Traumatic Brain Injury in Veterans

Greg

Age at interview: 40
Outline: While serving as a combat medic during two tours in Iraq between 2004 and 2006, Greg was exposed to IED and mortar attacks and was in the radius of several blasts. He attributes his TBI not to one incident, but the “cumulative effect of repeated brain injury.” The most apparent symptom for Greg is memory loss, which affects his job performance and his relationships, as he is often unable to remember someone he recently met or talked to. To cope with the symptoms of his condition Greg keeps a detailed schedule on his computer, which he links to his iPad and smart phone. He also relies on assistance from his wife who he texts with throughout the day.
Background: Military branch: Army National Guard 

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Greg served as a combat medic in the Army National Guard for seventeen years, including two tours in Iraq between 2004 and 2006. Several times during his deployments Greg was exposed to IED and mortar attacks and found himself in the radius of blasts, and says he attributed his diagnosis of a mild to moderate TBI not to one incident but the “cumulative effect of repeated brain injury.” Although he began noticing headaches and dizziness while still deployed and recalls feeling “goofy for a minute” after such incidences, even as a medic it didn’t occur to him that there might be something significantly wrong. “It was 'I’m fine, ruck up, soldier on.'” 

Retired in 2011, Greg returned to San Antonio where he lives with his wife and four children. He sought to continue his medical training in nursing school but began to notice that something was wrong. “I would study for hours and I wasn’t retaining it, it wasn’t staying in there.” His wife also began to note strange changes in Greg’s behavior. After an incident when he did not recognize or remember someone he had met just days before she prompted him to go for an evaluation at the VA where he was diagnosed with TBI.

With support from the VA, Greg returned to school to become an air conditioning technician. He struggles with memory issues every day, sometimes forgetting appointments or directions in a town where he has lived for many years. To cope with his memory lapses, which he says is the biggest issue associated with his condition, Greg keeps a detailed schedule on his computer which he links to his tablet and smart phone. He also relies on assistance from his wife who texts with him throughout the day, helping him with everything from appointment reminders to directions, and who is assisting him with the start of his own handyman business.

To those struggling with the effects of a brain injury Greg says it’s important to have a support system. “Somebody that is close to you that you can be close to that you can talk to on a regular basis,” he says. “You can tell them the things you’re forgetting. You can tell them the things that you’re feeling.”

 

Greg talks about the cumulative effect of repeated blast injuries.

Greg talks about the cumulative effect of repeated blast injuries.

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Well, it, actually my problem was a culmination, it was a cumulative effect of repeated injury. I was in the vicinity of and within the distance of the blast radius on several, we had a couple mortar attacks, IEDs, things like that, and I was inside that concussive wave. So, I never actually physically sustained injury, I never caught any shrapnel or anything like that, which I’m very happy for, but you know there were many times where I just, I got all goofy for a minute, you know I couldn’t focus, I was just kind of out of it for a little bit. And again, as far as I remember I never lost consciousness.

 

Greg didn’t see a doctor after his injury and wasn’t screened for TBI when he got back from deployment.

Greg didn’t see a doctor after his injury and wasn’t screened for TBI when he got back from deployment.

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My biggest problem was, being a medic, that I never went in and got seen. It was the next day or something, conversation over a cup of coffee with the doc, who I worked for - “Hey I’m kind of feeling like da da da da da, what do you think about da da da? Oh, you know what, you take a couple of those and if you don’t feel better in a day you know give me a call, come back and talk to me. Ok, cool.” Done. No paperwork, no real diagnostics, it was just a conversation over a cup of coffee.

I: When you got out was there any kind of screening or work up at that point?

When I got back from deployment? No. Nope. They give you a basic once over as far as medical, relying pretty much on what you’re telling them. Now had I known then what I know now, I would have sat down with that doc and been like, guess what, we’re gonna spend some time together because we need to document all this, we need to get all this on paper. The problem was, we just got back stateside. I want to go home. I don’t want to be here, you don’t want me to be here, none of us want to be here. How about I just check the boxes, sign off on the bottom, have a nice day I’m out of here. And that is a huge - and I’ve seen it over and over and over again. I had one guy that had a fairly major knee injury while we were over there, three weeks or four weeks in. But he roughed up, he soldiered on. We had a doc, so he maintained care for that guy, and he healed up ok. We kept him on light duty for a while, and da da da da da. Well we got back to stateside, that should have been, and it was in his record from over there, but that should have been investigated further. They should have referred him out. They should have sent him to ortho, said hey let’s take a real good look at this, now that we have the tools to do so, let’s take a real good look at this. They didn’t do that. He checked the box, they checked the box, off he went. I heard from him about four years later and he completely blew his knee out. It completely, he has to have complete reconstructive surgery. So, had that been an issue at the time, instead of “I just want to go home,” that may not have happened.

 

Greg said TBI “…affects all brains differently.”.

Greg said TBI “…affects all brains differently.”.

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Mild to moderate is no loss of consciousness to, I think, like an hour. And then moderate to severe is 24 hours or more. And then severe is like several days, or longer. Yeah. So, I have known guys that, I mean they were out for a couple few hours, they’re fine, they’ve got no issues. I know other folks like me that, as far as I remember, never actually lost consciousness, and I’m all goofy. It affects all the brains differently. I got evaluated at the VA. They did the long evaluation, all of the tests and all this. They did not do any brain scans, just the put the things in the box and, you know, tell me what numbers I’m telling you, etc. So, I got diagnosed mild to moderate. I didn’t know at that time that the mild to moderate had only to do with unconsciousness, not to do with how severe your symptoms, which just blows my mind.

 

Greg loves reading and says one of the benefits of his memory loss is that he can re-read books he already read.

Greg loves reading and says one of the benefits of his memory loss is that he can re-read books he already read.

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I get to re-read books. I do, I get to re-read books. I will, I’m a very avid reader, I love reading and there are times I’ll pick a book of the shelf and be like I know I’ve read this and I’ll start reading and I’ll end up re-reading the whole book and, I don’t know, I’ll probably remember 70% of it, 80% of it, or something. But there’s always that little surprise of I don’t remember that happening. So, I get to re-read books, I get to re-watch movies. What was it the other day, it was just a month ago or so, I had said to my wife, Of Mice and Men, I said, “Baby we need to watch this movie, we need to watch it with the kids, this is just such a powerful movie, I really wanna watch it. Baby we did. When? Last year. All of us? Yes, all of us. I haven’t seen this movie in years, I can’t remember the last time I saw this. Yes, it was last year. You sure? Yes, I’m sure.

Ok, can we watch it anyway?” So, it annoys the kids to no end. 

 

Greg took a $10 hour pay cut because he forgets important things at work.

Greg took a $10 hour pay cut because he forgets important things at work.

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My problem is my memory. And it really does - I took a ten-dollar an hour pay cut in January because I’m forgetting to call customers. I’m forgetting to call insurance companies. I’m forgetting which customer said what day he was going to be available. I’ll have a conversation with somebody in the truck, you know I got my little hands-free thing and I can’t write anything down obviously, so I’ll have a conversation with a customer say ok, you know what, tomorrow 2 o’clock, that sounds good, I’ll be available, ok great. So, I got you down Mr. Smith for tomorrow at 2 o’clock, awesome. Hang up, get to my destination five, eight, ten minutes later, whatever. Who the hell did I talk to? I don’t remember which customer that was. Or, that was Mr. Smith, when did he say he was going to be available? Was that tomorrow or the day after? I don’t remember. And so, I’ll have to call the customer back, which is really obnoxious, for the customer anyway. What time did I tell you? It makes me look like an idiot.

 

After realizing he could no longer work in medicine, Greg got support from the VA to train as an air conditioning technician.

After realizing he could no longer work in medicine, Greg got support from the VA to train as an air conditioning technician.

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So, I got out of medicine. I decided that I could continue, I could just keep chomping away at it, but if I get forget to charge up an air conditioning system with refrigeration and I burn it up, well that sucks. If I forget which patient needs which med and I kill someone, that’s a bad day. So, I stepped away from medicine, and I became an air conditioning technician. The VA paid for me to go to school, and all this. It’s a nine-month school, and it came really easy. I mean it’s not particularly mentally intensive work as the nuts and bolts of doing the job. As with any other type of service industry, the diagnostics, the dealing with people, things like that. That’s all, you can’t teach that. You gotta, kind of get it as you go along. But again, for that nine months I would spend hours and hours studying to keep up with my peers and honestly my peers were not the brightest bulbs in the box. There’s a reason a lot of folks go to trade school. Good folks, don’t get me wrong, just…anyway. So, I would, you know I’d study for hours. I did graduate. I think I was like second in my class or third in my class, which was cool. You know, once I graduated, and I actually got hired a couple months before I graduated, so, and I have been working it ever since. And I love it. I love air conditioning. It’s great work. It changes every day, I’m driving all over the city and meeting all sorts of people, it’s great.

 

Greg’s number one pillar of support is his wife, who helps him remember things and cope with his TBI and PTSD.

Greg’s number one pillar of support is his wife, who helps him remember things and cope with his TBI and PTSD.

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Talk to my wife. That’s the number one biggest one. Cause honestly without her I don’t know where I’d be today, I really don’t. I mean, not just for the TBI, for the PTSD, and the whole nine yards. She’s my number one pillar of support. And as much as it just drives me crazy that she reminds me of everything all the time, even if I already remember it myself, it’s necessary, you know, I need it. I text her while I’m at work, like the conversation with Smith, I’ll get to where I’m going, if I remember the conversation I’ll text it to her. Smith, tomorrow at two o’clock, bring this and that. You know, received. And then I can reference my text messages later. I can, she can remind me later. I’m trying to get her to the point where she is starting to schedule for me because I’m trying to unsuccessfully run my own handy man business as well as being an AC technician.

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