A traumatic brain injury (TBI) often goes under the radar for years.
When it happened, the service members may have assured healthcare professionals and those around them that they were fine. The injury seemed to be mild at the time and perhaps is now a distant memory. But maybe there was more than just one injury. And, years later, symptoms are showing up and affecting daily life.
The consequences of a TBI can manifest in slower reaction times. It takes longer to learn things. It’s easy to get distracted. Mental stamina just isn’t there. It’s exhausting to go about daily tasks. By the end of the day, the weariness sends many of those with TBIs straight to bed. But sleep isn’t restful.
These are all symptoms described by people with mild TBIs. They make up about 80% of the diagnosed military population, according to Dr. James Kelly, chief medical scientist at the Invisible Wounds Foundation. For those experiencing severe injuries, the consequences can be much worse, including comas, lasting neurological deficits, physical challenges, and even death.
“I know these symptoms all too well,” said Kelly, a neurologist and founding director at the National Intrepid Center of Excellence (NICoE). “I’ve witnessed hundreds of service members return from their back-to-back combat deployments never expecting symptoms to surface months or years after their blast injury.”
More than half a million service members have experienced TBIs in the past two decades, according to the Department of Defense. Improved screening techniques used even decades after the injuries indicate that the population diagnosed with TBIs is only going to grow. In just the past five years, TBI identification at the Department of Veterans Affairs has increased by 26%, VA data show. The military-connected community in particular must continue to invest in ways to identify it, treat it, study it, and evolve how we’re thinking about preventing it.
The good news is that effective care is available. The George W. Bush Institute’s Veteran Wellness Alliance is proud to be part of the solution, helping connect thousands of veterans to high-quality care providers, at little to no cost, and peer organizations through our Check-In tool.
While the VA required the “big five” regional Polytrauma Rehabilitation Centers (PRCs) to create mild TBI treatment programs, many of the patients who currently go through these top-tier hospitals are active-duty service members and not veterans, Kelly said. Veterans may not choose to use government-operated healthcare, but they, too, need to be able to find high-quality treatment that’s integrated with the veteran community.
Still, it’s not easy to find adequately trained providers in the private sector to care for individuals with residual effects of TBI. Improvements in the care system will benefit society as a whole – not just veterans, but football players, lacrosse players, cheerleaders, kids who fall off their bikes or trampolines, and other causes such as motor vehicle crashes.
Ensuring these improvements requires increased awareness throughout the healthcare system, including building TBI identification and treatment into curriculums for physicians and other health professions. Then, health professionals can put together a coordinated, integrated evidence-based treatment approach. To be successful, the system as a whole must be held accountable said Terri Tanielian, a nationally recognized expert on veteran and military health policy.
Identifying veterans with a potential TBI could be as simple as training primary-care providers to ask whether patients have served in the military. This could help catch people that initial military TBI screenings missed. Cooperation and coordination with the VA can also be helpful, particularly in training health professionals and making referrals to specialist providers.
“We hear stories all the time from veterans that something’s just not right – something’s wrong with me, but I can’t put my finger on it, and no one’s believing me,” Tanielian said. “We see from the research an increased risk for suicide, the increased risk for other types of health problems like substance use and depression, and those could create societal burdens and horrible potential outcomes for the veteran and their family.”
Often, family members are the first to recognize these changes from a TBI, and care programs deliberately try to incorporate family members into the healing process, both Tanielian and Kelly said.
“It’s important to pay attention to signs and symptoms, be aware of resources, and seek care,” Kelly said. Patients “often did not anticipate the road ahead and crave connections to useful resources to help them thrive and heal post-injury.”
It boils down to recognizing the problem, navigating individualized resources, and connecting patients to treatment, and delivering the best possible care.
Veterans and their families deserve no less.
If you are a service member or veteran needing care or a caregiver seeking TBI care for your loved one that has served in our military, reach out: VeteranCheckIn.Org.
