Traumatic Brain Injury in Veterans

Luke

Age at interview: 37
Outline: On a patrol during his deployment in Iraq, Luke was exposed to a blast while outside his vehicle. His right eardrum was perforated and he was dizzy, disoriented, and sick to his stomach. Once home from deployment he was diagnosed with post-concussive headaches. Beyond his frequent headaches, Luke struggles with light sensitivity, memory issues and difficulty hearing coupled with ringing in his ears that has gotten worse over time. To cope with his symptoms Luke wears sunglasses and tries to live a healthy lifestyle including eating well and keeping active.
Background: Military branch: Army

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Luke was out on patrol one night during his deployment in Iraq when he dismounted his Humvee. As he walked around the front, an “IED detonated next to the Humvee. And I just remember waking up, kind of coming to, and I was on the other side of the road and I was just very disorientated, confused, sick to my stomach, loud ringing and exclusion on like the right side, and then the fog started to lift a little bit and we responded. I went and got checked afterwards at the aid station when we finished the patrol, and I had, you know like perforated eardrum on the right side, and obviously had a pretty nasty headache and they prescribed Motrin and water and rest. And the very next night we were out on patrol again, so…[we continued] patrolling pretty consistently every evening, because if we didn’t go, there was nobody patrolling that area and then that gave the Iraqi insurgency at that point, you know, free reign over that specific area that was highly traveled back and forth.” 

Two months later his deployment ended, at which time he went to the VA for “problems with ringing and hearing and headaches.” He eventually was rated for post-concussion headaches, but didn’t actually seek any type of rating or to be connected until around 2009. “So, at the time, when I was evaluated, we did a, like a host of tests, and I scored pretty well on a lot of them, and so they talked about the difficulty of not being able to rate me for TBI being that they didn’t have a benchmark for how I performed earlier.” Luke has since returned to the VA to be re-evaluated.

Eleven years after the incident, he’s noticed “I get stuck a lot more often on stuff. The ringing has gotten significantly worse. I’m having difficulty hearing people in crowded rooms, you know, where there’s other stuff going on and focusing on stuff.” He suffers from “headaches every day so I’m really sensitive to light. I’m always wearing my sunglasses. And I know I’m going to get one almost every day so it’s a matter of how soon in the day am I going to get it or how bad is it going to be that day. If it’s really bad I don’t seem to ever recover until like I finally find a way to fall asleep and then when I wake up I’m usually pretty good to go. But there’s been days where I just couldn’t go to sleep because of it. So stabbing sharp pain, usually in a pretty specific area.”

Luke finds that his biggest challenges are word recall and short-term memory loss. “I get hung up on word finding. That and like short-term memory. Introducing, talking to people. Trying to remember names even though I’ve said it, you know, six or eight times in my head.” To cope, he tries “to eat better and do all the things you’re supposed to do to support an active healthy lifestyle. I seem to have more success if I’m, you know, hydrating properly and if I’m taking care of, make sure I wear my sunglasses and that I attack stuff earlier on when it happens so that I don’t wait until it’s somehow I can’t stand it and then I try and take something, and so I’ve learned.”

 

Luke talks about feeling frustrated when he can’t remember words and names.

Luke talks about feeling frustrated when he can’t remember words and names.

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The biggest thing for me is, I feel like today I’m having what my wife calls a moment of clarity. So, I get hung up on word finding. It’s very difficult for me, I can be talking about a desk, we can be standing in front of one, I can have my hand on it, but I can’t come up with the term for it. And then I get frustrated because I can’t get to it, and then I think, I feel like other people around me are like waiting for me to get to my point, or I lose track of something because I get focused on trying to come up with a term for something, and it makes me feel stupid. And I know, you know, I think I’m fairly intelligent. I have my bachelor degree and I graduated with honors and I never had an issue with academics before but that can be really frustrating. That and like short term memory, so - introducing, talking to people. Trying to remember names even though I’ve said it, you know, six or eight times in my head or I’ve done all the memory games where I try to associate it with something and I just, I have a really difficult time with that.  So, word finding, short term memory. 

So, there’s things, those terms, those things that I just drilled into my head back when I was on active duty, before I deployed, that I can recall. But if I’m studying for, like say for instance I just had a recent interview for promotion at my job and it’s, you know, scenario-based questions and stuff like that, so, “Tell me about a time when you did this and this and this.” And I just have the most difficult time recalling things that even happened, you know, two days ago or specific things. I work as a deputy sheriff. I’m actually assigned as a detective right now. And so, my, my partners have this uncanny ability to recall the names of all the dirt bags they’ve ever dealt with and the addresses and their girlfriends and I used to be really, really good at that and it’s just, it’s gone now, I can’t pull it up. So that’s really frustrating. 

 

Luke has a harder time recalling details and thinking on his feet, which is frustrating in his job in law enforcement.

Luke has a harder time recalling details and thinking on his feet, which is frustrating in his job in law enforcement.

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Well I used to, you know, when I used to memorize these manuals, these field or drill manuals and stuff or these study guides, you know, for promotional exams in the, in the Army, and the fact that I could still recall those things frustrates the hell out of me because I, I’m like this bank of useless knowledge that pertains to the military. But when it comes to like specific statutes or individual case law regarding my job or when it comes to recalling the details of a report or an event if I’m testifying on the stand, I almost have to commit things to, or do my best to commit things to memory because I, I won’t be able to give you dates or times or tell you specifically, and that translates to me not being confident on the stand, which a defense attorney just tears me apart then at that point because, you know, I’ll give you an example. I lost a, so I gave a traffic citation because a gal blew through a stop sign. And it was a teenage gal. So when you go to juvenile court, they bring me in and I’m testifying, and she’s sitting there with her mother, and they ask me, “Well, did you see her stop, you know, 20 feet before?” and like, “No, I just didn’t see her stop at the stop sign.” And I ended up losing that case because I couldn’t tell them for sure or not whether she had stopped prior. As soon as I walked out, maybe 20 minutes later, as I’m mulling it over in my head, well then I had all these points I could have articulated regarding 20, 20 feet back she would have been able to see traffic oncoming and the whole point of, you know the, the statute says that you have to stop at the line within a certain distance from the stop sign, etcetera, etcetera, so not only did I lose the case because I wasn’t able to articulate my point, defend my actions, now this girl, this 17-year-old girl got emboldened and thinks that, even though she screwed up, she was able to go in and win this case and whatnot. That like was a life lesson that she’s being taught, you know. So, so that stuff, professionally, yeah, it’s frustrating, because I, I still can recall the stuff from way back but now it’s, it’s a harder task for me.

 

Luke is sensitive to light and gets headaches every day, sometimes so severe that he needs to take time off from work.

Luke is sensitive to light and gets headaches every day, sometimes so severe that he needs to take time off from work.

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And then, you know, I get, I get headaches every day so I’m really sensitive to light. I’m always wearing my sunglasses. And I know I’m going to get one almost every day so it’s a matter of how soon in the day am I going to get it or how bad is it going to be that day. It gets to the point where I’ve had to take time off work and stuff. Because when I worked, I work as a deputy sheriff, so when I worked the road I would primarily work like evening, late evening hours and so you would do the transition of dark environments, bright laptop that I’m trying to focus on, information that’s coming and going. And then my emergency lights are going on and I’m using bright lights and then I’m transitioning back to trying to focus on this dark shadow and, you know, in the car or at the scene or whatever and so that transition back and forth was really difficult for me. Some days I’d just, I’d say, “I feel it coming, I’m going to get,” I knew I would get to the point where I would, the only relief would be to close my eyes, so I’d pull in and go home, so. That’s been difficult too because I never had, I wasn’t, you know, the guy who had headaches.

 

For Luke, the hardest thing not having the mental sharpness he used to and feeling like he isn’t operating at full capacity.

For Luke, the hardest thing not having the mental sharpness he used to and feeling like he isn’t operating at full capacity.

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It’s frustrating because I feel like I’m not operating at full capacity a lot of the time as far as, you know we’re always supposed to be growing smarter and stronger you know, up to a certain point, as we grow older. I feel like I’ve taken a little bit of a regression, so the things that came really easy to me in the past, so memory, recall of information, being able to, you know, react in a situation and being able to talk my way through it, whether it was interviewing and stuff, those things come to bear like pretty much every day when I was working patrol for the Sherriff’s Office. Because now I’m interacting with people who have this chaotic situation, you know. It may have taken them 20 years to screw up and now they’re asking me to come in, in ten or 15 minutes, find a fix for it. So, whether I’m acting with people who are aggressive or violent towards me or I’m dealing with multiple individuals that couldn’t find some common sense amongst them, so now I got called to deal with it and now I’m trying to separate these parties. When I get in the midst of an interaction with the citizen and I’m on work and I’m obviously in uniform and shaved and pressed and polished, when I get stuck on something in a conversation and there’s that pause, it makes me feel less safe, like I don’t have command presence, like control of the situation. 

And that’s, like it’s a huge piece of officer safety is whether you have a good command presence and whether you can exude authority, even though you may not have the answer at the time, people still think you have the answer or are giving them the answer. You know, a lot of the people that we deal with, if they detect or smell weakness on you, they’ll take advantage of that immediately because that’s what they’ve been doing their whole lives, is manipulating other people to their advantage so, and that has to stop with us, when we react to that situation, so. Whether it’s because I’m already having a headache and I’m dealing with that or because I’m fatigued because I didn’t sleep from the last night headache and I, I notice myself starting to slow down a little bit or, that’s probably like the biggest impact. Like headaches and pain and stuff I feel like I’m, I’d rather have that than a multitude of other issues, medical issues, right? But if I could change one thing it would certainly be being able to continue to have that sharpness and so that, that kind of, you know, looking back that kind of made me mad when I went into, to get rated or to do a rating determination and they said, “Well you scored really well on this test.” And I said, “Well that’s awesome, but what are, you know, what are you comparing that too? That’s not the best that I can do,” you know, “but if you’re using the bench mark as other people who have taken the test, these guys are going to have vastly different injuries and experiences and I’m sure a lot of them were way worse than mine,” you know.

 

Luke says that the ringing in his ears has gotten significantly worse and his headaches are worse and more frequent.

Luke says that the ringing in his ears has gotten significantly worse and his headaches are worse and more frequent.

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Yeah. I get stuck a lot more often on stuff. The ringing has gotten significantly worse. I’m having difficulty hearing people in crowded, crowded rooms, you know, where there’s other stuff going on and focusing on stuff. I think I’ve been putting that off for a while and it’s time, I’m glad today I started organizing stuff to go back in because whether or not I have to wear a hearing aid, or I know now, I’ve talked to other Veterans who have, who say there’s some noise cancelling features where they can adjust things, so that it matches the pitch of what they’re hearing at the time which will cancel it out and stuff. And the headaches have gotten worse and more frequent, unfortunately. But nothing, you know, I think those are probably the biggest pieces.

 

When he feels a headache coming on, Luke will try immediately to find a dark place to “zone out and close my eyes.”

When he feels a headache coming on, Luke will try immediately to find a dark place to “zone out and close my eyes.”

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Try to eat better and do all the things you’re supposed to do to support an active healthy lifestyle, you know. I seem to have more success if I’m, you know, hydrating properly and if I’m taking care of, make sure I wear my sunglasses and that I attack stuff earlier on when it happens so that I don’t wait until it’s somehow I can’t stand it and then I try and take something, and so I’ve learned those - like, as soon as I feel something coming on I’ll immediately try and, you know, find a dark place. Like when I, for instance, when I worked the road, we typically have a substation or a fire station that I could go to and, you know, close the blinds and just take a minute to zone out a little bit and close my eyes. And I would start chugging water right away. I maybe would take like my Excedrin Migraine like right up front, just to make sure, and that would usually get me through, and I would either be successful in mitigating it or it was just one of those things where I would delay the inevitable or I get to that point.

I: And how long does it usually last once it comes on?

If it’s really bad I don’t seem to ever recover until like I finally find a way to fall asleep and then when I wake up I’m usually pretty good to go. But there’s been days where I just couldn’t go to sleep because of it - so stabbing sharp pain, usually in a pretty specific area. But I’ve had MRI, you know, back when I did my initial consult for neurology I did an MRI and stuff and so it’s frustrating when you only expect that there’s going to be something there that they can pinpoint and they say “Oh yeah, this is it. We know how to treat that specifically.” So, when you don’t have something that they can say “Ah hah,” then it feels like they’re guessing, they’re just throwing stuff at it. “Let’s see if this works. Oh it doesn’t, we’ll increase the dosage. How about this? We’ll combine these things.”

 

Luke enjoys spending time with other Veterans who had similar experiences during deployment.

Luke enjoys spending time with other Veterans who had similar experiences during deployment.

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So he, he had similar experiences. He deployed and was in infantry and whatnot, just in a different area at a different time – so that’s really nice to have, you know. As time goes on I try not to, you know you want to keep those experiences close but you don’t want to keep going back to them, you don’t want to keep relying on them, so sometimes you get together with those folks, you know, your inclination is to talk about things that are familiar to both of you, but you know we also have other interests outside that - so it’s, it’s, it’s easier sometimes to try and focus on that stuff and not keep going back. But I do stuff like I, I have an annual golf tournament that I go - I golf one time a year - it’s at this tournament and I see a lot of the same people and similar experiences and stuff so.

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