Traumatic Brain Injury Clinic at Elmendorf AFB gives hope to wounded troops
November 25th, 2008
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As Warrior Care Month continues, we’re pleased to include another first-hand account from Airmen helping care for those who were wounded in action. Below is a story from Maj. Peter Osterbauer (photo below), Chief, Neurology Services, Elmendorf AFB. Maj Osterbauer worked to establish the Air Force’s only Mild Traumatic Brain Injury Center, where he currently serves as Medical Director.
It’s been nine months since we opened the Traumatic Brain Injury (TBI) Clinic here at Elmendorf Air Force Base. For those of you not familiar with traumatic brain injury—rather than being an entity with a clearly defined course of progression—it is a spectrum encompassing multiple different injury types, symptoms, and long-term consequences.
We classify a traumatic brain injury as mild, moderate, or severe, based on different aspects of the injury itself. Unfortunately, severe injuries most often result in a poor long-term outcome. From what we know about these types of injuries, the outcome of a moderate injury is more difficult to predict, while patients with mild injuries normally have a good outcome.
The focus of our clinic is mild traumatic brain injury. A mild TBI is characterized by no
loss of consciousness or loss of consciousness for less than 30 minutes, alteration of consciousness for less than 24 hours, and/or amnesia for less than 24 hours. Although classified as mild, the resulting symptoms can often significantly affect quality of life.
(At right: Tech. Sgt. Valarie Platt preps a patient for an electroencephalography scan in the Traumatic Brain Injury clinic Nov. 18. The electroencephalogram records brain activity to rule out different things like seizures that are accompanied by TBI.)
During these initial nine months, we have seen more than 1,500 patients. Almost all of these are troops who are returning here following duty in Iraq or Afghanistan. TBI has become one of the most common injuries suffered by our troops during the Global War on Terrorism, with estimates at around 320,000 men and women returning from deployment with some form of TBI.
The patients I see commonly experience headaches, dizziness, cognitive decline, irritability and mood swings, difficulty with concentration, and other symptoms. These are often intertwined with symptoms of post-traumatic stress disorder, which further complicates the picture.
Fortunately, most patients make a full recovery within 3-to-6 months of the injury. I have seen some patients take up to a year to recover, with approximately 15% never fully returning to their pre-injury baseline. The good news is that even in the most severe cases some degree of recovery almost always occurs.
I would like to emphasize to the family members, friends, and coworkers of TBI patients to remember that the effects of a traumatic brain injury are real, even though there may be no visible sign of the injury. Everything might appear to be normal, but in fact it’s not. By the same token, I think it’s important to understand that not everyone who hits their head carries a diagnosis of TBI, nor does a diagnosis of mild TBI imply permanent brain damage. (At left: Nurse Case Manager Kim Krick plays a memory game in the Traumatic Brain Injury clinic Nov. 18. Ms. Krick helps TBI patients set up their appointments and any other career transitioning processes that the patient may deal with.)
I’m happy to conclude by saying that mild TBI patients should be reassured they will return to their previous level of function within three months to one year. The most important thing is to never give up. Patients shouldn’t give up on their chance for recovery, and friends and family members should continue to support the patient during the treatment process. We’re doing everything we can to ensure our patients get the treatment they need and have the best chance at recovery.
It’s been nine months since we opened the Traumatic Brain Injury (TBI) Clinic here at Elmendorf Air Force Base. For those of you not familiar with traumatic brain injury—rather than being an entity with a clearly defined course of progression—it is a spectrum encompassing multiple different injury types, symptoms, and long-term consequences.
We classify a traumatic brain injury as mild, moderate, or severe, based on different aspects of the injury itself. Unfortunately, severe injuries most often result in a poor long-term outcome. From what we know about these types of injuries, the outcome of a moderate injury is more difficult to predict, while patients with mild injuries normally have a good outcome.
The focus of our clinic is mild traumatic brain injury. A mild TBI is characterized by no
loss of consciousness or loss of consciousness for less than 30 minutes, alteration of consciousness for less than 24 hours, and/or amnesia for less than 24 hours. Although classified as mild, the resulting symptoms can often significantly affect quality of life. (At right: Tech. Sgt. Valarie Platt preps a patient for an electroencephalography scan in the Traumatic Brain Injury clinic Nov. 18. The electroencephalogram records brain activity to rule out different things like seizures that are accompanied by TBI.)
During these initial nine months, we have seen more than 1,500 patients. Almost all of these are troops who are returning here following duty in Iraq or Afghanistan. TBI has become one of the most common injuries suffered by our troops during the Global War on Terrorism, with estimates at around 320,000 men and women returning from deployment with some form of TBI.
The patients I see commonly experience headaches, dizziness, cognitive decline, irritability and mood swings, difficulty with concentration, and other symptoms. These are often intertwined with symptoms of post-traumatic stress disorder, which further complicates the picture.
Fortunately, most patients make a full recovery within 3-to-6 months of the injury. I have seen some patients take up to a year to recover, with approximately 15% never fully returning to their pre-injury baseline. The good news is that even in the most severe cases some degree of recovery almost always occurs.
(Above: Maj. Peter Osterbauer, 3rd Medical Group chief of Neurology Services, uses a simple flash light tool to examine a patient’s eyes in the Traumatic Brain Injury clinic.)
One thing we all understand about TBI is that at this time, there is no specific "TBI pill" to treat all of the symptoms. Most of the symptoms I see can be treated, but this involves a team approach with professionals from multiple specialties. We have found that education, medication, talk therapy, and alternative therapies are used in combination to achieve the best possible outcome. One other thing worth mentioning is that research for novel treatments is also ongoing.
I would like to emphasize to the family members, friends, and coworkers of TBI patients to remember that the effects of a traumatic brain injury are real, even though there may be no visible sign of the injury. Everything might appear to be normal, but in fact it’s not. By the same token, I think it’s important to understand that not everyone who hits their head carries a diagnosis of TBI, nor does a diagnosis of mild TBI imply permanent brain damage. (At left: Nurse Case Manager Kim Krick plays a memory game in the Traumatic Brain Injury clinic Nov. 18. Ms. Krick helps TBI patients set up their appointments and any other career transitioning processes that the patient may deal with.)I’m happy to conclude by saying that mild TBI patients should be reassured they will return to their previous level of function within three months to one year. The most important thing is to never give up. Patients shouldn’t give up on their chance for recovery, and friends and family members should continue to support the patient during the treatment process. We’re doing everything we can to ensure our patients get the treatment they need and have the best chance at recovery.
Posted by Paul F. Bove, Air Force Public Affairs.
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