By Warren Wright
| U.S. Army Medical Department Activity, Fort Drum, NY | March 1, 2019
FORT DRUM, N.Y. – Elizabeth Kirkpatrick, the physical therapist for the Fort Drum Traumatic Brain Injury (TBI) Clinic, uses a model of the inner ear to demonstrate how a concussion can cause inner ear, or vestibular, damage which may result in dizziness, anxiety, depression, moodiness, balance problems and irritability to name a few. Healthcare professionals at the Fort Drum TBI Clinic provide comprehensive multidisciplinary strategies to help facilitate the rehabilitation and reintegration of service members who’ve suffered from a TBI. (Photo by Warren Wright, Fort Drum MEDDAC Public Affairs)
Not all the wounds of combat are visible. While tens of thousands of service members have returned home bearing the visible scars of war, hundreds of thousands of others have suffered from injuries that are unseen and are often misunderstood.
Since 2000, more than 380,000 service members have been diagnosed with a traumatic brain injury, or TBI. Most of those cases are classified as a mild TBI, more commonly referred to as a concussion, and for Soldiers often occur due to blasts from IEDs or other explosions while serving in combat.
A TBI occurs when “a trauma or an impact to the head causes a concussion,” said Tara Janssen, the occupational therapist for the TBI Clinic at Fort Drum, New York. “It can (result in) a loss of consciousness or an alteration of consciousness that causes symptoms that weren’t there before.”
Some common symptoms of TBI can include headaches, dizziness, nausea, ringing in the ears, changes in vision, changes in sleep patterns and changes in memory or concentration to name a few.
“Essentially, what happens is the brain moves a little bit and will bounce off the skull,” Janssen explained. “It can affect everyday life and it can have long term, lasting effects if not treated properly the first time.”
And effective treatment is precisely what the TBI Clinic on Fort Drum intends to accomplish with their patients. The clinic’s primary objective is to provide comprehensive multidisciplinary strategies to help facilitate the rehabilitation and reintegration of service members who’ve suffered from a TBI.
“Our main goal is to try to return the patient to their regular activities; whether that be within the military or within the civilian world,” said Elizabeth Kirkpatrick, the TBI Clinic’s physical therapist. “Where ever they’re heading, our goal is to get them to be the most functional in those positions and minimize symptoms as best we can.”
Such was the case for one infantry Soldier who suffered his first TBI early in his career before many people were aware of combat-related TBIs.
Sgt. 1st Class Marcus Moore, now the schools noncommissioned officer in charge for the 10th Mountain Division (Light Infantry), suffered his first TBI in 2003 right after the initial push into Iraq. Following a patrol, Moore and his unit were back at their base having a meal when a mortar attack occurred. While trying to find cover, Moore stuck his head on a beam.
“I don’t know how long it had been, but I woke up under the care of the medics, so I knocked myself out,” said Moore, a native of Sherman, Texas.
And that wouldn’t be the last concussion he would suffer during those initial months in Iraq. Almost three months later, during an attack on his convoy, one of the vehicles in his group struck an IED.
“It ripped me out of the gunner’s hatch,” he explained. “The blast kind of blew me back and I cracked my head on the side of the vehicle.”
Moore went years without seeking the treatment he needed to return to a normal routine. He would be diagnosed with PTSD in 2009, but it wasn’t until he moved to Fort Drum years later when he began receiving treatment for his multiple concussions.
“Once I got here to Fort Drum, I kept feeling dizzy and I kept feeling kind of sick and nauseous all the time,” Moore said. “I couldn’t focus on anything and a lot of my PTSD issues started resurfacing.”
That’s when a doctor at Fort Drum recommended Moore seek care at the TBI Clinic. Once there, Moore began speaking with a counselor, conducting physical and occupational therapy, and rebuilding ground again to get back on track.
“It’s been helping a lot,” he said. “I’ve been able to come back to a norm of regular life. What they’re doing (at the TBI Clinic) does matter and it’s improving Soldiers’ everyday life.”
However, Moore says there’s still a stigma surrounding Soldiers seeking medical help, especially when it’s related to mental and behavioral health. Something which had affected his decision to seek treatment in the past.
“If you had asked me (how I felt about seeking treatment) back then, I’d say there’s no way I’d ever go because of the stigma that goes along with it,” he said. “Ask me right now after my experience and I’d say I would do it - I’d go back and do it again.”
Moore explained a lot of Soldiers believe seeking treatment in behavioral health will end their career. However, he says focusing on getting better and getting the treatment needed to have a normal life free of TBI symptoms is far more important.
In recent years, the Army’s been focusing more and more on the treatment of TBIs. Soldiers are required to conduct cognitive studies both prior to and upon returning from a deployment to determine if there’s been a change in their cognitive functions. Additionally, Soldiers who’ve had a head injury are required to be seen by a medical provider within 24 hours.
If diagnosed, treatment for TBI can incorporate a multitude of specialties, specific to each patient, in order to best treat their unique cases.
“We do a lot of cognitive training, a lot with memory, attention and focus,” said Janssen. “The team is multidisciplinary. As a team, we sit down once a week and discuss patient care cases, so if there are concerns, we can bring them to the table and figure out solutions.”
Furthermore, studies into TBI and potential treatments have come a long way in the past 17 years. However, researchers and healthcare professionals still have more to learn, according to Kirkpatrick and Janssen.
“(We’ve come) very far with the research, but we still have a long ways to go,” said Kirkpatrick. “There are no long-term studies that have been done as of right now for prolonged symptoms. However, we’re using some of the latest research to make sure we’re really up to speed and we’re providing the best care possible to our patients.”
Both Kirkpatrick and Janssen recommend to anyone who feels they may have suffered from a concussion to seek treatment. The TBI Clinic on Fort Drum accepts walk-in appointments and anyone who feels they may have had a concussion is encouraged to visit the clinic and get an evaluation.
For more information on TBIs, treatment or the TBI Clinic, call (315) 772-8639 or visit the Defense and Veterans Brain Injury Center website at http://dvbic.dcoe.mil/.