So the MRI results came back negative for TBI.  In fact, they said my brain health was incredibly good.  Talk about a relief. The only problem is that I still have all of the problems but they just don't stem from TBI.  The only other viable explanation is extreme sleep deficit.

So Now What?

Well, I talked with the docs and did research online and it appears that folks with PTSD are substantially more susceptible to sleep dysregulation.  Working shift work where your schedule is inconsistent at best wreaks havoc on our systems.  It leads to a substantial loss of quality sleep and overall hours of sleep resulting in a major sleep deficit that, over time, erodes cognitive abilities and short term memory (among other things).

Their solution is to recommend to my employer that I get put on a consistent schedule that will facilitate a strong routine.  They want me to get up at the same time every day.  Start and end work at the same times every day.  Go to the gym the same time every day.  Make dinner the same time every day.  Go to bed the same time every day.

They said it will take time, but it will eventually retrain my body to digest, sleep, and burn at appropriate times and intervals.  Now I just need to see whether my employer will be able to facilitate this or not.  That is the major concern I have with all of this.  If they can't facilitate that, what then?  Well, I'm not crossing that bridge yet.  Let's see what happens when I meet with HR tomorrow.

Recently, I have noticed an uptick in the severity of my PTSD symptoms and my coinciding depression.  It's starting to make me worry a little bit that not having a functional group to attend is slowly eroding my ability to cope and adversely affecting the effectiveness of my coping mechanisms. Or...It could be just a temporary uptick because of the uncertainty surrounding my upcoming TBI evaluation.  Either way, it's decidedly annoying and not something I am handling well.

What to do?  I am going to have an individual therapy session this week and I plan on talking to my therapist about my concerns and my frustrations with not having a group to attend.  My PTSD is fighting to get through - the anger, the depression, the nightmares, and the insomnia.  I also have been dealing with a higher than usual level of hypervigilance.  Most nights I toss and turn so badly that I end up sleeping in my recliner, uncertain as to why I don't feel safe - I just don't.

I have been trying and trying to write this blog post and every time I start to write it, I can't seem to get anywhere.  Honestly, the whole prospect of TBI has been a lot to wrap my mind around and I have been having issues with my PTSD as a result.  It scares the hell out of me. What makes it worse is that I don't even know if it IS TBI - and that's what's killing me right now.  If it's not TBI, is it because I am not getting good sleep?  Or could it be that my brain chemistry has changes drastically and my med cocktail is out of wack?  What if it's all three or none of the above?  It's driving me nuts and I haven't been able to concentrate at all.  My ability to focus has gone right out the window.

Then there's the PTSD.  As a result of all of the added uncertainty and fear, I have been struggling to keep emotionally involved with my wife and daughter.  Granted, when I start to withdraw, I have been able to catch myself and pull myself back from becoming a cave-dweller, but it scares me that this whole situation has had such an adverse effect on my ability to cope with aspects of my PTSD that I have managed very well over the past six months.

The TBI evaluation cannot happen fast enough.  It's amazing how uncertainty can throw my life into total disarray.  If anyone has any brilliant suggestions on how to work through this, I am all ears.

Well, I had another session with my individual therapist today.  We did a lot of talking about my recent realizations about being black and white about everything.  We still haven't come anywhere close to a work around or work-through.  One realization that I did make was that survivor's guilt plays a huge role in setting the standards I hold myself to (and my inability to forgive myself for not being good enough) and why I can't forgive others for disappointing me (well, violating my trust is more accurate).  There's a lot more to this that I still have to work through, that's for sure.  One of the things she told me is that she's concerned that because I need to have people fall into one category or another (Trusted or Not), I may try to force people to fit into those narrow categories, even when they don't belong there.

We talked about this for the vast majority of the session and she asked me if there was anything else bothering when I unintentionally dropped a bomb on her.  I could tell it concerned her greatly because her demeanor went from relaxed and attentive to focused and intense.  Here's the situation:

Last week, Thursday night into Friday, I lost a day.  What do I mean by that?  I went to sleep a little after midnight and the next thing I remember coherently is waking up and realizing I have to be at work in 45 minutes - work started at 2PM.  I slept for over 12 hours.  I remember nothing in the interim.  The next thing I remember clearly from that night is helping to clean the slicers at the end of the night.  I know interacted appropriately with my coworkers, but I have absolutely no sense of the passage of time for that night.  None.  I have no idea whether I was asleep all that time either.

I drove home that night wondering whether I was going to be walking into a shitstorm at home.  I had no idea.  After talking about this with my therapist today and seeing how concerned she got, it raised some alarms in my head and I ended up not working on the newsletters I wanted to send out today - I could barely concentrate on writing this blog post.  So I decided to take a break and watch a movie or two.  I couldn't concentrate on anything and it was starting to ratchet up my anxiety something fierce.

What I thought was strangest was the timing.  Everything was going well.  My PTSD symptoms were wll-managed.  The only thing I can think of is that it happened the night after I talked to the consultant about incorporation and foundation documents for the non-profit and I had a funding proposal that I put before a local veterans group for consideration.  I was extremely excited.  I was thinking that maybe my body doesn't know how to tell the difference between excitement and fear.  I know my adrenalin was pumping like crazy.

Unfortunately, the end result was the same - I lost a day.

So now, I have to track when this happens to see if there is a pattern.  I did some looking online and the specific information about the symptoms of TBI seem to fall in line with some of the issues I have with short-term memory, loss of sense of time, anger, etc.  Anyone out there know more specifics or resources online that articulate this better?  I don't want to pee up a tree and send doctors looking for ghosts if there's nothing to this.

Again, the true and enduring cost of war illustrates how little politicians thought about the long-term ramifications of a decade of war.  These young men and women that took their lives survived unspeakable horrors overseas, TBI, other related injuries.  As a nation we have let them down.  The VA continues to struggle, in an outmoded business model, understaffed and underfunded.  The practitioners in the VA healthcare system are left with little option but to show compassion and do the best they know how, given extreme limitations on time and resources.

The DOD says that they have instituted successful programs to improve education, behavioral health services and access, and service member resiliency.  Go ahead folks, pat yourselves on the back.  Your programs have been so 'successful' that the suicide rate in the military jumped 16%.  Great job.

Then there's the other, more disturbing statistic:  According to the IAVA, the VA estimates that 18 veterans take their lives DAILY.  All the while, the useless bureaucrats at the VA are tilting at windmills and spending millions of dollars on pipe dreams and long shot research while ignoring the major problem the VA encounters on a daily basis - too many administrators, not enough caregivers.

The concerted efforts of the DOD and the VA are equivalent to putting a band-aid on a sucking chest wound.  While some can justifiably argue that the increasing suicide rate amongst active service members is a result of ten years of conflict, how do they justify the fact that they provide no support network for recently separated veterans who are in distress?  Does anyone think it's a coincidence that veterans with behavioral issues like PTSD, Acute Anxiety, and Depression don't come forward for help?  Most of the time veterans return to uneducated family members that don't understand what the veteran is going through.  Some take the time to understand their veteran.  Many don't and chalk up the changes as their veteran being an ass or a 'pussy'.  This ends up isolating our veterans without a support network with many holing themselves up in their homes and only having contact with the outside world through the internet.  The more they withdraw, the more time they have to get too far into their own heads.  They want to come forward to get help, but are fearful of the stigma they think they will face coming forward.

It's time to change this conversation and put pressure on our politicians, business leader, and everyday citizens to demand they step forward to care for the 1% willing to protect and ensure everyone else's freedoms.  The state of the behavioral health care system in the country is a disgrace.  The infrastructure is archaic and outmoded, unable to reach the people who need their help the most.  The conversation we should be having:  How do we change the system to best reach those that are at risk and isolated?  No one hears a cry for help in a shuttered room.

I implore you.  Share this message with everyone you know.  Send a copy to your Congressman, your Senator.  Stand up and be heard, stand up in solidarity so that we can end this epidemic.

Yours in Health,

Max Harris

I received a question right before Memorial Day.  Because of the very serious nature of the questions, I wanted to take the time to think deeply about it, consult some friends, and answer the questions as fully as possible.  Here's what she said:

I have a question I am a spouse of a OEF/OIF veteran, he is still active duty we are currently separated and we have endured a living hell my family and I the last four years. i am baffled does mild tbi have anything to do with adultery my husband did not have affairs or act violent towards me up until two years ago he gradually got worse? 

TBI and Changes in Personality:
There is so much that isn't known about the long-term effects of Traumatic Brain Injuries.  We are only now starting to feel the repercussions for NFL players, let alone for our service members.  What does seems to hold true is that the more severe the brain injury, the more likely it becomes for moderate to severe personality traits to manifest over the years following.  Additionally, there seems to be some compounding factor.  If a person has multiple m-TBIs, the effects appear to be cumulative over time.  I am not an expert on TBI and am not a doctor, so aside from relating to you the little I know, I will refer you to the experts on these types of injuries.

PTSD, Adultery, and Abuse:
This is a very complex issue as well and one that you don't directly mention.  Regardless, I feel compelled to address the possibility of PTSD being a major contributing factor.  Having TBI makes a person more susceptible to behavioral disorders such as PTSD.  When someone is suffering from PTSD, a person can feel an inability to connect with loved ones.  As a result, some turn to adultery as a way to deal with this.  From the guys I have talked to about this, they all say the same thing:  They don't want to be intimate with their spouses because they don't feel like they can connect with them.  Also, many have stated that it is safer to be intimate with a stranger who they don't care about because they CAN open up and if it scares the other person, they could care less.  At least they are not hurting their loved ones.

I know that rationale is convoluted.  I know it doesn't make any sense, but based on my experience and my conversations, it's classic avoidance of confronting their trauma and their PTSD.  I can't speak for your spouse.  There are so many individual factors that make this equation more true or less true for each person.  Only your spouse knows the truth of this.

As for the abuse, I can't speak for the TBI side of the equation.  That may play a factor.  As it stands with me, abuse demonstrates an conscious choice to hurt others, a conscious choice to let anger get the better of you and to visit your trauma on someone else.  If there is a medical reason for the personality change and loss of impulse control, that's one thing.  Regardless, I find the act of abuse, repulsive and reprehensible.  First and foremost, look out for your welfare and your family.  You can't effectively confront abuse if you are still subjected to it.

I hope that this has given you some insight.  I need to repeat, I am not a doctor or health professional.  I can only share with you the knowledge I have gained from personal experiences dealing with my own PTSD.  I wish you the best of luck in confronting these issues in your own life.  If there are any follow-up questions you may have for me, please let me know.

Yours in Health,

Max Harris