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Traumatic brain injuries among military members and veterans

 March 20, 2024 at 1:10 PM PDT

S1: Welcome in San Diego. It's Jade Hindman. Today we're talking about some of the issues facing San Diego's military service members and their families. This is midday Edition , connecting our communities through conversation. Welcome in San Diego , it's Jade Hindman. Today we are talking about some of the issues facing San Diego's military service members and their families , plus a conversation with NPR's Sarah McCammon on her new book about the ex Vangelis movement. This is Midday Edition connecting our communities through conversation. March is Brain Injury Awareness Month. One group that suffers from traumatic brain injuries or TBIs are our veterans and active military , whether through combat , in recent conflicts , or simply through training , hundreds of thousands of veterans have been impacted from brain injuries. Clint Pearman is a certified brain injury specialist as well as a board member of the Wounded Warrior Homes , which is a local nonprofit helping veterans with brain injuries. Clint , welcome to Midday Edition.

S2: Thank you for having me. I'm excited to be here.

S1: So glad to have you here. So before your work as a brain injury specialist , you served in the Marine Corps.

S2: So I go back to the end of Vietnam. I joined in 1975 , and the Marine Corps let me hang around all the way until 2006. So I retired in 2006 after about 31 years. I've had seven traumatic brain injuries. Four of them occurred while I was in the military. They weren't severe enough to warrant any major type of treatment. Uh , and I do not recall ever hearing the word traumatic brain injury ever being involved in any type of situation where the term traumatic brain injury ever came up. So I would have to say back , over the last 30 years , we have come a long ways coming out of the Vietnam era and moving into the Iraq or the Iraq and Afghanistan era. That's when TBI began to rise and the term became more known. In fact , the position I held as a brain injury education and coordination specialists evolved out of the need for people to train medical personnel. Because of all the traumatic brain injuries we were starting to see as a result of Iraq and Afghanistan.

S1: So was there any like , pivotal moment for you where you realized , you know , hey , there's not been enough research around traumatic brain injuries and not enough medical personnel know how to treat them.

S2: So the military had come up with that idea before me. They realize , probably around 2010 , that we did not have enough medical personnel that were trained properly to treat all the traumatic brain injuries that we were , that our service members were experiencing. So they and I think I could say they created this program where they brought on a cadre of between 10 and 15 , what they called regional education coordinators. And what we wore were brain injury education specialists. Our job was to go within our catchment area. I worked the Southern California area , primarily the main bases around Oceanside , so Camp Pendleton Marsh and those other bases in that area , and often down in San Diego and as far up as the San Francisco area. And the response my responsibility was to train and provide resources for the medical personnel assigned to military organizations , to help train them in how to diagnose , treat , and rehabilitate traumatic brain injuries.

S1: Well , that leads me to my next question. I mean , and you have experienced you experienced several traumatic brain injuries during your service. Yes.

S2: So the first thing in that training , even with the medical personnel , we have to explain what what exactly is a traumatic brain injury. So if you imagine your brain sits on your brain stem and then you have the brain , which is made of this butter like texture , it sits in your skull. Now , it is not strapped in your skull like a helmet. It literally floats around in your skull surrounded by cerebrospinal fluid. What causes a traumatic brain injury is when your head or your body hits something abruptly , a blow , a jolt , and your brain smashes into the inside of your skull. And depending on how hard that blow a jolt is , your brain can smash onto the inside of your skull and then rattle around on the inside of your skull , and all the areas where it smashes up against your skull can be bruised or injured. And depending on what areas those are , that's what do. That's what will predict what types of symptoms you have. First thing you want. Also understand is they come in three different levels. Mild , moderate and severe. The mild is the exact same thing we call a concussion. So when you hear the word concussion that's a traumatic brain injury. It just happens to be the mild version. And 80% of people , along with 80% of the traumatic brain injuries that occur are concussion. Also , 80% of the traumatic brain injuries that are concussions , 80% of the people will recover fully without any treatment. So you don't need any treatment. But that can be tricky because people can be lured into thinking that the mild is not a big deal , when in fact it is because there are some things that can happen if you don't get treated , and you could wind up being that 20% that don't fully recover. So what is a traumatic brain injury ? Your brain smashes onto the inside of your skull , and whichever areas your brain smashes up against it can cause the various types of symptoms , which range from cognitive symptoms , emotional symptoms and and physical symptoms.

S1: So what are those look like. If I was to have a TBI I'm what does that look like in my day to day life. Mhm.

S3: Mhm.

S2: So let's go with what happens. First. The way we identify a TBI is first there has to be an event. What we mean by an event a blow or jolt car accident for women. Domestic violence playing around hit in the head. In other words an event that causes your body or your head to blow , you know , to jolt forward , causing your brain to smash into the inside. When that occurs , we look for three things. First thing we look for is did you lose consciousness ? If you lost consciousness that meets the criteria for a traumatic brain injury and in many cases , the concussion version , the mild version ? But what if you didn't lose consciousness ? There's a second thing we look for , which would be loss of memory. So I would literally ask people , hey , when you hit your head , did you lose consciousness ? No. Well , did you lose your memory of what happened right before or right after the event ? That's the second thing we look for. Could be no , but the third one is the gotcha one. The third one is have you ever hit your head or your body ? And as a result , you felt dazed , confused , a little disoriented. Maybe you saw stars , or maybe you had ringing in your ears that meets the criteria for a traumatic brain injury. And then there's other things that would be done to determine whether it meets the mild , moderate , or severe. Now , let's say you've already had that brain injury and it's been a couple of days. Well , there are three sets of symptoms that we we also look at cognitive symptoms which involve things like confusion. I mean think about it. Your dazed or you're confused. You're disoriented. A person may have difficulty finding words a person may suffer from memory loss. They can't remember what happened or they have a slower thinking. So you have a friend and you suspect they may have had a traumatic brain injury. Let's use the word concussion for the mild. Since 80% of the TBIs are mild and they've told you , yeah , I hit my head. But you notice they're like thinking about what they want to say , which wasn't their normal flow. Sure.

S1: That's just grasping for words.

S2: That's what it is. Grasping. Yeah.

S1: Yeah.

S2: And then there are emotional symptoms which are things like anxiety , feeling depressed , irritability and mood swings. Those are TBI symptoms. And then the last set of physical symptoms balance problems um , dizziness , feeling fatigued , having a headache , nauseous , ringing in the ears. All of those are the types of things people can look for.

S1: So that's a huge range of symptoms. But um , if there's a way to summarize it like how are these symptoms treated.

S2: So the first step and I tell people this all the time , if you suspect you've had a traumatic brain injury or you suspect a friend of yours has , the first thing they need to do is go to the doctor. And then once if they conclude you you have sustained a traumatic brain injury , the first thing you're going to do is just tell you to rest. Well , let's back up. Depending on the level , if it is a mild remember , most people fully recover from that on their own. So the first thing that medical specialists is going to tell you to do is go home , take a 24 hours rest. That's what we do in the military. It's a required 24 hour rest. At the end of 24 hours , you're going to come back and then they're going to reassess those symptoms. If the symptoms no longer exist , you're probably all right. You're in that group of people that fully recovered on their own. But occasionally there will be some people that their symptoms will linger on. The doctor is going to treat the symptoms. So what if your symptoms are headaches ? Going to give you something to treat the headache. If you're dizzy , they're going to treat the dizziness. Well.

S1: Well.

S2: Uh , let's go up to the moderate level TBI. That's more obvious. You're going to know something is seriously wrong. If you're observing it in a colleague or a friend , you know something is seriously wrong. That's what the moderate , uh , they're usually going to wind up in a hospital setting , uh , with the the medical professionals treating you. Now , the severe we identify the severe , uh , one of the identification criteria is your you've been unconscious for the last 24 hours , so we're not going to talk about that. That's a whole nother ballgame if we talk about the moderate and the and the the mild , the medical professionals , there are things we can do to assess first which level you you you may you're at. And then once we know what level you're at , we're going to treat the symptoms. Yeah.

S1: Yeah. I mean what are some common misconceptions you hear when it comes to brain injuries.

S2: That it's a psychological issue. That's one of the biggest things we experience in the military. A lot of service members they don't want to report , which is similar to the civilian community. Uh , they don't want to report their traumatic brain injury because you can't see it and you don't know what's going on , but you feel something is going on in your head. You have a tendency to think it's psychological. No , a traumatic brain injury is a physical injury to your brain. That's not psychological. The catch is it can lead to psychological symptoms , but it is a physical injury. So one of the misconceptions people that they don't like talking about their brain injury because usually what they're experiencing are these psychological symptoms that they can't explain. Not realizing those symptoms are coming from the physical injury you had to your brain. Hmm.

S1: Hmm. So when we hear about brain injuries and veterans , you know , I think the first thing people assume is that the injury came from combat. But you say that's not always the case.

S2: It's it's it's kind of intuitive to think that TBIs come from combat blasts when they do , some do. However , 80% of the traumatic brain injuries we experience in the military are from not combat. They're from garrison training. Uh , when I speak to other service members about this , I like to say the stupid things we did when we were 18 and 19 , in the service , hitting our heads , playing sports. So if you look at these things , most of the TBI is going to come from sporting events , uh , training events , just playing around , car accidents , motorcycle accident. Um , and anything that you may have been involved with that wasn't combat related , that involved hitting your head or hitting your body , winding up dazed , confused or disoriented. The TBI and 80% of those are not combat related. Hmm.

S1: Hmm. Well , you're going to be hosting an event on brain injury with Wounded Warrior Holmes. Tell us about. That.

S2: That. So Wounded Warrior Homes is an amazing 501 C3 nonprofit. We provide what we like to call transitional housing for post 911 veterans that have gotten out of the service. And what makes us a little different from the other housing organizations is we look for veterans that are struggling with traumatic brain injury issues and post-traumatic stress issues , and then we can provide , we say , a house , but we actually provide a room and a roof over their head and food. And then we coordinate what we like to call wraparound services. So if they're trying to go back to college , we help coordinate that. They're trying to get their medical benefits. We help coordinate that. In other words , we take the veteran , try to catch them before they wind up homeless. Because once you wind up homeless now , the problem becomes even more difficult. So we catch you before you become homeless. We can put you in a home , and now we can help coordinate all the things you need to get back on your feet. Um , and because we focus on veterans that have experienced traumatic brain injuries and PTSD and March 28th , Wounded Warrior Homes will be hosting a what's called traumatic brain injury fundamentals , or TBI fundamentals what everyone should know. So it's going to be a 45 , 50 minute seminar that I'm going to do on zoom. So it's virtual and we will cover a lot of the things you talked about. But I'll go a little bit more in detail so that you walk away with a deeper understanding of. What a traumatic brain injury is , how to identify the signs and symptoms , what you should do if you've had one , and what your medical professionals should do if you show up and complain of a TBI.

S1: Yeah , and of course we'll provide a link for that on our website at Kpbs. Org. It's a really great service. It sounds like finally , what do you think society needs to do better when it comes to veterans suffering from brain injuries ? Absolutely.

S2: So what would I say is , is first to the to my service members. Don't be afraid if you're experiencing any of these symptoms that I , I talked about or you suspect a colleague or a friend may be experiencing these symptoms , go to your medical professional. Just go and tell them everything that you can. Tell them about your TBI , your experience , and let them figure out what to do because there are things we can do. That's another challenge. Some people don't think , what am I going to do ? It's a traumatic brain injury. There's nothing we can do. There's lots of things we can do , but you have to be the first one to make the first move to let us know I need help.

S1: I've been speaking with Clint Pearman , certified brain injury specialist and board member of Wounded Warrior Homes. Clint , thank you very much for being here and thanks for your service.

S2: Thank you for having me.

S1: Coming up next , we hear about the biggest concerns military families are facing in California.

S4: The fact that military families move so often during their time during service. I think it's hard for them to be able to create community where they are.

S1: You're listening to Kpbs Midday Edition. Welcome back to Midday Edition. I'm Jade Hindman. We just heard about the experiences of veterans and military members who have been impacted by brain injuries. We now turn to the life of military families in San Diego. Blue Star Families recently released findings from its Military Family Lifestyle Survey , and the findings have raised concerns about the military's ability to meet its recruitment levels. Joining me now to talk more about that survey and its findings is Maggie Mesa. She is the chapter director for the Blue Star Families of San Diego. Maggie , welcome to Midday Edition.

S5: Thank you so much for having me.

S1: So one of the main findings from this year's Survey of Military Families is that few would actually recommend service in the military. There's been a huge drop since 2016 of more than 20%. So today just 32% of military families would recommend service. Tell us more about what you've learned about what military families are experiencing.

S4: Well , I think that with the fact that military families move so often during their time during service , I think it's hard for them to be able to create community where they are. And so that's part of what we do with Blue Star families , is connecting them to their community to try to give them that sense of belonging so that we can try to make military life awesome. Yeah.

S1: Yeah. And now Blue Star families , I mean , you all just you really offer a support for military families , right ? Right.

S4: We do , we do. We really try to get them out into their communities. We provide them free opportunities to , um , attend local events and then have programming inside of our organization to support them.

S1: Now , military spouses finding jobs seemed like another big concern for respondents of the survey.

S4: And that's due to the , the the time that they move. Um , so often. And I think that for us , we have our initiative , our four plus one initiative where employers can do their part and see that the military spouse community has , uh , brings a lot of value to their organization , their corporations , and they can offer opportunities for them , such as flexibility or remote work.

S1: Um , and like most Californians , cost of living issues like housing and childcare were also a major concern.

S4: Um , you know , 70% of our military live off of the military base. And so the cost of living here can be a little expensive. And , you know , one of one of the findings was , um , base pay. Their military base pay. They feel that they're not paid , uh , properly. And so they're paying more out of pocket. And then when you have that military spouse that can't find employment and help to provide for the family , that's where the childcare issues come into play.

S1: What is the basic needs allowance , and how does that play a role to military families in San Diego and across California ? Right.

S4: So the basic needs allowance is supposed to compensate for what military pays out of pocket. And um , it obviously doesn't compensate well enough. And so that's where , um , military families are having to find , um , second , um , jobs and , and employment at.

S1: The center of the experience of military families is relocation. Moving every few years becomes really a way of life for so many. You yourself are part of a military family. What is that experience like , and how could the military make that easier ? Right.

S4: So , um , for my experience , um , we moved every 2 to 3 years. And of course , at first it was hard , but after a while we knew it was happening and we turned it into an adventure. And , um , you know , I think that even though that that's common knowledge in the military , uh , you know , providing families an opportunity to be able to stay places longer would benefit in the long run. Hmm.

S3: Hmm.

S1: How are the survey results different for California than the rest of the country ? I mean , does anything stand out to you there ? Certainly.

S4: Uh , cost of living here sticks out. And our military spouse employment. I know that those are national responses. Uh , but locally , I think it's just amplified because of the cost of living here.

S1: And we started by talking about. How there are fewer military service members that would recommend joining the service.

S4: Could step in and , you know , do their part to support and understand our military. It may help with service members wanting to either stay in longer or to recommend service. I know for me , you know , uh , my my husband served 30 years in the Marine Corps and it gave us a great life. It provided opportunities for us that we may have never experienced at any other time. And my children have been able to grow and learn and be more accepting of others and their environments that they live in.

S1: Another factor in the experience of military members is the experience of children. I think you mentioned your daughter went to multiple high schools.


S4: Tell you that April is the month of the military child. And , you know , we celebrate our our young heroes that month and our my children that I can speak for my children. They are so much more , uh , open to , um , new experiences and environments because of the lifestyle that we lived. Um , they're not afraid to go out there and kind of seize the day. Um , and I see that with a lot of military children and , and , um , you know , military life can be hard. But I think at the end of the day , it's all what we make of it. Yeah.

S1: Yeah. And you're right. It can be hard. I know that there. You know , when you first spouses , in particular when their service member , their spouse is deployed for months , I know that that , you know , I mean , you would feel like you're single parenting. The need for a village in a support is so much more important during those times.

S4: Um , and that is who we all leaned on to get through the tough times. And , you know , I think that's why it was such a joy for me to be able to transition when my husband retired , um , to be able to have this job , to be able to work to connect our military families to the community , to help them have that shoulder to lean on and provide resources for them.


S4: And , you know , you you may be living next door to a military family that is experiencing really tough times. And I think that's where you , as the individual and the , the , um , community can step in and just talk to our military families , get to know them , listen to their stories , and understand that they may be going through a tough time , but you being there for them can really be of help.



S1: All right. I've been speaking with Maggie Mesa from Blue Star Families of San Diego. Maggie , thank you so much for joining us.

S3: Thank you for having me.

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Crew members line the deck of the littoral combat ship USS Gabrielle Giffords pass under Coronado Bridge, July 5, 2017.
Matthew Bowler
Crew members line the deck of the littoral combat ship USS Gabrielle Giffords as it passes under the Coronado Bridge, July 5, 2017.

March is Brain Injury Awareness Month, and one group that suffers disproportionately from brain injuries is U.S. military members and veterans. On Midday Edition Wednesday, we hear from Clint Pearman, a brain injury specialist and a board member for Wounded Warrior Homes, to discuss these impacts on our veterans and military members.

Also, KPBS spoke with Maggie Meza, chapter director of the Blue Star Families of San Diego, about the experiences that military families often go through and takeaways from Blue Star's latest Military Family Lifestyle Survey.