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By Shireen Bedi, Air Force Surgeon General Public Affairs
/ Published December 19, 2017
Traumatic Brain Injury (TBI) can be difficult to detect with its typical lack of physical markers. Knowing the signs and symptoms of TBI is critical and ensures Airmen can return to duty. (U.S. Air Force photo)
“It is vital that we are able to recognize the signs of TBI not only in ourselves, but in other Airmen,” stresses Lt. Col. (Dr.) Jeffrey McClean, the TBI Consultant to the Air Force Surgeon General and neurologist at the 59th Medical Wing in San Antonio. “With early detection, Airmen are able to get help and return to duty.”
TBI occurs when someone experiences an injury to the brain as a result of an external force, which causes some change in brain function. The immediate changes can include loss or alteration of consciousness, confusion, or amnesia of the events immediately before or after the exposure.
“TBI can be categorized either as mild, moderate, or severe and can be a focused to a particular part of the brain or have widespread damage,” explains McClean. “Understanding the severity of a potential brain injury is critical to treatment.”
Fortunately, the vast majority of TBI cases are mild TBI, also known as concussion. Most patients with concussion can expect a complete recovery within days to weeks. Even among Airmen, these are usually sustained in non-combat settings like falls, accidents, sports injuries, or motor vehicle collisions.
While most cases are mild, the key to a quick recovery with minimal impact on readiness is a proper diagnosis. The fact that TBI is an invisible wound could potentially delay a patient receiving the necessary evaluation and treatment.
“The biggest issue, especially in military culture, is the belief by some that they should just tough it out and not seek care or evaluation after a head injury,” said Mcclean. “There may also be a fear of the potentially negative impact on an Airman’s career.”
In reality, the vast majority of service members with mild TBI, especially with prompt and appropriate care, can return to full duty within 7-10 days after sustaining the injury. If someone does not seek care, they might be performing activities or exposing themselves to risks that could ultimately lead to another concussion or unnecessarily prolong the symptoms. This delay in care could negatively impact their readiness and their ability to complete their jobs.
“This is why it is critical that we work on addressing this issue and ensure that all processes, policies, and providers are operating from a patient-centered approach to care,” said Michelle Padgett, Chief for the Air Force Invisible Wounds of War Policy.
The Air Force is currently working to open an Invisible Wounds Clinic within the next year, which will be located at Eglin Air Force Base. The clinic will focus on a holistic approach to TBI and Invisible Wounds care.
“We know that integrative pain management is an essential part of our treatment approach and have included this in our planning for the center at Eglin,” explains Padgett.
Part of the integrative and holistic approach is looking at TBI and post-traumatic stress disorder together. The combined efforts ensure that patients are receiving optimal care and a more effective treatment plan is being administered.
“It is not uncommon that an injury or particular traumatic event may cause both a TBI as well as PTSD,” explained McClean. “Often their symptoms overlap and in order to ensure the best outcome for patients, it is best to consider treatment options for both of these diagnoses together.”
In addition to providing quality care, the Invisible Wounds Center will offer advanced concussion care research, and multidisciplinary diagnostic and rehabilitation treatment. The goal is to provide the best patient-centered care for all invisible wounds.
“We are very good at training for the enemy, but not necessarily the enemy from within,” explains Padgett. “Increasing the focus on symptoms and healthy coping strategies will improve an Airman’s ability to access, seek, and receive care early so they can continue serving.”