Research Links PTSD to Blasts in Comba

 

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Posted in New York Times, June 10, Pg. A19 | Alan Schwarz

 

They are among war’s invisible wounds: the emotional and cognitive problems that many troops experience years after combat explosions sent huge shock waves through their brains. Whereas the link between concussions and post-traumatic stress disorder has become clearer in recent years, a specific connection between PTSD and blast waves has remained elusive.

 

Now, a prominent neuropathologist who researches brain injuries among military personnel says his team has identified evidence of tissue damage caused by blasts alone, not by concussions or other injuries. The team’s study was published on Thursday in The Lancet Neurology.

 

The discovery could eventually lead to better treatments and to improved head and body protection for troops exposed to high-energy blasts, some experts said. Other researchers advised that these initial findings should be bolstered by more studies before veterans and their families read too much into them.

 

”We talk about PTSD being a psychiatric problem — how people responded to the horror of warfare,” said Dr. Daniel P. Perl, the neuropathologist who led the study. ”But at least in some cases, no — their brain has been damaged.”

 

”The real black box is to figure out who has this,” added Dr. Perl, who works at the Uniformed Services University of the Health Sciences in Bethesda, Md., the medical school run by the Department of Defense.

 

Even the tentative results provided some solace to Jennifer Collins, who was married to one of the five male military veterans whose damaged brains were examined in the study. Her husband, David, served 17 years in the Navy SEALs, enduring countless explosions in Iraq and Afghanistan. He retired in 2012, and steadily developed significant depression, sleeplessness and memory loss. He killed himself in March 2014.

 

”This is proof that this man died in combat,” Ms. Collins said in a telephone interview, sobbing and struggling to find words. ”It took several years to kill him, but he died in combat. This finding is further validation about what I know about my husband.”

 

It is unclear how many of the 2.5 million United States service members deployed to Iraq and Afghanistan were exposed to blasts. A 2008 report by the RAND Corporation suggested that the number could be about 500,000. But some estimates suggest the problem could be greater: For example, a 2014 study of 34 living veterans from those conflicts found that a majority had experienced at least five blasts.

 

Explosions from roadside bombs, grenades and other devices produce a wide spectrum of injuries. Beyond the shrapnel and other objects that impale the head and body, the hurricane-force wind can blow troops off their feet, causing fatal head injuries and concussions on impact.

 

Less understood is how the blast wave — the pulse of compressed air that shoots in all directions faster than the speed of sound and arrives before the wind — affects brain tissue after crashing through the helmet and skull. Blasts are also believed to compress the sternum and send shock waves through the body’s blood vessels and up into the brain.

 

[Video: VBIED Attack Watch on YouTube.]

 

The researchers examined the brains of the five veterans who had been exposed to blasts, and compared samples with those of 16 other veterans and civilians with and without brain injuries from military service or other activities. Scar tissue in specific locations of the cerebral cortex, which regulates emotional and cognitive functioning, was found only in the blast-injury cases.

 

All five of those men also suffered from the symptoms of PTSD, which, given the location of the scarring, suggests that a physical combat injury could have led to or exacerbated their psychological troubles, Dr. Perl said. Any such connection, now only speculative and needing further research, could lead to a better understanding of a link between combat and PTSD, said Dr. Ibolja Cernak, the chairwoman of military rehabilitation research at the University of Alberta.

 

Dr. Cernak likened the blast-injury study published in The Lancet Neurology to the first reports of chronic traumatic encephalopathy among professional football players, whose disease was linked to repetitive on-field brain trauma and helped explain some of their cognitive and emotional problems decades later. As with C.T.E., the damage connected to blasts does not appear on any magnetic resonance imaging test or brain scan and can be located only after death.

 

”This could be for the military population what C.T.E. was for football players — enormous,” Dr. Cernak said of the research.

 

Beyond treatment options, the findings raise the possibility that better head protection for active soldiers could ameliorate a blast wave’s damage. Dr. Ralph G. DePalma, a special operations officer in the office of research and development at the Department of Veterans Affairs, called that prospect ”probably the most important aspect of this paper.”

 

”Looking at the mechanism of how the injury occurs and possible interventions immediately, that’s something that the Department of Defense is very interested in,” Dr. DePalma said. ”We know that certain blast exposures, the angles at which the blast encounters the face and helmet matters. So you can look at protection.”

 

Some experts are concerned that as significant as identifying blast-related damage in the brain can be, linking it to PTSD is premature. For example, Mr. Collins’s brain also showed signs of C.T.E., which has been found in previous autopsies of military veterans and could have contributed to his psychiatric condition. One of the other four subjects in the study had very small signs of C.T.E., but the other three showed none.

 

”We have to be very certain — it’s about not jumping the gun, not jumping to conclusions about the significance of the changes we find in the brain in terms of a person’s prognosis or their symptoms,” said Dr. Ann McKee, the chief of neuropathology at the V.A. Boston Healthcare System. She and others at Boston University have identified C.T.E. in the brains of about 100 former N.F.L. players and some military veterans.

 

”Until we really understand how those changes come about and what the changes really mean,” she added, ”we won’t understand the clinical factors that lead to disability from these diseases.”

 

Dr. DePalma added that even if no treatments could be developed for years, soldiers should not assume that they would emerge from combat with damage from blast waves. Genetics are believed to influence whether a football player will develop C.T.E., so military combat may pose different risks to different people.

 

”It’s not, ‘Oh my God, if I’m exposed to blasts I’m going to go crazy,”’ Dr. DePalma said.

FIREWORKS, RANGEGEAR & FAMILY

Independence Day! One of my favorite holidays. Last year we drove out to the lake on the golf cart, where thousands of people gather every year with, blanket, food and kids in hand. Last year though, Maiya was getting ready to turn 3. So I dug in the range bag and took along a few pairs of ear muffs. Well, everyone of course thought it was hilarious, until Maiya was really enjoying the action, and their kids, well… Not so much. I went to research the noise level a few days ago to write something about it. When I did, I ran across one of my favorite writers, Tactical Dad. He pretty much summed it up. So I thought I share his story with you, as well.

Originally posted by Guns And Tactics
JULY 1, 2014 Posted by DOUG MARCOUX in BLOG, TACTICAL PARENT

WITH INDEPENDENCE DAY APPROACHING IT’S TIME TO STOCK UP ON BURGERS, HOT DOGS AND FIREWORKS. IN THIS ARTICLE, DOUG SHARES HIS RECOMMENDATION TO KEEP KIDS SAFE WHILE DETONATING YOUR CELEBRATORY MUNITIONS.

Independence Day is one of my favorite holidays. I love the sense of patriotism and community it brings as friends, family and neighbors come together to observe the day. Like any red-blooded American, I also love to celebrate by blowing things up once the sun sets.

A few years ago, as we were beginning our annual fireworks display, my young son started fussing and made it clear that he was not interested in sticking around for the show. I realized that it was the noise from the explosions that was making him uncomfortable. I went inside to grab my range bag and pulled out a set of range muffs to put over his ears. Almost immediately he stopped being upset and everyone was able to enjoy the fireworks.

The next day I did some research and learned that the explosions from the fireworks are just as loud or even louder than the rounds we fire at the range, often exceeding 150 decibels (db) and even reaching up as far as around 200 db. The limit for sound exposure where immediate nerve damage can occur is only 140 db for adults and 120 db for children, so there is a pretty good case for everyone to consider wearing ear protection during your 4th of July fireworks display… including you! There are several youth-sized ear muffs available. My kids like the pink and blue Peltor Junior muffs made by 3M.

This year, thinking about it from the perspective of range safety, I considered the need for eye protection as well. Simply put, a firearm is far less likely to send something flying into your eye than fireworks – which explode in all directions and have questionable quality-control at best. Thus, since we wear eye protection at the range, it only makes sense to do the same while setting off fireworks as well. As I wrote in another Tactical Parent article, Tiny Ears & Eyes, I have found the SoundVision eye protection to work particularly well for children in terms of both coverage and comfort.

So this year dig out your extra range gear and make sure everyone has appropriate eye and ear protection. Even if your kids aren’t yet old enough to join you at the gun range they will still benefit from having their own gear and, I have to admit, it’s cute to see them wearing it. Adding these key pieces of safety equipment not only allows you to model good habits for your kids but it also dramatically reduces the likelihood of an injury. It will also, hopefully, ensure that even the littlest ones enjoy the show along with everyone else.

Doug Marcoux

Doug has a diverse background, both professionally and privately, in firearms, self-defense, and tactics… but most importantly, he’s a parent. He writes from the unique perspective of someone whose life involves combining concealment clothing, tactics training, and “everyday carry gear,” with car seats, exploding diapers, and questions like “why did you paint the dog with yogurt?” In our Tactical Parent series, Doug shares his perspective on gear, tricks and tips, defensive tactics, and best practices for parents who take an active role in protecting their family.

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58 November Down 03/13 by Christianswann | Blog Talk Radio

 

Wow, what an incredible story. 

Hear it live now, as Andy Andrew Downs and I discuss the story, along with never heard before audio

Between the pilot, FAA, and the FBI in the final moments that changed history. 

And, pardon the mike problem during the first few seconds. 🙂

58 November Down 03/13 by Christianswann | Blog Talk Radio

To hear more about the documentary of 58 November and see the trailer and news clips, visit:

http://www.58November.com

 

58 November Down 03/13 by Christianswann | Blog Talk Radio.