Repairing Traumatic Brain Injury | Commentary
By Amanda Bowman There is “no secure means of diagnosis, but there are also no known ways to prevent it and no cure,” wrote National Geographic magazine in a recent article dedicated to the signature injury of the Iraq and Afghan wars. The assessment reflects the almost universally shared conventional wisdom about Traumatic Brain Injury. The conventional wisdom is wrong.
For now, even as legislation for removing Medicare caps for brain-injury treatment and establishing sports concussion treatment guidelines are drawing bipartisan interest on the Hill, we can confidently peer beyond TBI as a life full of frustration, solitude and suffering and instead look confidently at treatment that leads to recovery.
As a result of a unique public-private partnership, new revolutionary research and treatment programs are coming out of the U.S. military. A decades-old foundation — the Intrepid Fallen Heroes Fund — has raised millions of dollars for construction of state-of-the-art TBI centers that upon completion are run by the Department of Defense. These facilities are where much of the advanced work on TBI is being done.
At the five operating and soon-to-be opened Intrepid Spirit Centers (with the Fund currently raising money to build four more) around the country and the research-oriented National Intrepid Center of Excellence on the campus of Walter Reed National Military Medical Center outside of Washington, TBI-afflicted service members receive comprehensive, interdisciplinary and individually tailored evaluations. Clinicians identify the biological, psychological, social and spiritual elements contributing to symptoms and conditions. They develop a comprehensive, goal-directed treatment plan that center doctors and staffs then implement.
The process is highly innovative. Advanced neuroimaging detects the locus of injuries within the brain. Virtual reality simulators drill down and diagnose key cognitive pressure points. Then caregivers couple mainstream medical and therapeutic techniques with such non-traditional treatments as acupuncture and aroma therapy, all linked to new findings about the operation of the brain. A winding floor labyrinth in a serene setting allows patients to relax and meditate but also stimulates certain cerebral sectors to self-repair. Music and art therapy programs prompt soldiers to open up and express their emotions and entrapments while activating specific neuro-healing processes. Once dismissed as new age therapies, these methods are applied in response to the latest discoveries about how the brain repairs itself when injured. Perhaps most important is the inclusion and deep involvement of family in the rehabilitation process.
How effective are these facilities? The Intrepid Spirit Center at Fort Campbell, Ky., was dedicated in August 2014 and treats approximately 1,800 patients per year. It reports TBI-treatment results approaching or exceeding the advances against infection after the introduction of penicillin to our forces in World War II. That conflict was the first in which fewer combatants died from disease than battle wounds. As determined by a battery of standardized neuro-cognitive tests that certify a soldier prepared to return to active duty, the success rate in TBI treatment at Fort Campbell is running at a 92 percent. Suicide rates are going down, marriages are being saved.
Since 2001, nearly 230,000 soldiers and veterans have been identified as TBI victims, mostly from blast events, according to the U.S. Department of Defense. But tinnitus, sleep disorder, headaches, dizziness, tremors and hypersensitivity to noise are no longer limited to the battlefield. On the football field, we are seeing similar TBI symptoms and diagnoses from repeated concussions — so much so that National Football League champions Steve Weatherford and Sidney Rice recently announced their brains would be donated to scientific research on TBI after their deaths. Victims of auto accidents experience similar symptoms, as do youth soccer players. The Centers for Disease Control and Prevention notes that in 2010, 2.5 million TBIs occurred either as an isolated injury or along with other injuries.
Meanwhile, the experts at the Intrepid facilities see an open door to treating sports related and other civilian concussions on a broader scale. But they also see hope for victims of multiple sclerosis, strokes, brain tumors, Alzheimer’s disease and Parkinson disease emerging directly from their work. They conclude that at almost any level the brain can be conditioned to fight back against what it is facing. If it is nourished, conditioned and exercised properly, the brain, they insist, is wired to fix itself.
Brain injuries no longer have to mean a life sentence in a prison of the head and heart. Recovery is right in front of us, not 10 years down the road. With continued awareness and attention we can continue to unlock its secrets and provide healing and hope. Congress may be able to help, but getting the science and treatment methods right are the first and essential steps.
Amanda Bowman has worked in various capacities on military and veteran issues for more than a decade. She is on the board of the Intrepid Fallen Heroes Fund.
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