LAKEWOOD, Wash. – What if a soldier went off to war, nearly got killed and three years later still couldn't think straight? In 2007, we profiled Army Staff Sgt. Richard Kellar. He was diagnosed with a mild Traumatic Brain Injury after his Stryker vehicle rolled over a 1,000 pound bomb. Today, Kellar is medically retired from the Army at the age of 29. But he's still crippled by his brain injury.
This was Richard Kellar three years ago explaining the symptoms of mild Traumatic Brain Injury.
Richard Kellar: “I can't remember anything. I can't remember how to make coffee. I can't remember if I took my Vicadin. I'll forget that I went to the bathroom.
And this is how Kellar describes his symptoms today.
Richard Kellar: “It's not a really a fog. It's just little bursts of anger because you just start to get tired of it. Really, really tired of not being able to remember certain things, or having to write everything down, or keeping a schedule on you.”
Three years later and Kellar's brain still isn't working right. We're sitting in the living room of his disheveled house in Lakewood, Washington. It's just a couple of miles from the local VA hospital. Kellar hasn't shaved. His eyelids are heavy. He's still on about eight different medications for his various physical and emotional wounds of war. But the wound that bothers him the most – more than his scarred nose, more than his PTSD – is his brain injury.
Richard Kellar: “I'm just at a loss of what to do. I'd expect that I'd be able to remember a little bit more, be more cognitive or doing the 9 to 5 and the rest of that. But as of right now I don't think it's possible.”
Kellar is going to community college. He's taking one class – that's all he can manage. He's working on his prerequisites for nursing school. But it hasn't been going well. He's flunked a couple of science courses. He says when it comes to test time he can't remember the information Dan Comsia is Kellar's mental health counselor. He calls his client a “bright, young man.” But he says the brain injury is a real problem. Comsia is frustrated with the Veterans Administration.
Dan Comsia: “He's not getting the kind of treatment from the VA that he should be getting. It's not enough. Definitely not enough.”
Kellar works on memory skills with a VA speech pathologist. But It's just once a month. At one point he was prescribed weekly sessions. Even that is pretty minimal says Dr. Keith Cicerone.
Keith Cicerone: “For somebody who's three years post, not doing well and struggling, I would say that's not sufficient. That's not going to turn this guy's life around.
Cicerone heads the Brain Injury program at the Johnson Rehabilitation Institute in New Jersey. He says his patients are in rehab up to fifteen hours a week.
Keith Cicerone: “We're really teaching people how to live with a disability or how to live with a traumatic brain injury and if he's three years post we would make the assumption that this is likely to be a permanent chronic illness.”
But that's not how the VA views mild brain injuries. Here's what VA guidelines say: there's no proven link between mild TBI and long term neurocognitive problems. Patients are to be” reassured and encouraged that full recovery is expected.” If the symptoms persist, VA doctors are instructed to consider other factors like “psychiatric disorders.”
Natalie Dong: “The symptoms can be caused by anything. They're only symptoms.”
Dr. Natalie Dong runs the Polytrauma center at the Veteran's Administration hospital where Richard Kellar is being treated. Three-hundred pages of medical records that I reviewed show the VA has done a lot to help him cope with individual complaints. But Dong calls it a “red herring” to focus on what's causing the memory problems. It could be the brain injury, PTSD …
Natalie Dong: “We cannot fix damaged nerves in the brain. What we can do is teach people work-arounds. We teach them compensatory strategies. We work with them on list making, cognitive prosthetics – use of a digital voice recorder for instance – use of calendar systems.”
Austin Jenkins: “Why not offer a more aggressive suite of therapies where they really are here a lot of hours of the week?”
Natalie Dong: “If we have patients with very high levels of need, then we provide very high levels of service.”
Austin Jenkins: “Do you have anybody here five days a week that's mild or moderate brain injured?”
Natalie Dong: “On the outpatient side, I don't believe we do.”
New brain research may ultimately change how the VA diagnoses and treats mild Traumatic Brain Injury. Dr. Elaine Peskind is a VA and University of Washington psychiatrist in Seattle. She just released a new brain scan study of veterans with mild TBIs.
Elaine Peskind: “We're seeing is as long as an average of five years out there are long-term, persistent chronic changes in the brain.”
Back at Richard Kellar's house he's suddenly realized he doesn't know where his wallet is. He says this happe ns all the time. I follow him out to his car. He rifles around inside.
Austin Jenkins: “So, what happened there?”
Richard Kellar: “Oh, I left a bunch of stuff in my car.”
Austin Jenkins: “Including your wallet?”
Richard Kellar: “Ya.”
Austin Jenkins: “I can tell it kind of makes you mad at yourself.”
Richard Kellar: “Ya, it's just about the millionth time it's happened. It just gets old, really old.”
When we first met Kellar three years ago he had a wife – Sheree – to help him remember. But they've split up. Now, this former soldier who once led a squad of eight men is trying to keep things together by himself. He admits he's not the best patient. He misses appointments. Gets frustrated with some of the brain exercises he's supposed to do. But he also nearly gave up his life for this country.
Richard Kellar: “I don't think the VA is letting me down. I just think that the system doesn't know what it's dealing with so the system can't give me the treatment that I need or deserve.”
When Kellar medically retired from the Army nearly three years ago, his captain wrote a letter. It said: “Provide this proud Soldier world-class treatment in order to insure he remains a top-flight contributing member to society.” Kellar says today he's the least productive person he knows.
The Pentagon estimates since 2002, 150-thousand troops have suffered brain injuries. Non-military studies suggest those numbers could be much higher.
Copyright 2010 Northwest News Network