HomeNewsArticle Display

National Intrepid Center zeroes in on traumatic brain injury

The National Intrepid Center of Excellence, a directorate of Walter Reed National Military Medical Center in Bethesda, Md., helps service members and their families manage traumatic brain injuries and accompanying psychological health conditions through diagnostic evaluation, treatment planning, outpatient clinical care and TBI research.

The National Intrepid Center of Excellence, a directorate of the Walter Reed National Military Medical Center in Bethesda, Md., helps active duty, reserve, and National Guard members and their families manage their traumatic brain injuries and accompanying psychological health conditions through diagnostic evaluation, treatment planning, outpatient clinical care, and TBI research. DoD photo

The National Intrepid Center of Excellence, a directorate of the Walter Reed National Military Medical Center in Bethesda, Md., helps active duty, reserve, and National Guard members and their families manage their traumatic brain injuries and accompanying psychological health conditions through diagnostic evaluation, treatment planning, outpatient clinical care, and TBI research. DoD photo

WASHINGTON (AFNS) -- Defense Medical Surveillance System and Theater Medical Data figures show that more than 339,000 service members have been diagnosed with traumatic brain injury since 2000.

Traumatic brain injuries are a contributing factor to a third of all injury-related deaths in the U.S., the numbers reveal.

Further, an estimated 1.7 million people suffer a TBI annually across the nation. Of them, 52,000 die, 275,000 are hospitalized and over 1.3 million -- nearly 80 percent -- are treated and released from an emergency department.

For service members on their roads to recovery, the National Intrepid Center of Excellence in Bethesda, Maryland, stands ready to help.

NICoE’s mission

NICoE, a directorate of Walter Reed National Military Medical Center, helps active-duty, Reserve, and National Guard members and their families manage their TBIs and accompanying psychological health conditions through diagnostic evaluation, treatment planning, outpatient clinical care and TBI research.

Service members are referred from their home station’s primary care physician or mental health professional to the NICoE’s range of treatment options. These include the four-week intensive outpatient care treatment program, the one-week assessment track, ongoing outpatient care services, inpatient consultation, and a range of individual, nonpackaged diagnostic and evaluative options. The benefit of coming to NICoE is that service members will have access to any one of these treatment options, depending on the need, with a streamlined evaluative pathway where many of the providers and services are located together.

“The integration of medical care is amazing,” said Dr. Gene Casagrande, a team coordinator and primary care physician.

“We make decisions the same day amongst each other,” he continued. “My office is next door to the neurologist, as well as to the psychiatrist, so if any of us have a suggestion, we can walk down the hall and make those changes as needed. Communication is very important, and the patients appreciate that and see that interaction.”

For more than five years, NICoE has treated patients with mild, moderate and severe TBIs.

“We have a system of care where anybody who’s referred to us from anywhere in the world will have the most appropriate treatment option available to them,” said Dr. Louis French, the NICoE’s deputy director. “We can move people back and forth between our various treatment platforms in our care system to make sure they are getting what they need.

“We can do very specialized assessments,” he continued. “We can do intensive treatments. We conduct research so we can better understand how people get better, under what conditions they get optimal recovery, and to pioneer new treatments and techniques that might not be available elsewhere.”

NICoE also has a significant research mission, and its researchers are studying the specialized evaluation techniques including neuroimaging, and treatments such as, art therapy, animal-assisted therapy, and other complementary and integrative medicine techniques such as biofeedback, acupuncture and yoga. Additional unique and highly specialized tools, such as the Computer Assisted Rehabilitation Environment, a magnetoencephalography machine and a 3 Tesla magnetic resonance imaging capability aid in NICoE’s mission as a clinical research institute.

With support from the American public, NICoE is expanding its reach through the establishment of Intrepid Spirit centers, which will enhance a national pathway of care for TBI across to the nation. So far, centers have been established at Fort Belvoir, Virginia; Camp Lejeune, North Carolina.; Fort Campbell, Kentucky; Fort Hood, Texas; and most recently at Fort Bragg, North Carolina.

Treating the whole person

Using research and technology in conjunction with a team of neurologists, psychologists, family care doctors, psychiatrists, nutritionists, neuropsychologists and other specialists, NICoE providers are able to treat the whole person, French said.

“Our experience is that people don’t get better unless we treat the whole person,” he explained. “One of the sad realities is that the primary mechanism of injury that we’ve seen in the last few years has been explosions or blasts. And when you’re close to something that blows up, there are many ways you can get hurt.

“And we know that we need to start at the head and work our way down the body and treat the sensory impairments people have and the pain issues,” French continued. “We need to treat the emotional impact of what they’ve experienced. We need to treat the impact on the family. We need to treat the cognitive dysfunction. If we’re not targeting all those things, and you’ve fixed one but you haven’t fixed the sleep, you’re not fully successful.”

Providing information

Casagrande said part of the treatment is educating spouses and caregivers.

“A lot of family members come here not knowing anything about TBI,” he explained. “There’s a significant education piece for the spouses, as well, to deal with -- what it’s like to have someone with TBI and the various symptoms that are associated with that, including irritability issues, social withdrawal, avoidance and other behaviors TBI patients experience. Education plays a very important role here. We do have a family therapist on staff, and child care is available for the children who come here, so the spouses and service member can spend some time here at NICoE.”

Both doctors said treatment also includes education about many issues associated with TBI and psychological health, such as sleep and how important a role it plays. For this reason, all patients go through a sleep study within the first few days they are at the center, and get started on appropriate sleep therapies within a few days.

Casagrande expressed his amazement with the progress he sees in patients after four weeks at NICoE.

“It’s one of the most rewarding parts about being at NICoE -- watching someone get better in such a short period of time -- and you just see it week by week,” he said. “I tell everyone, ‘I can’t promise you we’re going to make you better, but we’re going to do our darnedest to try.’ And we all do.”

Engage

Facebook Twitter
Since Aug.1, 1948. @RealAFOSI has been #USAF's major investigative service, providing criminal investigations and… https://t.co/pKmUbamHWD
RT @AFSpace: Captain Rachael Preslar, a #TeamBuckley Panther, is the first active duty female to win Mrs. Colorado! She currently serves as…
RT @WrightPattAFB: “With the new system, we will have six times the processing power as Thor.” -- Air Force looking to improve weather data…
RT @ulalaunch: The countdown has begun for this morning's #DeltaIV rocket launch of #GPSIIISV02 for the @USAirForce and @AF_SMC. The launch…
RT @ulalaunch: Weather forecasters from @usairforce @45thspacewing say conditions are favorable to proceed with tower roll and for the rest…
RT @HQUSAFEPA: #APFKenya continued yesterday with tactics techniques and procedures on tactical combat casualty care and 5-line call for fi…
RT @StripesCarlos: Only 2 months in #Okinawa, @KadenaAirBase Airman helps save a 4-year-old boy from drowning at the beach... Read more of…
RT @AirForceMag: .@HQUSAFEPA this week kicked off its premier training and engagement event, the African Partnership Flight, at Laikipia AB…
RT @AFThunderbirds: **Update** Air Force Thunderbirds to Join Royal Air Force Red Arrows, F-35s & F-22 in Historic Aerial Parade over the…
RT @AF_Academy: The 68th Rescue Squadron spent time with USAFA cadets in the Ops Air Force program while jumping out of aircraft in #Arizon
RT @F22DemoTeam: BREAKING NEWS: We are excited to announce that we will be joining the @AFThunderbirds, @rafredarrows, and @thef35 Demo Tea…
RT @GenDaveGoldfein: Flew from RAAF Williamtown to Canberra by way of 2SQN Wedgetail w/ #AusAirForce. Absolutely impressed by the crew’s pr…
RT @cmsaf18: Great perspective on the Resiliency Tactical Pause: "We have to practice the pause" so we can actively listen when our #wingme
RT @AirForceMag: #AVGEEK ALERT: The @AFThunderbirds will join some of the finest flyers from the US and UK militaries—including the @USNavy
RT @starsandstripes: "Sesame Street" is offering resources to help the youngest members of military families navigate the changes that come…
RT @Space_Station: .@Astro_Luca and @Astro_Christina are assisting spacewalkers @AstroHague and @AstroDrewMorgan before the duo exits the s…
RT @DVIDSHub: Did you know the B-2 bomber recently had the 30th anniversary of its first flight? Read about an event hosted at @northropgr
RT @48FighterWing: Read about how the #MightyBlackPanthers are sharpening their air interoperability tactics in support of @RoyalAirForce e…
RT @AFSpace: Will you be watching as @usairforce @AstroHague and @USArmy @AstroDrewMorgan head out for their spacewalk today? This is Drew…
RT @F22DemoTeam: CHICAGO. What an incredible weekend. Thanks for all the support and for allowing us to send it over your beautiful skyline…