By Cmdr. Randy Reese, head of Navy Medicine’s traumatic brain injury programs
Editor’s note: Throughout March 2016, Navy Medicine is focused on brain injury awareness. To begin the conversation, we asked Cmdr. Randy Reese, head of Navy Medicine’s traumatic brain injury programs, to discuss how Navy Medicine helps patients recover from traumatic and mild brain injury. Reese is refining Navy Medicine out-treatment programs that coordinate with research activities to provide the most up-to-date knowledge to treat our injured warriors. Before joining the BUMED team, Reese was a staff neuropsychologist at the Intrepid Spirit Concussion Recovery Center at Camp Lejeune, providing comprehensive treatment to service members with persisting concussion-related symptoms.
Brain injury awareness provides us the opportunity to increase public knowledge regarding prevention, correct definitions of brain injury, risk factors and prevention strategies, and educate the public about symptom identification and treatment options and resources. The impact from the effects of brain injury can extend well beyond the injured individual. It also includes family, caregivers, and the workplace.
More than 80 percent of traumatic brain injuries in the Navy are not deployment or combat related. A vast majority occurs during training and non-duty related events, such as during sports or recreational activities. When injuries are not identified, the affected individual, family, and command can all be impacted. Thus, education on prevention, symptom identification, and treatment is essential to optimize treatment, quality of life, and ability to sustain the mission.
I’ve been asked, what’s the difference between a traumatic brain injury (TBI) and a concussion? It’s a valid question that requires explanation as it can create confusion for consumers of TBI literature and information. “TBI” stands for traumatic brain injury. There are three severity levels for traumatic brain injury, including mild, moderate, and severe. One of the main differences between mild TBI and moderate and severe TBI is the presence of abnormal findings on brain imaging in the latter two more severe categories. Mild TBI is not diagnosed when abnormal imaging findings are present. Also, symptom course and recovery are generally quite different between mild TBI and moderate/severe TBI.
It can be confusing when literature and media refer only to TBI without more specific information, especially when talking about symptoms and outcomes, as these are very different between the types of injuries. The vast majority of people suffering a concussion experience a full recovery in a relatively short period of time. The savvy consumer will always ask, “Are they talking about concussion/mTBI, or about moderate or severe TBI?” To improve clarity, we often use the term “concussion” when referring to mild traumatic brain injury.
If Sailors, Marines, their families, beneficiaries and retirees need early assessment, appropriate individualized treatment, education and case management for their recovery, the front line for questions and initial assessment is their primary care provider. For a new injury, get evaluated by a qualified provider or go to an emergency room. After initial treatment is completed, if there is a need for further assessment or intervention, the provider will refer the patient to the appropriate local or MTF resource. Resources and options vary by location.
Always remember that the effects of traumatic brain injury can extend beyond the affected individual. In a minority of cases, there may be persistent problems in functioning, as well as associated changes in mood or other problems that can impact performance in the workplace, as well as behavior at home.
Navy Medicine is committed to improving the lives of those suffering from a brain injury by ensuring all medical staff are trained on identification and intervention procedures. Furthermore, education and training is required for all Navy personnel to promote understanding, support, and access to resources across the entire service, including peers, work place, and chain of command.
We are committed to providing the best, up-to-date care utilizing evidence based practices. Partnering with our sister services, as well as several other organizations in research and treatment activities will keep Navy Medicine at the cutting edge of treating our injured.
Navy Medicine is all-in supporting the month-long brain injury awareness campaign led by the Brain Injury Awareness Association (BIAA), and its theme, “Not Alone”, and the Defense and Veterans Brain Injury Center (DVBIC), “Think Ahead”. Join the conversation #BrainInjury, #ThinkAhead, #BIAMonth. More information and resources can be found at http://dvbic.dcoe.mil/aheadforthefuture.