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WORLD / Health
Thousands of US GIs cope with brain damage
(AP)
Updated: 2007-09-10 10:59
NASHVILLE, Tenn. - The war in Iraq is not over, but one legacy is already
here in this city and others across America: an epidemic of brain-damaged
soldiers.
Bryan Malone, 22, an Army specialist from Haughton, La., exposes a scar
on his scalp as he scratches his head while working with speech
pathologist Sara Granberry at Vanderbilt Medical Center Aug. 2, 2007 in
Nashville, Tenn.?[AP]
Thousands of troops have been diagnosed with traumatic brain injury, or
TBI. These blast-caused head injuries are so different from the ones
doctors are used to seeing from falls and car crashes that treating them
is as much faith as it is science.
"I've been in the field for 20-plus years dealing with TBI. I have a very
experienced staff. And they're saying to me, 'We're seeing things we've
never seen before,'" said Sandy Schneider, director of Vanderbilt
University's brain injury rehabilitation program.
Doctors also are realizing that symptoms overlap with post-traumatic
stress disorder, and that both must be treated. Odd as it may seem, brain
injury can protect against PTSD by blurring awareness of what happened.
But as memory improves, emotional problems can emerge: One of the first
"graduates" of Vanderbilt's program committed suicide three weeks later.
"Of all the ones here, he would not have been the one we would have
thought," Schneider said. "They called him the Michelangelo of Fort
Campbell" - a guy who planned to go to art school.
As more troops return from the war, brain injuries are a growing burden -
for them, for the few programs to treat them, and for taxpayers who pay
for their care and disability if they cannot hold jobs.
Most TBIs are mild, and most of these patients recover within a year. But
one-fifth of the troops with these mild injuries will have prolonged or
lifelong symptoms and need continuing care, the military estimates.
Nearly all of the moderate and severe ones will, too.
Though the full number of those suffering from TBI is still unknown, the
problem is straining the US Department of Veterans Affairs. Until now,
"they were dealing with a cohort of aging veterans with diabetes, heart
disease, lung disease," said Dr Jeffrey Drazen, editor-in-chief of the
New England Journal of Medicine and a VA adviser.
Now, these young, brain-injured troops need highly specialized care, and
how much it will help long-term is unknown, he said.
People with TBI have frequent headaches, dizziness, and trouble
concentrating and sleeping. They may be depressed, irritable and
confused, and easily provoked or distracted. Speech or vision also can be
impaired.
Some sufferers have been misdiagnosed with personality disorders. Others
have lost jobs because of unrecognized and untreated symptoms.
"It's the so-called invisible injury. It's where a troop takes 10 times
the normal time to pack his rucksack ... a complicated injury to the most
complicated part of the body," said Dr Alisa Gean, a neurosurgeon at the
University of California, San Francisco.
Diagnosing it is imprecise - damage rarely shows up on CAT scans or other
tests.
Treating it is even more difficult. Lacking a cure, doctors focus on
symptoms - headaches, anxiety, vision problems, etc. But they lack good
treatments for some of these, too, and are considering some experimental
approaches being pushed by private companies with little proof they work.
Many troops get no care at all. Some are sent back to fight with their
brain injuries undetected, especially if they had no obvious wounds.
What happened to Eric O'Brien and Bryan Malone shows the scope of this
problem.
O'Brien, a 32-year-old Army staff sergeant from Iowa's Quad Cities, was
teasing Malone, 22, a specialist from Haughton, La., in a Baghdad gym
last summer.
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