Traumatic Brain Injury in Veterans

Kevin

Age at interview: 56
Outline: While serving in the US Coast Guard in 1980, Kevin was knocked off a pier by a ship’s mast, which swung and struck him from behind. Almost immediately he began grappling with symptoms stemming from the accident such as headaches, pain, and memory loss. He also began to notice changes in his personality. He struggled with mood swings, had difficulty getting along with others, and increasingly isolated himself from the rest of the world. It wasn’t until 34 years later that he learned he had suffered major brain damage in the incident and that the back part of his brain was now dead. Learning that he had a TBI was a major relief for Kevin. After the diagnosis, he was able to move forward in getting medications and therapy to help alleviate some of his symptoms including anxiety and depression.
Background: Military branch: Coast Guard 

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Six months into his United States Coast Guard enlistment in 1980, Kevin was knocked off a pier by a ship’s mast. He took a glancing blow off a log, 30 feet under the water, and then sunk another 40 feet before returning to the surface. He was immediately taken to the Naval hospital for an x-ray, but deployed with his ship prior to receiving the results. It took two years for his x-rays to catch up to his ship where there was no medical care to assist him. After nearly three years at sea, he transferred to a location with a medical facility, where he tried to get medical care, but his records were in so much disarray, they didn’t know what they were treating him for.

Kevin didn’t find out until 2010 that eight disc spaces in his neck and my entire cervical spine was “blown out.” Similarly, it wasn't until 2014 that he was told “the whole back of my brain, encompassing about 20% of it, is dead.” Even though he didn't get a diagnosis when his injury first happened, he suffered the consequences immediately, and for decades to follow. In addition to constant "raging" headaches and other pain, he was less tolerant and found it difficult to get along with people, became obsessive compulsive, and had a difficult time learning and remembering. When he was finally given a diagnosis of TBI he said, “it was a relief. It was an absolute relief. Because then I could, I had something tangible that I could understand why all these changes happened to me in my life. Why when I came back from the service I wasn’t the same person at all. Finding out that I have this TBI, now I can put the pieces together in my life and it, it all makes a little more sense to me.” 

Kevin’s diagnosis led his doctor to switch his medications, because the specific antidepressant he was on caused erratic behavior and severe depression and anxiety. Due to the medication change, “I am no longer, I’m not agitated. I’m not sinking into the depressions as deep and dark. I’m not getting those suicidal thoughts that I used to have. It has calmed my head down so much and my thoughts, my racing thoughts all the time. My anger issues have subsided.”

To who have had a TBI, he says, “The human body is very resilient. People with TBIs, I just want you to understand the resilience of the body. The brain is resilient too, OK. You just have to figure out how it’s rewired itself, and that’s the hard part.” He noted that the rewiring “doesn’t happen immediately or overnight. It’s been happening with me over the last 35 years.” He also recommended “don’t set too high of expectations for yourself. You have to limit those expectations and understand the way your mind works and learn how your mind is working, because it works differently than other people.”

 

After being shoved off a pier by the mast of a ship, Kevin fell over 30 feet and “landed head first on a log.”

After being shoved off a pier by the mast of a ship, Kevin fell over 30 feet and “landed head first on a log.”

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On November 27, 1980, a shipmate and myself were given an order to perform a simple, common and ordinary task that changed my life forever. On this miserable, rainy Seattle day, we carried forth a command to transfer a 350-pound tarp from the pier to our ship. As we lifted the tarp, my partner tripped. Letting go, the mast fell against me, shoving me off the pier, falling 30 feet, landing head first on a log that prevents the ship from surging against the pier. By God’s grace, and a glancing blow, I woke up in the water, no air in my lungs, sinking 40 feet, while unconscious, laden by my zipped-up foul-weather jacket and work boots. Seeing no blood in the water and finding where up was, by a single shiny spot glimmering through the murky abyss I was descending to, I started kicking with all my might, wanting to take a breath of air that was only water, when suddenly my head popped to the surface. I missed the log. I’m still alive. My training worked. In subsequent denial and shock, I told the command I felt no pain, and resumed my duties without medical care, for there was no medical staff on board, and civilian care was no option under the circumstances.

 

After hearing his story, Kevin’s primary care doctor did a comprehensive evaluation and told him that he had a “very bad” TBI.

After hearing his story, Kevin’s primary care doctor did a comprehensive evaluation and told him that he had a “very bad” TBI.

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But I get fabulous care at Reno. They took me, the, my primary care doctor sat me down, heard my whole story, and then said OK, we want to start at the top and work down. They did a brain scan. They did a cervical MRI and a lumbar MRI. I knew my neck and back was bad. And this was just a year and a half ago. I had an appointment with my primary care doctor and he was a really, really cool and understanding person. Really good guy. And he wasn’t happy with the VA, particularly the way it was being, the way it was processing us. So, he went out of his way to help better, and listening to their story, because he knew that’s where the disconnect was. The VA won’t, doesn’t believe the Veteran’s story because all they think is you try and get money, OK. A lot of cases that’s true, some it’s not. For me it’s not. 

Anyway, he sat me down and he said, “You’re right, you, you racked your head really, really, really badly.” And I said, “What?” He said, “You have a very bad traumatic brain injury.” And I just kind of, I couldn’t respond. I, I didn’t know what to say. And he said, “I want to make a, an appointment with our neurologist here at Reno so you can talk to him.” I said “OK.” So, about a month later, it was right at a month, real good here at Reno, I saw the neurologist and he sat me down and he started going through the levels of the MRI. And he said, “Now you’re good up here, the top of your brain, the top of your head, front part of your brain is pretty good.” He went down a little further and said, “You see this black?” He said, very gently he said, “Everything that’s black is, is not functioning. It’s dead.” I said, “OK.” He said, “I’m going all the way down through your brain now.” And I couldn’t answer. All I could say, I said, when he was done I said, I said, “That’s my brain?” And he said, “Yes.” And he said, “It’s old. It, it’s an old injury that happened a long time ago. OK.” I said, “Yeah I know, when I fell.” He said, “Yes.” As a result, the whole back of my brain, encompassing about 20% of it, is dead. By God’s grace, I can still talk. I can still, I still have the facilities within my thoughts. I can speak. I can write. But I have a lot of other limitations that I didn’t know I had.

And then I was sent to see a psychologist, and she explained it a little further. And did a test, a 4-hour TBI test that the VA does, that determines what parts of your brain are, have deficits. And, as a result she said, “Well, the front of your brain has been rattled. Not badly, but it got bruised really bad. It doesn’t organize things properly. The back of the brain and into the center cortex got rattled quite badly, which effects your primeval things, senses to want to eat, sexual desires, you’re kind of out of the picture. And temperature, body temperature, organ control, rate, controls your heart rate, probably your breathing, swallowing.” She said, “That’s been rattled quite well.”

 

Kevin has a harder time learning and remembering new things and following conversations.

Kevin has a harder time learning and remembering new things and following conversations.

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I was, I‘m still very intelligent, but I have a difficult time learning things anymore. I can’t, when I’m reading, after the incident. I used to like to read a lot. I, I can’t stand reading anymore because I can’t remember what I just read after I read it. That, that was a big change. So, when I was, when I opened my business and I started getting into business deals and writing contracts and everything else, it became a real disadvantage because I couldn’t understand contracts like I should have, OK. Or I’d engage in conversation and I couldn’t remember what all, everything was said because my thought process, I don’t pick up, when I’m in a conversation with someone, I don’t pick up on everything in a conversation or I, like I had here, I get, I get off on something else other than the conversation, OK. So, it became a real detriment. And, and, like with my wife, we knew, God bless her, we had a wonderful relationship. She knew something was wrong with my thinking and so she, just her blessed heart and the person she was, she became a strong point for me in that area. She could read people where I couldn’t. Because I can’t read people at all. 

 

Kevin talks about how his brain has rewired itself over the years and discovering that he had a gift for writing.

Kevin talks about how his brain has rewired itself over the years and discovering that he had a gift for writing.

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And like I said I never knew I had this speaking or writing ability and I’ve since learned that, because of the part of my brain that got messed up, it triggered, and my mind has over the years, and it’s been a slow process, because it takes years, it’s rewired itself to do this, OK. Because I never used to be able to do this. But my mind has rewired itself. And this is what I’m saying, with a traumatic brain injury, your brain always, it continues to heal, but it doesn’t regrow or regenerate but it rewires the other parts of the brain to maybe do the functions that it can’t, that the other part can’t do anymore. And it doesn’t happen immediately or overnight. It’s, it’s been happening with me over the last 35 years. I see it, OK. I just learned my gift to write. I just learned I had it four years ago, OK. Prior to then, I mean, I just, I didn’t know it was there. And I had even gone to college. And didn’t realize it was there. 

 

Kevin self-medicated and battled addiction issues while still in the service.

Kevin self-medicated and battled addiction issues while still in the service.

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So, I finished my enlistment. I got 3.8, 3.9 marks. But by the time I got out, and I don’t like admitting this, I had a horrible cocaine problem, because I was using cocaine for as long as I could and any way I could, any amphetamines, anything to medicate myself so I could keep doing my job for the US government.  And that was even when we were on our long deployment so I would make sure that I would stockpile enough of whatever to get me through as long as I could. I’m not proud of that. I never thought I’d pick up, buy 10,000 hits of speed in Antarctica, from a friend of mine, which, had I not had that, although I’m grateful for it, I hate to say it. So, I had to self-medicate for many years. I wanted to stay in the Coast Guard but I couldn’t, because I had such a raging drug problem they were going to bust me and I was going to be in a lot of trouble. So, I got out of the service and went into drug rehab, because I knew I had a problem and had to undo it. I spent a year in drug rehab and then I moved back to my home town, hoping to make things right with my family, once again, because that was partially why I went into the service was to get away from my family and because, um, anyway I don’t want to get into that. 

 

Kevin sees a psychologist at the VA who helps Veterans and only Veterans and recognized that he was in need.

Kevin sees a psychologist at the VA who helps Veterans and only Veterans and recognized that he was in need.

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I see a psychologist here that helps Veterans and only Veterans. That’s her job. That’s her, she set up a thing called Welcome Home Vets. And she recognized my need, that I was one of those Veterans that just got forgotten about completely. I mean after, when I got out of the service I had an option. They said, when I got my discharge papers, all they said to me was well, and I, I knew I was hurting but I couldn’t put anything together. I, I couldn’t get any medical care. But anyway, they said, they handed me my discharge papers and said, “If you think there’s something wrong, then go to the VA.” And I said, “What, am I supposed to be hurt? Am I hurt?” I don’t know because no one’s told me, definitively. Well, so I just went on with life, OK.

 

Although his mind still works, Kevin explains that it works differently than before and he needed to adjust his expectations.

Although his mind still works, Kevin explains that it works differently than before and he needed to adjust his expectations.

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Yeah, don’t, with the TBI, because your mind, maybe your mind still works, but it tends to develop expectations that are way above and beyond what you’re able to do, OK. And that’s because you want to do it and you think you should be able to do it. Because your mind still works, it still works, it just doesn’t work like it’s supposed to or like it should, OK. It, it’s, it’s off all the time. But don’t set too high of expectations for yourself, OK. Because you cannot, you have to limit those expectations and, and understand the way your mind works, and, and learn how your mind is working, because it works differently than other people.

 

When Kevin doesn’t take medication for his headaches, the pain will be so bad that he “can’t stand the way his brain feels."

When Kevin doesn’t take medication for his headaches, the pain will be so bad that he “can’t stand the way his brain feels."

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And the VA, when they put me on this Depakote, I mean it’s a medication I will never not be able to take again.  If I do not take it, my head starts feeling so bad, I don’t want to live, OK.  I, I, I will not be able to stand the way my brain feels.  I can not.  I ran out of it here a few months ago and I just, I, I wanted to kill myself, OK.  I wanted to literally kill myself because it hurt so bad, because my thoughts just started going everywhere.  Anxiety started setting in.  I just went into a depression that was so dark and deep it was horrible.  And that was just recently.  And I called the pharmacist and I said, “I need the Depakote man.  I ran out and my script and I’m just not getting enough and I keep running out.  I gotta have it.”  So now I’m getting adequate amounts so that I don’t run out.  But this is where it’s at.

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