Traumatic Brain Injury (TBI) the “silent epidemic.”
By CONN HALLINAN
June 17, 2008
David Hovda, director of the Brain Injury Research Center at the University of California at Los Angeles (UCLA), calls traumatic brain injury (TBI) the “silent epidemic.” It is the most common cause of death for U.S. adults under the age of 45, deadlier than AIDS, Multiple Sclerosis, spinal cord injury and breast cancer combined.
It strikes down 1.6 million Americans a year. And while TBI may be a quiet wound, its consequences for victims, family, friends and co-workers can be catastrophic.
Adding to that 1.6 million figure are two wars whose signature injury are blast-induced head wounds. A recent study by the General Accounting Office found that, “Traumatic brain injury has emerged as the leading injury among U.S. forces serving in Afghanistan and Iraq.”
According to a Walter Reed Hospital study, “closed brain” injuries—injuries with no visible marks—outnumber “penetrating brain injuries” seven to one. Other researchers put the ratio much higher.
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TBI is hardly new.
Some 5.3 million people in the country are currently hospitalized or in residential facilities because of it. And its consequences surround us.
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While medicine is beginning to understand more about the kind of TBI generated by car accidents, falls, or sports injuries, no one is quite sure exactly what causes the TBI generated by roadside bombs in Iraq and Afghanistan.“It is a complicated injury to the most complicated part of the body, says Dr. Alisa Gean, chief of Neuroradiology at San Francisco General Hospital, who has worked with wounded soldiers at the U.S. Army’s Regional Medical Center at Landstuhl, Germany.
Multiple tours and longer deployments mean soldiers are exposed to more explosions. “The multiple nature of it is unprecedented. People just get blasted, and blasted, and blasted,” says Maj. Connie Johnmeyer of the 332ed Medical Group, a unit that deals with psychological problems.
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But with a major shortage of troops, the pressure is to get lightly wounded soldiers back into battle. Out of the 1.6 million who served in both wars, some 525,000 troops have had more than two combat tours, 70,000 have served three, and 20,000 have done five or more.
When soldiers are first wounded, says Gean, “The acute care [at Landstuhl and Walter Reed] is truly world class,” far better than most people could get in the U.S., bar a few trauma centers. But she thinks that the TBI problem “is larger than we think,” and she worries about “what happens after” they leave.
The worry is well placed. Soldiers return to find that there are few psychological resources for them, and virtually no individual therapy. “There are two things going on regarding vets,” says Col. (ret) Will Wilson, chair of the American Psychological Association’s Division 19 (Military Psychology). “One, there are not enough care providers available, and two, there are not enough people focusing on the problem outside of the military.”
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Last July Congress passed the Wounded Warrior Bill (S 1606) to improve care for troops and veterans, and the House Energy and Commerce Committee just passed a reauthorization of Traumatic Brain Injury Act (HR 1418) to support research and rehabilitation for TBI sufferers.
Rep. Pascrell led the push for the bill. “This is not just for the military,” says Pascrell’s Communication’s Director, Caley Gray, but for TBI sufferers nationwide.
It has taken a war to put the issue of TBI on the nation’s health agenda, but the cost of that awareness in blood, flesh, and decimated relationships is high. Even if the war ends soon, there will be hundreds of thousands of soldiers and veterans who will bear the burden of TBI.
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