JBER Public Affairs
8/7/2014 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- Sgt. 1st Class James Spoo, an explosive ordnance disposal technician assigned to the 716th Explosive Ordnance Disposal Detachment, 17th Combat Support Sustainment Battalion, at Joint Base Elmendorf-Richardson, deployed to Afghanistan three times in his career. As part of his job, Spoo had already been on more than 20 temporary duty assignments ranging from days to months, and was used to the routine.
"You get used to them being gone all the time," said Michelle, Spoo's wife and a native of Bend, Oregon. "I supported him, helped him get done what needed to get done. I had to get him to realize he had injuries. I think that's the hardest thing with these guys. [They have the mindset] 'there's nothing wrong with me,' especially EOD."
James Spoo, a native of Gerlach, Nevada, had been interested in joining the military for years when the infamous terrorist attacks happened on Sept. 11, 2001. By the end of November that year, at 30 years of age, he'd joined the Army to become an EOD technician.
"He was the first one in his family to go military," his wife said. "Being a military brat, I knew what I was getting into."
Mannheim, Germany, was Spoo's first duty station. Surrounded by the Benjamin Franklin Village community, Sullivan and Turley Barracks and other Army posts, Spoo gained experience in his trade. His second and final duty station was JBER in 2006.
Spoo went on three deployments to Afghanistan in between his numerous shorter temporary duty assignments. His first lasted six months, the second a year.
"I think his third deployment made him realize there was something wrong with him," Michelle said. "He had suffered another concussion while he was over there, and so I think he realized that he wasn't going to get better on his own, that there was something wrong with him."
Improvised explosive devices gave Spoo concussions and left his body and brain needing to heal. Tripping over a tree root on a night patrol and landing across a ditch with more than 125 pounds of gear and nothing to support his core, he hyperextended his back, adding to his injuries. The fall gave Spoo a need to overcome constant pain. Unable to complete his tour, he was medically evacuated and returned home to Michelle, who eventually convinced him to seek help for his traumatic brain injuries as well as his back and various other problems that added up to life-altering pain.
Spoo was seeking help for the pain and other injuries after his second deployment when he was tasked to return to Afghanistan for the third, and ultimately final, time. He wasn't in the best physical condition to make the trip and carry his gear, but his command was asking, and he wasn't about to let them down. He never let anyone down, his wife said.
Spoo was unable to complete his tour for medical reasons and, after four months, returned home early.
"The injury that ended his career happened on his third deployment, a back injury," said Public Health Service Capt. Kelton Oliver, MD, TBI physician. "The problem is these things kind of get rolled into one another."
The TBI clinic frequently sees patients who might get a concussive injury and "they do pretty well because they've got good coping skills," Oliver said. "It doesn't mean they're not having some limitations."
When something happens that requires emotional energy, and the patient's brain and body are focused on compensating for an injury that causes constant or consistent pain, the patient will begin to lose coping skills, he said.
"That's one of things that Jim had to struggle with," the native of Washington, Okla., said. "He had a pretty bad one at the second deployment. The one that he got on the third deployment was nothing to sneeze at, but he probably would have shook those off reasonably well over time, but he had a pretty severe back injury and they kind of all tend to roll up together. The things that are required for you to recover from a concussive injury will be co-opted by the other stuff that you're struggling with. That's very common. That's more the pattern than not with our patient population."
Chronic symptoms of post-traumatic stress disorder include flashbacks, avoidance, hypervigilance, nightmares, and re-experiencing phenomenon. Symptoms of TBI include headache, sensitivity to light or noise, nausea or vomiting, vision problems and dizziness. Symptoms shared by PTSD and TBI include cognitive deficits, irritability, insomnia, depression, fatigue and anxiety. Members who have or are experiencing these should see their primary care manager.
Acute symptoms of a concussion may include headaches and/or vomiting, ears ringing, amnesia or altered/loss of consciousness, double vision and/or dizziness, or something feeling "wrong".
Spoo had a lot of problems with memory, Michelle said.
"Then he'd get really frustrated with himself," she said. "He didn't have the patience he used to have; it was really hard for him to deal with people and kids. It increased with the third [deployment], in addition to being in pain all the time and there'd be nothing he could do for it except see Doctor Oliver."
The physician got to practice a new skill while treating Spoo.
"I started with ear acupuncture because, at that time, that's all I had learned," Oliver said. "I was still in my course. As I learned more, I was doing energy movement down the spine, and then I was doing 'seven dragons' for anxiety and stress. I pretty much used everything in my bag of tricks. It helped - he was getting better.
"At the same time, we were doing stuff to help him work on memory issues. We have a program to help strengthen their memory or to help them work around the areas where they have problems. He was very motivated to get well - really, he was an ideal patient."
Coping tips for a mild traumatic brain injury include writing things down, storing important items like keys in a designated place to keep from losing them, pacing and taking breaks as needed, focusing on one thing at a time, and allowing time for your brain to heal - the most important thing. It is also advised to avoid smoking or drinking, sit out of contact sports, get 7-8 hours of sleep a night, take medications as instructed, avoid overexerting oneself physically or mentally, and staying engaged with the family and medical provider.
Spoo got to know the pain clinic, the mental health clinic and the TBI clinic as though he were part of the family. He was their success story; living proof that someone could recover enough to learn to live well or productively again after a traumatic brain injury.
"Part of who Jim was is that he always did things to help other people," Oliver said. "He wasn't going to give that up just because he'd been injured - he was going to find another way. He prided himself on teaching the younger Soldiers and helping them to navigate their careers. It was his idea of who he was, and a big part of that was what he did for and taught other people. That's one of the things that was so endearing, that's the reason we liked him so much - you can't really not like somebody who is all about helping people."
Patty Raymond Turner, Regional Education Coordinator for the Defense and Veterans Brain Injury Center, leads a class called 'Warriors and Concussion: Everything You Need to Know.' The class offers aids such as education, peer support and coping mechanisms. She introduced Spoo to the class, and he became a valued part of it, she said.
"These are service members who either have been recently diagnosed with having had a concussion [mild TBI], or perhaps a moderate traumatic brain injury, or they're having persistent symptoms sometimes after years after the injury or injuries," she said. "Jim came in and addressed the class to give them hope, and to let them know that it is possible to recover most or all of what you had in terms of how your brain works. He was a living example and an inspiration to my other students."
Spoo was recovering through the combined successful efforts of the pain clinic, the mental health clinic and the TBI clinic. He died of an unrelated ailment. He was out walking his dog, Diesel, when he suffered a pulmonary embolism, which resulted in a heart attack, Raymond Turner said.
James Spoo lived from June 4, 1971 to May 15, 2014.
"Rest in peace, Jimmy; your friends and family will always remember you," Michelle said.
For more information on concussion, or mild traumatic brain injury, please visit http://dvbic.dcoe.mil
If you suspect you have had a concussion and are having symptoms, see your Primary Care Manager.
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