John

Age at interview: 62
Outline:

John suffered a traumatic brain injury when he was involved in a car accident, which broke his face in 178 places. Although they were able to reconstruct his skull, his brain was damaged leaving him with permanent memory loss, hearing loss, headaches, sensitivity to light, vertigo, and chronic pain. To cope with his condition John has retired from work to cut down stressors, takes regular walks, and keeps a calendar and schedules his next-day activities the night before.

Background:

Military branch: Army, National Guard

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John had been retired from 12 years of military service just one year when he was involved in a head-on collision that broke his face in 178 places and changed his life forever. He was able to have his face reconstructed but his brain was forever altered. Since his accident John has grappled with symptoms including headaches, sensitivity to light and sound, sinus problems, memory issues, vision issues, chronic pain and a “constant case of vertigo” due to damage to his inner ears.

After military service in the Army for four years, and the Army National Guard for 8, John held administrative jobs for the Department of Army and the VA and worked in the Water Resources Division for the U.S. Geological Survey. However due to symptoms of his TBI he has found it increasingly difficult to retain new information and perform more complex tasks and has noticed a correlation between the effort needed to function at such levels and the amount of pain he is in. “The more stress and the more pressure you’re under, for me, the worse the pain gets, and the longer the day.”

As a rule, John does not drive as his “brain just can’t wrap around the backwards things.” To cope with the symptoms of his injury John tries to keep both his body and brain active. He does brain tests like Luminosity, is trying to learn Gaelic, and walks “two miles a day.” He says that retirement has reduced his stress, which has also reduced his headaches. To deal with memory issues his wife sends him reminder emails and they keep an active calendar, going over the next day’s activities repeatedly the night before, of which John says “sometimes I remember and sometimes I don’t.”

Of TBI in general John says it is like “going from superman to half man” and reminds others to “be forgiving of yourself” and to keep active. “Don’t sit in the room and sit there and mull over all this stuff,” he says. “You just can’t do that, you’ve got to keep moving.”

 

John hit his head on the dashboard during a head-on auto collision and broke his face in 178 places.

John hit his head on the dashboard during a head-on auto collision and broke his face in 178 places.

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I was in a head-on collision, I was wearing a seatbelt. It broke my face in 178 places. I have nine plates, six titanium teeth, Kevlar mesh under my check, a silicone mesh eye socket. And at first, they said I would never work, then they said I would probably only be able to work in a limited way. And I was rebuilt by a plastic surgeon. I remember the accident well, but after the ambulance got there and everything it starts to become a little murky. I got out a lot quicker than they said I would. They said I’d be in the hospital per a minimum of three months, and then they said six weeks, and I was out in seventeen days. They found two of my teeth here, of my original teeth, and they found one other up here in the cheek. So, I have titanium teeth, they’re permanent. They told me, the plastic surgeon said you will always have sinus problems, because my sinuses were smashed, and I would always have pain, headache pain. 

 

John had reconstructive surgery to rebuild his face and struggled with pain and feeling uncoordinated and unable to focus.

John had reconstructive surgery to rebuild his face and struggled with pain and feeling uncoordinated and unable to focus.

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I went through - the surgery to rebuild my face was 12 and a half hours. Rebuilding my mouth took two years.

I: Do you look very different than you did before?

My nose is different. Everything else, except I’ve got this big lump, because I’ve got that big plate. But everything is pretty much the same. The nose is too broad, because they couldn’t make it - they didn’t have enough bone to support the way it should be, so they spread it out a little bit. He told me, you know, after it’s all healed, you can come back. I’ll pass, thank you very much. But the teeth were the worst, putting in the implants, because I had broken teeth, and they had to remove all those, and then stitch them closed, allow them to heal. Got two bone grafts on the bottom and the top. They pulled a bunch of them that were cracked - all of them cracked. I had like six crowns. Anyway, that took forever. So, you’re dealing with the pain, and then you’re dealing with the dental stuff, too. And I actually had people who would come in and check on me, because I was trying to do things like run, because I had been running. And of course, I couldn’t do it, I would just fall over. It was dreadful, you feel so uncoordinated.  Nothing seems to be working right, you can’t focus on anything. It’s not your eyes, your brain isn’t focusing on stuff. It just won’t do it.

 

For John, the bad part is that they can’t fix it and most of the time they can’t even find it.

For John, the bad part is that they can’t fix it and most of the time they can’t even find it.

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The bad part is they can’t fix it. Most of the time they can’t even find it. I did an MRI probably a hundred times of my head trying to find something, they never find anything. And the titanium plates have a tendency to make it difficult. And my understanding is that’s pretty typical of TBIs.

Some get over it in a few weeks, some don’t get over it. But from what I have heard, which is from other Veterans, a lot of them don’t get over it. It’s like a permanent thing. And they only give 20% disability for it. They give you 80% for PTSD and they give you 20% for a TBI…They denied TBI for 2001, 2002, even 2003 they were denying it, until - because you can’t prove it. I can’t prove to you that any of these issues I have. I can’t prove it. There’s nothing shows up in here, but the body of evidence. If all these guys are always saying I have this, and I have this, and I feel this, and I feel this, and I feel that, you know, they couldn’t all be getting together and making it up, right?  So, the body of evidence indicates that yes, there really is TBIs.

 

 

John says that for many of the younger guys, it is like going from Superman to half man.

John says that for many of the younger guys, it is like going from Superman to half man.

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But initially, it’s the fact that you feel like an idiot, because you can’t remember your family’s name, you can’t remember what you did fifteen minutes ago, and words escape you, words you know, and you’re like and you can’t bring a word up, and then you lose it entirely. So, you go through that, and then eventually, you know the brain’s pretty talented, it starts to reconnect some of the synapses so you get better. I think for the young guys the hard - I was 41-years old when it happened - for the young guys it’s going from Superman to half man, and I was a little bit more mature so it wasn’t easy for me, but it’s got to be devastating for them. Because things you should know and should be able you don’t know. You can’t remember, you can’t keep a coherent thought for even a short period of time, and concentrating actually will cause you, the stress, causes you headaches, so you suffer from headaches.

 

John explains that PTSD is like an innate fear and TBI means that you don’t have a rational way of reacting to your fear.

John explains that PTSD is like an innate fear and TBI means that you don’t have a rational way of reacting to your fear.

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PTSD is like an innate fear, all the time. You’re afraid something’s going to blow up, you’re afraid something’s going to hit you, you’re afraid you’re going to be shot at. You’re afraid you’re going to have to perform medical procedures on your squad mates that you know so well, and you’re always - even though, rationally, yes, I’m here at home, I’m walking down the street. You see a car coming outside, you hear an explosion, anything like that, the fear factor goes in. And what happens when you’re really scared? You either fight or you run, and that’s what happens to them. So, for them, you’ve got that, plus you’ve got an impaired brain. Okay, you’ve got TBI, you’ve got an impaired brain. So, you’ve got the fear, but you don’t really have a rational way of even reacting like you would pre-TBI.

 

To deal with his pain, John started running.

To deal with his pain, John started running.

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But, I started running, and running actually - you get a lot of endorphins when you run, so when I’d run pain goes down to two, you know?

I: Yes.  So, you were able to get enough of your coordination back?

Yes. Yes, it did come back, and a lot of it does come back. It may not seem like it does. I mean, I wasn’t, like, fleet of foot or anything. I mean, I run about an 8.5, 9-minute mile, but I ran 11 miles. The Shamrock Run, that’s up here? I ran 15K, I ran it. I finished - I started dead last, I’d never run a race before and I didn’t think I’d be very good, and I finished 79th. And for the first three blocks you just walked, because it’s so crowded you couldn’t run. But that day I ran an 8.5-minute mile. But the running helps, doing - having an activity helps. But for me, I can’t - I would like to do, because I was in the martial arts program, but I can’t do it because I can’t - for one thing, I’m arthritic in this shoulder. I can’t do the twisting and stuff, it induces the vertigo. And believe me, when you get vertigo, of all the things I experienced, the vertigo is the worst. You know, I can deal with everything except the vertigo.

 

To combat vertigo, John went through the Epley maneuver eight times.

To combat vertigo, John went through the Epley maneuver eight times.

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And weird things happen - when you get a traumatic brain injury it can damage the inner ears, and when it does it breaks off all those little nerves. So, you’re constantly, every time you move your head, you have these broken pieces that are just lodging the natural - which causes you, your brain to tell you that you’re somersaulting, so you’re in a constant case of vertigo. And that’s one of the things you can’t prove. I’ve been through the Epley maneuver eight times. The Epley maneuver is used to fix that kind of a problem with the inner ears that have been damaged. And I believe if you’ve been in a concussion with a cannon you can feel it, it hits you, it’s a tangibly tangible thing. But they would do surgery, microscopic surgery, to move those broken pieces. Well a guy named Dr. Epley came to Portland, came up with a way where they manipulate your body, and they take those broken pieces and they move it until they hit the fatty tissue that’s sticky, and it makes them stick to that tissue and that eliminates a lot of the vertigo, not all of it, but a lot of it. For me it was like somebody raising a curtain, I was that out of it.

 

John felt it was too overwhelming to seek care for his TBI within the VA.

John felt it was too overwhelming to seek care for his TBI within the VA.

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When you’re TBI, trying to force yourself to - just for me to go in and go through the whole rigmarole of going in there and writing all that stuff out, and going down there and getting American Legion to help me was almost an overwhelming task for me. And so, to have to go back and try to find somebody who would help me with that, and go back to VA and say, “Yes, it is. You guys need to foot the bill.” At least at the time, I just retired - it was just more than I felt like I could do. It’s funny how many Veterans don’t fight for their stuff. I was talking to Arnold, he got a bone spur in the Army, and it’s noted with the Army, and they won’t pay him for it.

I: How does that make people feel?

You know, I don’t know. If you’re a combat soldier, you don’t expect them to give you anything. You really don’t. It’s like, you pay to die. So, you don’t really expect them to do stuff for you. If you fight, you can get some of it, and a lot of it boils down to how much you’re willing to fight with the system to get it done, you know? It’s like - and a lot of them won’t. A lot of them won’t do it, even when they’re entitled.

 

John didn’t receive counseling after his accident and it took ten years before he felt he was starting to stabilize emotionally.

John didn’t receive counseling after his accident and it took ten years before he felt he was starting to stabilize emotionally.

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It took me probably a good ten years before I got up where I felt like I was emotionally starting to stabilize. I had no help. I had nothing, nobody. Four years after my accident I went into Kaiser, and they said, “Well you got your counseling after your accident.”  I’m like, “What counseling?  I didn’t get any counseling.”  “Well, you should have been counseled.” I said, “No, I got nothing.”  They just said here you go, don’t do anything weird, it will take eight years for your face to heal up and your swelling to go away, and just take it easy.