Veterans' Health: Conditions and Stressors
An overview of what many veterans and their families experience after serving in war, including PTSD, traumatic brain injury, limb loss, and more.
Spinal injuries can cause visible loss of limb function and loss of bowel or bladder control or sexual function and result in dependence on caregivers.
Kim Whitmoyer, LCSW, who is coordinator of spinal cord injuries at the VA Medical Center in Atlanta, tells WebMD that rehabilitation involves the entire family. As with limb loss, emotional challenges can be the greatest.
Many paraplegic veterans today are young men between 18 and 25. They go away fit, strong, and independent, and they may come home dependent on parents or spouses.
“We have to be mindful of the fact that they have lost a whole lot of control and need a safe place to be able to express that,” Whitmoyer says.
Before paraplegic veterans come home, they may spend a year undergoing medical treatment and physical, speech, and psychological therapy. Inpatient rehabilitation culminates in apartment therapy, during which a caregiver if needed, usually a mother or spouse, joins the veteran in an apartment outfitted with the equipment and adaptations they will have back at home. The two relearn their daily routines with the veteran’s changed abilities. When the caregiver is a spouse or partner, the couple also learns how to bring intimacy back into their relationship.
Whitmoyer says life will be difficult for patients and caregivers for up to two years after returning home. They may struggle with their changed relationship. The paraplegic may resent needing help or may relinquish control altogether. Caregivers can run the risk of putting loved ones before their own physical and mental health.
Although it is important to watch for signs of substantial emotional distress in patients and caregivers, Whitmoyer says it is not the norm. “They come out on the other side and they do really, really well.”
Traumatic Brain Injury (TBI)
Capt. (ret.) Mark Brogan nearly lost a limb and became paralyzed when he was hit by a suicide bomber while on foot patrol in Iraq in April 2006.
When his wife received a call from the U.S. Military Hospital at Landstuhl in Germany, she was told she needed to come decide whether to continue life support. Brogan’s brain injury was so severe, he would likely not survive, and if he did, he would be brain dead. The shrapnel in his spine would render him quadriplegic, and he would lose his right arm. Nearly a quarter of Brogan’s skull had been removed so his brain could swell.
Sunny Brogan insisted her husband be brought home. Against all prognoses, by June Brogan was on his feet at Washington D.C.’s Walter Reed Army Medical Center and trying to play the keyboard.
With its virtually invisible symptoms, Brogan’s severe traumatic brain injury has permanently altered his and his wife’s lives. Brogan’s wife, a former loan officer with a degree in business, is now a full-time caregiver. She accompanies Brogan on about 15 doctor’s appointments per month for primary care, severe hearing loss, seizures, and physical therapy.