According to the General Secretariat of the Army, 64% of combat veterans suffered "blast" injuries (attacks with rocket-propelled grenades, improvised explosive devices or improvised explosive devices born in vehicles). Many others suffered blast injuries with no visible external injuries. As a former soldier's wife, I can't name a soldier I know who hasn't been hit by one of these devices at close range at least a few times.
Explosive attacks can cause TBI (Traumatic Brain Injury) or MTBI (Mild Traumatic Brain Injury). According to the Center for Brain Injuries of the Defense and Veterans (DVBIC), "Explosive injuries are injuries that result from the complex pressure waves created by the explosion ... Air-filled organs such as the ears, lungs, and digestive tract and organs are surrounded by Fluid-filled cavities such as the brain and spine are particularly susceptible to primary blast injury (Elsayed, 1997; Mayorga, 1997). The shockwave dissipates quickly and is the greatest risk of injury to those closest to the explosion.
While there is much unknown about brain injury, a 2003 study of returning soldiers conducted by DVBIC at Walter Reed Medical Center found that 61% of soldiers who suffered blast attacks had brain injuries. P. Stephen Makedo, a neurologist and former Veterans Administration physician (cited by Ronald Glaser in a March 2007 article in the Washington Post), estimates that at least one-third of all veterans who have served in Iraq or Afghanistan are likely to have experienced it. Brain damage.
With nearly 2 million soldiers, sailors, pilots and marines currently serving in Iraq or Afghanistan, that estimate means around 670,000 returning heroes will suffer brain damage. This is far fewer than the only 12,274 reported TBI cases reported in March 2007. The drastic difference in the numbers may indicate that current procedures for reviewing and diagnosing military and veteran administrations are inadequate.
It's also possible that most of our characters can be diagnosed with PTSD (Post Traumatic Stress Disorder) when in fact they need to be diagnosed with TBI, MTBI, or a combination of PTSD and brain trauma. Many symptoms of brain damage, mild or not, mirror symptoms of PTSD. People who self-harm or self-harm typically experience one or more of the following symptoms: memory loss, difficulty concentrating, decreased alertness, slower thought processes, irritability, trouble sleeping, depression, and impulse control problems. With so many common symptoms, it is impossible for many trained professionals to determine which disease (or both) a soldier has.
However, it is necessary to provide adequate long-term care to the nation's heroes so that medical providers can perform the necessary tests to determine if there is a brain injury. This is very important because, according to the American Brain Injury Association (BIAA), brain injury causes and accelerates many diseases, including respiratory, circulatory, digestive, and neurological diseases. Without adequate initial care, veterans will not receive examinations and follow-up care to prevent or reduce further harm.
Our family's personal experience with TBI/MTBI screening by the Veterans Administration medical system has not been entirely favorable. My husband suffered over twelve explosions (a combination of RPG and IED) while serving in Iraq. His post-seizure neurological symptoms fall well below the diagnostic criteria for brain damage (available on the BIAA website at www.biausa.org) because he has been losing consciousness periodically for some time since the explosion. He received an initial screening at our local VA outpatient department, followed by a “second rate assessment” at our regional VA hospital. The second assessment was very unprofessional and seemed to depend on the opinion of the doctor so I sought advice from the BIAA. Through him I learned that my husband actually has at least one MTBI and should receive follow-up care and testing according to “civil” care guidelines. However, according to the VA Clinic, my husband's mental, behavioral, and physical changes were entirely due to PTSD.
There are many current military and VA procedures and policies that need to be adjusted and improved to properly treat and diagnose our many returning heroes. The current level of concern among soldiers for brain damage is certainly one example. If you or a loved one has served in Iraq or Afghanistan and have any of the symptoms of TBI or TBI listed below, please make an accurate and complete diagnosis. We hope that when enough veterans and family members stand up and ask for more, we will pave the way for our other brothers and sisters to return.