Casualties on the home front: Pendleton family grapples with Iraq veteran's traumatic brain injury

By: BRIGID BRETT - For the North County Times | Saturday, February 24, 2007 7:17 PM PST ∞

By the side of a Camp Pendleton pool, Master Sgt. Kenneth W. Sargent shows where he was hit by a bullet during an August 2004 ambush in Iraq. The line on his forehead is from swimming goggles; the scar above that is from the brain surgery that inserted a steel plate in his skull. The bullet exited below his left ear and damaged the front of his brain.
BILL WECHTER Staff Photographer
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Tonia Sargent has the glossy brown hair of a teenager, the take-charge attitude of a CEO and the eyes of a military wife who has said too many goodbyes. When she looks at the scar that cuts a swath across her husband's skull she sees a map. A map of his life, of her life and the life of their family.

"When I look at his face on the right side of the scar I see the man he was. When I look at the left side I see the man he is now," she tells me. "I try not to constantly grieve for what I once had ---- to adapt to what I have now. We're all trying ---- every minute of every hour of every day."

We're in the living room of their house on Camp Pendleton. Tonia's husband, Master Sgt. Kenneth W. Sargent, is dozing on the sofa, their dog, Lily, in his lap. In August 2004, Kenny, or "Top" as Tonia calls him, was a gunnery sergeant on his second deployment to Iraq. When his vehicle was ambushed, a bullet struck him below the right eye, exited below his left ear and damaged the front of his brain. He survived but has lost half his vision, much of his hearing and some cognitive functioning. These past 2 1/2 years have been an extended boot camp of loss, pain and readjustment ---- not only for Kenny, but for Tonia and their daughters, Tasha and Alishia, who were 17 and 15 at the time of their father's injury.

Although more troops are surviving wounds in Iraq than any other conflict in history, the result is that more of them are coming home needing extensive rehabilitation ---- especially after suffering blast injuries. Recent statistics from the Walter Reed Army Medical Center indicate that as of Dec. 31, traumatic brain injuries, or TBI, constituted 29 percent of battle-related injuries requiring medical evacuation. There are no statistics that indicate the effects of these injuries on family members ---- physically, emotionally or financially.ÝÝÝÝ

"Some days I don't feel so good," Kenny tells me when he wakes up. Today is one of those days. Like most sufferers of severe TBI, he experiences a range of symptoms, from memory loss to anxiety, depression and extreme fatigue. Sometimes he can't sleep and sometimes sleep comes upon him swiftly and without warning. He cannot be left alone for more than an hour or two because his anxiety becomes so acute when Tonia is not there. Tasha and Alishia watch over their dad at those times.ÝÝÝ

And yet Kenny is one of the lucky ones. After 20 years as a military wife and as a key volunteer at Camp Pendleton ---- a spouse who provides comfort and support to other Marine spouses ---- Tonia has become a powerful advocate, not only for her own family but for injured military families nationwide. She has heard countless stories of abuse, abandonment, even suicide. She tells me about the man who had his jaw blown away and who now takes care of his five kids on his own because his wife couldn't bear to be married any longer. And about the 21-year-old National Guardsman who returned from Iraq with groin injuries and now has to wear diapers. His wife, Tonia says, is desperately trying to find ways that they can be intimate again.ÝÝÝÝ

Tonia doesn't judge the spouses that leave. She has experienced firsthand the anguish of having to care for her childhood sweetheart around the clock, of not being able to pay the bills, of monitoring her daughters' depression over the loss of the dad they once knew, while at the same time trying to decode what benefits she and her family are eligible for.

"Families of the deployed," she says, "live a bipolar life. We're either on a high because someone has returned or we're down in the depths because of another crisis we've run into. For us, normal is a constant low-grade depression."

As she says this I picture the images of the joyous reunions we see splashed across the front pages of our newspapers and realize few of us get to see what comes next ---- the nightmares, the anger, the lashing out and pulling away ---- all behind closed doors.

These can be symptoms of post-traumatic stress disorder, which is widely known as PTSD, says Richard Henley, counselor and case manager of the family program at Veterans Village in San Diego, a substance abuse treatment center for homeless veterans.

An invisible injury, PTSD can easily go undiagnosed and can take weeks, months or even years to appear. Although there are many resources both within and outside of the Veterans Affairs system to help families cope with the insidious and corrosive effects of PTSD, as a mental illness it is often shrouded by shame and stigma, and those who suffer from it most are often reluctant to ask for help.ÝÝÝ

Besides the physical and mental wounds, Henley sees three huge challenges confronting injured service members and their families:Ý trying to navigate the medical care system within and outside the VA, reintegrating into the civilian world, and the loss of income.

"When a service member is severely injured and cannot go back to work, the spouse often has to give up their job to care for him," he says. "Going from being a two-income family to a one-income family can create serious hardships."Ý

Serious hardships also arise because it can take months for a medical claim to be processed. Just as it is rare for severe injuries sustained on the battlefield to be simple ---- many of the injured have multiple physical and mental issues ---- so is it rare for a VA claim to be simple. A complicated set of requirements determines the outcome of a single claim, based on medical review boards, VA personnel, case managers and statements from the service members and their families. Add into the mix an antiquated medical filing system and the frequent disappearance of records as they are transferred around the world onto a myriad of desks already piled high with paperwork, and you can see how the "seamless transition" that the VA is trying to provide returning troops can be more like a ride through the desert in a sandstorm. ÝÝÝÝÝ

"I don't believe in blame, but I believe in accountability," Tonia says, her eyes blazing. "There is always more we can do."

When Kenny was undergoing rehabilitation for a month at Palo Alto's VA unit for traumatic brain injuries, she saw the need for a "home away from home" for the frightened and isolated families of the patients. So she launched into a frenzy of fundraising that led to the building of a 21-suite Fisher House on the VA grounds, where families can stay for free in "a place of healing and friendship."

"I've become a very squeaky wheel," she says. "Who is monitoring our needs? Is it the Command's responsibility? Is it Chaplain Services' responsibility? Is it Severely Injured Center's responsibility? Is there an assumption that someone else is doing it?"

Never assuming that anyone else will do it, Tonia is personally taking a "call to action" to Sen. Dianne Feinstein's office. One of her goals is to have long-term community-style housing for the families of the severely injured, who will never again be able to earn a living in the civilian world and who can no longer live out their lives on base. She is working with Habitat for Humanity in Orange County (www.habitatoc.org) to realize this vision.

Her other goal is to have a state ombudsman like there is in Missouri, who can serve as a point of contact and help meet the needs of service members and their families that are not otherwise being met.

"So many people are in the same predicament. They don't qualify to receive particular veterans benefits, they're not aware of the benefits available to them, they're embarrassed to ask for help or they don't know where to go for help," she says. "For instance, I can't pull on Kenny's Social Security until he's 62 or 65. ... What if he's dead? Do I still get it? Do I get a portion of it? What if he doesn't die due to his combat relation? How can I plan for the future if I can't plan for the now?"

When Kenny gets up to go to the bathroom, Tonia turns to me.

"They gave him back to me as roadkill," she says, cupping her hands as if holding a small, dead animal. "They didn't know if he'd be able to walk or talk again. ... I nursed him back and now my biggest fear is that I'm going to have to watch him slowly deteriorate again."

For the past few weeks he's been having "episodes" where he gets the chills, becomes breathless and is unable to speak. Nobody knows yet if these episodes are from TBI, PTSD or silent seizures.

I start to leave but Kenny invites me to stay for dinner. There is nothing he loves more than barbecuing for his family. Over pork chops, chicken and the best baked beans I've ever had, he tells me about Friday nights in Iraq when he'd cook for his men.

"It made me so happy to see them eat," he says. "Some of them didn't want to eat and I'd tell them they had to. They were good guys. I miss them."

Valley Center resident Brigid Brett is a freelance columnist for the North County Times. Contact her at brigidbrett@aol.com.

Where to get help

To donate to, volunteer with or seek help from organizations that assist military families and veterans, contact:

Operation Homefront

San Diego/Camp Pendleton Chapter

P.O. Box 26747

San Diego, CA 92196

Contact: Christine Mandilakis

Phone: (866) 424-5210

www.operationhomefront.net

San Diego Armed Services YMCA

3293 Santo Road

San Diego, CA 92127

(858) 751-5755

www.militaryymca.org

Veterans Village of San Diego

4141 Pacific Highway

San Diego, CA 92110

Contact: Jeanie Levinson

(619) 393-2030

www.vvsd.net

Habitat for Humanity of Orange County

2200 S. Ritchey St.

Santa Ana, CA 92705

(714) 434-6200

www.habitatoc.org

Fisher House Foundation

1401 Rockville Pike, Suite 600

Rockville, MD 20852

(888) 294-8560

www.fisherhouse.org

"Returning From a War Zone," a 2006 guide published by the United States Department of Veterans Affairs' National Center for PTSD, is intended to help families of military men and women deal with post-traumatic stress disorder.

Find it online at http://www.ncptsd.va.gov/ncmain/index.jsp.

The guide discusses:

-- What is a combat stress reaction?

-- Experiences in the war zone

-- Expectations about homecoming

-- Effects on family life

-- What are the symptoms of PTSD?

-- How often is PTSD diagnosed in veterans?

-- What causes combat stress reactions or PTSD?

-- Other common stress reactions

-- Role of the family in problem solving

-- Encouraging a veteran to seek help

-- How treatment works

-- Common therapies used to treat PTSD

-- Where to go for help

Help with traumatic brain injury

The Traumatic Brain Injury (TBI) Unit at VA Palo Alto Health Care System is one of four national centers treating veterans and military personnel who have sustained brain injuries as a result of traumatic events. Operation Iraqi Freedom and Operation Enduring Freedom resulted in a substantial increase in the number of active duty patients seen in the program, many for nine months or longer.

Although Kevlar helmets and body armor have saved the lives of many soldiers, they do not protect against impacts that cause brain injury. Furthermore, brain injury can occur when there are no obvious external injuries and to those not directly hit by the blast.

Family members are often the first to notice increased irritability, poor memory, anxiety and depression. These changes directly impact daily life, making everyday choices and interactions a struggle. Relationships with family members are often strained, sometimes leading to violent confrontation. Confrontation also can occur with strangers without warning.

For more information, visit http://www.palo-alto.med.va.gov/polytrauma/tbi.asp

Also, contact the Defense and Veterans Brain Injury Center at Walter Reed Army Medical Center.

at (800) 870-9244 or online at http://www.dvbic.org/

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