The VA\u2019s real surprise is the low number of diagnoses for traumatic brain injury (TBI),
\nwhich has become one of the signature injuries in the Iraqi\/Afghanistan
\nconflict due to the large number of roadside bombs, mortars and
\nrocket-propelled grenades.<\/p>\n
Four years ago, the Rand Corp. interviewed 1,965 vets and projected in its controversial
\n2008 report that 18.5 percent of all returning service members would meet the
\ncriteria for either PTSD or depression (14 percent for each, but there\u2019s some
\noverlap), and that another 19.5 percent would experience a probable TBI while
\noverseas. Again after taking into account that overlap, it said 31 percent of
\nall returning troops would suffer from one or all of those ailments.<\/p>\n
The VA\u2019s actual treatment figures show 28.5 percent of the returning vets are seeking
\nmental health care, which is right on track with the Rand Report. But while the
\nRand Report projected that some 320,000 American soldiers would need help for
\nTBI, the VA says only 54,070 vets (a little over 4 percent of the returning
\nvets) qualified for that diagnosis.<\/p>\n
\u201cThat\u2019s absurd, preposterous, erroneous,\u201d snorts Mike Zacchea, a Marine Corps
\nlieutenant colonel retired on a medical disability after service in Iraq, where
\nhe survived a bomb in a mess hall, almost daily sniper attacks, mortar attacks
\non his unit\u2019s convoy, and a rocket wound during intense combat in Fallujah. All
\nof those took a huge physical and emotional toll on Zacchea.<\/p>\n
As of last June, the VA had data on 544,481 vets whose brains might have been affected by
\nbattlefield explosions, according to Dr. David Cifu, national director of the
\nVA\u2019s Physical Medicine & Rehabilitation program. Of that number, he says,
\n\u201c19.8 percent have screened positive for a mild TBI (concussion), that is were
\nexposed to explosions that might have caused traumatic brain injury.<\/p>\n
\u201cWhen those 19.8 percent of veterans were evaluated by one of the 100 TBI specialty
\nteams across the nation, approximately one third (or 7.8 percent of the original
\n544,481) tested positive for TBI with persistent symptoms,\u201d says Cifu. \u201cAnother
\napproximately 2 percent were found to have a TBI that pre-dated their military
\nservice. Those two figures (the 7.8 percent plus the 2 percent) add up to
\n54,070 veterans.\u201d<\/p>\n
The difference, says Cifu, is that the Rand Report used the total number of
\ninjuries as its TBI figure while the VA used only the number of vets still
\nshowing TBI symptoms a year after their injuries.<\/p>\n
\u201cThe Rand Report was pretty accurate on the number of those who may have had injuries due to a
\nblast, but didn\u2019t take into consideration that many of those may have injuries
\nthat will fairly quickly get better over time,\u201d says Cifu. \u201cWe know that up to
\n97 percent of those who experience concussions are normal without symptoms
\nwithin a year. So we\u2019re tracking just the people who continue to have
\ndifficulties.\u201d<\/p>\n
But Zacchea, a staunch member of Veterans for Common Sense, charges that the VA is trying hard to deny this
\ndisability. \u201cToday\u2019s cutting edge neurology is that any symptoms that last
\nlonger than two weeks indicate traumatic brain injury,\u201d says Zacchea. \u201cThey\u2019re
\nusing the one-year time frame because that benefits them, but that\u2019s just
\nmedieval.\u201d<\/p>\n
Zacchea says he was quickly diagnosed with post-traumatic stress disorder after returning from combat, but
\nthat he had to fight for his TBI diagnosis. \u201cThey wouldn\u2019t even let me see a
\nneurologist,\u201d he says. So he took his case to the Yale Medical School, got a
\nprivate diagnosis of TBI and challenged the VA to disprove it. After a number
\nof verification tests, he was finally granted a TBI diagnosis by the VA in
\n2008.<\/p>\n
His ongoing symptoms include migraine headaches, sensitivity to light and noise, and loss of fine motor
\nskills. \u201cMy fingers are numb, and I\u2019m always dropping things,\u201d he says. \u201cI have
\ndifficulty tying my shoes so I usually wear slip-on shoes.\u201d He also has a
\ndistinct taste in his mouth. \u201cI\u2019ve lost most of my taste sensation,\u201d he
\nexplains, \u201cso I put hot sauce on pretty much everything.\u201d<\/p>\n
A new book, The Concussion Crisis,<\/em> concludes that even minor concussions repeated regularly can be Dr. Allen Brown, head of the Mayo Clinic\u2019s Brain Injury But in the civilian world, he says, only about 8 percent Brown agrees with Cifu that \u201can overwhelming majority\u201d of brain injuries resolve themselves, although And he calls the disparity between the Rand Report and the VA\u2019s definitions of TBI \u201cone of the most <\/p>\n","protected":false},"excerpt":{"rendered":" The VA\u2019s real surprise is the low number of diagnoses for traumatic brain injury (TBI), which has become one of the signature injuries in the Iraqi\/Afghanistan conflict due to the large number of roadside bombs, mortars and rocket-propelled grenades. Four years ago, the Rand Corp. interviewed 1,965 vets and projected in its controversial 2008 report […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-89","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts\/89","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/comments?post=89"}],"version-history":[{"count":0,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts\/89\/revisions"}],"wp:attachment":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/media?parent=89"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/categories?post=89"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/tags?post=89"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nharmful, leading to impaired cognition and ultimately early-onset dementia
\namong athletes such as boxers and football players, as well as among soldiers.
\nIn reviewing the book, Connie Goldsmith wrote: \u201cThere is no such thing as a minor
\nconcussion. Every concussion is a potentially devastating injury. These stories
\nfocus on concussions among athletes of all ages, as well as concussions among
\nsoldiers and victims of auto accidents. Some of the stories are heartbreaking:
\nadolescents who suddenly die after what appear to be minor head injuries;
\nboxers and football players with early-onset Alzheimer\u2019s disease and dementia;
\nand returning veterans left to wander through the medical system seeking
\ntreatment for their unrecognized or misdiagnosed concussions.\u201d<\/p>\n
\nUnit, defines a TBI as an external mechanical force impacting a body and
\ncreating a brain injury. Thus, by definition, every concussion is a TBI and should
\nbe part of the medical record.<\/p>\n
\nof brain injuries are severe enough to be labeled a \u201cdefinite TBI,\u201d as opposed
\nto a \u201cprobable TBI\u201d which is milder or a \u201cpossible TBI\u201d which is symptomatic. A
\n\u201cdefinite TBI\u201d involves any of the following: loss of consciousness for more
\nthan 30 minutes, post-traumatic amnesia for more than 24 hours, significant
\nloss of motor skills as measured on the Glasgow Coma Scale, or intracranial
\nbruising or bleeding.<\/p>\n
\nrepeated injuries increase the risk of significant damage. \u201cIt\u2019s pretty clear
\nto me that the cumulative effect of any injury increases the risk for secondary
\nproblems, including repeated TBIs that could lead to loss of cognition later in
\nlife,\u201d he told me. \u201cIt may not happen in every case, but the risk is whoppingly
\nhigh.\u201d<\/p>\n
\nargued-over controversies in medicine.\u201d<\/p>\n