Army Capt. David McRaney has spent the last two years of his military career coping with a traumatic brain injury (TBI). It’s been a slow and challenging process.
“A lot of people don’t realize that when you have a brain injury, it doesn’t change your intelligence; it changes your speed of thinking,” said McRaney, RN, BSN. He likens it to the difference between high-speed Internet and dial-up service.
At a recent church retreat, McRaney saw a woman fall down. A former nurse, he ran over but couldn’t think of how to help her at first.
“Another guy asked her a question and I thought, ‘That’s a really good question.’ I would have asked that one earlier,” he said. “When I worked as a nurse, I wasn’t the smartest nurse on the floor, but I made up for it by hard work and quick thinking. It’s so frustrating, this know-ledge that you know your brain is struggling.”
McRaney graduated with a nursing degree from North Georgia College & State University in 2004 and worked as a cardiac care nurse before a 19-month deployment to Iraq. When he returned, McRaney worked for WellStar Health System, mostly in renal telemetry and oncology.
In April 2010, he was deployed to Afghanistan and served on a small base in southern Kandahar Province. The base had been taking fire regularly. McRaney was standing in the doorway watching three civilian contractors walk to shelter in a bunker. A mortar exploded nearby, and the three men — who weren’t wearing protective gear — were killed.
“I had my gear on and it saved my life,” McRaney said. “Most of the shrapnel hit between the bottom of my helmet and the top of my armored vest.”
He suffered fractures in his occipital and temporal lobes and had metal shrapnel lodge in his cerebellum. Five days later, he was at Walter Reed Military Medical Center in Bethesda, Md., where he began the long recovery.
Supportive spouse
McRaney’s wife, Jennifer, RN, BNS, a health care information technology and ER nurse, has been his chief advocate. She started researching TBI while he was in the hospital, moved to Maryland and got a nursing job there.
“The therapists were always great, but every provider has different opinions about TBI and there’s so much conflicting research. Sometimes you have to fight the system,” she said.
For example, McRaney began passing therapy tests early on, but the tests are generic. An 18-year-old and a 38-year-old with two college degrees aren’t going to score the same. The couple believed that his brain function wasn’t close enough to pre-trauma levels, so they pushed for additional treatment.
McRaney has undergone months of therapy and surgeries to remove metal fragments from his cerebellum. “They’re finding that shrapnel [made from lead, arsenic and copper] left in the brain rusts and leaches, causing problems down the road,” he said.
“We went to the neurosurgeon armed with research, thinking we’d have to fight to get it done, but he was so pro-active and completely supportive. He said, ‘Let’s do it,’ which was a huge relief,” Jennifer McRaney said.
For a year, he had as many as 15 medical appointments a week, including cognitive therapy, behavioral-health group sessions, and TBI- specific occupational and speech therapies.
“It was self-paced, but I was aggressive with it, because I knew I’d have fewer resources at home in Georgia,” McRaney said.
McRaney considers himself lucky to have penetrating wounds, with shrapnel that shows up on a CT scan.
“TBI is a complicated diagnosis when people have no physical wounds. The symptoms are often the same as PTSD [post-traumatic stress disorder] or bipolar disorder. It can be misdiagnosed,” he said.
When McRaney was granted a scholarship to Colorado Technical University through the Yellow Ribbon Fund, he started an MBA program, taking one class at a time. He holds a bachelor’s degree in business administration from Mercer University, so business is a familiar subject.
“I treat it as cognitive therapy. I knew I needed to challenge myself,” he said.
He also became an intern at Walter Reed, working on the Wounded Warrior floor.
Looking ahead
He is now back home in Paulding County, taking classes, awaiting his retirement from the Army and trying to establish a new routine.
“I feel like I’m making progress, that I’m better, but I’m still not myself,” he said. “Sometimes I’ll do something and Jennifer will ask me why I did that. I honestly can’t give her an answer.”
Coping strategies help. He’ll wear a binder clip on his sleeve to remind his wife that he has a brain injury. At social functions, he uses a code word to let her know when he needs to get away from the crowd.
“I think it’s harder on the families, and I’m grateful to have had a lot of support and help. I can’t thank the people at our church enough,” he said.
McRaney’s goal is to adjust to living at home, finish his MBA, go through a nursing re-entry program and work again.
“It’s tougher being a nurse,” he said. “I know I can’t go back to the type of environment I was in before. I’ll be looking for a more structured, routine setting.”
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