Monday, August 24, 2015

Traumatic Brain Injury: Share with Family & Friends for Understanding

Traumatic Brain Injury or TBI, is one of the “signature wounds” and a physically damaging, but often invisible injury of the most recent conflicts.  In some cases of traumatic brain injury, PTSD is also present. 

For families, it is often very challenging to have extended family and friends understand because there may not be a visible wound or scar and they can be judgmental.  Please share this blog with them, or the TBI Video on’s Video Resource section.  Support for you, the caregiver, is immeasurably valuable.

Traumatic Brain Injury or TBI, is actual physical or biological damage to the brain, and treatment can be complex depending on the severity of the TBI. There are multiple descriptions of TBI:  mild, moderate, and severe, leading to the diagnosis and treatment path with the severity of the injury.  For the caregiver, this designation also can be a measure of describing the tasks the injured person may have challenges with, but – it also depends upon which part of the brain was injured.

There is also a “penetrating TBI”, meaning something (shrapnel for example) has breached the skull and the membrane covering of the brain, the dura. There are also blast injuries to the brain, which in simplified terms means that the brain has been blasted and bruised inside the closed confines of the skull. Since the brain is crucial to executive decision making, personality, judgment, and countless other functions, any brain injury is meaningful to both the veteran and the caregiver. 

Some of the symptoms of TBI are headaches, intermittent dizziness, and fatigue, which can be initially shrugged off as adjusting to life in the community. Additional symptoms such as blurred vision, more consistent dizziness and balance issues, restlessness and agitation benefit from treatment.  Though the veteran may be unclear about their behavior, when memory and concentration issues complicate the relationship and household, getting help cannot be ignored.  Some of these symptoms may also be in reaction to vestibular (inner ear) issues, and having the correct diagnosis is important for VA ratings and treatment. 
Traumatic Brain Injury remains one of the most challenging undiagnosed conditions of the recent conflicts.  If you know that you are seeing personality changes, memory issues, balance, dizziness, insomnia, and/or frustration that manifests itself in anger or isolation, please ask for an evaluation ruling out an undiagnosed TBI.  Persist. Even if you’re told that playing football in high school is the root cause, remember that blasts and concussions are cumulative, and there is a rare FOB that didn’t take incoming rounds. 

Traumatic brain injury may also not show up right away, but over time, and unusual, agitated behavior that may include unfiltered speech can baffle and test all concerned. Relationships are often affected, and there is challenge to holding down a job, resuming the former routines, and fulfilling ordinary family roles. 

Communication and denial are common before diagnosis and persistence in seeking help is encouraged.  Leaving the brain injury undiagnosed or untreated can strain the best of marriages and partnerships.  As a caregiver walking on eggshells wary of a sharp comment, seeing the veteran forget how to drive home from a familiar place, or suddenly withdrawal from the family or relationship are additional signs.  Your family member may have no idea that there is something wrong until it becomes very obvious, or the relationship is tested beyond the breaking point.

With neurological assessments and cognition testing, the severity of the brain injury can be determined, and treatment plans coordinated.  Sometimes the most difficult thing for the caregiver is to convince the vet there IS something organically wrong, and it's important to seek treatment. 

It's important to remember this is a physical brain injury, and that significant recovery options should be considered and researched as everyone is unique. Interestingly, we have the NFL and football players bringing TBI into the news and urging new and innovative treatments. Know that help exists, and be vigilant in seeking help.  

If there is an undiagnosed TBI in your household, continue to keep a journal of symptoms that show a pattern to share with the care team. Help and improvement is possible with treatment, and learning more helps everyone in the care team and extended family and friends making things more supportive - rather than more isolating.  There are excellent resources for living with TBI and for newer innovative treatments such as Hyperbaric Oxygen Treatment; look at what is best for you and your family.

Linda Kreter & the
VeteranCaregiver Team

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