“The headaches were so severe I would close my eyes in a dark, calm space to ease the pain. I experienced panic attacks due to the migraines and could not take care of anything other than to be a part of myself and manage the breathing.” explained Navy Veterans JL. “It is the worst and most stressful moment in my life. I’m a mom and I had to take take care of my children and I couldn’t manage myself.”
In the case of JL, headaches are an result of an injury to the brain that was traumatic (TBI) caused by a motor vehicle crash. JL was in Italy and was employed as a translator. She sustained skull fractures, injury to her face, as well as the blindness of both eyes. Then she regained vision on her left side. She required multiple reconstructive surgeries to fix the injuries to her face and head.
“After the incident, I was transported to Germany after which, when I was strong enough to be able to return home to U.S., I was transferred into the Navy hospital in Bethesda, Maryland, where I spent almost a year recovering,” continued JL. “When I finally felt healthy enough to be released of the medical facility, I attempted to return to my normal civilian life.”
“My discomfort was a nine-out of 10.”
The life of a nomadic JL following being discharged medically from the Navy. She relocated across Maryland and then New York to Nevada to Tennessee before finding a place to call home in the Tidewater region in southeast Virginia with Zeus, her dog service. Zeus.
At the time, she worked with a variety of VA or civilian health professionals in order to treat and alleviate discomforting headaches.
“The headaches were always part of my life post accident. My pain was typically an ‘nine-out-of-10 and, up to five times a week I was completely incapacitated,” she explained. “I am not sure how I got through it. I was just aware that I had no other option.”
It was finally time for relief for JL after he connected with JL’s Polytrauma System of Care team at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia.
Like with every new patient at the first appointment, it was important to collect details about the event that led to the injury and any prior treatments as well as the specific requirements and objectives of the veteran.
Holistic approach with less drugs and
JL along with JL and Dr. Karen Williams designed a treatment plan together. JL was not looking for to be treated with many medications that could have potential adverse consequences. They talked about her goals for treatment and the best way to reach them with an integrated treatment plan.
Williams is the deputy director for the Headache Center of Excellence in Richmond.
JL had been diagnosed as having post-traumatic headaches due to her serious TBI and an anxiety. The treatment plan she received from Dr. Williams and the headache center was combined with treatments from her polytrauma/trauma provider. Together, they worked on her memory issues and also other TBI associated injuries.
“JL initially was advised to re-initiate her Botox injections and they proved somewhat successful” stated Dr. Williams. “We then added occipital block to help reduce the pain of the posterior part of the head as well as acupuncture to ease the headaches and also switched her medication to a different medication which led to faster resolution of headaches and less adverse negative side negative effects. A neuromodulation device, which is a device that provides low-frequency electric stimulation was later added for use at home to assist with anxiety-related symptoms as well as relaxation methods. She was also referred to a psychologist to help with processing the traumatizing memories of her crash.”
Encouragement to encourage others is a crucial element
Through her entire treatment providing information on the diagnosis, treatment options, and providing supportive support were important elements in aiding JL get better and increase her performance.
“Like most of us Veterans, JL deals with numerous complicated problems,” continued Williams. “We have to take the time to peel back the layers one at a time in order to find the best treatment. This is about giving the Veteran determine what is most important to them and then making use of resources to assist the Veteran improve their health and functioning.”
JL’s treatment remains in Richmond VA. She continues to work on improving her headache treatment program and tackle other physical issues. Rehabilitation after the trauma of a TBI is a lengthy process. But, her life is improved thanks to the doctors at the Richmond Virginia’s Headache Center of Excellence.
“My lifestyle is far easier to manage.”
“The main thing I appreciate was the fact that the doctor. Williams understood I wanted an alternative approach to my treatment. I am a fan of treatments where I’m not ‘clogged up. My quality of life may not be as good as I’d like for it, however ever since I came across Dr. Williams, my life is much more manageable.” JL said. “I have more time to spend time with my children. The treatments have provided me with an increased capacity to be more active and social. I’m not as anxious. I’m taking a medication that can ease my anxiety should I suffer from a bad headache while on the go.”
For more information about VA treatments for migraines and headaches, visit www.polytrauma.va.gov/headache/.