Traumatic brain injury, or TBI, has been called the “signature injury” of more than 11 years of combat in Afghanistan and Iraq. Injuries Soldiers receive downrange can originate from improvised explosive devices, rocket-propelled grenades, mortars, gun blasts, accidents, and equipment failure. Many service members have experienced multiple deployments due to the length of war, translating into multiple exposures to potential TBI events.
Fort Huachuca is home to a Level 4 TBI Program, providing outpatient care to Soldiers with mild traumatic brain injuries or concussions. Dr. Richard LaMacchia, a neuropsychologist; Tracey-Jean Santoro, psychology technician; and Renate Schmitt, occupational therapist, are part of RWBAHC’s TBI team.
To promote recovery, the team’s mission is to assess and evaluate physical, cognitive and emotional or behavioral symptoms to optimize care, improve outcomes and reduce disability through a patient-centered approach. Referrals to the TBI unit are given to service members who meet certain criteria. To obtain an accurate medical history, the team reviews the service member’s medical history; details the injury event(s); and screens for preexisting or co-occurring conditions and psychosocial risk factors.
While a few Soldiers are immediately referred to the TBI program after a potential brain injury, most obtain referrals after having experienced a TBI injury in the past. Typical symptoms include headaches, short-term memory problems, irritability, difficulty sleeping, balance issues, vision, hearing or cognitive issues, and post traumatic stress disorder, or PTSD.
As soon as possible, the TBI team develops an individual care plan for each Soldier, unique to their injuries, to ensure timely, quality care. Members do this by assessing, re-evaluating, educating and removing barriers in the medical and behavioral health community. The process includes empathy, competence, dedication, honesty and commitment to the service member.
The TBI team assists with referrals and appointments, follows up on test results, communicates with various healthcare providers, and monitors each Soldier’s progress in reaching their care-plan goals.
The time it takes to achieve established goals varies; it may take a few months or a long period of time. Goals typically include headache frequency and intensity reduction; onset and length-of-sleep improvement; improvement in short-term memory, balance and vision; and reduction of PTSD symptoms.
The TBI team works with a variety of disciplines within RWBAHC and the local community. These include physical therapy, optometry, psychology, neurology and sleep labs. The TBI team tracks office visit notes and testing results. They share these with other RWBAHC team members and the Soldier’s primary care and case managers.
Soldiers who do not respond to treatment can be referred to inpatient programs elsewhere. One option is the 72,000 square-foot National Intrepid Center of Excellence, or NICoE, in Bethesda, Md. The staff is considered a world leader in treatment of psychological heath issues and traumatic brain injuries.
The TBI team at Fort Huachuca coordinates the Soldier’s NICoE referral and placement. Its members communicate with providers at NICoE during the Soldier’s 20-business-day stay and participate in the multidisciplinary discharge meeting, helping to coordinate needs of the returning Soldier.
The RWBAHC TBI team is available Monday through Friday, 7:30 a.m. – 4:30 p.m. For more information, see your primary care provider or call 533.5161.