Posted on Mar 19, 2015
Why our “Take a Motrin” approach could be hurting our troops: Part I of II
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All of us have experienced – or at least heard about – this type of situation unfolding overseas: a troop suffers a potential head injury, is hastily evaluated (despite best intentions), and is put back into the fight too early. “Take a Motrin,” the adage goes, where unit-level medics give troops a few Motrin, ask them to recite the alphabet backwards, and tell them to shake it off. Added to this is that military personnel have a tough mentality; they too often avoid admitting they’re hurt or in pain until it becomes unbearable. But by then, it could be too late, and tragedy becomes almost inevitable.
The unit-level “screening” tests conducted in the military actually do not tell us much about the true brain injury that may have occurred. For example, we don’t know whether taking a Motrin helps or actually HURTS a troop with a serious head injury. In a literal sense, this means a troop could have a TBI, and the military’s protocols could actually be hurting him/her. It’s true, as much as I wish it wasn’t.
What we need is a test that tells us whether this troop is truly injured, how bad the injury is, and how we may be able to best treat him. Magnetic Resonance Spectroscopy (MRS) is such a test. It’s a unique version of an MRI that measures the chemicals in the brain – a completely harmless procedure that can tell if chemicals in the brain have changed. A renowned Harvard brain scientist, Dr. Alex Lin, is spearheading an ambitious study to bring this test to the DoD – a change that would save the lives of countless members from among our military community.
Currently, we can look at MRS studies in mice to see how their brain chemicals change after head trauma from a blast. We can also look at MRS studies from NFL players and professional soccer players, and make predictions about what chemicals might change in military troops due to a blast. However, scientists don’t know exactly how the brain responds to an IED blast versus a high-impact football tackle. This requires us to further investigate how an IED blast specifically affects troops’ brains.
Through Dr. Lin’s MRS study, it will be possible to not only determine what chemicals in the brain change due to an IED blast, but also start the process of developing new treatments that could improve – and ultimately save – troops’ lives on the battlefield and years later at home, after they have taken off the uniform.
Perhaps most groundbreaking for readiness across the DoD today, these MRS studies will also allow doctors to easily identify troops at risk for PERMANENT damage if they are hit by another blast – thus preventing troops from returning to the fight before they are ready.
-- How you can do your part to save troops’ lives –
While these studies are sometimes enigmatic, they are critical in that they enable us to learn what we don’t know. The success of Dr. Lin’s study ultimately requires active troops and veterans to volunteer a few hours of their time to be scanned. Being that I am a veteran who is no longer serving, the decision to take three hours to get my brain scanned was easy – the whole time I was thinking, “I am doing my part to save the lives of my brothers and sisters in arms.” The medical community is working to equip line medics with better diagnostic tests and tools to protect troops suffering from a TBI, and as individuals we can all play a role in pushing this process forward.
Dr. Lin in Boston, MA is conducting this study. If you are in the New England area, or are willing to travel to do your part just like I did, please say so by posting a response in this thread, or by clicking this link: http://bit.ly/bwh_study
In my Part II follow-up in this series, I will share my own experience going through this study with Dr. Lin. Coming soon!
The unit-level “screening” tests conducted in the military actually do not tell us much about the true brain injury that may have occurred. For example, we don’t know whether taking a Motrin helps or actually HURTS a troop with a serious head injury. In a literal sense, this means a troop could have a TBI, and the military’s protocols could actually be hurting him/her. It’s true, as much as I wish it wasn’t.
What we need is a test that tells us whether this troop is truly injured, how bad the injury is, and how we may be able to best treat him. Magnetic Resonance Spectroscopy (MRS) is such a test. It’s a unique version of an MRI that measures the chemicals in the brain – a completely harmless procedure that can tell if chemicals in the brain have changed. A renowned Harvard brain scientist, Dr. Alex Lin, is spearheading an ambitious study to bring this test to the DoD – a change that would save the lives of countless members from among our military community.
Currently, we can look at MRS studies in mice to see how their brain chemicals change after head trauma from a blast. We can also look at MRS studies from NFL players and professional soccer players, and make predictions about what chemicals might change in military troops due to a blast. However, scientists don’t know exactly how the brain responds to an IED blast versus a high-impact football tackle. This requires us to further investigate how an IED blast specifically affects troops’ brains.
Through Dr. Lin’s MRS study, it will be possible to not only determine what chemicals in the brain change due to an IED blast, but also start the process of developing new treatments that could improve – and ultimately save – troops’ lives on the battlefield and years later at home, after they have taken off the uniform.
Perhaps most groundbreaking for readiness across the DoD today, these MRS studies will also allow doctors to easily identify troops at risk for PERMANENT damage if they are hit by another blast – thus preventing troops from returning to the fight before they are ready.
-- How you can do your part to save troops’ lives –
While these studies are sometimes enigmatic, they are critical in that they enable us to learn what we don’t know. The success of Dr. Lin’s study ultimately requires active troops and veterans to volunteer a few hours of their time to be scanned. Being that I am a veteran who is no longer serving, the decision to take three hours to get my brain scanned was easy – the whole time I was thinking, “I am doing my part to save the lives of my brothers and sisters in arms.” The medical community is working to equip line medics with better diagnostic tests and tools to protect troops suffering from a TBI, and as individuals we can all play a role in pushing this process forward.
Dr. Lin in Boston, MA is conducting this study. If you are in the New England area, or are willing to travel to do your part just like I did, please say so by posting a response in this thread, or by clicking this link: http://bit.ly/bwh_study
In my Part II follow-up in this series, I will share my own experience going through this study with Dr. Lin. Coming soon!
Posted >1 y ago
Responses: 34
I'm a case study for this.
Early in 2012, a SF Assessment reject came back to the unit and he was put in charge of PT. (PT stud should know everything about PT right?)
2 days after he took over PT, I was injured while conducting a downhill buddy carry sprint. My right knee basically bottomed out compressing and tearing my meniscus.
PT stud SF Reject didn't believe in the severity of the injury so he had me finish PT and I couldn't go to the Aid Station until the next morning. (Because that's what we do, we schedule injured soldiers medical care instead of sending them ASAP)
Long story short, after multiple visits to the Aid Station, several temp profiles and Motrins later, I still had not been seen by a specialist, or at least an X-Ray taken.
This continued until deployment in April 2013, finished my deployment with a horrendous knee pain and more Motrin and basically "Take it easy on the knee".
Came back from deployment and only upon RSRC, when asked about any joint pain, I mentioned the knee history and treatment (or maltreatment) and I was immediately referred to a Knee specialist, who ordered X-Rays and MRI.
Shortly after I was then referred to the actual Chief of Medicine (also a knee specialist) for a more specific MRI and eventually Surgery.
Bottom line is, my Meniscus was torn, bone had been shaved, there was a fragment of both bone and cartilage stuck behind my knee cap which was the reason for the cracking, popping and grinding.
So as a result of all this, now I have an Arthritic Knee, courtesy of both the SF Reject PT Stud and a series of PAs that can only prescribe Motrin.
Rant mode off.
Early in 2012, a SF Assessment reject came back to the unit and he was put in charge of PT. (PT stud should know everything about PT right?)
2 days after he took over PT, I was injured while conducting a downhill buddy carry sprint. My right knee basically bottomed out compressing and tearing my meniscus.
PT stud SF Reject didn't believe in the severity of the injury so he had me finish PT and I couldn't go to the Aid Station until the next morning. (Because that's what we do, we schedule injured soldiers medical care instead of sending them ASAP)
Long story short, after multiple visits to the Aid Station, several temp profiles and Motrins later, I still had not been seen by a specialist, or at least an X-Ray taken.
This continued until deployment in April 2013, finished my deployment with a horrendous knee pain and more Motrin and basically "Take it easy on the knee".
Came back from deployment and only upon RSRC, when asked about any joint pain, I mentioned the knee history and treatment (or maltreatment) and I was immediately referred to a Knee specialist, who ordered X-Rays and MRI.
Shortly after I was then referred to the actual Chief of Medicine (also a knee specialist) for a more specific MRI and eventually Surgery.
Bottom line is, my Meniscus was torn, bone had been shaved, there was a fragment of both bone and cartilage stuck behind my knee cap which was the reason for the cracking, popping and grinding.
So as a result of all this, now I have an Arthritic Knee, courtesy of both the SF Reject PT Stud and a series of PAs that can only prescribe Motrin.
Rant mode off.
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Good article....and if that is really all your unit level medical does you need to replace them. There are many field tests that can be done to help rule-in and rule-out head injuries that are much more precise that the "copish" test of counting backwards, saying abc(s), or walking a straight line. A neuro exam is not a difficult thing to learn....it just needs to be added to the Army curriculum ....it's aleardy in the AF's ....but there medics are required to be at least EMT B certified....anyway as I started with get a new medic if that's all they are doing....they are hurting you in more ways than one I assure you.
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Side note btw....it's been my experience that the Sq NCO or Commander want the solider back in action....and no matter what the Medic (especially if they are enlisted) says they are going to keep their "star players" on the field. I've had to call above the commander's head to keep a guy on bed rest....but a lot of folks wont' do that....to afraid of the repercussions.....anyway just saying it's not always the medic sometimes it's leadership or the "coach."
I had a kidney stone in country. The HM1 decided that all I needed was motrin. Once I started screaming and writhing in agony, he decided to go to a larger dose of aspirin. Surprise, surprise, this didn't work and I ended up at Charlie Med getting Dilautin shots until it could pass. I have minimal respect for the "Motrin Cures All" mentality.
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Piss poor medic....sorry you had to suffer like that.
SGT (Join to see)
Not defending the Corpsman in question but what is the most a medic can do for someone in that situation ? I'm not being sarcastic.
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During my 20 years, the TMCs would have standard "Ranger Candy Packs"... bottles of 60 ea, 800 Mg Motrin for general dispersal. Granted we were 82nd Airborne Division and We ate them and Liked it. But Thinking back on it... probably not the best thing for us.
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Motrin and Ibuprofen are the quick cure all for them and has always been that way. When I had any type of health issue no matter what it was, Motrin was prescribed. I eventually had 2 bouts with Pneumonia and found out I was allergic to coral. They couldn't figure out why my system was reacting the way it was. It didn't matter if there was pain, fever or whatever.
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There was a study going on at Saint Louis university, they were studying the difference between 4 groups, Military with/without TBI, and civilians with/without TBI. I don't know all the info of the study, but it was hard, it went too fast to proccess for me.
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Recent study and warning by the FDA that the use of NSAID's, in higher-level prescription medications (800mg of Motrin) increased the risk of cardiac arrest by about 50 percent
Advil, Aleve, Motrin, more can cause heart attack or stroke: FDA
An Emory professor is among a group of medical experts echoing the government’s warningthat certain non-aspirin painkillers, including ibuprofen, can actually increase the risk of heart attack and stroke, even in low doses.
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Army medical through ATTRS has a pretty good course on TBI and Omega-3 run through Walter Reed and some docs around the country. The problem is real out there, but the bigger problem is that when a soldier reports an injury in the contemporary climate of the military they are at risk for being bounced out rather than helped. I personally know this fight. Hell they even try to PEB you instead of MEB. With so many cases like that going on, the "take a knee and drink water" approach is how we do it. It's how we have to do it if we don't want our careers on the line. Watching a DS in basic smoke us until one girl dislocated her arm after 4.5 hours was ridiculous, I ended up with an LOD from that nonsense snapping something in my shoulder too because I didn't officially report it until later under direct orders from a drill sgt. She was processed out for her reporting, and I was not. The system is a double edged sword, and one edge is serrated. Until we fix that, and make sure soldiers know they will be able to continue to serve and that their health is truly important, we won't have reporting of injuries on the levels that they should be.
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