Vietnam Veterans Mentorship: How to Manage and Control Anger?

Like every week, yesterday I met with a group of Vietnam Veterans in the New Mexico area. The group is conducted by a counseling professional. I need to say, every week it is so refreshing to meet with them. The group is very uplifting. There are only two OIF/OEF Veterans in the group; all others are Veterans of the Vietnam War. Most of them are living with Post Traumatic Stress that resulted from their experiences in combat. The Vietnam Vets have welcomed and embraced me, regardless of having fought different wars. They always have great advice. I always tell them that they are great mentors because they already walked the path I am walking today. I thank God every day for putting them in my life!

Yesterday, we had an awesome discussion on anger and managing it. It seems that anger is common amongst Veterans of all wars. In the conversation, we addressed those things that trigger anger. Amazingly, most agreed that on of the biggest triggers seeing people in the communities that act like they are the center of the universe and disregard those around them. For example, those people at the grocery store that leave the shopping cart in the middle of the isle while they go read labels or browse products. Yes, those folks are irritating. Some mentioned the way of how others drive brings anger in them. The trigger that stood out was seeing others behaving disrespectfully, selfish, and discourteous.

After the military, anger is a feeling that I personally deal with. I do not drink, but I can see how alcohol can blur judgement and affect how someone reacts and manages the anger. My advice to those that do drink alcohol: if anger is present, stay away from alcohol. The consequences can be long lasting and in some cases can be catastrophic.

Some thoughts shared were how the feelings of loneliness or worthlessness can put an exponential to the anger we may experience.

How to cope with it? During the group session, we discussed on ways to manage anger.

1. Try to withdraw from situations that trigger anger.

2. Try to put things and experiences into perspective.

3. Recognize that we cannot change everything or everyone.

Some situation are difficult to put into perspective because of our structured way of thinking and because of the military experiences. While in the service, as leaders we fix or raise a flag when we see wrong things or misconducts. Outside the military, it is not as such. Most times, we cannot engage on situations and we cannot correct people the way we used to do in the military. Maybe that sense of feeling impotent can bring anger.

After a Traumatic Brain Injury, the management of emotions becomes harder. Abstract thinking may become a problem. I am a witness to it. We may take things the wrong way, we may take it with meanings that were never intended. This may result in a reaction that is out of line or totally incoherent with the situation at hand. Remember, always try to stop, think and gain awareness on what is happening. In my opinion, being aware of our surrounding and our emotions is fundamental in order to control our reactions.

Bottom line is: we are going go get angry, and probably more often than somebody that has not been in a combat situation. Combat experiences may exacerbate emotions. Whatever the situation try to apply common sense. The ultimate goal should be to manage our feelings and to stay out of trouble. Remember, our behavior and reactions will affect our relationships and our well being.

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TBI After the Military: Loneliness

After many years serving in the Army, I can say that retirement is not close to how my days were while in the Service. Some would think that my days are frustration proof because I am attending school or involved in the Veterans community. Being in school and around Veterans is a very gratifying and I am thankful for it. The reality of things is that most of my days I feel some kind of frustration or anger. I want to say that the cause of these feelings are related to a new life adjustment. This new life more often than not, requires a high level of motivation and self-drive. Many days, I ask myself: what can I do to help others?

For many years all my days had a mission, which involved being around many people and involved in things that were impactful to the Army's mission. I do not have that anymore. I have to create my own daily mission, and motivate myself to be engage in life tasks. I have asked to fellow Veterans (OIF, OEF and Vietnam) about the feeling of loneliness. It has been common to hear amongst them that they have dealt with loneliness since the separation from the military.

It has been my personal experience that the feeling of loneliness turns into anger. Well... I call it anger, maybe it's something else. It is nothing related to violent behaviors, it feels more like an extreme feeling of being overwhelmed and being stuck at the same time.

Maybe Veterans that read this can relate to these feelings.

What has helped me deal and manage this feelings?
1. My faith in God.
2. I talk about it with my wife and with counselors.
3. Avoiding isolation.
4. Go out to a store, to dinner or to watch a movie (even when don't want to)

I have found very helpful to have situational awareness, which is knowing what's going on inside me. It is important to recognize triggers that if not avoided can exhacerbate the feelings. Reaching a point of being saturated with feelings of loneliness can turn into sadness, or even worse, can turn into depression. In my opinion, the key to success in surviving these feelings is to be watchful of not becoming isolated or alienated from society and from our support network. It might feel that these feelings overtake us but, I am a witness that there is light at the end of the tunnel. There will be good days and not-so-good days. The good days will always happen more often than not.

Talk about it. We are not alone!

Veterans Suicides Increased: Coping Advice from One Vet to Another

It is alarming to see the recently released statistics on suicides amongst military Veterans (22 per day/ 1 every 65 minutes).  This issue brings to mind the questions of:

• Are we doing enough?
• Is this a result of measures put in place to merely check the block?
• Why are Veterans not speaking up?
• If they speak up, are they being heard?

I want to share my own personal experiences and coping strategies. 

I was medically retired from the US Army last September 2012.  After spending many years in the military, it is shocking and a dramatic change to be in this status.  While in the Service, I was always around Soldiers and I was part of a mission that was bigger than myself.  Now, retired, my days cannot be compared to those spent in the Army. Now, life forces me to embark in the great quest for meaning, purpose, motivations, and drive.

• Does it sounds like isolation, lack of purpose and motivation can be common issues amongst Veterans?
• Does the lack of purpose, meaning, motivation and drive, could result in self-destructive behaviors?

I will not attempt to answer these questions, I would defer that to the mental health professionals.  But, I can share those things that I find helpful in overcoming sadness, frustrations and isolation.

Based on my own personal experience, I want to advice other Veterans to try to engage in tasks that will be meaningful and will give some level of gratification.  For example, in days I feel sad and isolated I read, write or do something meaningful in the house that will be noticed by my wife.  The simple fact that she notices it, gives me gratification.  Reading or writing gives me the satisfaction of feeling of having accomplished something at the end of the day.  The constant engagement in different things gives purpose to my day.  I also try to engage in some kind of physical activity or exercise on a daily basis. I understand that engagement can be very difficult after a traumatic brain injury.  It is difficult but not impossible. 

As Veterans, we need to be vigilant for those behaviors that if rooted can potentially become problematic.  Finding purpose, motivation and meaning is unique to each individual.  All can be found and attained. Maintaining discipline and a neat personal appearance have been very helpful in the upkeep of my feelings and emotions.  Even though I am not in the Army anymore, I still keep and present myself with a Soldier-like attitude and appearance. 

Things I have found instrumental to avoid negative emotions are:

• Involvement with the church and God
• Speaking to other Veterans
• Speaking to other people in general
• Attending school
• Physical activities/ Exercise

Please remember:

• God cares; no problem is too big for him.
• Your family loves you; the pain inflicted on them by a suicide is gigantic.
• Many people out there treasure and value your Service; they would love the opportunity to help.
• Never be ashamed for sharing and talking about things that are bothering you; getting things off your chest will be a relief.
• There is always HOPE.
• It will get better.
• We care for you; and we are thankful for your Service.

The Veterans Crisis Line (1-800-273-8255) is there to help.

Thank you for serving!

HOOAH!

Carolina Reyes invites El Paso Military Spouse, Roxana Delgado, to attend State of the Union | U.S. Representative Silvestre Reyes

Carolina Reyes invites El Paso Military Spouse, Roxana Delgado, to attend State of the Union | U.S. Representative Silvestre Reyes Here is my wife. She will be attending the State of the Union Address tonight!!!

Traumatic Brain Injury (TBI) or Post Traumatic Stress Disorder (PTSD or PTS)

First and foremost, I will make the disclaimer that I am not a medical professional.  I am not trying to act like one.  I believe that my experiences and the fact that I survived a Moderate Traumatic Brain Injury gives me a voice to express thoughts in this subject.  The purpose of this article is to create a healthy and respectful discussion.

Many times, in the military, I hear the terms Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD or PTS) forced together in a phrase or a sentence.  It is implied that TBI and PTSD are "kind of" the same thing and that the treatment for one works on the other.  As many of you know I sustained a TBI in Iraq. It is expected for me to have PTSD.  Well... I am PTSD free.  My symptoms are 100% neurological that resulted from the TBI.  

I have heard that PTSD and TBI are comorbid.  I am sure that in many cases both conditions are present.  But according to the definition of comorbid, one does not exclude the other.  Not because they can coexist means that one will be treated and the other should be taken care by itself (which I have heard many times).  The American Heritage Medical Dictionary defines comorbid as coexisting or concomitant with an unrelated pathological or disease process. 

Rarely, I hear "amputee and PTSD" on the same line.  The amputee receives treatment and rehabilitation for the loss of a limb. If there is PTSD present they receive care for that as well.  Two separate injuries, two separate treatments.  But when it comes to TBIs, commonly I hear it side by side with PTSD.  Rarely I hear TBI by itself.  I believe talking about these two different conditions so attached to each other brings misconceptions, dismissal, downplay, and widens the room for error.  

The National Institute of Health defines Traumatic Brain Injury as: a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.  Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.   A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.  A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.

Also, the National Institute of Health defines Post Traumatic Stress Disorder as:  is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.

Clearly, TBI and PTSD are two separate and very different conditions that should require two separate and very different approaches. One is a physical injury to the brain whereas the other is not.  In my opinion, the care team should include different specialists for each of these conditions.  I am not a medical professional and I can see the difference.

I have heard that many of the behavioral issues after a TBI are due to a frontal lobe injury.  http://neuroskills.com defines the function of the frontal lobe as: The frontal lobes are considered our emotional control center and home to our personality.  

A question comes to mind: How many PTSD are frontal lobe injuries? Or, how many frontal lobe injuries are taken as PTSD?

Bottom line: TBI and PTSD are obviously two separate and very different conditions.  

I leave you all with the question:  Why are these two conditions are being forced to be "married"?

Traumatic Brain Injury: Feeling Useless or Unproductive?

Many times after a Traumatic Brain Injury we feel as if we are not good with anything.  In my experience this is a feeling that comes and goes.  From my personal stand point, at times I feel it becomes very difficult to engage on things.  Most importantly, it is those things that others expect us to do but we cannot find a motivation or a drive to get our hands on the given tasks.  I have to say that even utilizing the compensatory strategies it is hard to find that drive or motivation.  Everything seems to be a lot of work.  Even the things we used to enjoy before the injury.  I experience these feelings quite frequently.

I have learned to go around my impairments in a way that I do not focus on them.  There are some areas that are what makes us functional, those I do face with courage.  At the end we want to achieve complete independence, with or without impairments.

So, how to feel useful and productive?

The answer lies within our own selves.  What works for me is not going to work for everybody, but it can give you a general idea on how to to avoid such feelings.  I always try to focus on the things I can do well, and set a goal on a daily basis.  This set goal is one that can be achieved, is realistic and can be measured once completed.

For example:
I like to write and journal.  Let's say today my goal was to write this post.  Since I have been doing it for a while it has become something that does not take that much effort.  As soon as I finish writing it I will be able to see that I achieved what I had planned.  As for realistic, my goal was to write a blog post, I did not set myself the goal of writing a book or an essay today. In no way that can be a realistic goal, it is not likely that I will be able to complete that goal in one morning or one day.  It do not matter how many road blocks or struggles I find on my road today, at least I can say that I accomplish one task and one goal.

In my opinion feeling productive has a lot to do with what we accomplish in a day.  Accepting our limitations is a crucial part of overcoming feelings of uselessness.  We have to set those goals that we know we can achieve.  Setting goals that are too hard or close to impossible will bring those feelings we do not like and we want to avoid.

So, how do I succeed at accomplishing what others require me to do?  My life has become about setting goals and accomplishing them.  I have created a task list that goes by days and deadlines.  Every morning I look at the tasks for the day.  As I accomplish any given task I cross out the task as completed.  My goal every day is to clear the tasks that I have on my list.  At the end of the day I have a great feeling when I see my list being cleared.  When I am not able to clear it, I still feel good because when I look back I can say that I accomplish many things in the day.

Every Traumatic Brain Injury is different, I know that compensating is different for all. I hope that my experiences and strategies can be helpful in achieving success.

No matter how your day goes, always remember that "IT WILL GET BETTER".

Speech to the Miners at the University of Texas at El Paso

Hi all. This afternoon Roxana and I had the opportunity to address the women's basketball team at the University of Texas at El Paso. Needless to say it was a very gratifying experience. We shared the floor with a person that survived a car accident caused by a drunk driver. Him along with his wife and two children shared their survival experience with the team. The audience as well as Roxana and I were deeply moved by their story.
I spoke about my injury as well as coping skills, hope, and motivation. Also during the speech we addressed how life can change in the split of a second. The audience was you and energetic. I was humbled to see how my words had caught their attention.
As their season approaches we were ask to talk to them to help the come into focus and motivation for the upcoming games.
They could clearly understood that besides the blessing of being able to play their sport, there are opportunities that present in our lives that should not be taken for granted. I included in my speech my perspective of a team and leadership. I told them that the principles applied in the military for the execution of missions could be applied to the game of basketball. In order to be successful they needed to understand that they have to know each member of the team. They need to be able to know what the other is thinking when no words are spoken. I addressed that regardless of winning or loosing they always needed to play the best game possible. Life is not easy as the games are not going to be easy. But they had to play their best game every time.
At the end they seemed motivated and I think the goal of the event was met. Roxana mentioned something that stuck on them as well as on me. She said "The opportunities of today will define your future".
They named us honorary coaches of the team. I am honored and humbled by the opportunity.
Good luck to the Miners during this season. Go Miners!

September: Suicide Prevention Month

Hi everybody.  September is the Suicide Prevention Month. Many days in our lives are busy, rushed and at the end we wish we had more time to accomplish more.  At the same time we are going through our regular days, some people are going through an extremely irregular day because they might be contemplating the idea of suicide.  When was the last time you looked at all those around you and wonder if they are in need of help? The National statistics (http://www.cdc.gov/nchs/data/databriefs/db64_fig5.png) are alarming.  In 2009, there were approximately 11,838 suicides. That is a significant number.  In my opinion, 1 or 11,838, is significant when we are talking about suicides. 

How can we prevent suicide?  Regardless of our social status, job position, age, ethnicity, gender, political affiliation, etc, we should be taking care of those to our left and right.  We should be talking to them and be concerned if we see any sign of suicides.  As we see this signs we should become an instrument of hope, support and information. 

There is a very famous quote by Charles F. Browne "We can't all be Washingtons, but we can all be patriots".  In suicides, one cannot prevent all but we can all prevent one.  It is sad to see that a life is so hopeless that they contemplate suicide as an option.  It deeply saddens me when I learn through the media that somebody has committed suicide.  There is a lot that all of us can do to help prevent such deaths.

There are resources that by us knowing we can share with those in need.  Nationally we have the National Suicide Prevention Lifeline, the American Foundation for Suicide Prevention, the Veterans Crisis Lifeline, the Defense Centers of Excellence, Real Warriors, churches, chaplains, among many others.

Let's do our part!

Let's put our grain of sand!

Let's be people of action!

Let's help others!

Let's be instrument of change and support!

One life lost is too much!

             

                               

Sleep Problems After a Traumatic Brain Injury?

Yesterday a friend contacted me and mentioned that he couldn't sleep
well after his head injury, which is the reason why I am writing this
today.  The things I am about to mention are based on my personal
experience.  I am not a medical professional but I can tell you that I
know first hand what a brain injury is.
Immediately after I sustained a brain injury I had sleep issues.  The
issue that stood out the most was that I could not sleep enough.  I
went from being a person that could sleep a few hours, waking up full
of energy to a person that could not get enough sleep.  That was one
of the first signs that those around me noticed.  When it was time to
wake up, the alarm would be going off for hours and I could not hear
it.  I would sleep twelve plus hours.  This is an issue is an ongoing
today but I have disciplined myself to avoid any oversleeping.
I have heard from other TBI survivors that their problem is the
opposite.  They cannot sleep.  This has happened to me but the most
common for me is not being able to wake up in the morning.
Sleep is something that more than a need it is a process.  For this
process to happen optimally we have to understand that we have to
control and adjust our environment.  I know that many have TV sets in
the bedroom.  This is not recommended but at the same time it is
something that many of us are extremely used to.  The question now is:
what are you watching prior to sleeping? Are you watching Law and
Order? Are you watching a news channels? Watching programs as such
affect the amount of time I need to fall asleep. Many of us are
dependent of the TV, one thing that has worked for me is to watch
documentaries.  Not the type that show the gangs or people fighting in
prison.  I watch the type of documentaries that involve nature,
especially those that involve the ocean. This type of programs make me
feel some kind of relaxation. Last week I watched Oceans, a
documentary produced by Disney. I found this one very soothing.  It
got me so relaxed that I even fell asleep watching it.
Other things Roxana and I do is that we keep our bedroom very clean
and organized.  In order for me to have a pleasant sleep, I need the
environment to be peaceful.  I honestly don't believe that having a
mess can contribute or help for a good night sleep.
Once we are ready to go to sleep, we turn on a water fountain and the
recording of a thunderstorm.  I grew up in a place that thunderstorm
were almost a daily event. The recording I have sounds exactly like
the TStorms back at home.  We leave the fountain and the TStorm
recording run all night long.  With that I rarely wake up in the
middle of the night.
I have met other people that use things like guided imagery or
meditation before going to sleep.  According to them it works greatly.
If you are having sleep problems this can be another tool to
experiment with.
I have heard also, that avoiding looking at the clock while trying to
sleep is helpful.  So, I recommend to put the clock in a way you can't
see it. I use my phone as a clock at night.  When is time to sleep I
flip it upside down.
In my opinion, good sleep hygiene does not involve only the act of
sleeping but is a process that includes the person and the
environment. A neat environment can contribute to feeling at ease.
Only you know what bothers you and what might help.  Others can only
offer advice.
Remember, that after a brain injury we have to adjust the environment
to maintain our independence.  The same goes to sleep. We have to make
adjustments to succeed at having a good night sleep.  Keep trying and
you will see that you will succeed.

IT WILL GET BETTER

TBI Warrior Launches New Redesigned and Improved Webpage

http://www.tbiwarrior.com ~ During the past several months I gave some thought on how to improve the TBI Warrior webpage. On the new webpage you will find Forums. Users will be able to share, ask, answer, or just simply connect with others in the Traumatic Brain Injury community. I encourage survivors, caregivers and care providers to introduce themselves and network with others in the community.
You will also find a redesigned News tab. Here you will find the latest headlines Related to the care and treatment of TBIs.
Aside from the forums there is a "Share Your Story" area. Here, Survivors or Caregivers, Military or Civilians, can write and publish their own story.
The new page has a military look but is NOT limited to military and veterans. Bottom line, regardless of your mechanism of injury, a head injury is a head injury. We all have symptoms that manifest differently but they can be categorized within same categories. Military and civilians possess the power to support each other.
Feel free to stop by the webpage and submit any feedback to info@tbiwarrior.com.

"IT WILL GET BETTER"