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Service Members and Traumatic Brain Injury

Blasts are a leading cause of traumatic brain injury for active duty military service members in Iraq and Afghanistan, making TBI the signature injury of the war.

How does a blast cause injury?

Blast injuries are injuries that result from the complex pressure wave generated by an explosion. The explosion causes an instantaneous rise in pressure over atmospheric pressure that creates a blast over pressurization wave. Primary blast injury occurs from an interaction of the over pressurization wave and the body with differences occurring from one organ system to another. Air-filled organs such as the ear, lung, and gastrointestinal tract and organs surrounded by fluid-filled cavities, such as the brain and spinal cord, are especially susceptible to primary blast injury (Elsayed, 1997; Mayorga, 1997). The over pressurization wave dissipates quickly, causing the greatest risk of injury to those closest to the explosion.

In a blast, brain injuries can also occur by other means such as impact from blast-energized debris, the individual being physically thrown, burns and/or inhalation of gases and vapors.

(Elsayed, N. M. (1997). Toxicology of blast overpressure. Toxicology, 121, 1-15. ) and (Mayorga, M. A. (1997). The pathology of primary blast overpressure injury. Toxicology, 121, 17-28.) DVBIC website.

Signs & Symptoms

The signs and symptoms of a traumatic brain injury (TBI) can be subtle. Symptoms of a TBI may not appear until days or weeks following the injury or may even be missed, as people may look fine even though they may act or feel differently. The following are some common signs and symptoms of a TBI:

  • Headaches or neck pain that do not go away
  • Difficulty remembering, concentrating, or making decisions
  • Slowness in thinking, speaking, acting, or reading
  • Getting lost or easily confused
  • Feeling tired all of the time, having no energy or motivation
  • Mood changes (feeling sad or angry for no reason)
  • Changes in sleep patterns (sleeping a lot more or having a hard time sleeping)
  • Light-headedness, dizziness, or loss of balance
  • Urge to vomit (nausea)
  • Increased sensitivity to lights, sounds, or distractions
  • Blurred vision or eyes that tire easily
  • Loss of sense of smell or taste
  • Ringing in the ears

(Centers for Disease Control and Prevention (CDC), Facts about concussion and brain injury, 1999.)

Wisconsin Resources

Family Assistance Center (FAC)

The Military Family Assistance Center was formed to assist family members with a variety of services, which can be utilized before, during and following deployment of the service member. FAC can help with:

  • Pay & Financial
  • Communication
  • Red Cross
  • Emergency Assistance
  • Counseling Referrals
  • Reintegration

FAC’s are located around the state of Wisconsin. Services are available to all active duty service members and their families and no military personnel or family member will be turned away from a FAC regardless of their branch. All calls will remain confidential. To find your nearest Wisconsin Family Assistance Center and to speak to FAC staff, call 1-800-292-9464.

Vet Center

The Vet Centers are community based and part of the U.S. Department of Veteran’s Affairs. The goal is to provide a broad range of counseling, outreach and referral services to eligible veterans in order to help with post-war readjustment back to civilian life. The centers also provide bereavement counseling services to surviving spouses, parents, children and siblings of service members who die while on active duty. There is no cost for Vet Center readjustment counseling and services also apply to activated Reserve and National Guard personnel.
The Vet Center has 2 offices, which serve all Wisconsin counties.

Madison Vet Center
147 S. Butler Street
Madison, WI 53703

Milwaukee Vet Center
5401 N. 76th Street
Milwaukee, WI 53218

Call the nearest Vet Center or visit www.vetcenter.va.gov for more information.

Wisconsin Veteran’s Affairs Centers

Wisconsin Veteran’s Affairs Centers provide information about the VA Centers, services offered, outpatient clinics and other VA resources. There are 3 VA Centers in Wisconsin.

William S. Middleton Memorial Veteran’s Hospital – Madison, WI
Phone: 1-608-256-1901
Telephone Care 24 hrs/7 days a week: 1-608-280-7066 or 1-888-598-7793

Clement J. Zablocki Veteran’s Affairs Medical Center – Milwaukee, WI
Phone: 1-414-384-2000
Telephone Care 24 hrs/7 days a week: 1-888-469-6614

Tomah VA Medical Center – Tomah, WI
Phone: 1-608-372-3971
Telephone Care: 1-800-872-8662 or 1-608-372-3971 (Mon – Fri., 8:30am – 4:30pm)
Telephone Care: 1-800-442-8170 or 1-608-372-1177 (Evenings & Weekends)

County Veterans Service Officers (CVSO)

All Wisconsin counties have a part-time or full-time County Veterans Service Office to assist the county’s residents with state and federal veterans’ benefits. CVSO’s are most WI veteran’s first point of contact for benefits and eligibility questions, applying for benefits, or questions regarding current benefits. A full list of CVSO’s can be viewed by visiting the website, www.dva.state.wi.us/cvso

WI Department of Veterans Affairs/Welcome Home

The WI Dept. of Veteran’s Affairs launched Mission Welcome Home to help service members’ transition form active duty to everyday life. The program has 2 main components: An Ambassador Program and Welcome Home Packets.

National Resources

www.dvbic.orgDefense & Veterans Brain Injury Center. The mission of the Defense and Veterans Brain Injury Center (DVBIC) is to serve active duty military, their dependents and veterans with traumatic brain injury (TBI) through state-of-the-art medical care, innovative clinical research initiatives and educational programs.

www.va.govU.S. Department of Veterans Affairs. This site is an official Federal government agency that provides benefits and assistance to veterans and their dependents. This comprehensive website includes information that links to: Veterans Health Administration; Veterans Service Organizations; Benefit information and more. Call 1-800-827-1000 for more information.

www.polytrauma.va.govU.S. Department of Veterans Affairs- Polytrauma/TBI System of Care. Website to increase awareness about Traumatic Brain Injury (TBI) and the services provided to Veterans and service members recovering from TBI and co-occurring complex injuries. Includes a documentary and other videos highlighting individual stories of recovery for some of the most severely injured and wounded Veterans.

www.thankyouforyourservice.us – Weekly Online News Site. Read amazing stories from our troops about progress in Afghanistan and Iraq. Find weekly stories about and for our troops, veterans, families, military support and veterans groups.

www.neurorestorative.comNeuroRestorative. Post acute rehabilitation services for people with brain injury, chosen as a contracted provider with the Veterans Health Administration Assisted Living Pilot Program for Veterans with Traumatic Brain Injury. NeuroRestorative programs integrate multidisciplinary individual and group therapeutic interventions as well as vocational activities and social experiences to help Veterans build skills, develop self-esteem and actively participate in the community. Referral line 1-800-743-6802.

Services & Supports

www.mentalhealthscreening.org/military/The Mental Health Self-Assessment Program (MHSAP) is a voluntary, anonymous mental health and alcohol screening and referral program offered to families and service members affected by deployment or mobilization. It is offered online 24/7, as well as through in-person events. The DoD Office of Health Affairs funds the MHSAP. The programs are offered at no cost to military units and service members and their families.

www.samhsa.govThe Substance Abuse and Mental Health Services Administration (SAMHSA) has established a clear vision for its work – a life in the community for everyone. To realize this vision, the Agency has sharply focused its mission on building resilience and facilitating recovery for people with or at risk for mental or substance use disorders.

www.ptsd.va.govNational Center for PTSD, a special center within Veteran’s Affairs. Mission is to advance the clinical care and social welfare of America’s veterans through research, education, and training in science, diagnosis and treatment of PTSD and stress-related disorders.

www.woundedwarriorproject.orgThe Wounded Warrior Project. This project was created to raise public awareness and enlist the public’s aid for the needs of severely injured service men and women, to help severely injured service members to aid and assist each other, and to provide unique, direct programs and services to meet their needs. Call 1-904-296-7350 for more information.

www.iava.org/index.phpIraq & Afghanistan Veteran’s of America. Founded in 2004, this is the nation’s first and largest group dedicated to the Troops and Veterans of the wars in Iraq & Afghanistan, and the civilian supports of those Troops and Veterans. Its mission is to ensure the enactment of policies that properly provide for our Troops & Veterans, keep our military strong and guarantee our national security for the purpose of a stronger America. Call 1-212-982-9699 for more information.

www.dav.orgDisabled American Veterans (DAV). DAV is focused on building better lives for disabled veteran’s and their families by providing free assistance in obtaining benefits and services earned through their military service. Its largest endeavor is the National Service Program. In 88 offices, a corp of 260 National Service Officers (NSOs) & 26 Transition Service Officers (TSOs) directly represent veterans with claims for benefits from the Dept. of Veterans Affairs and the Dept. of Defense. This service is free and available to all veterans. Call 1-877-426-2838 for more information.

www.vetcenter.va.govVet Centers are community based and offer readjustment counseling for veterans and their families. There is no cost and services also apply to Reserve and National Guard personnel. Contact your nearest Vet Center by calling during normal business hours; 1-800-905-4675 (Eastern) and 1-866-496-8838 (Pacific)

www.mortgageloan.com/veterans – Mortgage Loan.Com gives a comprehensive consumer guide on housing and mortgages for veterans and active military.

Vocational Rehabilitation Services

www.vba.va.gov/bln/vreThe Vocational Rehabilitation & Employment Program (VR & E). Delivers timely and effective vocational rehabilitation services to veterans with service-connected disabilities so they can prepare for and find jobs within their physical, mental and emotional capabilities. Call 1-800-827-1000 for more information.

www.tinyurl.com/yhmgynVocational Rehabilitation and Employment. This program is for Veterans who have a disability rating and an employment handicap who may be entitled to vocational rehab and employment services under Chapter 31 of the GI Bill. Service include but are not limited to counseling, training, education and job placement assistance. Call 1- 800-827-1000 for more information.

Employment Services

www.dol.gov/vets/Veterans Employment and Training Service (VETS). VETS offer employment and training services to eligible veterans through (1.) Disabled Veterans Outreach Program and (2.) Local Veterans Employment Representatives Program. Programs are possible through cooperative efforts with, and grants to, each state..

www.veteranemployment.com/Veterans Employment. In partnership with Monster.com. Veterans, active duty, guard and reserve can search for thousands of jobs for veterans from employers who value military experience. There is also a special section for security clearance jobs.

National Poly-trauma Centers

Polytrauma care is for veterans and returning service members with injuries to more than one physical region or organ system, one of which may be life threatening, and which results in physical, cognitive, psychological, or psychosocial impairments and functional disability. Some examples of Polytrauma include:

  • Traumatic Brain Injury (TBI)
  • Hearing Loss
  • Amputations
  • Fractures
  • Burns
  • Visual Impairments

The centers provide comprehensive, high-quality, and inter-disciplinary care to patients. Teams of physicians from every relevant field plan and administer an individually tailored rehabilitation plan to help the patient recover as much as possible.

Improvised explosive devices and rocket-propelled grenades often result in devastating injuries, including amputations, sensory loss and brain injury. Modern body armor and advances in front-line trauma care have enabled combat veterans to survive severe attacks that in prior wars were fatal. In response to the demand for specialized services, VA expanded its four traumatic brain injury centers in Minneapolis, Palo Alto, Richmond and Tampa to become polytrauma centers encompassing additional specialties to treat patients for multiple complex injuries. This is being expanded into a network of 21 polytrauma network sites and polytrauma clinic support teams around the country providing state-of-the-art treatment closer to injured veterans’ homes

These centers treat traumatic brain injury alone or in combination with amputation, blindness, or other visual impairment, complex orthopedic injuries, auditory and vestibular disorders, and mental health concerns. VA has added clinical expertise to address the special problems that the multi-trauma combat injured patient may face. This can include intensive psychological support treatment for both patient and family, intensive case management, improvements in the treatment of vision problems, and rehabilitation using the latest high-tech specialty prostheses. Polytrauma teams bring together experts to provide innovative, personalized treatment to help the injured service member or veteran achieve optimal function and independence.

Because brain injury is being recognized as the signature injury of the current conflict, VA launched an educational initiative to provide its clinicians a broad base of knowledge with which to identify potential traumatic brain injury patients, mechanisms for effective care, and a better understanding of patients who experience this condition. VA has made training mandatory for physicians and other key staff in primary care, mental health and rehabilitation programs.

VA Palo Alto Health Care System (VAPAHCS)
3801 Miranda Ave
Palo Alto, CA 94304
Toll Free: 1- 800-999-5021

Minneapolis Veterans Affairs Medical Center
The Minneapolis Polytrauma Rehabilitation Center
One Veterans Drive
Minneapolis, MN 55417
Toll Free: 1-866-414-5058

James A. Haley (Tampa) Veterans’ Hospital
13000 Bruce B. Downs Blvd.
Tampa, FL 33612
Toll Free: 1-888-716-7787
The Tampa Polytrauma Rehabilitation Center is one of four facilities in the country designed to provide intensive rehabilitative care to veterans and service members who experienced severe injuries (including brain injuries) to more than one organ system.

Hunter Holmes McGuire (Richmond) VA Medical Center
The Hunter Holmes McGuire Polytrauma Rehabilitation Center at Richmond
1201 Broad Rock Blvd.
Richmond, VA 23249
Toll Free: 1-(800)-784-8381