Congressionally Mandated Longitudinal Research on Traumatic Brain Injury

To improve our understanding of TBI in a military cohort by developing a data repository that contains clinical interview, neurobehavioral, neurocognitive, neuroimaging, blood specimen, and sensory/motor data on service members who were injured since October 2001 during deployment to OIF/OEF.

Exploring the Natural History of Traumatic Brain Injury Within a Military Cohort – A Longitudinal Database and Blood Banking Study

Ranger Run with Team Red White and Blue

I was planning on delaying my second post for a few weeks, but I got the opportunity to support a good charity. This year I have purposely limited my schedule to spend more time advocating for veterans issues. I saw that my friend Mike Erwin (founder of Team Red White and Blue (TRWB) and psychology Instructor at West Point) was on a team of fundraisers and I wanted to contribute. The Ranger Run is a team of athletes that run a total of 565 miles in the month of February to raise money for veterans as well as awareness for veterans’ issues. TRWB has become so central to my own recovery and sense of pride. Without their emphasis on growth I have no idea where I would be right now.

In 2011 I was having a good year in the public eye, but not below the surface. My performance at my job would single me out for the U.S. Army ROTC Instructor of the Year, but I was hiding my problems. I used a full time job, a full load in graduate school, and a busy race schedule to avoid my own problems with PTSD. I became severely depressed, and began to have suicidal thoughts that overtime became an obsession. Only at this broken time in my life did I find the courage I needed to face my challenges. I had been exercising over four hours a day to manage the rage within me. I ran the Pineland Farms trail 50 miler and it broke me off something fierce. Yet I was so proud of the achievement. I found strength when I was broken. I began to realize that I had done nothing wrong, and was not morally or physically inferior because I had PTSD.

Overtime and after finishing more races, I found the courage to be more public about my own struggles with PTSD and mTBI. There is no Panacea for these conditions but TRWBs philosophy has changed my life. Do not get me wrong none of the symptoms of my medical conditions have alleviated, but I am happy. Like an Ultra Marathon I just keep pushing on with the Relentless Forward Progress necessary to grow with and not in spite of my medical conditions.

 In November I had the chance to meet Mike Erwin in person at the JFK 50 miler and had one of the best runs of my life. After running a Western States 100 qualifier despite struggling through a series of Panic Attacks at the outset of the race I began to have the courage to be public with my story. I wrote my first public account of my struggles with PTSD on TRWB’s blog. Days afterward some my friends thanked me for telling my story and, even better, others who struggled with panic attacks thanked me for my frank account. All of my own struggles to find growth were now so much more tangible because they were helping other people.

That’s TRWB’s philosophy. “Other People Matter. Period.” This Organization’s philosophy was better than therapy or treatment, and the running I was doing to manage my anger was now helping others. I proudly “Wear the Eagle” every chance I can. Trust me that you will never finish an Ultra Marathon if you focus on the whole event rather than taking one step at a time. TRWB is not just about healing but being proud of yourself and continuing to show the courage you have from the day you swore an oath to the Constitution. Its not about disability its about growth and pride. I am hooked this philosophy. Also it sponsors many more activities than 50 mile runs.

I know that not everyone can run races and that only crazy people like myself will ever try to run races longer than marathons, but it is so essential that we find ways to contribute to our communities. It is essential that we still place ourselves on teams dedicated to our value system. This who we are and why we joined the military, and when we stop doing this we lose key piece of ourselves. TRWB may not be the thing for you, but it has helped me so much. I only want to emphasize how much joining a team of veterans can help, and how fitness is “much cheaper than therapy.”

Impairment Honesty Without Sacrificing Goals

By Joseph Miller


It takes a couple of years to realize that the people who you surround yourself with will never truly understand the daily and constant battles that a veteran suffering from PTSD and mTBI go through. I have simply stopped trying to communicate these problems with my peers or even my friends and family. It is not because I am ashamed, though I certainly have been ashamed in the past, but more that people do not really want to understand how hard the little things in life have become. As a student in graduate program at a research university I doubt significantly that any of my colleagues regularly meet with neuropsychologists or speech therapist to manage their calendar and appointments. I doubt that they have trouble knowing what day of the week it is or can be thrown it days of painful migraines by getting a bump on the head or by whatever stimulus throws you into another round of painful memories. They often do not understand why you put yourself through the rigors of graduate school when your subsistence is provided by other means, and would not likely put themselves through the same challenges were they in the same position. If I did not constantly remind myself that my friends who have died do not have the opportunity to come home and find a way to continue supporting their communities then I would have quit a long time ago.

As scholar my research is on PTSD during the U.S. early national period will certainly be the focus of my future contributions, but I would rather provide some stark and unapologetic honesty about my own struggles following three tours of duty in Iraq. When I began to write my Master’s Thesis I recognized how writing about violence was a triggering my PTSD and I began to do what veterans do when they are reminded of their own traumatic experiences. At first when I wrote about violence I avoided it by putting anything I could in front of it in my schedule. Once I recognized it I used alcohol to help me face it. Though this is what got my drafts finished they were terrible and by engaging in this negative behavior they became difficult emotionally. Proofreading became a challenge, and worse they required a great deal of editing because I needed to self medicate to even finish them. This process has taken about a year and a half longer than it should have because I was not prepared for what research on warfare would do to me emotionally.

But this is not a cautionary tale; rather it is actually about growth. Like many students working on a Thesis I had a few unanswered questions that did not directly relate to the project. I had been researching military officers serving the revolutionary period since I was in high school and I began to realize that they were often “invalided” by unexplainable conditions. I was studying the Battle of Detroit and one of my sources had detailed descriptions about a fever called “ague.” I had PTSD for a long time and when I went back to Iraq the third time I had TBI and pretty severe PTSD. I was sick for the first two months and at times bedridden. I felt fevered and I constantly threw up, but when seen by doctors I had no discernible illness. Like my somatic expressions of a psychological disorder I realized that all the bouts of ague came after traumatic events and could also have been expressions of PTSD.

This realization did not provide enough material to prove that there was PTSD, and I will not get into my methodology, but it does illustrate how I have learned to use the terrible experiences and difficulties I face everyday as a worthwhile perspective to analyze warfare affect on the individual. PTSD casts a strange kind of amnesia about war because it causes those most affected by it to do everything in their power to avoid reminders of traumatic experiences. So my perspective despite the pain it has caused me in the past (I certainly no longer use alcohol to get through a project) is a useful to provide a better understanding of war as a source of emotional trauma. It has led me to look to different sources and to follow the lives of soldiers after the wars were over. It has become apparent that many suffered from the same sort of odd illnesses suffered by then men in my Master’s thesis. This work will be a significant contribution to the field of history. This realization could not have occurred if I had not conducted by research at the time that I was most impaired by PTSD. It may have delayed my Thesis, but it has helped me uncover something much more important about how war has affected the lives of American veterans from the very beginning of U.S. history. For others struggling with invisible illnesses you are not the first ones, and your generation is not weaker than the preceding veterans. Your impairments are significant and challenging, but they can also become a source of strength and an incredibly valuable perspective.


Joseph Miller  in 2003 commissioned as an Infantry officer and assigned to the 82nd Airborne Division. Deployed three times to Iraq in support of national elections and as an Iraqi Army adviser during the 2007 surge. During his second rotation he was injured by an IED. His awards include the Bronze Star Medal, Combat Infantryman’s Badge, Iraqi Campaign medal with three service stars, Senior Parachutist Badge, and Ranger Tab. Recently named 2011 Army ROTC Instructor of the Year and is completing his Master’s degree in Canadian/American History at the University of Maine.

Symptoms Appear Suddenly But Control You Over Time

By Travis L. Martin

My hands shook for the first time after an ambush on one of our convoys in 2003. I figured it was the adrenaline; but it didn’t go away.

We came home to protesters outside the gates of Turley Barracks in Mannheim, Germany.

The next year, while serving in garrison, my friends made fun of me because I was always covered in sweat. Typically, I sweated the most when out in the city or in a confined area with lots of civilians. Maybe I was just fat?

We all drank. I drank my entire first deployment’s savings away. I’d wake up shaking uncontrollably and blacked out three-or-four nights a week.

I had never heard of “Post-Traumatic Stress Disorder.”

Add another deployment in 2005.

I went through withdrawals the first two weeks.

It was infinitely more luxurious with the hot chow and air-conditioned rooms. We were better at our jobs the second time around, too. But so were the bad guys.

I returned to Germany and finished up my four-year enlistment in 2006.

Sometimes, it took me an hour or more to get out of the bed. The dreams were so violent. I couldn’t imagine how a good person could dream up such horrible things. I shook everyday: in formation, before PT, when talking on the phone. Eventually, I isolated myself.

I passed barracks inspections with flying colors. My room was immaculate, the product of hours and hours of crawling around on all fours, picking lint out of the carpet, scrubbing the wall lockers with lemon-scented pledge, and meticulous spacing between the hangers on which my uniforms hung.

Maybe all those stupid rules taught in basic were invented by other soldiers with shaking hands. Maybe they were looking for some measure of control in the outside world because they couldn’t find it within themselves.

I decided to get treatment.

End, Part 1

Travis L. Martin served two tours of duty in Iraq as a sergeant in the 51st Transportation Company. He holds an MA in English from Eastern Kentucky University, where he founded The Journal of Military Experience. Currently, he teaches and is a PhD student at the University of Kentucky. His research interests include trauma, autobiography, and war memoirs from the nineteenth and twentieth centuries.

Cardiac Lab Procedure at the VA Hospital in Houston Texas

I had been having chest pains for a couple of months, which finally manifested themselves into my conscious realm of not being able to ignore them any longer. As it so happened I had chest pains while seeing my Prime Care doctor at the VA and he put me in the hospital. OK, we will find out what is going on.

Early the next morning a young woman came in pushing what I thought to be an EKG machine. It turned out to be my doctor pushing a notebook computer on a cart like contraption. I use the words young woman loosely; she did not look old enough to be out of high school. Really, no exaggeration on this point. She introduced herself as Dr. ??? and I said OK. She also informed me she would be the doctor performing my procedure in the ‘cath lab in a few minutes.’ In a few minutes; I had gone from waking up to being primed for a cardiac procedure in a few minutes. NEAT… Dr. ??? is asking me questions and typing her data into the computer as we speak. Man, this is neat… This doctor comes to my room herself to get my info. Wow… Did I mention that I was her first patient and that she was so excited that she literally ran all the way from the cath lab to my room to get her lab rat ready? She did not mention that to me at the time either.[...]

Dreams

I took a couple of elective courses during my Masters’ work and came away feeling like the courses were established for “normal” people and not Combat PTSD veterans… I know you are going; DUHHH!!!  I was hoping to find some answers other than in the numerous psychopathology courses I had taken on why my dream world is so much better than my real world.  I don’t mean the night mares, flashbacks and hallucinations; I mean real pre-combat like dreams.  The think I wanted an answer for “why aren’t I an active part of the dreams?”

A phenomena related to the dreams is that I don’t even recognize the places or people, and I am not a part of the dream.  I am aware subconsciously that I am observing things; but I am not an active part of the interactions of the characters that make up my dream world.  Is this a preview of my next life?  Is my subconscious picking up on wishes and/or subconscious parts of my pre-combat self that was good and innocent to the cruelty that man can inflict on man in the name of war?  I am even able to feel emotion in these dreams; unlike my post-combat self that many times have to manufacture emotions to satisfy the needs of others.  I am not saying this is all of my dream world, because it is not.  But it is the part that I do not want to wake up from.  This dream world is so much better than the real world that I exist in on a daily bases.  Reaching out to satisfy others needs in not part of my dream world.  The emotions I observe are not pretentious, but overtly genuine.

How many of us have wanted to reach out and give our wife, husband, or child and give them a hug; but this terrible disorder keeps us at arm’s length?  My wife tells me she understands; but this is only empathy and not true understanding.  Myself, along with many of you, I am sure feel different levels of sorrow for our loves ones.  Why could they have not loved someone else?  Why did they get stuck with us?  Someone who is capable of returning true unadulterated love and emotions from a person that has not seen the horrors of war?  Why did our children have to have someone like us as a parent?  Why could they have not been blessed with a parent who still viewed the good in things and not the negativity that accompanies Combat PTSD?  I will talk more about this at a later date; but I hope this some small manner answers a few questions for the family members of Combat PTSD veterans.

Rob

MEDS

Psychotropic medications for Combat PTSD that are prescribed for you by your doctor; DO YOUR RESEARCH BEFORE YOU START TAKING THE MEDS… 
After my crash I came in under the old VA model of fill your butt full of psychotropic meds and adjust downward.  The young warriors are under the new VA model of cognitive intervention along with medication as needed.  BUT NOT IN ALL CASES!

Do your homework on your meds. If you yourself are having too many problems to do the research, and when I mean research I am speaking of the side effects of the medications, have your wife, partner, or someone you trust Goggle or better yet if you have a psychopharmacology book look it up.  I will get into this in much greater detail in the future; but for now please don’t just stick meds down your throat because the VA says you need them.

You may wish to live with the disorder on a different level than the side effects of the meds dictate you to live your live on.  I will list all my meds that I have been on over the last ten years in a later post…  I decided pleasing my wife sexually, and dealing with the hallucinations and night terrors was preferable to the medications.  I am on a regiment of meds.  But it is a regiment that my psychiatrist at the VA and I have agreed upon and he had done his best to minimize the side effects that undesirable for me.  THINK… 
Rob

First Person: Combat PTSD

My name is Rob Honzell, Sr. and I am a Marine Combat Veteran who served in the Vietnam War. I served two tours with 1st Recon eventually assigned to the Phoenix Program. I am the author of First Person: Combat PTSD. The offering was self-published, not by necessity, but by choice. The two publishers that bid on the book wished to turn my life’s journey into a novel. I did not reveal very intimate details of my live to have it turned into something that the average combat vet and his/her family could not relate to. The most gratifying emails and comments concerning the book are, "I read your book and realize that this is my husband", "I now know why my dad acts the way he does", and "My wife is a different person since she came back from Iraq, now I know why." This is why I chronicled my life and laid it out for public scrutiny and examination, and why I gave up so much in doing so. In a later contribution if I will explain the previous statement in greater detail.

I still have family members and ex-wives not talking to me over the book. It is what it is; a detailed account of my combat experiences in a special operations unit. An account of the trauma that precipitated the onset of the anxiety disorder labeled as Combat PTSD.