Fort Bliss center treats troops with traumatic brain injuries
El Paso Times, Texas
EL PASO, Texas — For soldiers who have served in Iraq or Afghanistan, traumatic brain injuries are almost like an invisible or silent wound.
"Those closest to a soldier may be able to sense that something isn't quite right with them, but it's not as visible as a broken bone," said Theresa Prudencio, an occupational therapist at the Warrior Care Center at Fort Bliss.
The 7,000-square-foot center is within the larger Soldier Family Medical Clinic, 2496 Ricker, on West Fort Bliss.
The Warrior Care Center opened in March 2012. It treats soldiers who have sustained concussions — what used to be called mild TBI — or have stabilized moderate to severe brain injuries. The clinic concentrates on patients who haven't responded to regular medical treatment.
Previously, the clinic's different functions were scattered among several locations at William Beaumont Army Medical Center and a clinic at Fort Bliss.
"We want to be a one-stop shop that's 100 percent focused on patient care for soldiers with head injuries," said Dr. Sean Sebesta, one of three doctors at the brain-injury clinic.
March is National Brain Injury Awareness Month. Officials at Beaumont are highlighting the treatment soldiers who are suffering from brain injuries are receiving.
"The signature wounds of the conflicts in Iraq and Afghanistan are blast injuries, including mild and moderate traumatic brain injuries," said Col. Michael S. Heimall, commander at Beaumont.
"Since 2008, Army Medicine has invested more than $439 million to improve the screening and treatment of these injuries," Heimall continued.
Clinics like the Warrior Care Center "are advancing our understanding of TBI and the best methods to treat these invisible injuries," he added.
About 95 percent of the Warrior Care Clinic's patients have concussions, and 80 percent were wounded in combat, Sebesta said.
The clinic sees 800 to 1,000 patients a year.
According to the Department of Defense, nearly 25,000 service members suffered some sort of brain injury in the first nine months of 2012. About 84 percent of those injuries happened in a nondeployed setting, according to the Defense Department. Frequent causes include crashes in privately owned and military vehicles, falls, sports and recreation accidents and military training.
During deployments, explosions are the leading cause of brain injuries, according to the Defense Department.
Fort Bliss has a higher percentage of soldiers with head injuries sustained in combat because it is a major deployment point for the military, officials said.
Sebesta characterized soldiers with head injuries as the "walking wounded."
"They are walking and talking but not at the same level as before," he said.
This clinic is for those who are stabilized and have not responded to regular medical treatment, Sebesta stressed.
Soldiers who have suffered a concussion in the past week should go to the emergency room or should see their primary care physician if it happened in the past four to six weeks, Sebesta said.
The Warrior Care Clinic uses a team approach to treating soldier with brain injuries.
It has three doctors on staff, two occupational therapists, two occupational therapy assistants, one physical therapist, a physical therapy assistant, two speech language pathologists, a licensed counseling social worker, a nurse case manager, a case manager assistant, an optometrist and five support people.
The clinic is also hoping to hire a neuro-psychologist, a psychologist and a psychiatrist, but those plans are on hold because of sequestration, the automatic budget cuts that federal agencies are dealing with, Sebesta said.
That doesn't mean soldiers who need counseling are going without this important service. The social worker on staff can do counseling and there are also behavioral health care professionals embedded in units throughout the installation, Sebesta said.
The clinic was specifically designed and remodeled to provide the best possible care to soldiers with brain injuries, Prudencio said.
Soldiers can receive a range of services at the clinic that include occupational and physical therapy, speech therapy, counseling and regular medical care.
Clinic staff members also meet with members of unit commands to educate them about their soldiers who have suffered brain injuries and what they are going through, Prudencio said.
"The education piece is huge," she said. "It's probably the most important part. We have amazing equipment. We have the experience. We have the office of the Army surgeon general with the latest research and guidelines on the best practices."
The clinic is full of state-of-the-art equipment. An example is a driving simulator where soldiers can "make sure they are safe behind the wheel but also gives them an opportunity to practice concentration, problem solving and decision making," Prudencio said.
Many patients suffer from vision problems that are connected to their head injuries, and they work on special equipment with an optometrist to relearn how to use their eyes properly, reduce eye strain and address other eye problems, she added.
Typically, treatment can last four to six months, but it can go longer if the patient needs it.