Sunday, January 8, 2012

Much better place now!

I think a big turning point for Dean (and us) was his going to Project Victory in Galveston, Texas. They are a residential rehabilitation program that wrap services around polytrauma soldiers/veterans (those with many injuries but including a brain injury). He was there for 9 weeks and was able to see therapists every day. He saw Occupational Therapists, Physical Therapists, Recreation Therapists, attended group and personal counseling, and had nursing care too. Being there was such a good experience that he came home a different guy again!

The OT there taught him a routine that he followed each day. It showed him that he CAN be functional day to day by learning some habits because habits form in a different part of the brain than just trying to remember.

The PT he got there was amazing! One practitioner happened to be experienced in sacro-illiac dysfunction and gave him daily adjustments and got his back in the right alignment. This took weeks to do because his muscles were used to holding his back in its wrong position. Over weeks he learned to walk without relying on his walker and went from a pain level of 8 to 10 down to a 0 to 2!!! Amazing! This gave him such hope. He had been living on 5 Hydrocodone 10's a day for 9 months and still in such pain and without having much mobility...he thought that was the rest of his life. After being correctly adjusted, he learned that he doesn't have to live with the walker, pain, and immobility forever....but with the correct treatment he could have a better life!

The RT he got there really helped him learn techniques to use when going out in public. It taught him that he has the power to speak up and tell people what he needs. He also learned to play some games that are good for his thinking and now we play them together. This is actually a bigger deal that it may sound like. In the 10 years we've been together, I love to play games and he never like playing them. Since his TBI-PTSD it is hard for us to have intimacy/emotional closeness. He is in a closed, protective shell with his feelings all the time and so getting him to open that shell and let me in requires a lot of planning and controlling the environment (which is hardly ever possible with our son around). Now that he plays games with me, it is like we found a way to bypass his shell. While we are playing games it keeps his mind focused on the game and emotions are more open and spontaneous. He has an actual "happiness" about him while we play and it is one little way that I can be close to him again. That means a LOT!

The group therapy helped a little in that he knows he's not alone. But I don't think he was as receptive to opening up in a group setting at the time (or even now for that matter), so I don't think he got as much out of it as he could have.

The personal therapy was another AMAZING experience for him. The therapist he saw there had a special sense of what Dean needed. While he was there he was able to shed a lot of childhood issues that he'd been carrying around all his life. These childhood issues had manifested as his opinion of himself. Before his deployment he managed his life with those opinions but after coming home with his injuries and life's new forecast, those opinions couldn't be there peacefully anymore. Mixing his new brain and emotions with his childhood scars made for his own internal IED. The therapist at Project Victory helped him completely remove the childhood scars! I know God had a hand in it too as He has had His hand in everything in our lives! Now Dean can smile at funny things, he has an ability to relax, he doesn't hold himself in constant judgement and ridicule which just makes for a happier person.

The nurses there helped him learn a new way to track his own medicine tracking. That was helpful in the fact that it gave him something he can be in charge of. Any task that he can be in charge of makes him feel more like a man than a dependent person.

All in all Project Victory did what they said they could do. They helped him be more independent. For 9 weeks he learned that he could make it through the day without me. That is a big deal for an adult. He is the kind of man that likes to carry those around him on his shoulders. He always prided himself as the provider and protector, the doer and fixer, the worker and the rock who was there for me and the kids. After his injuries all of these things were challenged. Project Victory helped him see that although he could not hold a paid position at a job outside the home....he was NOT useless. Now he can see that he still provides for his family by having fought for our country and now is not ashamed to have to collect VA disability pay and Social Security Disability. He can see that he can still protect us. He can still do things and fix things but those things would take a little more time, planning, and focus. He was still a worker in the sense that he had a job to do in our family to be a father and a husband. He learned that being a rock will just have to be defined differently, that although he doesn't have the brain function or emotional strength to take on my hard day, he could still put his arms around me and love me and that would give me strength. As a couple we have had to redefine a lot and reorganize how our family functions. We are still learning but have come such a LONG way!

Saturday, January 7, 2012

Lots of emotional hills to climb

During our discovery process Dean has come a LONG way emotionally. Initially he was ashamed to be "broken". He thought he wasn't a man anymore. He knew he couldn't work so now what was he supposed to do? I was mourning the future I thought we would have while trying to stay strong for him and letting him know that we will figure it all out and will be just fine. He was depressed on top of everything else.

In seeing all the things he needed me to do for him, I began to really get my new "job" down to a science. When I wasn't directly helping him, I was trying to figure out how we were going to pay our bills, networking with other wounded warrior wives, and reading about his injuries. During the months and months of VA appointments, Dean couldn't drive so I was it. He would have 10 to 20 appointments a month. All of this business began to take its toll on me. I was getting burnt out. Along with helping Dean, I was still being little Dean's mom. Add to those roles the fact that living with a PTSD-TBI veteran was NO picnic and there was lots of fighting due to misunderstandings, fighting due to him feeling dispair, lots of hurting my feelings because he was misunderstanding our whole situation. I would worry that he would kill himself because I knew he thought we'd be better off financially if he were dead and he was alone with no one to truly understand what he was going through. I had no time for me and I was getting emotionally & mentally beat down by our circumstances! I became depressed.

This is not my husband???

It took only a few days and I knew that this was not the Dean that I sent to Afghanistan a year ago. I knew that this was more than just reacclimating. The first thing I noticed was that he was forgetting what I told him 10 minutes ago, then he was repeating stories he had told me earlier that day over and over. He didn't want to leave the house. He wanted to be alone a lot. He couldn't handle the lights or sounds of our house. And as he became more and more accustomed to being back home and now wearing his civilian clothes, he settled into his new self even more. Where just a few weeks ago driving in the car was this routine we had to do to get him home for a day, now driving in the car was a very scary endeavor. I realized that when he was in uniform and in the car, he was being a soldier and "soldiering" his way around the world....tough exterior, always battle ready, no weakness! But in civies he was afraid, vulnerable, and alone. When we would drive, he would freak out that me driving 20mph was WAY too fast. He was jumping out of his skin at any random piece of garbage on the road. In his mind everything around him could be an IED and blow up. The cars that drove next to us could be an ambush. The people at the store could be following him and watching him and could take him out. Leaving the house became too much to handle.

Way back in May, during his R & R he wore civies and wasn't like this. But looking back I now had a deeper meaning to attach to his statement that "this isn't my home, my home is in Afghanistan". In May wearing his civies was just a costume he was wearing to fit in while on this "vacation" from battle. He wasn't really here....he didn't live here. Yes in May he was nauseous in the car and thought I was driving too fast but he wasn't as emotionally reactive because he was still being a soldier maintaining his strength to back to battle. Now in November was a whole different story!

As I started to realize how different he was, I started to do what I always

We began our journey with the VA in December of 2010, got super lucky to get the most awesome primary care doctor on the planet, and started to get confirmation of all the problems that had been hiding underneath his tough exterior. While at Ft Lewis he tried to tell them that his back hurt and his neck hurt, but they didn't listen. They gave the same scripted response that the papers say he's here for the elbow and so that's what they will treat him for. Nobody at Ft Lewis paid any attention to all that was going on with Dean and nobody was communicating with me at all. They told him that he's taking up a bed that a soldier with no legs could be using. They told him that he's not big Army, he's National Guard and so let them take care of you. They made him feel so worthless there which only added to him feeling depressed. Now at the VA he was being listened to and encouraged to express his feelings about things. He told them his back and neck was hurting so they sent him to get MRI's and x-rays. He said he couldn't hear things very well, they sent him for a hearing test. He said he was repeating things and forgetting things so they sent him for TBI testing. This went on and on from December of 2010 until about September of 2011.

In that time we discovered the extent of his injuries. He had sustained a broken back, likely in his first blast. He has degenerative disc disease in his back and neck, some hearing loss, TBI, severe and persistent PTSD, headaches, balance problems, tinnitus, and sacro-illiac dysfunction.

Throughout this year of discovery, I accompanied him everywhere and became his working memory and decision making helper. I became his calming safety and his rock to lean on. I became his caregiver.

His injuries have come to define our life now since every minute of our family's day and our future plans are all determined by them. Day to day I remind him to take his medications, to wake at his intended time, to eat, to shower, to put clean clothes on, and to our day's activities. I remind him of his goals and why they are important to him. I remind him of our discussions and the conclusions to them. I keep him on track. I also watch him for symptoms that visibly show but he doesn't recognize like him having a bad balance day or being dizzier than usual or him having hurt himself yesterday by overdoing it and so to take it easy today. I have to try and control the noise level in our house (with a 3 year old boy) and be mindful of lights. I can tell when he has a headache and know to ask him for verification because he won't know that he can take an Imitrex and he won't know when he can take another one. Why not just set an alarm to go off and remind him of these things? We have tried to set alarms for things and he looks at his alarm, reads what he needs to do, heads off to accomplish the task, and by the time he gets to the right room he forgets why he came in there and finds some other reason to be there. He doesn't remember that his alarm is what brought him there. Walking from one room to the next presents so many new stimuli that he is in a new time that is not connected to 2 minutes ago. For this reason, I am his caregiver.

Chapter 2

So now he was at Ft Lewis. I couldn't be there with him, so it was him against the stupidity. Since he arrived there in a private vehicle by some out of the ordinary orders, they didn't know what to do with him. They had him staying in a visitor trailer and had him reporting to doctor's appointments, but nobody really had a plan for him. All Dean could think about is getting back to his unit! He couldn't sleep, he couldn't stop thinking about the danger his unit was in and that he wasn't there to help them. He was so afraid that someone would get hurt or killed and then he would feel responsible for it. After a few weeks he found a Special Forces doctor who told Dean that if he could perform these physical tests, that he would sign Dean's papers to go back to Afghanistan. Dean completed said tests through the pain he felt. He got his wish and was sent back.

Upon arrival back in country and back to his unit, his Captain told him he had to be cleared medically before he would send him out on missions. This time they x-rayed Dean's arm and his elbow was still badly broken. His Captain flipped his lid and wondered how the hell Dean got cleared to be there???? He told Dean he was going back home! And the process to have Dean medevac'd out began.

This time Dean was flown to Landstuhl, Germany and was evaluated there. They told him he would need surgery on his arm. They gave him a TBI test and notes were made for Ft Lewis to further watch this. From Landstuhl he was flown to Ft Lewis. This time when he arrived there, they knew what to do with him. They housed him with wounded warriors and got him in their "process" of supposedely helping them. It's the end of August 2010 by this time and Dean knows that there is nothing he can do to be sent back with his unit. So he begins to realize that he's done fighting.

Depression starts to set in which comes out in anger mostly and he sleeps a lot. After a couple weeks there, he starts to earn weekend passes which means I drive up there on Friday, we drive home Friday night (3 1/2 hour drive each way) he gets to be home Saturday and on Sunday we drive back up there. During the months of September through the end of October we got to spend most weekends doing this travel routine and this entire time I hadn't really noticed anything different about Dean. During that two week R & R we spent together back in May I hadn't noticed anything different about Dean either. I mean, ya he was distant, easily angered, not really "here", and slept a lot! but I attributed all that to him trying to reacclimate back to the States??? I didn't know anything. When I asked him about Afghanistan he made sure I knew that that subject was OFF LIMITS! When we drove in the car he always felt like he was going to throw up (which was very unlike him). Again I just assumed all part of reacclimating? During these weekends together we didn't hardly talk. On the trip home Friday he complained about how horrible Ft Lewis was, how they had him running all over the place and he couldn't understand why. He was angry because he believed they were "out to get him" and trying to throw their weight around by confusing him and making him look stupid. He would tell me about their nice, clean, neatly pressed uniforms and how they didn't know shit because they've never been in country. He hated it there and he hated how they made him feel there! Saturdays were reserved for him sleeping. He said he couldn't sleep well at Ft Lewis and at least he was a little more comfortable in his own bed so he was trying to make up for lost sleep on Saturday. Sunday was spent packing up, explaining to little Dean that we had to take daddy back the the Army Base and console his poor little feelings....and we would talk about how Dean was going to hate being back up there. He began to cling to me as his salvation from that hell.

It wasn't until he returned home for good right before Halloween in 2010 that I knew there was something terribly wrong!

Dean's experience in Afghanistan

My husband Dean was deployed to Afghanistan from November 2009 to 2010. He is a combat engineer and his unit's mission was to do route clearence in Helmand Province for the Marine Corps.

On March 23, 2010 he was struck by 2 IED's within hours of each other. Both blasts knocked him unconscious for at least a few minutes (although he doesn't quite know how long). The first blast (an anti-tank mine) happened right underneath his driver's side tire of the truck he was driving. When he came to, he went to get out of the truck and fell into the hole the blast had left. He got up and started randomly picking things up....not really aware of why or what he was doing. He finally realized they were in a fire fight and he settled into his training and began to fight. After the firefight, he was told to drive in another soldier's truck. The terrain they were driving on was treacherous! He can only liken it to driving on a jackhammer with your body repeatedly slamming down onto the seat and for his unit they drove like this for 15 to 50 hours at a time....non-stop....6 to 10 days at a time with a 2 to 3 day "break" in between missions. The "breaks", however, were spent repairing equipment for the next mission.

While riding in the 2nd truck he was in such excruciating pain. He had to take his Kevlar off (which you are trained NOT to do!) and hold his own head down to his knees by putting his hands in his open mouth and holding his lower jaw. His back and especially his neck and head were pounding to the terrain. About 2 hours later, while riding in this 2nd truck, they hit another anti-tank mine. This blast tossed the guys around the inside of the truck and further cemented Dean's injuries. He doesn't remember anything after this blast for quite a few days. He knows they completed the mission and returned back to their FOB.

When Dean's unit went outside the wire, they were gone 6 to 10 days in the middle of nowhere with nothing around them. They were their own self-contained "city". They had no other soldiers to rely on for help or backup. It was their job to get the Marine's to their next location safely. They drove at 5mph or less and always had guys on foot detecting IED's as well. The whole unit was under a tremendous threat every moment of each mission...any moment could be their last.

A couple weeks later Dean was driving the 916 (like a semi truck) when he was hit by another IED. This one hit the rear passenger side, lifting the truck's rear, blowing out the rear window of the truck and jolting Dean and another soldier up and forward. Dean remembers hitting his head on things and being very shook up. He doesn't think he lost consciousness with this one...but the first two blasts had already scrambled his brain and so things after March 23rd are not remembered well.

I've heard statistics that 80% of Dean's unit was hit by IED's at one time or another and so they all suffered with the same constant complaints of headaches and backaches. The medics didn't seem to be able to tell who was affected worse than who and no one was ever medevac'd out for brain or back issues. As for Dean he says it was pounded into their heads that if they said they lost consciousness when asked by the medic about the blast, that they would be medevac'd out and that the helicopter used to transport them would not be available to a more seriously wounded soldier. Dean always reported to the medic that he didn't lose consciousness. He always kept on going through pain and confusion.

At the end of April 2010 he was at the FOB and following orders to go get something. He was running between the tents in the pitch black darkness (there are no street lights and someone had not properly marked the tent wire so that it could be seen at night. He tripped over this tent wire and stuck his arms out to catch his fall. His body came down mostly on his left arm and as he hit the ground he heard a loud *snap*. He was in instant, excrutiating pain! He went to a medic to have it looked at and was told it was probably a sprain. It continued to swell and turn black and blue over the next days and he saw another medic who said the same thing???? He was sent out on missions and was totally fine with that (going on missions was what he signed up for and what he loved to do!). As his R & R date approached the medics cleared him to come home for his 2 week visit. When he got here, I took one look at his arm and knew this wasn't a sprain!!! Not knowing how military procedures worked (we were new to this life) I took him to Kaiser ER the next morning. Their x-rays confirmed that he had a bad break in his elbow and a "non-union". News of this injury traveled through the units' wives and made it to his Lt. Col. who was here in Oregon. He told us we had to get Dean up to the nearest military base (Fort Lewis in Washington) ASAP. He said someone would contact us to let us know what to do.

From there we followed the instructions we were given. I took him up to Ft. Lewis and that's where chapter 2 begins - lol. What a joke of an experience he had there....