Living With Traumatic Brain Injury

McClatchy Newspapers

October 21, 2008, Kansas City, MO – Marshall Dial sits at the picnic table and slides packages of chocolate wafers and licorice sticks to his friend, a fellow Iraq war veteran.

“They didn’t have MoonPies,” Dial says.

His friend looks at the packages without expression. He doesn’t open them. He and Dial both have traumatic brain injuries caused by roadside bombs, and both suffer post-traumatic stress.

Two weeks earlier, Dial’s friend got drunk and began cutting himself with a razor. Police referred him to a treatment program here at the Kansas City Veterans Affairs Medical Center. Same way Dial came here last year. Walk in or we’ll carry you in, the police told him. Dial walked. Dial, 34, has short brown hair and a well-trimmed beard. He wears a white T-shirt and shorts, and he idly twirls the sunglasses he wore in Iraq. He compares traumatic brain injury with a head cold. You feel a little dopey, in a fog. But with a cold, eventually the fog lifts. With TBI, it doesn’t.

As the number of veterans with traumatic brain injuries continues to climb – up to 320,000 who served in Iraq and Afghanistan, according to the latest estimates – the federal government is realizing that they need more help.

The Department of Veterans Affairs recently announced a substantial increase in disability payments for veterans who suffer from mild forms of TBI. Those with symptoms such as dizziness, headaches, ringing in the ears and sensitivity to light had received $117 a month. Now that amount could increase to $600 a month. The VA estimated the changes will total $120 million through 2017.

More than 22,000 veterans are being compensated for TBI, including almost 6,000 who served in Iraq or Afghanistan. Many veterans may not realize they have TBI.Most of the returning vets are younger than 35, and their care could last years, says Claude Guidry, who coordinates programs for veterans of recent conflicts for the Kansas City VA hospital.

“What does long-term mean?” he said. “It could be 40 years, but we have to care for them.”

Dial joined the Army after the Sept. 11, 2001, attacks. It was almost an instinctive reaction. He decided to be a combat medic so he would have a skill after his enlistment.

He served in Iraq in 2005 and 2006. He can’t remember the date when a roadside bomb caused his brain injury. He knows it happened in summer 2005, sometime after July, but the exact date remains out of reach.

However, the details of that day remain clear. He was in the third vehicle of an Army convoy, a four-seat Humvee. Soft top, double-armored. A friend drove. Dial was listening to radio traffic when the vehicle struck a roadside bomb.

His door blew open. He recalls the driver shaking him, shouting. Dial saw his mouth moving but couldn’t hear him. His ears rang. Smoke was thick. He turned around to check the guys in the back seats. It was a miracle no one was killed or burned to a crisp. His stomach, neck and back hurt. He felt a huge adrenaline rush.

Back at Anaconda, he felt sick and vomited, unaware that was a TBI symptom.

Last year, returning from a camping trip with his wife Lori and their kids, Dial was stopped at a police checkpoint. The car’s air conditioning didn’t work, and Dial opened the door. An officer told him to close it. He did. Moments later, he opened it. The officer told him to shut it again. He did and then opened it once more. He couldn’t remember what he had just been told.

This went on – back and forth, back and forth – for minutes at a time until the officer had had enough and grabbed Dial’s arm. After an altercation that included more officers, Dial was taken to the police station.

Lori explained her husband was an Iraq war vet with post-traumatic stress disorder.

Eventually, they reached an agreement. Dial would be released providing he left the station and drove directly to the VA with no stops in between. With counseling and therapy and medication, Dial has improved. He has prescriptions for an array of medications to help with sleep, migraine headaches and anxiety. Lori sorts them for him.

Dial carries a cell phone that beeps to remind him of appointments. A car navigation system helps him when he gets lost on familiar streets. The equipment, he jokes, is only as good as the person using it.

Still, he struggles. It might take him two or three days to cut the lawn. He gets distracted and wanders off. Or he’ll change the oil in the car and not remember he changed it.

He asks Lori the same questions over and over. She calmly gives the same answer, but he knows he stresses her. She is his rock, the left side of his brain. But she has the children to watch over, too. She can’t rely on him like she once had.

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