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http://news.yahoo.com/news?tmpl=story&u=/a..._from_war_brain

Soldiers Taught to Exercise Injured Brains

By LARRY MARGASAK, Associated Press Writer

WASHINGTON - Brain injury specialists at the Army's premier medical center have taught Spec. Jamie Brown how to exercise his mind and get it working again.

He is learning to recall the last thing he read and remember the next place he is going, just as he learned to be a cook and college student in civilian life — and a forward artillery observer for the Indiana National Guard.


Brown, 22, knows progress can be slow after a grenade explodes in your tent and the blast sends you hurtling into a metal pole.


The Associated Press interviewed Brown and two of his doctors at Walter Reed Army Medical Center in Washington to see how the military and Veterans Affairs Department treats brain-injured soldiers and airmen.


Some are injured in plane crashes and vehicle accidents. Many more are victims of roadside explosions and rocket-propelled grenade attacks in Iraq (news - web sites).


Brown came to Walter Reed in a medicated stupor in early December. At the combat hospital in Iraq where he was first treated, he learned that he had lost a kidney, his adrenal gland and spleen. His pancreas were damaged. Shrapnel in his stomach caused a stabbing pain.


And his brain was damaged.


Brown became a patient in the Defense and Veterans Brain Injury Center at Walter Reed. It is one of eight brain injury facilities run jointly by the departments of Defense and Veterans Affairs.


The centers report that traumatic brain injuries now account for 14 percent to 20 percent of casualties for those who survive combat.


Brown was lucky, his doctors said. His brain damage was mild enough to permit recovery, even though he was injured when he was not wearing body armor or his helmet.


"He's made remarkable progress," said Dr. Lou French, a neuropsychologist who has been guiding Brown through rehabilitation.


French and other specialists have tried to improve Brown's memory, problem-solving ability, speech, use of language and speed in making decisions.


Among the techniques are:


_a short story about a storm, with a dozen details to be recalled.


_plastic balls, arranged in patterns, to be duplicated by the patient with the fewest number of moves.


_14 minutes of nonstop concentration on a computer screen, with a mouse click needed every time a designated letter appears.


_pictures of objects to identify, as common as an acorn and as infrequently seen as a mathematical protractor used for measuring angles on paper.





"It was very draining," Brown said.

Brown was injured on Nov. 20, 2003, in Iraq while sitting in his tent. He said he was watching a movie with fellow guardsmen when a grenade exploded about 8 feet away.

"The next thing I know, boom. I can remember feeling the heat, I can remember seeing the dirt and the sand fly everywhere," he said.

Brown arrived at Walter Reed two weeks later. For a while, every day was a blur. His weight had dropped from 170 pounds to 110. He awoke one day to find his wife next to him.

"My first day of full consciousness," he said.

It was the start of a long distance race to recovery as Brown learned the first day he had a dental appointment at the hospital.

"I asked my wife six times where we were going," he said. "I may have to read something a couple of times instead of just once."

Brown's first test of retention and memory "suggested he wasn't retaining things the way he should," French said.

"He had a tendency to get an idea in his head and he couldn't let it go. There would be one part of a story he would keep repeating. He couldn't remember other parts," the doctor said.

Someone with major brain trauma often loses confidence, said Dr. Deborah Warden, who is based at Walter Reed but is national director of the government's brain injury network.

She has seen brain-injured soldiers wait until the mess hall was about to close before arriving for meals, just to avoid crowds, the cacophony of many conversations and the sudden sound of a dropped tray.

Many soldiers experience what she called blast-plus injuries: the initial explosion which can jar the brain, followed by the kind of blunt trauma Brown experienced when he hit his head.

A neurologist and psychiatrist, Warden said she is trying to link together the experiences of blast victims to see whether there is a common thread in their injuries that may lead to new treatments. She even videotaped one soldier's vivid description of the blast that cost him his legs.

"It's important for us to find out if blast patients are different," she said. "We're looking into it vigorously. We're linking together their stories about injuries, problems, the immediate aftermath."

The one private facility in the government's brain injury network, Virginia NeuroCare in Charlottesville, Va., is in a residential setting. Patients are taken around town to reacquaint them with the experiences of normal living.

"In an explosion, there are emotional problems," said Dr. George Zitnay, who runs the facility.

"They witness someone being blown up, they see a friend die, there's trauma. There are people with lingering fears, nightmares and anxiety. They are afraid of the future: Will I be able to go home, get a job, get back in the military?"

The link to normal life worked for Brown, who said his most dramatic improvement came in April when he went back to familiar territory, his home town of Evansville, Ind., for a short leave. The surroundings improved his mental state, Brown said.

French agreed.

"I sensed he was much less distressed," the neuropsychologist said. "His speech was smoother, he spoke at a normal rate, he smiled more, he was generally happier."

Brown now is thinking about the future. He'd like to return to college, at least part time.

"We want to see any pattern that he's forward-looking," French said. "Looking forward helps recovery."