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Overcoming the Hidden Wounds of Traumatic Brain Injury

Man at computer with woman looking over the shoulder

Veteran Hubert Wright with Occupational Therapist Mary Graddon completing a memory task.

A cookout with friends has more meaning these days to Hubert Wright.

As part of a reintegration group for traumatic brain injury patients at VA Puget Sound Health Care System, Wright and the six other group members organized and hosted a cookout and picnic for their doctors, therapists, families and friends.

“They decided to do this completely on their own,” said Kenneth Jarrett, a vocational specialist at the American Lake division near Tacoma, WA, “and that demonstrates how the group provides a strong community” for patients in the Polytrauma unit. “It provides them more opportunity for the social interactions that they are sorely missing.”

To Jarrett, the journey of Hubert Wright shows how involvement in therapies and reintegration groups can be the key for TBI patients to take back their life.

When Wright first came to the VA unit, Wright described himself as “a lost puppy.”

After his two tours of duty in Iraq, Sergeant Hubert Wright had suffered multiple exposures to blasts. He showed the symptoms of Traumatic Brain Injury or TBI: he had problems with forgetfulness, a shorter attention span and slowed processing speed.

In addition to the reintegration group, Hubert Wright actively participates in therapy for cognitive deficits and other trauma-related issues.

Going back to school is a chance not just to learn a new profession but to give back to society. He is now training to provide drug interventions for youth. Already Wright is making strides, and one of his proudest moments came last fall when he successfully completed some courses.

To keep track of information and appointments he uses a personal digital assistant (PDA) as well as his phone and writing things down. For practice, Wright says he will rehearse dates aloud and ask someone to help remind him about an appointment or date.

PDAs that have been helpful to Wright are just one part of technology’s role in therapy for brain injury patients. Many patients like Wright are young, pursuing new careers and going back to school.

“We will teach them how to use a digital voice recorder or a live scribe pen so that it helps to make up for the distractability component,” says Dr. Natalie Dong, a neuropsychologist and director of the VA Puget Sound’s Center for Polytrauma Care.

And it’s not just technology that’s helping doctors treat patients with TBI. How doctors think about treatment has changed, said Dong.

“I think that one of the really big things that is coming out of polytrauma programs at this point in time is a real awareness and sensitivity to the contribution of a range of simultaneous problems. That it isn’t a concussion occurring in isolation, but it’s a concussion occurring in context of a lot of complicating factors.”

Helping to treat both the injury and the complications is VA’s new practice of the Patient Aligned Care Team. Dong says she believes it can be helpful in advancing access and tailoring treatment for veterans.

“It’s all about the one-stop shopping, or having a dedicated team that understands the complex diagnostic picture and the complexities of treatment,” said Dong. “The more we can simplify and streamline the system for them, the better off they’ll be.”

For Wright, he’s grateful for the progress he’s made in therapy. To other veterans going through treatment for TBI, he offers encouragement.

“It’s easy to get in one mindset and want to go one way then jump on another — just stay on board. Although, it may just seem that you change your course six or seven times, just stay on board, keep running and eventually you get there.”