Brain Injuries Signature Wound of Iraq War

Brain injuries plague soldiers
by Cary Leider Vogrin

In what may be the largest study of its kind by a military installation, Fort Carson has found that 178 of every 1,000 soldiers returning to the post from the Middle East suffered from at least a mild form of traumatic brain injury.

“As it turns out, TBI may very well be the signature injury of this war,” Col. John Cho said Tuesday while announcing the results of a 22-month study that included 13,440 soldiers. The post began screening soldiers for traumatic brain injuries in June 2005.

In all, 2,392 of the soldiers analyzed received a TBI diagnosis.

The injuries being seen among Fort Carson soldiers are overwhelmingly caused by explosions, said Cho, who commands Evans Army Community Hospital on post…

While shock waves from ex- plosions are the leading cause of the injuries, TBI also can be caused by penetrating wounds from bullets or shrapnel.

Symptoms associated with mild TBI include headaches, memory loss, irritability, difficulty sleeping and balance problems.

“We don’t have a cure for the common cold, but we do treat the symptoms,” Cho said, referring to treatment protocols such as prescribing low doses of Celexa for irritability.

The post also is focusing on “mind therapy” — encouraging soldiers to engage in card games, board games, crosswords and other activities to stimulate the brain.

And the earlier the better; studies have shown outcomes improve with early treatment.

In addition to a TBI questionnaire given to each soldier as he or she returns to Fort Carson, soldiers with potential injuries are being assessed on the battlefield, he said.

Evaluations include a series of questions about potential TBI-inducing incidents as well as exercises meant to test memory and concentration, such as having the soldier repeat specific words.

Cho said much remains to be learned about TBI and, like post-traumatic stress disorder, there is no “identifying marker” for an easy diagnosis.

“We have an obligation to determine what the long-term effects are of TBI,” he said. “No one has that answer, but you have to start somewhere.”

Fort Carson will be submitting its study results to a leading medical journal for review and possible publication, said Col. Heidi Terrio, chief of deployment health at Evans.

In many instances in the post’s sample group, symptoms of TBI did not occur until months after a soldier’s return, and in others, symptoms resolved themselves even before a soldier got home.

The post relies on a second screening 90 to 120 days after homecoming and on input from family members and the chain of command.

“It’s important to screen more than once,” Cho said. “Symptoms can present themselves at different points in time. And you might ask why. I can only surmise that when a soldier returns to the United States and is subjected to the activities of daily living — traffic, making formation . . . perhaps the stressors then bring some of these symptoms to light. The good news in all of this is we have the mechanism to catch this.”

Capt. Matthew Staton, 30, noticed he was having symptoms of TBI after returning home from a 2003-04 deployment during which he was exposed to multiple blasts.

“It’s like getting your bell rung,” he said of the explosions.

His short-term memory is affected, and he relies on a digital voice recorder and palmtop computer to remember things. He also is quick to anger.

Staton attends weekly rehabilitation sessions at Memorial Hospital and will be medically discharged from the Army.

He said the injury has been stressful not just for him, but his wife, too.

Another Army wife, Shelia Scott, said she knows what he’s talking about. Her husband, Sgt. Leroy Scott, was in Iraq.

Scott, an Army medic, had been in Iraq for four months when his vehicle was ripped open by a roadside bomb in July 2005.

A skull fracture and bleeding on the brain were just two of many injuries. Scott’s right leg was amputated below the knee and he also had several bone fractures and a collapsed lung.

The TBI — the injury that’s the least apparent — has been one of the most difficult to deal with, Shelia Scott said.

She said her husband is easily angered and has difficulty concentrating and sleeping. He’ll dwell on little things — the dishes not being done or the sidewalk not shoveled as the snow falls, she said.

“We don’t know when he’ll snap,” she said. “It’s hard on a family.

“When he does not sleep, I don’t sleep. He will keep me up — turning lights on, turning the TV on.”

Scott and his wife recently separated.

“The boys seem a lot happier because they don’t have to walk on eggshells,” she said of the couple’s three children.

Still, she said she checks on her husband daily, stopping by their home in Falcon.

She also advocates for his health care as he transitions out of the Army.

“I worry,” she said of her husband of 12 years.

“You can find people who can do great, skiing and swimming and just a wonderful story. But there’s a lot of people who are suffering. The wives are suffering, the kids are suffering. Life’s not ever going to be the same.”

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