S2: Episode 2 - Concussion/TBI in the Veteran Community
S2: Episode 2 - Concussion/TBi in the veteran community
In this episode of The Sharing Experiences With Concussions/TBI podcast, Simon Kardynal welcomes May Machoun, Ryan Carey, and Blair Hennessy to talk about brain injuries and head trauma in the military and veteran community.
Episode Sponsor: Ontario Brain Institute
How to listen
Episode Timeline/Highlights
[05:40] Introducing our participants and the topic of today’s episode.
[10:05] In your experience, what is the culture around concussions in the veteran community?
Blair: It’s a challenge to try to show up to work and show someone that you’re injured without looking like you’re injured. People anticipate that you can work the same way you worked before, but you’re not able to do that. The medical/physical therapy system is difficult to navigate, too.
May: I always thought the military had the best medical care, but ironically, concussion was a small blurb in the neurotrauma education for military PAs. There is a stigma around concussions and the problem is the military is not following current research on diagnosing and treating head injury and concussions. It’s so much easier for them to understand and treat a PTSD diagnosis. It was a struggle to convince medical personnel that you’re not faking it. The system needs to change.
Ryan: My experience with head injury in the military is that it’s overlooked. You just keep going (after an injury). I didn’t tell anyone. And oftentimes, we don’t even know if we have a head injury because we’re just trying to survive. In training, there’s this peer pressure, which is good, but it’s not good when someone is not identifying with your injuries. There’s also a lot of patient-blaming, even when your condition is getting worse because of the lack of treatment. Medical professionals should be asking us about head injuries and especially their effects on mental health.
[22:00] How can we eliminate the stigmas around brain injury and concussion in the military community?
Blair: As a physical therapy student, everything is based on evidence-based approaches, yet the resources we’re learning about neuro-rehab are from 2008. There’s much more recent, accurate information that can be utilized. It’s also about looking out for your buddies. It’s so simple. Your job is to look out for your buddy and if they’re not able to do their job like they could yesterday, you need to start thinking of the tomorrows and ask them what’s going on. I went from calm and collected to having lash outs if you looked at me the wrong way. Luckily, my sergeant noticed, pulled me aside, and got me on the path to being medically released.
[24:50] Were there any positive aspects of the concussion protocols?
May: For me, it was getting involved with Headsup and becoming an advocate. I could have just paid for my glasses and vision therapy, but the reason I’m doing this work is to help the leadership wake up and realize there is a serious problem when it comes to concussion and concussion treatment. We don’t need to create another command or transition unit for releasing members, yet at the same time, that same unit has no clue about brain injury or what survivors need to move forward.
Blair: Becoming an advocate and being able to share not only my experience but other peoples’ experiences. This whole experience lit a fire under my ass to do what I’m doing in school right now, to be a physical therapist that can actually treat concussion, differentiate it from someone experiencing PTSD or a neck injury, or refer people to the proper health professionals.
Ryan: It’s important that there’s more education around concussion. The microtraumas add up. When you see young football players start hitting at 9 years old and they commit suicide at 20 and you look at their brains and they’re full of CTE… that’s saying something. If you don’t understand that, then how are you supposed to identify that in a soldier? If the right information is given to the soldiers, they’re going to implement it. But if that information isn’t coming from the top down, change isn’t going to happen. A positive aspect from this is that anyone presenting with a mental health challenge can do a diagnostic to see where their brain health is at. Living a healthy lifestyle and learning new things has been helping me. When we come together and share our stories, we can make change.
[34:20] What can the veteran/military system do to educate people about concussion/TBI?
May: Back in 2009, Health Services introduced The Road to Mental Readiness (adopted from the US) for PTSD, mental health, etc. The US began population screening for brain injury, suicide, etc., and created a detailed guide for treatment and post-care for concussion/TBI. Education is there, but the policy and directions from the CDS need to direct to Health Services leadership, which filters down into the rest of the medical system and the soldiers. Again, we need a top down approach.
Blair: PT professionals offer a lot of educational insight and resources for those navigating TBI, but I would also love to see brain injury education implemented in sports as well.
[41:05] Sometimes it’s easier to avoid the root cause of a problem… Are there blinders on the medical system to avoid having to deal with concussions?
Ryan: I don’t know. But, through our support line with veterans who are transitioning out, it’s still not being addressed. Over-prescription of pharmaceutical drugs is rampant, doctors just keep adding medications. If the system is not willing to accept it, veterans can’t even advocate for themselves to get the help they truly need. It’s unfortunate that it’s taken this long to make positive top down change, but I’m optimistic more change will happen this year.
May: It must be top down because the entire military system is based on what directions, including healthcare provided to soldiers, are dictated by the mission and policies from the CDS to the Surgeon General.
[47:30] When you experienced your brain injuries, did you experience doubt that you were actually hurt?
Ryan: I never identified with it. I remember getting almost knocked out, then my sergeant major told me I was done for the day but that was it. I didn’t think anything of it or mention it until after I was released. It’s hard to self-identify when you have a brain injury.
Blair: Even after I was released, I spent a lot of time thinking I was making things up. I had headaches and I just thought I was dehydrated. Then, at work I realized I was doing things backwards and something was wrong. I never believed it was a severe thing, but there are all these small signs that no one ever knows to notice… and they catch up with you. Before, I often felt weak, but now not so much because I know it was all real.
May: I knew my symptoms didn’t make any sense and before I recognized it was a concussion, it was a military physiotherapist that had extra training in concussion that diagnosed me. That was the only way I knew. Then, I could start seeking help. Before then, it was a struggle to even get approval to get these services. Without policy change and improving medical education, a lot of these stories are going to continue happening.
[59:10] Conclusion:
These are learned behaviors. Leaders teach their subordinates that these behaviors are signs of weakness and instead of leading with empathy, they lead with what they know which is not always what’s best. A shift in policy is needed. We need a non-judgmental, case by case process for dealing with head injuries in the military. We need thorough education on TBI and a holistic approach to treating TBI. We only have one brain, one spinal cord, so you have to look out for yourself, advocate for yourself, and look out for your fellow veterans.
The Canadian Forces are leaders in bringing attention to PTSD, mental health, and OSI, so the potential for greater impact is still there. Let’s be leaders for the CF!
Project Enlist has a support line! If you or a loved one is struggling with mental health related to head injury, reach out for support at https://concussionfoundation.org/programs/project-enlist.
Never EVER give up hope.
Resources Mentioned
Operation Brain Health: https://concussionfoundation.org/programs/project-enlist/operation-brain-health
Connect with us!
Visit The Headsup Concussion Advocacy Network’s website: www.headsupcan.ca
Follow Headsup on Instagram: www.instagram.com/headsupcan
Follow them on Twitter: www.twitter.com/headsupcan_
Visit The Ontario Brain Injury Association’s website: www.obia.ca
Follow Ontario Brain Injury Association on Instagram: www.instagram.com/ontariobia
Follow them on Twitter: www.twitter.com/OntarioBIA
Podcast Facilitator
Simon Kardynal - Veteran/Trench Leadership Podcast/Project Enlist Ambassador
Simon Kardynal is a Canadian who currently lives in Ottawa, Ontario. He was a member of the Canadian Armed Forces for a little over 26 years, starting as an infantryman, then becoming an aircraft structures technician (think autobody for airplanes), and eventually becoming an institutional leader when he was promoted into the trade of aircraft maintenance superintendent.
Simon has completed many formal leadership military training courses, and in 2021, he completed a Master of Arts in Leadership degree from Royal Roads University where he found his desire to help emerging leaders create strong foundations as they embarked on their leadership journeys.
Simon retired from the Canadian Armed Forces so that he could follow his passions for being a private pilot, riding his motorcycle, running, and being the host of his leadership-themed podcast, Trench Leadership: A Podcast From the Front.
Participants
May Machoun
Veteran, HeadsupCAN Volunteer
Ryan Carey
Veteran, Concussion Legacy Foundation Canada - Project Enlist, Military/Veteran Liaison
Blair Hennessy
Veteran, Student at University of Western Ontario
THANK YOU TO OUR EPISODE SPONSOR!
Ontario Brain Institute
This episode is sponsored by The Ontario Brain Institute. Learn more about them at https://braininstitute.ca!
Learn More about Project Enlist Canada
Project Enlist Canada
Project Enlist seeks to end the concussion crisis among veterans and serving Canadian Armed Forces members.
Research into the physical impacts of military service upon the brain will allow us to understand the links between head impacts and traumatic brain injury (TBI), chronic traumatic encephalopathy (CTE), and Post-Traumatic Stress Disorder (PTSD). That understanding will lead to better awareness, triage, reporting, diagnosis and treatment of brain injuries as they occur.
Project Enlist also supports veterans experiencing complications from head injury through outreach focussed on awareness and assistance in locating treatment providers who recognize the significance of concussive exposure and its impacts upon wellbeing.
The Sharing Experiences With Concussions/TBI podcast is made possible by The Headsup Concussion Advocacy Network whose mission is to build collaborative networks and partnerships that work to innovate concussion education, research and awareness. The podcast is also made possible by The Ontario Brain Injury Association whose mission is to enhance the lives of Ontarians living with the effects of acquired brain injury through education, awareness and support. Thank you!