Photo By Master Sgt. Ben Navratil | U.S. Army Pfc. Jeremiah Mullins, a military policeman from Richmond, Va., attached to...... read more read more
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KHOWST PROVINCE, Afghanistan – Over the last few years, interest in the effects of concussions on sports figures, especially in hockey and football, has increased dramatically.
The issue of concussions, also known as mild traumatic brain injuries, is not one that only affects sports stars. Anyone who suffered a head injury is at risk of being affected, particularly soldiers who have been struck by improvised explosive devices or other attacks.
But these soldiers have help in their recovery from this common but potentially severe injury. Task Force Duke’s mTBI Reconditioning Center at Forward Operating Base Salerno is just one facility of many operating in Afghanistan to help Soldiers recover.
According to the Defense and Veterans Brain Injury Center, mTBI is any “disruption of brain functioning from a blow or jolt to the head or a penetrating head injury.”
While that may sound fairly simple and direct, what can occurs inside a person’s head, and the ensuing injuries, can be very severe.
The physical effects on the brain itself from being bounced or twisted inside the skull, or even penetrated by an object like a bullet or bone fragment, is only one factor physicians need to consider at when working with an mTBI patient, said Maj. Thomas Hair, a family care physician, and department chief for warrior care at Ireland Army Community Hospital in Fort Knox, Ky.
Hair deployed to Afghanistan with the Fort Knox-based 3rd Brigade Combat Team, 1st Infantry Division, Task Force Duke, and is currently serving as the battalion surgeon for the 201st Brigade Support Battalion, 3rd BCT, 1st Inf. Div., TF Duke.
In addition to the physical injury to the brain, the affected soldier may also suffer from emotional trauma as a result from the injury, said Hair.
During an injury resulting in a loss of consciousness, the rational part of the brain can be damaged and stop working properly, sending the emotional center into a frenzy, which often results in varying degrees of post-traumatic stress disorder, he said.
The symptoms exhibited by soldiers affected by mTBI vary, and can often be subtle, or may not appear until later, Hair said.
“A lot of time guys will come in and they ‘just ain’t right’,” he said.
“You can’t find any one thing wrong with them. But everything they do is two or three percent slower than they used to be. They can remember things, but it takes five seconds longer than it used to,” he said.
U.S. Army Spc. Chamai Shahim of Portland, Ore., a CH-47 Chinook mechanic with Company B, 1st Battalion, 168th Infantry Regiment, 3rd BCT, 1st Inf. Div., TF Duke, was playing basketball when another player’s jaw came down hard on the top of her head.
“I was vomiting and slurring my words,” she said, but she didn’t realize it had to do with her head injury until she met with U.S. Army Capt. Emily McGinty, an occupational therapist from Brooke Army Medical Center in San Antonio, Texas, and currently the officer-in-charge of the TF Duke mTBI Reconditioning Center.
Shahim explained her symptoms to McGinty, who advised her to get a professional examination. She was diagnosed with a concussion and referred to the center for out-patient treatment.
Another U.S. Army Soldier, Pfc. Jeremiah Mullins, a military policeman from Richmond, Va., attached to 1st Bn., 26th Inf., 3rd BCT, 1st Inf. Div., TF Duke, was on duty in a guard tower at Combat Outpost Bak when a mortar shell exploded within five meters of where he was standing.
“The blast knocked me out,” he said, and since then he’s had bad headaches, trouble sleeping, bad dreams and difficulty getting the incident off his mind.
This was the second time Mullins had been in an incident like this – an improvised explosive device detonated near him previously – so he was referred to the center by his commander to ensure he was examined for any sign of mTBI and for treatment if necessary.
One of the keys to treating mTBI, is early diagnosis from a physician and the proper medication and treatment.
As long as soldiers seek help from medical personnel, Hair said, they can recover from almost all head injuries.
“The most important treatment is time, reassurance, realistic expectations and rest,” said Hair.
Affected soldiers are first examined by their unit medics. If they show signs of concussion, they are ordered to get at least 24 hours of rest.
If they continue to show symptoms after the rest period ends, they are sent to see a doctor who determines if the Soldier needs treatment at the mTBI center.
Rest is the first treatment Hair recommends; ideally the affected soldier will get 72 hours of real rest, if the mission allows it.
“Most soldiers in a combat zone are sleep-deprived to begin with,” he said, “The reality is someone who is sleep-deprived looks just like someone who’s had a concussion.”
He added that sleep is one the best ways for the brain to heal itself.
But that doesn’t mean soldiers can take three days off to do whatever they want.
To get good rest, the soldiers must avoid as much stimulation as possible, said Hair, so that means no video games, caffeine or cigarettes, to name a few restrictions.
“Soldiers need to go to bed at night, instead of staying up late watching TV or talking on the phone,” he said. “This is actual rest.”
“I was told to stay in a dark room and get as much sleep as I could for the first couple of days,” said Shahim. “I try not to do anything mentally exhausting or stimulating.”
Shahim said she had insomnia before the injury, which complicated her healing process since she couldn’t get proper sleep on her own.
She was prescribed medication to help her sleep by a healthcare provider. The sleep has led to a noticeable improvement.
She said she isn’t bothered by slurring words or nausea anymore, but she still gets headaches when she exerts herself.
When she no longer shows any symptoms, Shahim will move to the next step, known as the exertional period of her recovery, where she will conduct some basic physical training, like riding a stationary bike.
If she can increase her heart rate without a recurrence of her symptoms, she’ll be cleared to return to her normal duties, said McGinty.
Mullins, on the other hand, is scheduled to leave the facility Wednesday and return to duty, which he’s looking forward to.
“I feel a lot better now,” he said. “The memory building exercises and the brain game I played on the Wii really helped out a lot.”
“Nintendo’s Wii gaming system is used by the center as a training tool for visual, perceptual, balance and cognitive rehabilitation,” said McGinty. “It’s become a standard practice tool in all four established mTBI reconditioning centers in Regional Command – East.”
“The Wii Fit game focuses on improving balance and coordination through games that require the service member to challenge his vestibular system,” said McGinty. A person’s vestibular system is located in their inner ear and contributes mostly to their movement and balance.
The Wii also allows occupational therapists like McGinty to identify a patient’s improvements by providing feedback regarding the patient’s speed and accuracy, and it adapts to patients’ progress by increasing the challenges as they improve, she added.
Using a guided recovery process with graded intervention, the TF Duke mTBI reconditioning center treats soldiers affected by mTBI with care, and challenges them to get better.
The center has treated 33 patients since October, said McGinty, and only one had to be sent on for level III treatment, which is conducted by a five-person team at Bagram Airfield, Afghanistan.
That soldier was eventually able to fully recover and return to normal duty.
“[mTBI] is not new,” said Hair. “Discussion of brain injury dates back to the beginnings of medical literature, and even the ancient Greek dramas. We know how to deal with it as doctors. The Army knows how to deal with it as an Army. We just need to treat it, and be intelligent about it.”
| Date Taken: | 03.16.2011 |
| Date Posted: | 03.16.2011 10:41 |
| Story ID: | 67171 |
| Location: | KHOWST PROVINCE, AF |
| Web Views: | 591 |
| Downloads: | 0 |
This work, PTF Duke rehabilitates Soldiers with brain injuries, by MSG Ben Navratil, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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