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TBI 2.0: JBLM’s new head injury clinic aims for a personal touch

The nonprofit Intrepid Fallen Heroes Fund is building an $11 million clinic for traumatic brain injuries at Joint Base Lewis-McChord. The construction project had a groundbreaking ceremony on Oct. 29.
The nonprofit Intrepid Fallen Heroes Fund is building an $11 million clinic for traumatic brain injuries at Joint Base Lewis-McChord. The construction project had a groundbreaking ceremony on Oct. 29.

The next evolution of treatment for soldiers with serious head injuries at Joint Base Lewis-McChord may mix a dash of yoga in with whole lot of personal attention for wounded veterans.

JBLM last week broke ground on an $11 million facility that aims to advance care for troops who’ve dealt with traumatic brain injuries by offering them special, personalized treatment in a comprehensive program partly supported by private donations.

It’s called an Intrepid Spirit Center, and it’s expected to be one of nine mental health facilities at military bases built with money from the Intrepid Fallen Heroes Fund, a nonprofit organization that has donated more than $150 million to veterans and military support organizations since 2003.

JBLM has hosted programs for traumatic brain injury since early in the Iraq War, when the Army recognized that soldiers exposed to blasts on the battlefield may experience ongoing problems with headaches, mood swings and sleep loss. They were signature injuries of the Iraq and Afghanistan wars that have impacted more than 330,000 military service members.

The new model at the Intrepid center attempts to take that care a step further by giving patients four to six weeks in a special setting to focus on their injuries and find a path to heal, said Col. Beverly Scott, a Madigan Army Medical Center neurologist who will lead the program as its first director.

“We’re going to be expanding things hugely,” she said, ticking off special services the clinic will offer that include spiritual resilience, physical therapy, memory classes and yoga.

She spoke with The News Tribune last week about her plans.

Q: How is the new Intrepid Spirit Center different from the TBI program Madigan created during the Iraq War?

A: When the TBI program was set up almost eight years ago, it initially served as a concussion-screening clinic. We’ve really had to reinvent ourselves with fewer (returning) troops and a large number of service members who had chronic and ongoing problems from trauma-related issues. Now we really are a comprehensive and ongoing care program.

Q: What symptoms do patients experience that bring them to you?

A: The most common symptoms we see are continued headaches, sleep problems and cognitive issues that last beyond a period of days or weeks.

There are often contributing factors. There may be a prior history of migraines that may be exacerbated by a concussion, and this is an example of how important it is to appropriately and optimally treat it.

My history doesn’t begin with, ‘Tell me about your concussion.’ The history begins with childhood, or those first early deployments that may have predated their trauma exposures.

Q: What will this intrepid center allow you to do that you can’t do now?

A: The Army Intrepid Spirit model of care includes additional features beyond what the traumatic brain injury program now provides. One is that it’s interdisciplinary, including our pain program and our behavioral health program. These individuals are often very complex. The first step in the model of care is that very careful evaluation in the TBI program with specialists from behavioral health and pain management.

Another is that it is predominantly an intensive outpatient program. It’s a four-to-six week program that will consist of individual treatment and instructional classes. It’ll be the service member’s place of duty for that piece of time. It’s sometimes challenging for them and for us to optimize their care because they need to go to work. They still have stresses at home and other challenges. This program will enhance the likelihood of success.

The service members will go through the training in a cohort. What I anticipate is that there will be a lot of relationships formed. It’s the soldiers interacting with each other and the relationships and bonds that result.

The final thing is the enhanced case management. We have excellent case managers throughout Madigan, but the Army Intrepid model calls for each patient to have his own advocate

Q: Far fewer soldiers are deploying to the wars today. Why is this program needed at this time?

A: Many of these individuals may experience chronic pain related to other injuries sustained during deployment or even a garrison-related trauma. There may be behavioral health issues contributing to their ongoing problems.

It’s never too late to identify those issues and provide the appropriate care to assist that service member to recovery. We really do think of this as a highly individual program with the goal of returning these service members back to their units and back to their lives.

Q: Former Army Vice Chief of Staff retired Gen. Peter Chiarelli in a Tacoma TedX speech this year said the Army had spent $1 billion on programs for TBI and mental health during his tenure, but he felt the military had little to show for it. The Army seemed to be searching for a silver bullet that would address TBI years ago. This program seems to have a smaller but more focused ambition. Why is that the answer for the Intrepid Spirit Center?

A: There’s still currently significant research addressing TBI across the spectrum, from mild to severe. I do believe that the first step is the evaluation of exposure to trauma, to identify those root issues that contribute to why an individual is still having problems.

It’s complicated and it does require a specialty team to sort that out. It’s not simple, but it is a simple concept. It doesn’t require a lot of fancy research. It requires good clinicians who are interested and will spend the time with patients. It takes time to take good care of patients. These patients have complicated stories, and you have to take the time to listen to their stories to really understand what their current problem is and provide the appropriate care

It’s not fancy, but it can be extremely successful.

Adam Ashton: 253-597-8646

adam.ashton@thenewstribune.com

@TNTMilitary

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