News & Information - The Mercury - January 2009 Mercury

Story and photo by Air Force Staff Sgt. Don Branum

	COL Augustin Gomez, a psychiatrist with the 1835th Medical Detachment (Combat Stress Control), speaks with a Soldier about post traumatic stress disorder at Joint Base Balad, Iraq.

Air Force and Army medics at Joint Base Balad in Iraq work as an integrated team to treat post-traumatic stress disorder (PTSD) and traumatic brain injuries, two of the most common injuries to affect wounded warriors.

The cooperation between services reduces the number of service members who must be aeromedically evacuated from the theater, said Air Force Col. Mark Mavity, 332nd Expeditionary Medical Group commander.

The Army provides neurosurgical capability through the 207th Medical Detachment head and neck team and acute stress care through the 56th Multifunctional Medical Brigade.

Time is precious when someone suffers a head injury, said MAJ Shaden Marzouk, a neurosurgeon with the 207th. Injuries to the brain or skull can cause fluid to build up inside a patient's skull, creating pressure on the brain. If the pressure becomes too great, the top part of the brain, or cerebrum, pushes into the medulla—the portion of the brain that controls the heart, lungs and other involuntary organ systems.

"Patients with traumatic brain injuries need immediate care to preclude that injury from becoming fatal," Mavity said.

The Army also works with the Air Force to provide for patients' mental-health needs, said Air Force Lt. Col. Jim Whitworth, officer in charge of the mental-health clinic.

The Air Force mental-health clinic helps patients deal with traumatic brain injury cases, most of which are mild concussions, said Maj. Rich Barker, a psychologist. Five of six patients there are Soldiers, Barker said. They typically suffer symptoms such as headaches, insomnia, irritability and anxiety. The mental-health clinic relies in part upon psychiatrists with the 1835th Medical Detachment (Combat Stress Control), an Army Reserve unit.

"Traumatic brain injuries and PTSD have many of the same symptoms," said COL Augustin Gomez, a psychiatrist with the 1835th who specializes in treating PTSD. "If we suspect an individual has a traumatic brain injury, we screen them and send them to the Air Force clinic."

Common symptoms of PTSD and traumatic brain injury include insomnia and anxiety. Gomez uses therapy, medication and acupuncture to treat his patients, while the Air Force clinic offers relaxation therapy and prescriptions through patients' primary-care managers.

"There are a couple of symptoms we really try to tackle—headaches and insomnia," said Whitworth. "Insomnia fights the healing process, because resting is the number-one way of healing."

The most important step in healing is continuity of care, Gomez said. Service members shouldn't assume their PTSD has gone away simply because the symptoms have disappeared.

"PTSD is a chronic illness, and they may have a relapse," he said.

Both the Air Force and Army medical teams complimented their counterparts.

"Post-traumatic stress and traumatic brain injury often go hand in hand - the same patients can suffer from both following a single event. The 56th MMB focuses on post-traumatic stress, and the Air Force mental-health professionals work with mild traumatic brain injuries," Mavity said. "They're working in great partnership to take care of all of these patients' needs on both ends of that spectrum."

"We're very seamlessly integrated," Marzouk said. "We don't think of ourselves as Army or Air Force; we're just another part of a great team."

(332nd Air Expeditionary Wing)

From the January 2009 Mercury, an Army Medical Department publication.