Friday, July 2, 2010

Traumatic Brain Injury - The Unseen Wound

The following article talks about traumatic brain injuries and the struggles endured by warriors and their families. This article is written by Chelsea Travers of CareMeridian:

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Traumatic Brain Injury & the Military

[Traumatic Brain Injury (TBI) is all too commonly associated with modern warfare, particularly the War on Terror. Many veterans suffer from these injuries without realizing it, until serious problems develop. Through awareness, we can help our military friends and family members avoid the serious implications of a traumatic brain injury.]

Military men and women are continually involved in situations where risk of injury is high. One silent war wound that often goes unnoticed is a traumatic brain injury (TBI). A TBI affects the function of the brain and can often cause life-altering damage ranging from personality and behavioral changes to complete loss of brain function and the ability to communicate. Therefore, some of the affects are not just life-altering, but also life threatening, and wind up requiring, long-term, specialized traumatic brain injury rehabilitation.

According to the Veterans Health Initiative, active male members of the military were hospitalized due to TBI related injuries at a rate of 231 per 100,000. The rate for female members of the military was 150 per 100,000. Based on these statistics, over 4,000 military personnel are hospitalized on average each year for traumatic brain injuries. Some are diagnosed as a mild TBI (aka concussions), while others result in moderate to severe TBI.

Mild TBI refers to loss of consciousness, confusion and/or disorientation for a duration less than 30 minutes. They are often overlooked at the time of injury but in at least 15% of cases can still have effects that last longer than 1 year. Symptoms associated with a mild TBI are fatigue, headaches, impaired vision, memory loss, inability to focus or pay attention, impaired sleep, dizziness, emotional impairment, depression and seizures. They are not always experienced right away and behavior changes are usually noticed by friends and family members before the victim realizes there is a problem. Therefore, it is important that any soldier suffering a physical blow to the head get examined immediately even though they might feel fine at the time of the injury.

The spouse of a veteran returning home from war can play an instrumental role in preventing long term damage stemming from a mild TBI by recognizing the difference between the “normal behavior” of their significant other and the occurrence of the abnormal symptoms listed above. Since spouses often spend more time together on average, they could be considered the first line of defense against long term damage from a TBI. If they understand the symptoms and know what to look for, when they recognize them, they can encourage their husband/wife to seek treatment immediately. Likewise, soldiers returning home should not dismiss any health concerns pointed out to them by those closest to them. Early treatment of a mild TBI will allow a patient to have the best chance at a full recovery and give the entire family an opportunity to maintain (or return to) a normal lifestyle as it was prior to the victim suffering the injury.

Moderate TBI refers to loss of consciousness, confusion and/or disorientation between a range of 30 minutes and 6 hours with a Glasgow Coma Scale (GCS) of 9 to 12 (15 being the least severe). Severe TBI refers to a brain injury resulting in loss of consciousness, confusion, and/or disorientation for a duration longer than 6 hours and a GCS of 3-8 (1 being the most severe but 3 being the lowest score achievable while considered non-vegetative). The GCS is a cumulative point system that combines three different scores determined by a patient’s eye, verbal and motor responses.

In cases of severe TBI, patients suffer cognitive damage including all of the symptoms of a mild TBI with the additional difficulty with impulsiveness, language processing and executive functions. Severe TBI patients may have difficulty speaking, understanding words, reading or writing and may alter the speed at which they try to communicate. Impairments to their sense of sight, touch, hearing, smell, and taste are likely. Seizures can ensue and damage to the individuals’ physical and emotional health can be devastating, including physical paralysis, chronic pain, bowel disorders, malnutrition, menstrual difficulties, anti-social behavior, lack of motivation, aggression, depression and denial.

A patient and the friends/family members of a patient suffering from a severe TBI will undoubtedly experience significant changes to their lifestyle throughout the recovery process and especially in the event that the patient cannot recover. The best way to prevent TBI is through awareness. Recognizing and responding to the early symptoms of a TBI can often aid in preventing further damage caused by the injury. So it is vital that serviceman and their families are aware of TBI so that they can recognize the symptoms and help the victim seek medical treatment if symptoms are present.

Written by Chelsea Travers: Chelsea is a communications representative for CareMeridian, a well-known subacute care facility located throughout the western United States for patients suffering from traumatic brain injury, spinal cord injury, or medical complexities such as neuromuscular or congenital anomalies.

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War veterans (or their families) who believe they may suffer from the untreated effects of traumatic brain injury should contact their local Veterans Hospital, VA clinic, or the Department of Veteran's Affairs as soon as possible.

Charles M. Grist

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