh, that’s bad,” and other people go, “Oh that’s nothing.” So, there’s no consistency. But that’s what I’ve noticed about all doctors. There’s never a consistency. They all have different opinions. I would like to know more about how my brain works now, because I know I don’t think the same way I used to. I don’t see things the way I used to. And it’s not seeing them, it’s perceiving them, not just physical perception with the colors but just the way I take things, and also the way I take things when it comes to, like for instance, when you have diabetes. 

 

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