Support Our Veterans, Increase Funding for Traumatic Brain Injury.

USA Today broke the story of funding cuts for traumatic brain injury (TBI) research and screening at the Defense and Veterans Brain Injury Center 2 weeks ago. The media response has been unusually abysmal – even in the perspective of the past decade or two of substandard journalism. When I went to write an LTE at the Denver Post Friday, I found 24 links on the home page to Jon Benet articles, plus a slide show and video. Googling produces no other current newspaper articles. TBI is a complex subject for TV to cover with any level of thoroughness.

When Pamela posted on the funding cut last week here, we had comments from Stuart Hoffman PhD, an assistant professor of emergency medicine at Emory University and a brain injury researcher. Dr. Hoffman’s Op/Ed on this was published today in the Atlanta Journal-Constitution .

Fight for brain-injured troops

By STUART HOFFMAN
08/21/06

Now in my early 40s, I still remember the nightly casualty reports from Vietnam being read by Walter Cronkite. At the time, to someone my age, these numbers were just numbers. As I got older, I came to understand the magnitude of what I had witnessed, and when I became a student of neuroscience, and in particular, brain injury research, I came to realize the lingering costs of the war in human suffering and the lack of attention given to those who served so honorably there.

Most of the brain injuries sustained in Vietnam were visible, primarily caused by bullets and shrapnel. Veterans with injuries to certain areas of the brain were found to have much more severe neurobehavioral problems than those with other types of brain injuries. These neurobehavioral problems, largely ignored by our government, led to high rates of unemployment, divorce and homelessness. We are now facing a new influx of head-injured soldiers from Iraq and Afghanistan. Thanks largely to the protective benefits of body armor, traumatic brain injury has emerged as the “signature wound” of these wars. But unlike brain injuries typical in the Vietnam conflict, much of the damage in the contemporary combat is the result of improvised explosive devices that produce blast-induced traumatic brain injury, often without any visible scars. But inside the brain, it’s a different story.

Some soldiers with traumatic brain injury have symptoms that are hard to distinguish from other mental conditions such as depression and post-traumatic stress disorder. Scientific research on soldiers with blast-related traumatic brain injury indicate that many have damage to the same brain areas as Vietnam veterans with neurobehavioral problems. However, the total number of soldiers suffering brain injuries in the current conflicts appears to exceed the numbers from previous wars.

According to Bob Bazell of NBC News: “Brain injuries — thousands of them — could be the legacy of this war just as much as post-traumatic stress and problems from exposure to Agent Orange persisted among many of the troops who served in Vietnam.”

At least 18,000 troops have been wounded in Iraq or Afghanistan to date. Some reports suggest that up to 60 percent of those casualties (as many as 10,000) involve some degree of brain injury. These figures do not include civilian contractors or members of the news media who have suffered brain injuries.

There are signs our government is heading down the same road it followed during the Vietnam War — denying the magnitude of the brain injury problem and thereby depriving soldiers the treatment they need.

Until now, the Defense and Veteran Brain Injury Centers program has taken the lead in collecting information on how many soldiers have suffered TBI and how severely have they been injured. The centers have accomplished this on a shoestring budget of $14 million per year spread out over seven centers. This program helps returning soldiers, their families and our government understand the implications of TBIs and their future impact on soldiers’ lives, and facilitates the rehabilitation of these casualties.

To deal with the influx of brain-injured soldiers returning from combat, these centers requested that their 2007 fiscal year budget be increased from $14 million to $19 million, a paltry sum compared to the billions a month we are spending on the wars. Instead of granting the requested increase, the budget proposed by President Bush and rubber-stamped by both houses of congress eliminates the program.

Citizens of this country should demand answers to these questions:

•Why does the White House want to kill this program, and why is Congress going along?

•Are Bush administration officials embarrassed by the numbers of brain-injured soldiers returning from Iraq and Afghanistan?

•Do they believe that if data collection is stopped, the problem will vanish?

Military discipline prohibits our troops from speaking for themselves. We must speak for them.

Call, write or e-mail your U.S. senators and representatives. Tell them you are outraged by the decision to eliminate the Defense and Veteran Brain Injury Centers from the 2007 fiscal year budget. Those who repeatedly admonish us to “support our troops” should be willing to do so themselves.

What is a Traumatic Brain Injury?

According to the National Institute of Neurological Disorders and Stroke:

TBI, also called acquired brain injury or simply head injury, occurs when a sudden trauma causes damage to the brain. The damage can be focal – confined to one area of the brain – or diffuse – involving more than one area of the brain. TBI can result from a closed head injury or a penetrating head injury. A closed injury occurs when the head suddenly and violently hits an object but the object does not break through the skull. [Any injury that involves the brain being thrown against the wall of the skull can also cause TBI. This includes shaken baby syndrome, whiplash and explosion shockwaves.]

The most common cognitive impairment among severely head-injured patients is memory loss, characterized by some loss of specific memories and the partial inability to form or store new ones.

TBI costs the country more than $56 billion a year, and more than 5 million Americans alive today have had a TBI resulting in a permanent need for help in performing daily activities. Survivors of TBI are often left with significant cognitive, behavioral, and communicative disabilities, and some patients develop long-term medical complications, such as epilepsy.

Other statistics dramatically tell the story of head injury in the United States. Each year:

· approximately 1.4 million people experience a TBI,

· approximately 50,000 people die from head injury,

· approximately 1 million head-injured people are treated in hospital emergency rooms, and

· approximately 230,000 people are hospitalized for TBI and survive.

This year, the Institute of Medicine of the National Academies was commissioned to review the Health and Resource Services Administration program for people with TBI. The program was enacted in 1996 by Congress with:

The focus of the HRSA TBI Program is on meeting the needs of a particular subset of the TBI population—namely, individuals with TBI (and their families) with post-acute impairments who require the services of complex public and private service systems. HRSA’s role was envisioned as spurring state action to bring about improvements and lasting change in state-level service systems for TBI survivors and their families.

The review found the state programs to be improving but still inadequate to meet the diverse and long term needs of many of these people.

The Defense and Veterans Brain Injury Center is specifically funded to identify vets who have sustained these injuries and research new treatments. It may be that some of the vets would eventually be served by the HRSA TBI program since they may not live close enough to a VA center to receive the support they need. Meanwhile, the $12 million shortfall between the request and the proposal is 0.003% of the DoDs $400 BILLION budget. Independent estimates place underfunding for the VA at $3 billion dollars – about 5% of their budget.

In addition to the ususal letters, emails, faxes (don’t forget to contact your local congressmen running for office) there are Vet groups working on this:
IAVA and the VFW

No excuses about being on vacation…

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2 Responses to Support Our Veterans, Increase Funding for Traumatic Brain Injury.

  1. Rachel Schwartz says:

    I have been incredibly shocked at discovering that the entire congress voted against funding for the treatment of TBI for veterans. I know that treatment was denied in the past, but enacted at some point so that veterans could get the treatment they so badly need.

    I am a survivor of TBI, injured while working as a civillian for the U.S.Army. It was a hard row to hoe at that point in history (1985) but I was luckier than most and eventually received treatment in New York City which was developed by an Israeli Psychologist who began to think of TBI in relationship to servicemen and develop a treatment pholosophy. He was funded by NIH for 8 years, a very unusual length of time.

    Since then I have volunteered at the National Brain Injury Association, the MD Brain Injury Association and served on the Board of the Oregon BIA as well as conducted support groups in Portland, OR. I know quite a bit about TBI.

    Of the things I know, perhaps the most important is that correct diagnosis can only occur through psychological tests. Aside from the obvious physical disabilities, slurred speech, and the many other aspects that part of a person, people who have not been treated are likely to be impulsive, frustrated, suicidal, unable to work, maintain a job, have poor social control and on and on. And here’s the kicker. Not knowing what the matter is and feeling frustrated and helpless, people turn to self medication in the form of drugs and/or alchohol. In my former life I was a college professor. At one point I taught in a prison and it didn’t take long to realize that many of the prisoners I taught were not playing with a full deck. If I asked them to write a personal history, an event was often mentioned that could have led to a brain injury. I have no statistics on this, but the personal experiences of other people who work with prisoners could indicate that there is a relationship between stupid crimes, like robbing a bank, and the inability to think through the possibility of not getting caught.

    100,000-and-counting returning veterans with TBI, PSTD, and other emotional problems is not going to be good for them, their families and our society as a whole.

    After rehabilitation, I attempted to return to the work force. Although I look and act like a “regular” person, I was unable to get hired. I had a lot of interviews where the interviewer clearly got vicarious pleasure attempting to pry information out of me which they were not entitled, legally, to ask about or know. I was forced to disclose my disability because I was receiving Worker’s Compensation. It was humiliating and embarrassing and more important very depressing. I kept at it for five years until I was declared unemployable by reason of not being able to get a job. Since than, I have been living a kind of shadow life. I went from a person who carried their weight in the family and in society, to a dependent with no status at all. I volunteer here and there, but am not really a part of anything. Again, I have been unusually lucky. Many people with TBI find themselves divorced by their partner. It’s too difficult, inappropriate behavior, often sexual and directed toward the family children, the fact that the person is no longer “there”, permanent behavioral chages, and on and on and on.

    We MUST appropriate funds for TBI. Our legislators must be educated about it and learn not to fear it. With the right therapy, a lot can be done to return people to useful lives.

    I will write to everyone I can, but I think that there must be a national movement to restore the benefits as well as increase them. There are still Vietnam veterans living on the streets. Will we reward the veterans of Afghanistan and Iraq with the same fate?

    Sincerely yours,

    Rachel Schwartz, Ph.D.

  2. annie stokes says:

    I am looking for the names of the Senators who do not support the funding for TBI surviors in the military.