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Prevent Vet Homelessness with Correct Diagnosis

Matthew Gosney, author of Hidden Wounds

Matthew Gosney, author of Hidden Wounds

Dr. Mark Gordon’s traumatic brain injury (TBI) treatment program could be a life-changer for a huge number of veterans, including many who have sunk into chronic homelessness and many more who are at risk. TBI is so prevalent that some journalists refer to it as the “signature wound” of the American presence in both Iraq and Afghanistan.

The public perception of head trauma is pretty much limited to damage done by roadside bombs, as seen on television. But jumping out of a truck can cause as much damage as an improvised explosive device, if someone does it enough. Mere acceleration or deceleration can have an effect that never goes away (think about whiplash, and then think about what that same motion would do to the brain). A lot of life events cause brain damage in small increments that can add up to tragedy.

Add to that other random factors like football. A healthy young soldier probably played sports in school, and got a “head start” on a life-threatening brain condition. A helmet does not help, because it can’t stop the brain from slamming against the inside of the skull, which causes direct damage. Of course, veterans are not the only victims. A disproportionate number of civilians experiencing homelessness have head injuries in their medical histories.

What Happens Over Time

Dr. Gordon has found shocking deficits in the pituitary hormones of head injury patients. For instance, a shortage of growth hormone causes serious psychological, emotional, and neurological problems. We’re talking about muscular weakness, obesity, sleep loss, heart attack risk, hypertension, diabetes, memory loss, anger outbursts, attention failure, mood swings, and the inevitable depression that will haunt anyone in such a miserable state of health. As Dr. Gordon explained to journalist Joseph Carrington, the long-range consequences are weighty:

These processes include alterations in cerebral blood flow and increased pressure within the skull, contributing substantially to damage from the initial injury… Increasingly, we are discovering that traumatic brain injury is also a causative factor for accelerated hormonal deficiencies.

It starts with the hypothalamus. Via the connection known as neuroendocrine function, it rules the pituitary, which in turn sends out orders to the various endocrine glands, telling them to secrete more of something and less of something else. Damaged by traumatic brain injury, the hypothalamus and pituitary can get out of sync, and only interventional endocrinology can restore their balance.

Even the world of professional sports has started paying attention to how the effects of small, secondary injuries can accumulate over time. They cause symptoms that don’t show up for years. When a person retires from the boxing ring or is discharged from the military, an exit physical will not reveal every possible problem — far from it.

A Bum Rap

Testosterone is another chemical whose insufficiency brings serious repercussions to the traumatic brain injury patient. This fact is very controversial because of the hormone’s negative image. The medical and military establishments see it as a vanity drug that bodybuilders use to cheat in competitions. Also, the public intuitively associates testosterone with violence. The feeling is that a certain number of brain-damaged warriors are already volatile and potentially aggressive — why add fuel to the fire? But, as Dr. Gordon explains, “it doesn’t work that way.”
He defines yet another serious problem:

Unfortunately, people with so-called minor traumatic brain injury, who comprise the largest group of brain-injured patients, have no visible damage at all on brain scans.

In other words, this type of devastation will probably not be uncovered unless the doctor looks for hormonal deficiency. For this reason, brain injury is often misdiagnosed as post-traumatic stress disorder and therefore untreated or under-treated.

Like PTSD victims, patients with hormone deficiencies show up with depression, low energy, fatigue, poor emotional state, poor quality of life, and bad disability rating scores. It is easy to mistake one condition for the other, and indeed some people are afflicted with both. But it is no longer necessary to make this mistake, when apparently it can be avoided by asking the right questions and administering the relevant blood test to detect pituitary dysfunction.

Another frequent problem with VA medicine is that even if the doctors recognize, for instance, testosterone deficiency, they tend to prescribe far too much of the hormone. When Dr. Gordon accepts a patient, his pioneering protocol begins with the panel of hormone tests. After a complete physical exam and a detailed narrative history, he creates an individualized hormone replacement program in which both physical and cognitive functions are re-evaluated every month. (In April, he will teach his method to 100 doctors who recognize that once in a while, a Big Answer comes along, and this might be one of them.)

The Patient Who Went Public

Former Navy SEAL Matthew Gosney describes the long, drawn-out VA process of being prescribed one thing, then another, then something a bit stronger (“come back in 3 months”) and finally winding up on a total of 12 meds, 3 of them opium derivatives, and none of them effective. If not for Dr. Gordon, he says, he would be dead. Gosney is working on a book, Hidden Wounds

I went years with hormonal deficiencies that were not tested for … on a protocol that did not and could not help me recover … The second part of the book focuses on PTSD and how after getting physiologically back to baseline I was finally in a place where the hidden wounds of my mind could finally be processed and dealt with … The purpose of this book is to get information out there so veterans can be empowered and take back their lives. There is hope and an answer.

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Source: “Using Hormones to Heal Traumatic Brain Injuries,” lef.org, January 2012
Image by Matthew Gosney