Traumatic Brain Injury in Veterans

David

Age at interview: 43
Outline: On his second tour in Iraq, David was wounded in a suicide bomber blast that killed 16 and wounded 52 people and left David with burns over 40% of his body. While in recovery in the burn ward he began experiencing vertigo and noticing issues with his balance, and after more than a year in recovery was diagnosed with mild TBI. David still struggles with balance and vertigo issues as well as memory loss. To cope with these symptoms David writes notes to himself, uses repetition, uses a smart phone, and keeps written records of conversations by sending follow-up emails.
Background: Military branch: Army

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On his second tour in Iraq, David was wounded when a “a suicide truck bomb with about 100 tanks of propane was drove to the front of my police station and the truck suicide bomber detonated that, and it created a fireball that they saw two miles away. I happened to be standing in the middle of the compound and wasn’t wearing any ballistic armor or anything like that so I took the brunt of most of the blast.” The explosion killed 16 people, wounded 52, and left David with burns over 40% of his body.

While in recovery in the burn ward he began experiencing vertigo and noticing issues with his balance, and after more than a year in recovery was diagnosed with mild TBI. David still struggles with balance and vertigo issues as well as both short-term and long-term memory loss. “Long-term memory-wise, I just have a bunch of different gaps in my memory as far as some of the stuff not showing up, some of the early years of my marriage, stuff with my kids, and then most especially after the blast, a lot of the first year of my injury, and things like that.”

To cope with these symptoms David writes notes to himself, uses repetition, uses a smart phone, relies on GPS to get around, and keeps written records of conversations by sending follow-up emails. David also relies on the support of his managers at work who will write things in an email so he can reference it when he can’t remember and relies on the support of his family. “I tell my wife and kids stuff four or five times a day so I don’t forget, if I remember to, and that way they can remind me.”

To other struggling with a similar condition David says, “take all the help that’s there. Get educated, whether that’s you or your immediate family member that’s helping you. Create a support system outside of your own family to help you deal with it, because it’s not, literally not something you can do own your own.”

 

David describes the blast that caused his TBI while he was deployed in Iraq.

David describes the blast that caused his TBI while he was deployed in Iraq.

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OK, so I was on my second time I toured to Iraq. I was assigned 1st armor division, an MP, so I was actually responsible for setting up one of the first Iraqi police stations in Ramadi, Iraq. And at that time, I guess it was called like the Wild West, on the news or something. So, I took a team of military police up there. We had about 225 Iraqi police officers that we trained, and then we basically built a police station out of a water pump, a water pumping station on the side of the Euphrates River. So, our goal was to train them and equip them like a regular police force and then teach them how to be cops for normal people. So, I was in charge of the entire operation there and, basically, we were given a mission and told to figure it out, because that was one of the actual police transition teams that Richmond created, and on the day that I got injured, a suicide truck bomb with about 100 tanks of propane was drove to my, front of my police station and the truck suicide bomber detonated that. And it created a fireball that they saw for about two miles away. I happened to be standing in the middle of the compound and wasn’t wearing any ballistic armor or anything like that so I took the brunt of most of the blast. Wounded 56, killed 16. I brought six of my MPs back to the U.S. because we were burnt so severely, to San Antonio, Brooke Army Medical Center. Most of us had severe burns. And I think that’s basically the single event that created my TBI.

 

David talks about learning to distinguish between the symptoms of TBI and PTSD.

David talks about learning to distinguish between the symptoms of TBI and PTSD.

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I think the initial onset, you know, is very similar. The same thing always. But once you, you get bounced out, and you start getting medication and treatment that you can actually see and distinguish a difference between the conditions that are caused by the TBI and conditions that are caused by PTSD. It has a lot, it also has a lot to do, educating the Veteran on what the differences are. Because I had no idea what was what, until they literally broke it down for me and my wife, and then we started noticing and trying to see, you know, when I had TBI problems and when I had PTSD problems.

I: How did they break it down for you? Like what was the way they categorized between the two?

So, when it started we were breaking down, like single symptoms, you know, the different symptoms, like, it might have an indication of balance for my PTSD, then that obviously, if you already know the side effects, so if you have balance problems that’s not attributable to the medication you’re taking, because you know what the side effects are, you know how to execute things like that. You know, if you know that the stuff you’re taking for something else, PTSD doesn’t cause headaches, then obviously most of the time you know. And I’ve been taking meds for years so I know that the stuff doesn’t adversely affect me with, you know, headaches or balance or visual problems, you know, those types of things. And then I also, you know, I have seasonal allergies so you know, I know when, I know if my headache caused by my allergies feels like or, you know, how to notice that versus a headache that might be caused because I’m high stress on PTSD at the time. 

I: Is it helpful for you to be able to kind of distinguish between the two? 

To me it is, but again, I’m at ten years from my injury, so it’s a lot different than other guys. And I was forced to kind of live and deal with what I have, where a lot of guys with TBI, let’s say they’ve been in, you know, multiple grenades or IED attacks, and walk away from them, they’re just starting to try and figure out what’s what, you know, and getting treatment for both at the same time. But for me, generally speaking, it is very helpful and, you know, I share that information with other guys who, you know, have that problem or are told that they have that problem. 

 

 

David talks about using an Alpha-Stim® device to help alleviate headaches.

David talks about using an Alpha-Stim® device to help alleviate headaches.

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The Alpha-Stim®. You clip it on your ears and it sends whatever betta gamma, whatever kind of waves to your brain. So, it was originally created, and we tested it from the company, to help lower your tension and stress level for PTSD, so it’s proven to do it for that. But then I guess they also proved that it helps with traumatic brain injuries in certain people. So, the regional VA issues the Alpha-Stim® machine to try and help, you know, alleviate a little bit of the headache, and the other problems, you know, and things like that. Like it helps a lot with tension and things. I’ve only been using it for about six weeks so I really don’t know if it actually helps with the headaches. You know, last time I used it I figured it took about three months to actually see if it made a difference, so as far as the TBI goes I can’t, I couldn’t tell you yet if it’s worked for that. 

 

For David, VA-sponsored vocational rehabilitation services have helped him find ways to accommodate his injuries.

For David, VA-sponsored vocational rehabilitation services have helped him find ways to accommodate his injuries.

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So, most wounded warriors, they basically need to qualify for vocational rehabilitation through the VA. So, it’s just another education conduit, a funding stream, but it makes accommodations for your injuries that you sustained because of military service. So whether that’s a physical injury, you know maybe it’s an amputee who’s missing a leg or an arm and has to have special accommodation, or special equipment, or a lot of us with TBI and PTSD, who need, you know, certain types of technical devices or special software to work or being educated on what disability accommodations are actually provided, in the work place and in education, it kind of helps us, generally speaking, with our disabilities, depending on what it is, to actually function and get educated and, you know try and create a career, you know, aside from military service.

I: Has that been helpful to you?

Yeah, I mean it’s really been helpful to me because I’ve pretty much used every single device or opportunity that the program has. You know, when I first was injured and I started voc rehab, you know, they got me a computer and things like they get for most college students, but they also set up my learning environment at home. They brought in accommodations and based on my physical and my mental injuries, they set up my work environment and my user field where I use my computer, specifically tailoring it to also accommodate the other problems. It’s like, they taught me about fluorescent lights, because they pulsate when they send out electricity. That affects, literally affects your TBI, and your PTSD. It can cause headaches and it can also irritate you, cause irritation and you don’t know it. You know the type of lighting that they use, how you sit, because of my physical injuries how you sit in a chair, what type of chair you use. You know, whether or not you needed to be in a more closed space or quiet space rather than something with a lot of noise. So, that was like the first big thing.  And then, the vocational rehab specialists seem to be more understanding to the disabilities that they’re trying to assess you with, rather than, let’s say, a regular education counselor at college. Even with the disability accommodations, they told me more about what I was qualified, and eligible to use and available to me, rather than the ADA person, let’s say, at a college, who might not have specifically known even what’s out there because the military injuries are very unique compared to, let’s say, a civilian, maybe, who was in a car crash. 

 

David worries about the longer-term impact of his injury and the possibility of further decline.

David worries about the longer-term impact of his injury and the possibility of further decline.

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So, I think long term wise, thinking about it, some of the frustration I have with some of the research I’ve seen and people I’ve talked to is that most of combat Vets who have TBIs are probably going to get an early onset of Alzheimer’s, or some kind of condition like it, so, you know, getting older, compared to most of the other Vets, it kind of concerns me because you don’t know how far it’s going to go. So that’s, that’s a long term, I’d say my big concern is that, you know, when is it actually going to hit me where it’s going to change from me being able to cope, to the time where I’m going to start getting worse and declining, you know. Ten, fifteen, twenty years before somebody normally would have aging issues.

 

David would like to know more about what kind of TBI research is being done outside the VA.

David would like to know more about what kind of TBI research is being done outside the VA.

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So, I think in, when I transitioned from there to the VA, generally speaking, they have the whole part of identification and teaching the basics, of coping skills and things like that. Long-term wise, I don’t, I don’t see anything useful. So far, probably six of us have come back because we have problems with our TBI.  You know, they’re doing a little experimentation here or there. But some of the more innovative stuff that I know that civilians do with brains and research is not being done through the VA system, which is done by, you know, obviously my primary care team. But I think it has a lot to do with governmental restraints, generally speaking, you know. I think they could do a lot more, like, even like with the burns, there’s a lot of civilian program that should be used too. Other VAs like yours, where, you know, if the information and research were shared, that it would literally provide a better, more comprehensive, long-term support plan.

 

David’s entire life revolves around his injuries, and he is frustrated by the “strain” on his wife and kids.

David’s entire life revolves around his injuries, and he is frustrated by the “strain” on his wife and kids.

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…Not with my parents or friends but, with my immediate family, my wife and my kids, yeah. You know, over time, even though they know I have a TBI, you know sometimes it gets frustrating, because I may ask the same thing four or five times, whether it’s in one day or week. And they remember, and I don’t. So, and it could be something as simple as, you know, my daughter wanted to show me something, or my son asking me to get some information for him, or something like that. Or me asking my wife, you know, seven times what were we doing on a particular day. So, it kind of causes a strain because they all, you know, they were also, all three of them, were also my care providers for my other injuries. Which is not normal, like let’s say for, somebody who walked out of the battlefield or got left on their own, and, you know, maybe they just had a, they had a, a TBI, but you know they were, they might be able to live with it and deal with it after they came off the battlefield. For us it was a little different because my physical injuries also affect me now and how I do things now. So because I don’t sweat on 40% of my body, I also have to deal with adapting to that. And I can’t do things that most normal people do. So my entire life revolves around all my injuries. Whether it’s the TBI or the PTSD or my burns, you know or my hearing loss, you know, everything I do is kind of directly affected or has to be altered based on those injuries everyday. So, you know, obviously it causes mental strain in everybody else that doesn’t have it. And it frustrates me. So.

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