Military Lags on Promising Treatment for Brain-injured Soldiers
Two years after assuring Congress it would immediately begin researching a promising treatment for soldiers with traumatic brain injuries, the military is just getting started.
The tests – including at Fort Carson army base near Colorado Springs – are designed to determine how soldiers with brain injuries respond to hyperbaric oxygen treatments. The delay has resulted in a growing number of people, including members of Congress and a former secretary of the army, accusing the military of dragging its feet. It’s also left some soldiers and their families – who report sometimes-miraculous recoveries after they sought treatments off-base and from civilian doctors – shaking their heads in dismay.
“The military has perhaps not been as open to looking at, discussing and bringing forth even a small trial [to consider] hyperbaric oxygen,” said Rep. Pete Sessions, a Texas Republican who has been leading efforts to treat soldiers with brain injuries.“I believe they should more actively push the envelope.”
The military estimates that, as of 2008, more than 320,000 soldiers have returned from Iraq and Afghanistan with traumatic brain injuries (TBI).
The injuries are often the result of being in close proximity to explosions. Symptoms include agonizing headaches, insomnia, loss of memory and difficulty understanding what’s going on.
Patients undergoing the treatments are entirely enclosed in a chamber, breathing pressurized oxygen. The treatment is currently approved by the federal Food and Drug Administration for 13 illnesses, including for carbon monoxide poisoning, smoke inhalation and decompression sickness suffered by scuba divers.
Small civilian studies have shown that the use of hyperbaric oxygen also has eased headaches and confusion for people with brain injuries. But it is not government-approved for TBI victims, and therefore, insurance and the military won’t cover the treatments.
The military estimates the cost could be $32,000 per soldier, depending on dosage and payment rates. Multiply that by 320,000, and the price tag for treatments could add to billions of dollars.
Civilian tests detail success
Many of the studies that detail successes on treating TBI patients with hyperbaric oxygen have been conducted by Dr. Paul Harch, a professor of medicine at Louisiana State University. Harch’s seven-year long push for the military to adopt hyperbaric oxygen treatments has had the backing on Capitol Hill and from a former Secretary of the Army, Marty Hoffmann.
Under bipartisan Congressional pressure, the Pentagon promised in March 2009 that it would launch an 18-month study to determine whether the treatments should be adopted by the military. In addition to Rep. Sessions, lawmakers involved in pushing for research include Reps. Bill Pascrell (D-New Jersey), Larry Kissel (D-North Carolina), Todd Platts (R-Pennsylvania) and Allen West (R-Florida).
Congress expected the study to be completed by last December, but the military didn’t even begin to line up participating soldiers for testing until this spring – well after the deadline for completion.
Last month, the investigative arm of Congress blasted a four-year Pentagon effort dedicated to addressing TBI and Post-Traumatic Stress Disorder among returning soldiers. The report says the special “center for excellence” has been unable to define its mission – and it has lost track of how it has spent its money.
Rep. Sessions has been critical of the military’s slow response. “We have been on the back side of effectively finding a treatment,” he said.
But Lt. Col. Rob Price, the doctor in charge of the testing at Fort Carson, says the slow start was due to the need for numerous approvals for the research. The military also needed time to hire personnel, and lease clinic space and equipment.
“Good science takes time,” Price said. “We’re trying to research every avenue we can to help them get better. We can’t just give them treatment that’s not been proven to be effective.”
Price, a hyperbaric medicine specialist, noted that, “When I treat patients with (scuba diving) injuries, it is a miracle cure. I see somebody with paralysis of half their body … being fixed and better within five minutes.
“To see that kind of miracle occur, maybe there is something to it with a TBI, and we need to look at it further,” Price said.
The tests also are being conducted at three other military bases, including Camp Pendleton in California, Fort Lewis in Washington and Fort Gordon in Georgia.
But the testing, Price said, needs to incorporate in “sham control,” randomized trials as well assafety and dosage. The military, Price says, plans to continue testing until 2013.
Fighting since ‘day one’
The delay is inexplicable to Michael Mange of Fort Collins, whose daughter, Margaux Vair is an army veteran who has had remarkable success with oxygen treatments to help with her traumatic brain injury.
“We’ve been fighting for Margaux since day one,” says Mange. “But what about the soldiers who don’t have anyone?”
Vair was a star athlete at Alameda High School in Lakewood and signed up for the army hoping to play soccer for the Armed Forces team.
Instead, she found herself patrolling the Iraqi desert as a gunner on a Humvee. In 2007, an explosion threw her head first into the gun turret, bashing her skull.
Brian Vair, then a fellow soldier and now her husband, documented her injury, videotaping her in full combat gear with half her face paralyzed. She had trouble speaking.
At age 23, Margaux Vair was 100 percent disabled, she says, “...spending my days on the couch,” unable to function and in terrible pain.
“I had to carry her up the stairs,” her husband said. “And change her clothes and brush her teeth.”
People who didn’t know her assumed she was developmentally disabled. She forgot the names of vegetables at the grocery store. She often slurred her words.
The Veterans Administration tried several treatments, from acupuncture to brain surgery.Finally, with funding from a private donor, Vair received more than 100 treatments in a hyperbaric chamber at the Rocky Mountain Hyperbaric Institute in Boulder.
The institute’s medical director, Dr. Julie Stapleton, says oxygen can restore injured tissue, and give patients a better outcome faster. “And it’s a lot cheaper than what it costs to buy sleep, pain and anti-anxiety medications,” she said.
Vair is just one of a multitude of former soldiers who now swear by the treatments. Even with the help of oxygen, she acknowledges, “I’m like a third grader most of the time still.” But she is now in culinary school and loving it. She recently made a red velvet cake for her husband’s birthday. Before her treatments, she couldn’t follow a recipe. In fact, she says, she had to ask her dad the difference between a teaspoon and a cup.
“I think [the hyperbaric chamber] has done more for me than any pill or surgery or treatment I ever had,” she said.
Editor's Note: This story was originally published on Sun October 9, 2011. Updated on Mon October 10, 2011 with audio.