My Life in Brain Injuries

          Gary, a sixty year old Viet Nam war veteran, had recently retired from his civil service job when he entered our program for veterans with traumatic brain injury and post-traumatic stress disorder. His voice, a halting monotone, was quiet and slow as though he was considering every word before he spoke. He moved cautiously, as though guarding himself. In spite of his phlegmatic presence, he continuously rubbed his fingers together or jingled the change in his pocket, suggesting an underlying nervous energy.

          At his intake interview in 2009, Gary told us he had been exposed to Agent Orange, a neurotoxic element, while in Viet Nam in 1970. He had broken his nose in 1962 in a baseball mishap and again in 1970 when he fell from his top bunk on his transport ship heading home. He told us that after the second incident, he was unconscious all night, bleeding from his nose and ears and wasn’t found until morning.  As a consequence of these injuries, he had 7^th cranial nerve damage, resulting in partial facial paralysis as well as constant tinnitus. Of his many problems, he was most concerned with anxiety, depression, sleep disturbances and addictions, all of which had been haunting him for forty years.

          He said that falling asleep as well as staying asleep were problematic and it was difficult to get up in the morning, both because of fatigue and his extreme anxiety. Once out of bed, he had a hard time staying awake. Due to the fact his nose had been crushed, he reported a limited ability to breathe.

          He felt his heart pound whenever he had to meet someone new and therefore avoided social situations. He complained of tension in his face and butterflies in his stomach that only got worse when he had to deal with new situations. His mind raced although it was never a constructive process. He tended to ruminate regarding what he considered trivial matters, spinning his wheels, never able to solve problems.

          In 1972, Gary was hospitalized at his local VA with a diagnosis of paranoid schizophrenia for which he was given electroshock therapy. It did not help. He tried many antidepressants over the next eight years. He also spent many years self-medicating with alcohol, marijuana, hallucinogens, oxycodone, and cocaine. The oxycodone gave him a sense of well being but only until it wore off. He went into rehab in 1976 and remained clean and sober until 2006. At that time, he started secretly drinking on a daily basis for about a year when his family figured out what he was doing and demanded he stop. Of the addictions, he told us, “There is no help – no remedy. Every day since Viet Nam has been a struggle. I can’t calm my nerves.” At the point when we met, Gary was regularly taking lorazepam and zolpidem as well as Kava, Calms, theanine, rescue remedy, and L-phenylalanine.

          Married for nearly thirty years, his relationship with his wife was strained and they were in a trial separation. He told us this had happened before – trying to see if living apart was better or worse than living together. They have two adult children who are in their mid-twenties. “I try to be close to them, but it is difficult.” He told us that on the rare occasion that he laughs, it startles his family. He made it clear he has searched for help – even living in India for an extended period to seek emotional healing through meditation and spiritual discipline. His anxiety and difficulty breathing obstructed his process. He told us he never felt the calming the breathing exercises were supposed to give.

          During our intake, we asked Gary to rate his symptoms on a scale of zero to ten – zero meaning it is not a problem and ten meaning it is a very serious problem. This table represents the problems he rated most challenging.

          When Gary returned one week after his first session of LENS, a form of neurofeedback particularly helpful in addressing the many issues of TBI, he reported improved sense of well-being, with a better ability to deal with anger appropriately. He said he was able to nap after our session and woke with better energy, less anxiety and clearer thinking. He continued to take short naps throughout the rest of that week.

          Before he sat down for his third session of LENS, Gary said, “There’s something I think you should know. I’m waking up singing every morning. I have no craving for drugs or alcohol. None.” He went on to say he had “tons” of energy after his previous session and did not require a nap. “I’ve been able to relate to others without feeling self-conscious. My wife said I’m more ‘present’. I feel more mindful.”

          He told us that after a year of thinking about confronting someone, he was able to have the conversation he had dreaded for so long. “It went well.”

          After the third session, he reported singing often, sleeping well and being able to think through frustrating events, calming himself.

          At his fourth visit, we performed a bilateral nasal specific (BNS) on Gary in addition to administering the neurofeedback. A BNS is a physical medicine technique that opens the nasal meatuses, helping to drain the sinuses. He was elated at his ability to breathe again.

          When he came in for his fifth session, Gary reported the anger had drained away and he felt very stable. He also told us he had reduced his use of lorazepam and zolpidem by half.

          After his fifth session, Gary told us, “I’m more aware that the negative story I’ve told myself isn’t true. Instead I feel peaceful and still.” He reported that his wife was more supportive and caring and they were living together again.