Understanding the Effects of Concussion, Blast, and Brain Injuries: A Guide for Families, Veterans, and Caregivers Marilyn Lash, MSW, Lash and Associates Publishing/Training (page 1 of 3) Page 1 of 3

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• Understanding the Effects of Concussion, Blast and Brain Injuries - Table of Contents

Introduction

Why this guide was written

This guide has been written to help the families of service members who have sustained traumatic brain injuries. It is also intended for the caregivers, clinicians and therapists who work with them over the various stages of their treatment and recovery. Traumatic brain injury has become known as the signature wound of the war in Iraq and conflicts in Afghanistan. While helmets, protective body gear and armored vehicles help protect troops during combat and on patrol, they still are exposed to possible injury or death each day that they are in a war zone. The sophisticated battlefield medicine and rapid air transport that are provided when a service member is injured have resulted in extraordinarily high rates of survival among the troops who have been injured. Unfortunately, some have not survived and their deaths are tragic losses for their families and this country.

Service members with traumatic brain injuries

The global war on terror is resulting in new types of traumatic injuries. In previous conflicts, troops fought on the front lines of combat. There is no "front line" in Iraq and Afghanistan. The war is being fought in local neighborhoods, open markets, cafes and routine traffic stops. Sniper fire, explosions and ambushes are part of daily life for support, transport and combat troops. This lack of a safety zone creates additional stresses and risks for troops who must be on alert 24 hours a day, 7 days a week. Extended and multiple deployments add to the emotional stress and physical risks. Shock waves and blasts from improvised explosive devices (IEDs), land mines and rocket propelled grenades can cause terrible damage to the human body. Many service members have had injuries to multiple body areas – called polytrauma in medical terms. They are returning to the US with missing limbs, the scars of painful burns, and loss of vision or hearing. The brain is especially vulnerable in an explosion, collision or fall as it is the most complex organ in the body – and it controls how we think, act, move, feel, and communicate.

Just the words "traumatic brain injury" raises all sorts of questions and images. No two brain injuries are alike. Consequently, the recovery of each individual with a brain injury is unique. A mild brain injury (often called a concussion) may have temporary effects that last for only several hours, days or weeks. However, multiple concussions can have more serious effects over time. Moderate to severe brain injuries can result in more serious damage and increase the likelihood that a service member will become disabled. A traumatic brain injury can result in visible physical changes. Some individuals literally have to learn how to walk, talk, communicate, and do the basics of daily life all over again.

Consequences of traumatic brain injury

It is the changes in a person’s thinking, reasoning, behavior, and personality after a brain injury that are usually harder for others to understand. These are the less visible but major consequences of a traumatic brain injury that can have life long effects on an individual’s life and the family. A brain injury can change how a service member thinks, remembers, reasons, organizes, plans and problem solves – the very abilities that are essential for independent and active lives. There are also psychological and social changes that can alter the personality so that the individual literally seems like a different person. Impulsive, explosive and unpredictable behaviors and actions can be the direct result of damage to certain areas of the brain. It is these changes in thinking, emotions and behavior that become the most challenging over time for families and caregivers as service members return to their homes and communities.

This guide will help the service members, their families and caregivers understand the immediate and long-term consequences of traumatic brain injury. Ironically, if a silver lining can be found, it is that today’s veterans with brain injuries have the good fortune of timing. The medical treatment and rehabilitation of adults with traumatic brain injury has made many gains over the past 30 years. Brain injury medicine and rehabilitation has made amazing advances in care and treatment since the Vietnam War. That expertise is helping our service members injured in the Global War on Terror. We are now learning about the new types of brain injuries caused by blast injuries and shock waves and are using state of the art medicine. We also know from the struggles of previous veterans that post traumatic stress disorder (PTSD) can have serious consequences if unidentified and untreated. We have learned from the past. The advances in brain injury treatment are helping our service members who are being treated in the polytrauma centers under the Department of Defense, the Veterans Administration Hospitals and Clinics, and within the private civilian sector.

Coming home

The next big challenge for many service members comes when they return home. Surviving a brain injury is one thing; living with a brain injury is another. The transition from living in a war zone to coming home is not always a smooth nor easy one. Life has changed. Children have been born and grown, couples have grown together or split apart, roles and responsibilities have shifted, jobs have changed, homes have moved. This transition will be even more stressful and complicated for the family with a service member who is coming home with a traumatic brain injury. Programs and services in local communities for survivors of traumatic brain injuries and their families have not grown at the same pace as medical and rehabilitation services. Just sorting out the disability and health benefits and coverage under the various programs for active duty military, veterans and reservists is a challenge. The community of individuals and families living with brain injury stretches far and wide. Unfortunately, it continues to grow. While each person and each family are unique, the experience of having one’s life changed by an injury to the brain unites them.

From Lash & Associates Publishing Training Inc. Used with permission. www.lapublishing.com.

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