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NEWS | April 5, 2016

Concussions bring NFL and military together at last

By Senior Airman Bobbie Reynolds Colorado National Guard

BUCKLEY AFB, Colo. -- "We were in the air about 100 to 150 feet, just hovering (on the cable)," said Army Staff Sergeant Kathleen A. Lewis. "The wind below started spinning us in the wrong direction and the flight medic was trying to get us reoriented. Right as I reached the bottom of the helicopter, we got caught in the wind and we flipped in the hoist. The pulley system was still pulling us up and I ended up underneath the body of the helicopter. I slammed my head into the bottom of the aircraft.

    "I never understood why people would say they got the taste knocked out of their mouth, but that's exactly what happened. I felt the jolt, and the taste in my mouth changed to bile. It was very strange.

"Thank god I was wearing my Kevlar helmet," said Lewis, a health care specialist and traumatic brain injury trainer, assigned to the 928th Area Medical Support Company, Colorado Army National Guard. "The Kevlar dispersed the shock throughout my entire skull, so not one part of my head got hurt significantly.

"I did everything right. I did exactly what I was told to do. My instructors were vigilant; the aircrew was vigilant; everybody was exactly the way they should be."

She believed there was nothing else that could have been done to prevent her head from smacking into the aircraft.

"It was just one of those freak things that happened," said Lewis.

    After the initial incident, she didn't think much more about it.

It is possible, after a jolt to the head that causes the brain to slam against the skull, that taste sensations can change. It is possible for someone to get knocked out, and it is also possible that others just go about their business, not recognizing symptoms of a traumatic brain injury until long after it's taken place - if ever.

  "I was airlifted the rest of the way," said Lewis. "I got into the aircraft, no issue. We landed, I followed commands from the flight chief and was able to get up and evacuate just fine. Three hours later, I threw up."

"When I got back to work, I was sitting in front of the computer and the world was vibrating. It was shaking back and forth and I kept getting headaches. (I thought) I must be sick," said Lewis.

"I finally went to go see my doctor. He told me I had concussive syndrome," said Lewis.

He explained that concussive syndrome is the residual effect of having a mild concussion, and recovery time can last a couple of days to a few weeks.

"I took an additional day off work, to sleep it off. I stayed away from the computer, I stayed off my phone as much as I could and I stayed in dark rooms. I think I healed a little bit faster. It took me about three weeks to get over the symptoms," said Lewis.

It's absolutely necessary for service members to recognize, report and treat TBIs, otherwise known as concussions, appropriately, so they can recover quickly without any long-term physical or mental effects.

Lewis said one problem that continues to be a huge battle is service members who experience head trauma, yet don't recognize the symptoms of a concussion. They walk, run and participate in daily activities like they normally would. What they don't understand is, although they can't see the injury, it's there.

"The hardest thing about concussions is there's no blood, there's no stitches, there's no scar," said Lewis.

Lewis, together with Air Force Capt. Benjamin N. Garland, a public affairs officer for the 140th Wing of the Colorado Air National Guard and an offensive lineman for the Atlanta Falcons, collaborated to design a training that focused on educating service members about TBIs with an added NFL perspective.

According to Defense and Veterans Brain injury center, TBI's can be a result of military training or leisure activities that have no military tie but are a result of a hard blow to the head, such as football.

Together, SSG. Lewis and Captain Benjamin N. Garland, Public Affairs Officer, assigned to 140th Wing PA, Colorado Air National Guard and offensive lineman for the Atlanta Falcons, collaborate in a joint effort to create a training for service members peak interest and help motivate them to recognize TBI.
Lewis said she asked Garland to help her teach a TBI class because she thought he would have a knowledge base that her troops would respect. The word "concussion" has become a buzzword of sorts and it was important to bring in a military leader, who could offer two different perspectives - the NFL perspective and the military one.

"We're only in uniform two days a month," said Lewis. "This information doesn't matter outside of here. In football, on the other hand, it matters all the time."

Lewis thought bringing in a guest speaker most service members could relate to would help motivate them to take head injuries more seriously.

"I wanted my guys to listen," she said.

Symptoms of concussions vary from person to person, Garland said.

"Concussion symptoms include headaches, memory problems, nausea, vomiting and irritability, which is a huge one," said Lewis. "For whatever reason people just get mad. Ringing in the ears, dizziness, balance problems, visual disturbances and tingling in the fingers can all be symptoms as well."

For the NFL, confusion and loss of balance are big signs that a concussion could be present.

"We have had guys come up the sidelines that just don't know where they are, they're irritable or they're confused," said Garland. "A lot of time when people suffer from a concussion, they'll talk to you, they'll respond to you and they will have no idea what they said later when you ask them about it."

Once an injury has been self-identified, it needs to be reported.

BrainLineMilitary.org, an organization that provides military-specific information and resources on TBI to all branches of military, veterans and their families, said official figures show that more than 266,810 Soldiers from the Iraq and Afghanistan wars have suffered mild traumatic brain injury since 2002 - though the numbers could be significantly higher since many concussions go unreported.

    Military members and athletes may avoid reporting TBI symptoms for fear of losing their job status or being looked at as weak.

"If you don't have a solidified position as a 'star' player (in the NFL), it is a solid opportunity to lose your job," said Garland. "It's really easy for someone to replace you and you don't get your job back because the other person performed well."

For the military, members reporting injuries can feel like they're letting their unit down or they aren't worthy of service.

"They worry that if they're out for injuries, they're letting down the team and letting down the people they work with," said Garland. "If they're down, someone else is going to have to pick up the slack. People in the military care about other people. It's tough for them to put themselves ahead of everyone else, when in reality, they need to. It's for their safety and the betterment of their unit."

"The issue with the National Guard is if they get a concussion while not on military orders, they don't necessarily tell us," said Lewis. "They don't think about it. They figure 'This didn't happen on orders, why should I tell you?' But I need to know because it affects the mission. It affects our readiness, it affects a whole lot of things." 

Regardless of the circumstance surrounding a person faced with a possible TBI, it's absolutely imperative that a head injury of any magnitude be reported and treated immediately to avoid long-term problems.

"According to big Army, there is a chemical change," said Lewis. "There are highways in your brain and information travels through those highways. If someone gets a TBI, that highway goes under construction. It reroutes the information in a different way. If that construction (rest, sleep) doesn't take place immediately, those roadways start to erode. There's no amount of reconstruction that can fix that and then you have to adapt around it."

The American Academy for the Certification of Brain Injury Specialists states that after one traumatic brain injury, the risk for a second injury is three times greater. After the second injury, the risk for a third injury is eight times greater.

"If you get a concussion, you're supposed to be off mission for 24 hours," said Lewis. "They call it concussive protocol. It's very similar to the National Football League."

Lewis said military members will be evaluated with a tool called the Military Acute Concussion Evaluation, known as the MACE card. This helps determine whether or not a service member has a concussion and, depending on the amount of head injuries received within a given amount of time, will determine how much rest is needed for full recovery and return to mission status.

Quick detection of TBIs and immediately seeking medical evaluation can make all the difference in the length of recovery and the permanence of the injury.

"If it's detected and it's treated, you can recover from a TBI without having prolonged issues," said Lewis.

Lewis said senior leaders need to take the reins for concussion protocol and direct junior enlisted to change the military environment they work in. They need to make sure the next group of service members work in a military environment in which mental health, head trauma and medical issues are taken very seriously.

"If the top down lead by example, people don't have to question whether or not they should report a head injury," said Lewis. "It's always going to be yes, you should."

Learning to recognize TBI symptoms, proper reporting procedures and getting immediate treatment may not stop TBIs from happening, but it will ensure service members are ready when called to duty.
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