Fort Campbell Center Represents Benchmark in Treatment

By Samantha L. Quigley
American Forces Press Service

Feb. 21, 2009 - A tour of the Traumatic Brain Injury Warrior Resiliency and Recovery Center here yesterday made a favorable impression on the chairman of the Joint Chiefs of Staff. In fact, the program is something he said should be spread across the force.

"What I saw ... at Fort Campbell was terrific, and a marked improvement from what I've seen in the past -- an understanding of the care, a much better understanding of [post-traumatic stress] than we've had in the past," Navy Adm. Mike Mullen said. "So I don't want to spend a lot of time developing 10 more of those, or 20 more of those or 30 more of those. We ought to rapidly disseminate [this model] and get to that level as fast as we can."

Army Col. Richard Thomas, commander of Fort Campbell's Blanchfield Army Community Army Hospital, agreed.

"This is the Campbell model, but we have certainly incorporated all of the Army's and the [Defense Department's] guidance," he told Mullen. "What we have uniquely applied here is very early diagnosis, very early treatment, initiating that in a multidisciplinary approach, which is very progressive.

"We're a little bit ahead of the headlights, but that's OK," he added. "Once we get everyone else on the same page with us, this is the same ... model you could have at other institutions."

Of 134 servicemembers who have completed the treatment program, 77 percent have returned to active duty.

"The key point is early identification," Dr. David Twillie, director of the Traumatic Brain Injury Warrior Resiliency and Recovery Center, said. "If you get these guys earlier and treat them earlier, they're going to do better."

He said the program begins with an assessment to determine the challenges a servicemember is facing because of post-concussive syndrome resulting from a traumatic brain injury, or TBI.

"TBI is an event. You can be fine from a TBI, or you can have lots of issues from a TBI," Twillie explained. "If you have lots of issues, that's a syndrome we call post-concussive syndrome."

Twillie said some affected servicemembers get the feeling they're "just not right." Twillie described this feeling as a loss of sense of self, and said that because it can affect the entire family, the treatment program involves family members.

Once patients' issues are clearly defined, they begin a 12-week program that, in essence, is rehab for the brain. Twillie compared it to knee surgery. Even though flexing and extending the knee is painful after surgery, it provides the best chance of regaining full mobility, he explained.

"If you stress the brain at the place it's having problems, it will rewire in order to make up for that stress and we can help these guys get better," he said. "Having people like speech therapists, occupational therapists, physical therapists ... in a multidisciplinary approach is ... very, very helpful."

Machines that help the brain relearn to balance the body, reacquire visual and spatial memory or regain verbal expression are part of the treatment program. Another piece that occurs about seven weeks into the program involves exposing patients to stresses they might encounter while serving in combat.

"If the patient is going to have some sort of psychological freeze or challenge like that, I'd like to know today, not in Iraq," Twillie said. "Another thing it does for our patients is it gives them a sense of confidence."

It can also show those who think they're ready to return that they need some more time to heal, he said.

While the program is set up to take 12 weeks, that is just the minimum. "Once you get to 12 weeks, it's not, 'Ah, sorry. You're done,'" Twillie said. "But we plan to get you better in 12 weeks."

Some, like Army Sgt. Jesse Sage, take longer to heal.

In August, Sage was serving in Iraq when he was hit by a 250-pound homemade bomb. The blast left him with a "pretty bad" closed-head injury, and a diagnosis of mild traumatic brain injury, he said.

"I ... was suffering from headaches [and] memory issues," he said. "I was really dizzy. I was passing out."

Doctors had put him on what he described as hard-core painkillers to relieve the headaches. "I was definitely just kind of out of it, just was not myself, from my head injury and, I think probably to some degree, from all the meds," Sage said.

Twillie helped wean him off the medication and started him in the TBI treatment program that has helped get him back to feeling himself after five months of treatment.

He's about a month out from returning to active duty.

"It's been very helpful," he said. "Outstanding program, and I can't say enough about it and how well it's helped me to get back to 100 percent."

His wife, Amber, agreed.

"I would definitely say ... the TBI clinic has provided so much ... not only for my husband as a soldier, but for me as a family member," she said. "[They allow] me to attend his appointments and be a part of his recovery process."

This helped her understand what he was going through and provided her tools to help him at home outside of the therapy process at the center, she added.

"We really do get the families to be involved in the care process. We think it's a really important part of it," Twillie said. "He'll only be here with me for so long. He'll be with her for a lot longer."

While at Fort Campbell, the chairman also talked with Special Operations Forces, about 20 wounded warriors, and a large group of military spouses before participating in a groundbreaking ceremony for the post's new Soldier and Family Assistance Center. The center will be the focal point of the new Warriors in Transition Complex, construction on which will begin in the future.