ptsd Mild Tbi Possible

[out_here04]

For almost a year, I have been rated 100 percent schedular (temporary not permanent/total) for anxiety/depression. My "long-suffering" road to the rating began about 15 years ago on active-duty when I began complaining about bouts of lethargy, lack of concentration, confusion, muddled thinking, difficulty prioritizing, difficulty accomplishing tasks or a general lack of or stunting of what I have come to know as "executive functioning" or some similar term. I began re-reading sentences and paragraphs several times to get the meaning. Writing was and still is a chore, even though I have written well on many occasions, all the while thinking no one but me knows how much effort it takes. I ran across a term also that involves having to explain anything and everything and that seems to match up with the convoluted way I sometimes have to use to express myself. I think the term begins with "con...", too. I apologize for how hard it may make to follow this post.

Besides a self-thwarted suicide plan back when my symptoms bounced up against job performance, with subsequent tracking in the mental health pipeline, and two surgeries for chronic sinusitus and finally being diagnosed for sleep apnea, I STILL seem to have cognitive functioning issues. I have been a multiple-list-maker for years and constantly seek out planning/time management tools, trying them and giving up on them. I am a pretty good writer but doing so is like squeezing water out of turnips. My brain or forehead and scalp muscles (around my forehead, ears and down my neck)seem to tense up and there seems to be a lack of fluidity in doing this. Thinking is like pushing play-dough through one of those shape-makers instead of like water going through a garden hose. Getting anything done is like swimming upstream through molasses. I have virtually no self-motivation, self-discipline, even though I want to do so much. This resulted in me barely making it to military retirement (thank God I did) but I had begun getting into low-level administrative disciplinary actions taken against me intermittently and especially towards the end. I actually was more or less threatened into retirement even though my high year of tenure would have given me another two and a half years on active-duty. I would have continued to serve despite the effort it took. I considered challenging some bogus methods to "railroad" me but was advised not to by a military chaplain and others, plus I was too tired to fight any more. I tried civilian employment but was let go after about three months. I have not worked since which was five years ago. I fear trying again but might try some school work of some sort.

I ran across the term "mild TBI" while googling about my symptoms. My anxiety/depression is service-connected per my rating but I/docs never connected it to an event I believe could have been the root of everything to follow (and I think this was aggravated by resulting high stress levels and by separately by a subsequent PTSD stressor event that I have had validated through a buddy/commander statement with VA).

The reason I think I may have mild TBI is this: During a military exercise overseas much earlier in my career, I fell and hit my head falling out of a top-bunk rack. The floor was tile on concrete type. Laugh, I kind of do. I remember that I woke up some time later having missed or come in extremely late for my shift. It is a bit embarrassing to say this, but the symptoms seem to have originated then and there. No one in my chain noticed as I was working with a foreign national who did not speak English (he did give me some pretty intense scowls)/ I did not report this caring more at the time about staying out of trouble for being "AWOL" or "missing movement" or whatever the UCMJ could have thrown at me, or at least getting wrote up. I had been a "super troop" and supervisors at my home bases thought highly of me. After that, things began to change.

I am going to bring this up to my VAMC primary care and mental health providers at my appointments in the next week or so. I have wanted to get to the bottom of this for a very long time and feel this may be part of it.

After all that, my questions (besides any other thoughts welcomed from my explanation) are:

What types of VA or otherwise therapy/assistance are available for mild-TBI?

Any recommended websites (VA or other) would help me better understand these symptoms and how veterans or others cope with this?

I am not 100 percent certain if I would truly be diagnosed with mild-TBI but from what my gut tells me, I do.

[out_here04]

thanks again, i will continue to follow this and research those areas pointed out. makes sense about education and acceptance being a key part of recovery for tbi or similar diagnosis. i rarely get a headache but the numbness and executive functioning associated, as well as what i've called "mental fluidity" are my major concerns.

[Berta]

The VA web site as well as many many sites have info on TBIs.

Technology can rule in or out some TBIs, yet some do not show up on MRIs.

TBI is rated separately from PTSD and VA rates the residuals.

We have done shows at SVR with Dr. Van Boven, an expert on TBIs who VA fired because he reported them to the IG as to squandering TBI research money.

You certainly seem to have some symptoms of TBI but that would take a doctor to fully assess.

TBI is a disability that can affect the physical, mental and emotional status of a veteran.It is called the 'signature wound' of the Iraq War but is probably more prevalent in vets from all wars and peacetime service for many reasons.

The VA gives an extensive TBI C & P exam to determine any residuals from TBI.

[out_here04]

thanks, Berta. had my psych appt today and psychiatrist is scheduling a tbi screening appt, which may or not include another mri. i guess the screening will determine if necessary. i think it will.

at my request, i had an mri back in mid-90s and neuropsychogist, i think, reported "no significant findings", but did make note of a small white spot on the mri. he called it a UBO, unidentified brain object, and pretty much told me there was nothing he could do except operate to determine its exact nature. i think he was joking while blowing me off, sending me to follow-up with ent clinic because I was tracking with them, also, to determine why i was having concentration and memory problems.

i have a copy of the mri report somewhere, (pretty sure my VARO has the original, but i discovered yesterday i had copied the BACKS of several of my service medical record pages from that time period, may have other copies in my extras pile)but recall it mentioned something about the location of the white spot being in the virchow-robbins space. i saw mention of that in the link in another thread about white brain matter posted by hadit member "time", allan, i think.

also, my psych doc today noticed that i seem to have excellent recall for many events and details from years ago, but my short-term memory from minutes to hours to days beforehand can be ridiculously forgetful. doc said that is a trait of anxiety. i understand that, but want to rule out tbi, which has many symptoms in common with anxiety and/or depression.

i remember now that another psych evaluator also said that anxiety in and of itself can produce symptoms of mental lethargy, forgetfullness, disorganization and other executive functions, but i am going to follow this up until i get some more up-to-date answers. i have long thought a pet-scan or realtime mri or such would be valuable in chronicling how my brain works, bloodflow, etc.

[Berta]

There is some association between TBIs and Virchow Robbins:

http://www.ncbi.nlm.nih.gov/pubmed/16403696

If they have ruled out vascular disease in arteries of the brain (in your case I am sure they did rule this out with the MRI etc)it would lead one to assume that this stems from a TBI you had.

Sometimes the residuals of TBI are very hard to assess.

VA must rate TBI residuals separately from any mental disability such as anxiety,depression, or PTSD.

[timetowinarace]

thanks, Berta. had my psych appt today and psychiatrist is scheduling a tbi screening appt, which may or not include another mri. i guess the screening will determine if necessary. i think it will.

at my request, i had an mri back in mid-90s and neuropsychogist, i think, reported "no significant findings", but did make note of a small white spot on the mri. he called it a UBO, unidentified brain object, and pretty much told me there was nothing he could do except operate to determine its exact nature. i think he was joking while blowing me off, sending me to follow-up with ent clinic because I was tracking with them, also, to determine why i was having concentration and memory problems.

i have a copy of the mri report somewhere, (pretty sure my VARO has the original, but i discovered yesterday i had copied the BACKS of several of my service medical record pages from that time period, may have other copies in my extras pile)but recall it mentioned something about the location of the white spot being in the virchow-robbins space. i saw mention of that in the link in another thread about white brain matter posted by hadit member "time", allan, i think.

also, my psych doc today noticed that i seem to have excellent recall for many events and details from years ago, but my short-term memory from minutes to hours to days beforehand can be ridiculously forgetful. doc said that is a trait of anxiety. i understand that, but want to rule out tbi, which has many symptoms in common with anxiety and/or depression.

i remember now that another psych evaluator also said that anxiety in and of itself can produce symptoms of mental lethargy, forgetfullness, disorganization and other executive functions, but i am going to follow this up until i get some more up-to-date answers. i have long thought a pet-scan or realtime mri or such would be valuable in chronicling how my brain works, bloodflow, etc.

Be advised, if the screening your schedualed for is or includes the TBI Screening Reminder program, you won't get past the first question. The screening is for OEF/OIF Veterans. It's the only VA TBI screening tool I'm aware of. It's the first question of the screening, and if the answer is no-no service in OEF or OIF the screening is over. An explaination of the screening with screenshots of the actuall screening program can be found here:

http://www.avapl.org/pub/2007Conference/TB...05-29-07.ppt#10 Microsoft power point required.

Someone else from Hadit had been schedualed for this screening and was turned away. I know some have had success with it but they may have been OEF/OIF veterans.

I also encourage anyone seeking a possible MTBI diagnoses to do so through neuro-psycholgical testing. 1. Using CT and MRI is usually futile. Advanced imaging such as SPECT or PET are still in the experimental phases(in my opinion) and it is very difficult to get a referal for them as they are costly and in high demand. 2. Even in the event that imaging finds something AND that it was caused by TBI, neuro-psych testing is the only way to determine functional impairment and thus get a decent rating. Check the regs, for a rating over a certain percentage(can't remember what percentage, something like 20%) for functional impairment in memory, attention and consentration must be backed up with objective testing. Might as well start out with the testing as it is more likely to prove TBI anyway. 3. Yes, MDD, Anxiaty, PTSD and others can and do cause problems with memory and ect. However, the results of neuro-psych testing can determine the difference between functional impairment due to mood disorder and functional impairment due to TBI. An example: me. For twelve years I complained of memory problems. For twelve years I was told I was depressed-the cause of the memory problems. In that twelve years I took two or three personality assessment tests(these tests are designed to find mood disorders and other psyciatric conditions) and none of them showed any substantial depression, anxiaty or anything else. For twelve years I was treated for depresion anyway. I finally heard about neuro-psych testing and wa-la! I have substantial cognative dissorder due to TBI. And what depression and anxiaty I have developed is Organic, directly caused by the TBI. My opinon is that any psyciatrist that has a patient with MDD and/or anxiaty with a history of concussion that does not order neuro-psych testing is not worth their salt. 4. My MRI's are all clean. This was used against me. Because the MRI's were clean, no one would pursue the TBI any further.

Note: In the link posted above, during the screening there must be a relationship to symptoms complaint and objective findings on, Neuro-psychological testing, Physical examination, Neurological examination.

Edited August 15, 2009 by timetowinarace

[out_here04]

I am an OEF/OIF intheater vet. I did not suffer concussion there, just dealing with symptoms that may have originated from a concussion. confusison, I suffered way back in 1982. The symptoms of fatigue, shorterm memoyr loss and lower exective functioniing, along with early bouts of anxiety/deppression began there and continued throughout my deployment and to this momemnt.