Dr. Patrick Armistead-Jehle, chief of the Concussion Clinic at Munson Army Health Center, uses a brain model while discussing concussion treatment Feb. 8 in his office at Gentry Clinic. Call the MAHC Appointment Line at 913-684-6250 to see a primary care provider, who can make referrals to the MAHC Concussion Clinic or specialized care if needed. Photo by Prudence Siebert/Fort Leavenworth Lamp

Charlotte Richter/Staff Writer

From participating in training exercises and deployments to having an active everyday lifestyle, many military service members have experienced concussions or even traumatic brain injuries.

The Munson Army Health Center Concussion Clinic serves adults affected by concussion and TBI, following initial visits to primary care, to help set profile conditions and identify next steps in specialty care.

The Centers for Disease Control estimates that more than 430,000 military service members have been diagnosed with TBI in the last two decades.

Dr. Patrick Armistead-Jehle, chief of the Concussion Clinic at Munson Army Health Center, uses a model to show how a concussion impacts both the front and back of the brain while discussing concussion treatment Feb. 8 in his office at Gentry Clinic. Photo by Prudence Siebert/Fort Leavenworth Lamp

Dr. Patrick Armistead-Jehle, chief of the Concussion Clinic at Munson Army Health Center, said there are three main kinds of TBI: mild, moderate and severe. He said mild TBI, or concussions, are the most common and represent an estimated more than 80 percent of cases in the military and civilian sector.

“The majority of TBI and concussions in the military happen in Garrison environments, so the majority are not downrange; A lot can happen down there, and we know more about it because of the wars, but certainly we’re drawn out of the wars now. Most (cases) happen in training, car accidents, slipping and falling on ice … so the majority of these happen in Garrison.”

Because of the many administrative and academic positions on post, Armistead-Jehle said the Concussion Clinic sees fewer TBI cases relative to installations that emphasize training exercises such as Fort Leonard Wood, Mo.

“The (cases) we do have here are more car accidents or falls and those of the acute, sub-acute ones, those who have a remote history of TBI. Though, even with the acute, subacute ones, our numbers, relative to other posts are numbers are actually small.”

He also said moderate to severe TBIs have different biometrics and prognoses. Armistead-Jehle said cases vary from person to person depending on the severity of the injury and pre-existing health conditions. For example, while headaches are a common symptom, they might not be the result of TBI, or if an individual has another injury, it could change the presentation of TBI.

“Symptoms after a concussion are not the same for everybody. There are three kinds of general symptoms they fall in — somatic symptoms, physical things like dizziness, sensitivity to light, nausea, vomiting; cognitive symptoms; and emotional symptoms, irritability, anxiety, sometimes depression that might not have been there before. Everybody’s concussion symptoms are different, even in the same person sometimes symptoms are different between injuries.”

Armistead-Jehle said a patient’s symptoms will affect their day-to-day function and they often risk prolonging symptoms by returning to work or normal activity right away. He said the recovery process, sometimes a six-phase progressive return to activities, is essentially a good balance of work and rest.

He said professionals will also encourage light exercise and movement that can help with improvement based on individual treatment plans. He also said people with concussions usually recover quickly, some as fast as a few days, others as long as months.

“Short term, they should be cared for by their primary care doctor at the very least, and especially if care is required; then you can order neurology or vestibular therapy and different things that can be helpful to expedite the process.”

Armistead-Jehle said after patients seek help through primary care, MAHC will configure resources through the Concussion Clinic through professionals like himself to identify a work/life balance for adults. He said specialized care is typically most common after two weeks with no improvement of symptoms, and the clinic will outsource within a network of other trusted specialists and providers.

He said research in the field is currently seeking to identify the effects of chronic conditions, co-current conditions and general biomarkers for diagnoses. He said he finds the variability between responses and injuries most intriguing, especially in the individual variability in recovery.

“From a public health point of view, if you have an injury, go see your doctor. Expect to get better, but (mTBI) does need to be managed — we’re talking about the most important organ you have, and there are physiologic consequences from having the injury, but most people get better from this.”

Call the MAHC Appointment Line at 913-684-6250 to see a primary care provider, who can make referrals to the MAHC Concussion Clinic or specialized care if needed.

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