JOINT BASE SAN ANTONIO-FORT SAM HOUSTON –
Army Spc. Kevin Wear was riding in an armored vehicle in Afghanistan last summer when a roadside bomb exploded, tearing the vehicle into three pieces and killing three of the five passengers inside.
But Wear remembers nothing of that incident or anything that happened a few weeks prior. The blast injured his leg and caused a traumatic brain injury that left him in a coma for about a week and a half.
"I woke up in San Antonio," he said, referring to San Antonio Military Medical Center, "and was in an amnesia state for a month or so."
Nearly a year later, Wear is still coming to terms with the aftermath of his TBI. He struggles with short- and long-term memory, but has learned "tricks," such as association and rhyming, that help him get by.
"Sometimes I have trouble, but I play it off," he said in an interview at the Brooke Army Medical Center Warrior Transition Battalion headquarters. "All five of my kids believe I'm Superman - the toughest, strongest guy in the world. I just want to keep that as long as I can. I don't want to feel different - or less."
Wear is one of the more than 266,000 military members who have sustained a TBI from 2000 to 2012, according to http://www.Brainlinemilitary.org. Additionally, each year, a reported 1.7 million civilian brain injuries occur in the United States.
TBI is defined as a disruption of function in the brain from an external force, such as a car accident or, as in Wear's case, an explosion.
Brain injuries range in severity from a mild TBI, also known as a concussion, to a severe injury that involves an extended period of unconsciousness or amnesia.
Symptoms of a TBI are typically divided into three basic categories, explained Dr. Jan Kennedy, a neuropsychologist and senior scientific director for the Defense and Veterans Brain Injury Center, Department of Neurology, San Antonio Military Medical Center.
These categories include cognitive, such as issues with memory and attention; emotional, such as depression, anxiety and irritability; and physiological, including headaches, dizziness and problems sleeping.
Spc. Rizaldy DeJesus refers to TBI as an "invisible wound" that's difficult for others to understand.
The Army medic was injured in Afghanistan in July 2011 while on a convoy delivering supplies to a forward operating base. The convoy was moving along a narrow hillside road when an explosion knocked the vehicle DeJesus was riding in down a two-story cliff.
DeJesus woke up in Germany with a fractured ankle and back, dislocated hip, and a TBI. Through individual and group therapy he's come a long way since, he said, but still has trouble with his memory and is easily irritated.
"It's a long process of healing," he said. "I see myself improving slowly and am thankful the Army has a really good program for TBI."
On the battlefield, Soldiers involved in a potentially concussive event, such as feeling dazed after an explosion, must undergo a medical evaluation and a minimum rest period. Experts are on hand in theater to identify and treat service members, and to refer them to a higher level of care if needed.
More than 90 percent of those with a TBI will fully recover; however, recovery hinges on the severity and location of the injury, Kennedy explained. In all cases, experts agree that a patient's best course of action is to seek care as quickly as possible since rest is a vital component in concussive recovery.
Education is another vital component, Kennedy noted, and the Army is working to raise awareness about brain injuries, including prevention, diagnosis and treatment. According to the Office of the Surgeon General, the Army has invested more than $800 million in research and development activities to better identify and treat brain injuries.
At SAMMC, several neuroimaging studies are under way to improve diagnostic and detection capability, Kennedy said, and experts at the TBI Clinic are looking at cognitive rehabilitation's benefit for service members who have suffered a mild TBI.
Leaders also are working to combat the stigma to seeking care. They encourage battle buddies and family members to keep an eye out for any changes following a head injury and to encourage Soldiers to seek care.
Army Sgt. Edward Matayka said he doesn't want to be treated differently because his brain "got rattled."
The Vermont National Guard medic lost both legs and suffered a spinal injury, back and face fractures, a TBI and a stroke after a roadside bomb blew up his vehicle in Afghanistan in July 2010.
Having a brain injury "doesn't mean you're broken," he said. "You just have to learn mechanisms to deal with it and to deal with the different way you may have to process stuff. I'm still the same person."
Wear said he gets frustrated at times, particularly when he forgets a name or how to spell a word, but doesn't let that deter him. He practices memory tricks and studies words up to two hours a night to speed his recovery.
"I don't want people to think any differently about me," he said. As a dad and as a Soldier, "I feel like there's a lot more I can do."