Healing Beyond the Blast: A Holistic Treatment Journey for Veterans with Chronic TBI & Comorbidities”
The Story Begins: Why This Matters
Imagine someone who carried the weight of war, the invisible injuries of combat or a violent accident—and then, years later, the echoes of that injury keep coming back: headaches, sleepless nights, memory lapses, emotional storms, chronic pain. That person might live in Karachi, Cape Town, Tokyo or London. The story is global.
In the recent case report An integrative, holistic treatment approach for veterans with chronic traumatic brain injury and associated comorbidities: case report, researchers from the MossRehab Institute for Brain Health (MRIBH) documented a veteran with multiple traumatic brain injuries (TBIs), post-traumatic stress, chronic musculoskeletal pain—and show how a deeply tailored, interdisciplinary, holistic program ignited real change. Frontiers+2PMC+2
As your lecturer-friend here, I want you to keep this thought: injury is not just physical. Recovery cannot be just physical. The mind, body, community—all must be woven together.
Understanding the Challenge: The Veteran’s Profile
Let’s meet our “case”: a 47-year-old veteran (“Mr Doe”) who had multiple TBIs. One significant event was a motor-vehicle collision in 2017 leading to moderate-to-severe TBI (right frontal hemorrhage, possible diffuse axonal injury), multiple facial fractures, skull fracture, lung contusions, rib fractures, and more. PMC+1
On top of that:
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Persistent headaches, sleep difficulties
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Cognitive issues: memory, attention, executive functioning
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Emotional/behavioral: depression, anxiety, anger, PTSD
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Chronic pain in musculoskeletal system
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Vision/oculomotor dysfunction
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Gait, balance, dizziness issues
This is not a mild case. This is the sort of injury where people often resign themselves to “this is how it will always be.” But that’s why this story matters, because change did happen.
The Integrative, Holistic Program: What Was Done
Here’s what the team at MRIBH did—and keep in mind, this is rich, multi-layered care, not one single pill or therapy. This is the kind of program that someone in Karachi, Nairobi, or SĂŁo Paulo might adapt in spirit (even if not exact).
1. Assessment & Team Planning
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A 3-day evaluation by multiple clinicians (physical medicine & rehabilitation, PT, OT, speech-language pathology (SLP), behavioral health (BH), art therapy (AT), integrative therapies) to map out the full spectrum of needs. Frontiers+1
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The treatment plan was individualized, and the same clinicians working on assessment carried into treatment to maintain continuity.
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Regular team rounds, secure collaboration platform, informal daily exchanges to adjust in real time. PMC+1
2. Intensive Outpatient Program (IOP) for 3 Weeks
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Approx 90 hours of treatment over 3 weeks, full-day structured, cohort of up to 5 veterans. PMC
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Disciplines included:
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Physical Therapy (PT): gaze stability, balance, motion habituation, gait training, VR training for motion sensitivity. Frontiers+1
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Occupational Therapy (OT): vision rehab, fine motor coordination, ADL/IADL routines, facility dog/animal-assisted therapy, community outings (grocery store, bowling). PMC
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Speech-Language Pathology (SLP): speech production, word-finding, reading comprehension, attention & executive functioning, compensatory strategies. PMC
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Behavioral Health (BH): emotional regulation, self-compassion, trauma re-processing via EMDR, grounding exercises. Frontiers
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Art Therapy (AT) & Dance/Movement Therapy (DMT): creative expression, body-mind connection, peer engagement. PMC
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Medical/Brain Injury Medicine: headache management (nerve blocks, medications), sleep management, neuro-optometry referrals. PMC
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3. Holistic & Integrative Elements
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Mind-body practices: yoga, breathing exercises, pain neuroscience education (so the veteran understands “why this pain is happening” and how movement, breath and mind interplay). PMC
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Animal-assisted therapy (facility dog) to support cognition, mood, social connection. PMC
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Community immersion: outings, peer cohort, social engagement to rebuild life beyond the clinical space. Frontiers
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Homework/home-exercise programs for carry-over beyond the 3 weeks. PMC
The Turning Point: Gains and Progress
Now the part I love—because it’s hopeful, and real. Even though this veteran had heavy and complex impairments, after just those 3 weeks he made measurable and meaningful progress.
Some highlights:
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Headaches: He reported a “10% decrease” in severity after nerve blocks. On Neurobehavioral Symptom Inventory (NSI) his score dropped by 42 points. Frontiers
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Balance & Gait: Activities of Balance Confidence Scale improved from ~35% (low function) to ~72% (moderate). Gait speed improved significantly (from 2.9 ft/s to 5.29 ft/s). PMC
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Vision/Oculomotor: Near point of convergence improved from 14 cm to 4 cm (normal). PMC
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Speech/Executive: Improved speech clarity, more routine in weekend scheduling, use of compensatory strategies—he reported better self-management. PMC
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Emotional/Behavioral: His distress (SUD) for the trauma incident dropped from 10 to 0. Depression moved from severe to mild; anxiety from severe to minimal. He began to identify himself as “an overcomer.” Frontiers+1
These aren’t half-measures. These are real shifts. Not full recovery (we must be honest) but enough to light the way forward.
What This Means for You, Me, and Communities Worldwide
Whether you’re a clinician, caregiver, veteran, or simply someone who cares about healing across culture, this one offers key lessons:
1. No “one size fits all”
When injuries are complex, we cannot rely on “just therapy X” or “just medicine Y.” This case shows that intertwining therapies—physical, cognitive, emotional, social—works. The authors themselves say a “one‐size‐fits‐all” approach is not recommended. PMC
2. The body + mind + community triangle
Healing isn’t just in the brain. It’s in the body (balance, vision, gait), in the mind (trauma, cognition, mood), and in the community (peer support, outings, connection). Globally, we often neglect one of those. This program didn’t.
3. Early momentum matters
Even a 3-week intensive program made marked difference. That means if people across global settings can adopt intensive, focused bursts of integrative care, that may open doors to recovery in places without long-term resources.
4. Hope is real
When the worst cases improve, it sends a message: regardless of culture, geography, language, trauma’s depth doesn’t have to mean static suffering. Change is possible. And that matters globally.
5. Implementation globally
Even if you’re in a lower-resource setting: you might not have VR gait training or facility dogs—but you can still integrate mind-body practices (yoga, breathing), peer-cohort groups, consistent routines, and interdisciplinary coordination (even if small-scale). The spirit matters.
A Friendly Call to Action
If I were standing in front of you, I’d say:
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If you’re supporting someone with TBI, PTSD, chronic pain—ask: “Are we treating the whole person?” not just the injury.
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If you’re a clinician or advocate: push for interdisciplinary access. Even short-term programs with multiple modalities can spark change.
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If you’re a person living with these challenges: remember this story. Use it as hope. Start small: a breathing practice, a peer group, a walk you weren’t walking before. Every piece counts.
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And globally: let’s adapt the essence of this model—holistic, integrative, human-centered—to our own communities, whether in Pakistan, Nigeria, Brazil or beyond.
Closing Thoughts
What this case teaches us is far more than rehabilitation metrics. It teaches us humanity.
It teaches us that the hardest battles—those inside the skull, inside the heart, inside the nervous system—can be fought together: by body, mind, team, community.
It teaches us that someone’s worst moment does not define their tomorrow.
Let’s make that message global, loud enough to cross oceans and cultures.
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