Brian

Age at interview: 28
Outline:

Brian suffered a series of blast injuries and a concussive head trauma while serving in the Army and Army National Guard. The symptoms that are most apparent to Brian are speech issues, memory loss and problems with concentration, which affect his ability to perform in school as he works toward a degree in computer engineering. To cope with these difficulties Brian uses repetition to retain information when studying, works with disability services through his school for aid with note taking in class and test preparation, and uses his phone to record appointments, notes, and reminders.

Background:

Military branch: Army, National Guard

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Brian was blown up three times in his four deployments to Iraq while serving in the Army for four years and the Army National Guard for another two. He had earlier suffered a concussion when high winds botched a parachute jump during an exercise in training camp, knocking him unconscious, but had shaken off the resulting brain fog and dizziness and “slept it off for a few days.” Although he never lost consciousness like the first time, Brian experienced similar symptoms after exposure to three blast incidences including a “fuzzyheaded feeling,” nausea, and headaches. Like the earlier incident that knocked him out, Brian got his bearings back and returned to work. “The mission is the most important thing,” he recalled of the general attitude in his unit. “You’re not unconscious, your limbs are all in place. You can function.”

It wasn’t until he completed his service in 2010 and was back in the states that Brian began to suspect that something was wrong. He felt jittery and noticed issues with his speech and with his memory and concentration. “I wasn’t feeling normal and whatnot, but I was still in that don’t ask for help mentality.” A year and a half after completing his service Brian’s girlfriend convinced him to go to the VA for a consultation. There he was told he probably had suffered a TBI coupled with PTSD, but could not be given a definitive diagnosis.

Brian says issues with memory and concentration are the things he struggles with the most. In school and working toward a degree in computer engineering, he uses repetition to retain information when studying and uses his phone to record appointments, notes, and reminders, but still second-guesses himself regularly.

To other Veterans struggling with symptoms of brain injury Brian says you have to work hard at finding the benefits and help that is out there. “You are your own biggest advocate,” he says. “No one is going to fight harder for you than you.”

 

Brian explains that there is a stigma against going to the doctor unless an injury is really bad.

Brian explains that there is a stigma against going to the doctor unless an injury is really bad.

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Yes, as long as you can - you know, you’re not unconscious, your limbs are all in place and - what was I going to say - you can function. I mean, the mission is the most important thing, and usually, like I said, we’d do these block parties and by the time you got back from a mission you’re so tired you just want to sleep. So usually most of the time, I mean - and there’s a stigma too against going to the docs, just you’re weak or whatever so it’s like, you know, especially with mental illness. And the unit I was in I was in a special operations unit, so that even heightened the mentality more being weak or being strong. So yeah, usually you didn’t go to the doc unless it was real bad because it was sort of suck it up, get some ibuprofen, and…  

I: Did you notice any impact?

Not from those times, no. I mean, there were residual effects I’d say for like 20 to 30 minutes, but I’d say those were overcome mainly due to the adrenaline because you’re about to get out of a vehicle and just start running, so that just sort of overtakes everything. I didn’t experience anything after those. With the parachute jump I did.

I: And what did you experience after the parachute jump?

Like brain fog, dizziness, vomiting - or not vomiting. No actually, I’m sorry. Just feeling lightheaded and sort of like had a hand around my head sort of deal. I just slept it off for a few days, and after that it went away. I mean I got an MRI here. They said it is probably and mTBI, and I’ve done like the four to six-hour neurological psych testing and they said it was within average range, bit with PTSD and TBI there’s a lot of overlap, so they said they couldn’t definitively say that I have TBI, but they noted it in my record.

 

Brian says “People are like if you can’t see it, it’s not there…”.

Brian says “People are like if you can’t see it, it’s not there…”.

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I don’t know how I would feel about a visible disability because I’ve never had one, but I think - I do think - I wouldn’t say misunderstood, but I think sometimes people are just if you can’t see it it’s not there, or it’s not as bad as you’re saying it is. Like, “Oh, you have PTSD. You’re using it as a copout or whatever.” It’s like no, I actually wanted to kill myself the other day. I think it’s downplayed a lot. Which is ironic because at the same time they think we’re going to snap and kill everyone. Right, there’s no middle ground. You’re either totally crazy or you’re making it up. 

I: In what way do you think it gets downplayed? Can you say more about that?

I don’t know how to say more about it. It’s basically like I said, you can’t see it, so it’s not there.  So, I think, like she said, it’s either this or this, so I think it’s just downplayed overall.

 

Brian has ongoing symptoms from both his PTSD and TBI including speech problems and trouble with memory and concentration.

Brian has ongoing symptoms from both his PTSD and TBI including speech problems and trouble with memory and concentration.

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I don’t know if it’s more relevant to your study but I’ll mention it anyways, just nightmares, having flashbacks, still battling alcoholism. Alcohol abuse wasn’t a problem when I was in the military, but now it is, and just avoidance, isolation. But in terms of TBI thing, what I’ve noticed, sometimes it feels like I have a speech impediment or, I don’t know, jittery sort of deal, and also definitely memory and concentration which again could be PTSD or whatever. 

 

When his thoughts start to snowball, Brian tries to distract himself.

When his thoughts start to snowball, Brian tries to distract himself.

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Usually what happens is my thoughts snowball, and one small problem I think about the problem escalating six months into the future and then, like I said, it snowballs and I start pacing around and talking very fast to myself and getting worked up. I’ve found either distractions have been good, deep breathing, sitting down, laying down and writing things down, just writing down the problem itself so you can - what’s the word - sort of deconstruct because it’s big. 

I don’t always do it. Sometimes I get ramped up or down whichever before I can implement those strategies, but those are some of the things I’ve used - or another thing, forcing myself out of the house. Usually once I’m out of the house, or apartment I should say, I’m good.

 

When he is down, Brian has sometimes lapsed back into drinking, isolated himself, and avoided things such as going to class.

When he is down, Brian has sometimes lapsed back into drinking, isolated himself, and avoided things such as going to class.

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I just get in these really depressive, isolated, avoidance things, and sometimes I won’t go to class for weeks or something like that, or I’ll relapse or binge drink. I just feel like I’m alone in a deep, dark place. But other times I get very motivated and try to put on the best - give it a go. It’s like I feel, like, unstable in that sense because it’s up/down, up/down.

 

Although the majority of his care at the VA has been “awesome,” Brian has had challenges.

Although the majority of his care at the VA has been “awesome,” Brian has had challenges.

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Let’s see, I’ve only had a problem with one. I do it in tiers in terms of exceptional; average; not bad but not good, maybe we didn’t connect or whatever and just sort of average relationship; and then bad. I’ve only had one bad experience where I was considering going to a patient advocate, but the majority of my care here has been awesome. The one big complaint I have is - I’m guessing it’s a staffing problem - but my primary care doctor is the only one that’s stayed the same. In the last year and a half, I’ve gone through three psychiatrists. One was on a fellowship that ended in September. Then I was with one for three months, and her and I didn’t get along, and that’s the one I was going to - yeah. And then, let’s see, then I had one who was a resident for about two months, but he was an OHSU resident and only there in the mornings on Monday, and my class schedule did not - was not compatible. So now I’m on number four now. It’s really difficult to establish. You don’t know what you’re getting into establishing a new relationship every single time with a psychiatrist or psychologist, especially when they keep rotating so many times.

 

Brian explains that many Veterans are frustrated by the number of hoops they need to jump through to receive VA care.

Brian explains that many Veterans are frustrated by the number of hoops they need to jump through to receive VA care.

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I mean, this is probably never going to happen or whatever, but I feel a lot of Veterans, especially the older ones, are not in the system, but even the younger guys coming back the hoops you have to jump through even in the VA - it’s like, go here. Well, to go here you need to go here and talk to this person. This person isn’t here or they’re only here from 2:00 to 5:00 and then all over. And I think a lot of people get frustrated, and they just give up, and they just don’t want to deal with all the red tape.

 

Brian talks about receiving services in school to accommodate his TBI.

Brian talks about receiving services in school to accommodate his TBI.

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They have a counselor that you can meet with once a week in terms of disability services. I’m registered with DRC, Disability Resource Center, so it gives me a place in quiet to take my tests away from everybody, and because of my memory and concentration time they give me twice the time allotted for the test. So, like instead of 60 minutes it’s 120 or whatever. So, it gives me time to process everything and whatnot. Oh, and they provide note taking services. Yes, so when I’m trying to concentrate on what he’s doing in class writing it down either missing something he’s saying or trying to multitask, I can write down the important things and concentrate on one class because I’ll have a scanned copy of notes.

I: But how is - I’m just curious how is the note taking service? You know how when you’re in school you take your own notes, and you know your own hand and your reminders and stuff, what was it like to have a professional?

Oh, it’s not professional. Basically, you send in your request at the beginning of the quarter and they have all these standards, the DRC does, that the note taker - it’s like a note taker agreement. Then the teacher makes an announcement at the beginning of class, and usually four or five students will come up after the second or third class and he’ll compare all of their notes and choose who - and then they get paid for it.

I: And that’s through Portland State?

Yes.

I: The Disability Resource Center is for all people with disabilities, not just Vets?

Yes.

I: Was it difficult to get hooked up with them?

No, that was very easy. All I had to do was just bring in some VA paperwork showing my conditions like PTSD tinnitus, knee, joint, ankle problems, TBI sort of thing.

 

Brian says he missed the sense of purpose and togetherness he had before.

Brian says he missed the sense of purpose and togetherness he had before.

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Again, I’ll just say whatever. I just felt like a fish of water and still do, kind of lost that sense of purpose, sense of togetherness. Sometimes I wish I was just back deployed because being deployed was easier. You had a set thing to do, and now hear you’re just sort of tossed out. So, that’s why I said the avoidance, isolation, drinking alone, that sort of thing came about. So, I mean, you got home and you had this huge support network, your boys. So, between a fast-paced lifestyle and your boys and all of that encapsulated, it just kind of funneled back. But as soon as, I’d say about six months after I got out, that’s when issues really started rearing their heads in terms of that.

 

Brian describes his discomfort with disclosing his Veteran status due to public misconceptions about Veterans with TBI and PTSD.

Brian describes his discomfort with disclosing his Veteran status due to public misconceptions about Veterans with TBI and PTSD.

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With my friends I’m comfortable with it. I mean, depending on the ring of closeness that they are that they’re in, is how much I let out, but I mean I feel comfortable with most of them explaining most of the details. But for people that I don’t know, I feel very uncomfortable disclosing it because I think there’s a misconception in the public about returning Veterans and mental health and brain injuries and PTSD. There’s a good comic that I really like. It’s a three-box comic, and the first box is the news reports, like, “Today an Iraqi war Veteran shot and killed three people and then himself.” And then the next one is like what the average civilian hears, “Oh my gosh, he had PTSD. He’s crazy. He just went out and blah, blah, blah.” And then the last box is what a Veteran hears or thinks, and it’s like, “Some dude just went and killed a bunch of people and then himself. He was probably already an asshole.” So yes, I do not feel very comfortable disclosing it because of what people even if they don’t say anything will judge you.

 

Brian thinks that education is the best way to combat the misperceptions people have about Veterans.

Brian thinks that education is the best way to combat the misperceptions people have about Veterans.

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Well, education in terms of that because when I was with my ex at first she didn’t understand dealing with Vets the amount of people that don’t - you know, like less than ten percent of the people there overseas leave the wire and go out and do missions or whatever. The majority are support, logistics or whatever. They may take mortar rounds or other things or attacks on the camps, but the guys who go outside the wire and get blown up and kill people and see people get killed are less than ten percent of the guys over there. So, she actually got really angry because - and this was a few months ago - I think there was a monthly medical staff meeting in the cafeteria or auditorium, and she basically said the speakers had no idea - or the speaker had no idea what he was talking about because he was saying - making it sound like everyone coming back has PTSD or is [indiscernible] in some sort of way, and that’s not the case. I’m not saying that they don’t - the VA is going to have a huge flow of Veterans with different problems, but basically, we’re not all crazy.

 

To other Veterans, Brian would like to say that you are your own biggest advocate and nobody else will fight harder for you.

To other Veterans, Brian would like to say that you are your own biggest advocate and nobody else will fight harder for you.

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I will say this, I’ve learned actually from just coming back and going to the VA, and I’ve taught myself this, and I think that’s the reason why I’ve gotten so far - why I have gotten so far and even my own care or whatever - it’s you are your own biggest advocate. No one is going to fight harder for you than you. So, for example, anytime I get a provider I write down there or put their extension in my phone so I can track them down if need be or go to whoever etc. etc.

 

 

Brian’s girlfriend started to feel more like a caregiver and left - now he is afraid of leaning too hard on somebody.

Brian’s girlfriend started to feel more like a caregiver and left - now he is afraid of leaning too hard on somebody.

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So she was like, “I feel more like a caregiver. I can’t be worrying about you all the time. I can’t have my physical safety at risk,” that sort of thing. It was like in February she said, “One of these days I’m just going to reach my threshold,” and two and a half months later she did. So it’s not like it came out of left field…… [Now] I’m afraid of repeating the past, of leaning too much too hard on somebody, and at the same time right now I’m scared because I don’t have that fallback mechanism I guess you could say or somebody who is right there. I mean, I’m literally alone in my apartment, so I guess you could say I don’t have a safety net anymore I guess you could say.