Episode 8 – Traumatic brain injury — with Veteran and former CFL player Ryan Carey

MIND BEYOND THE MISSION EPISODE 8: TRAUMATIC BRAIN INJURY WITH VETERAN & FORMER CFL PLAYER RYAN CAREY

Laryssa

What is a TBI? A traumatic brain injury is a direct blow or jolt to the head, penetrating head injury, or exposure to external forces such as blast waves that disrupt the function of the brain. Not all blows to the head or exposure to external forces result in a TBI. The severity of TBI may range from mild – a brief change in mental status or consciousness – to severe, an extended period of unconsciousness or confusion after the injury. That’s a definition from the Defense and Veterans’ Brain Injury Centre.

Brian

For me, it’s one of those things where something happens to you, and your buddies look at you and go, “You good?” and then your response comes a little later, like, “Yeah, totally. Good to go.” That’s where it is in some things.

Maybe it’s the thing that gets you into the hospital, and maybe it’s just that thing that gets you a little confused for a moment, but we’re going to be talking here about when that happens to you in a career, when that happens to you for years and years and years, and now you go to school and now you don’t know why you can’t study, why you can’t read. Why I, when I went back, I had to read stuff five, six times just to put it in my head.

This morning, I look back at the last year or so, and as I reached out to people in the community and I said, “I need to know more about this. Who’s the guy?” They all said, “Well, you’ve got to phone Ryan Carey.” So I phoned him and we’ve been talking for about a year, and so here we are. We’ve got the man Ryan Carey in person, and so this might get a little weird. We’ll do the Brian, Ryan, and then we’ll call each other the wrong thing a bunch of times, I’m sure, but we’re here talking about TBI, and Ryan is going to introduce himself. I’ll give him a little plug here. Obviously he’s here because he’s a Veteran and used to wear a jersey, one we might recognize. Why don’t you start there?

Ryan

Yes, so I was pretty lucky to play football most of my life. I played all through high school, played at university, Acadia University, and then was drafted and played in the CFL for [the] Winnipeg [Bluebombers] and Saskatchewan [Roughriders]. Dream come true, and lots of head injury. Lots of head contact up until before joining the military.

Brian

Before we get into that, the single point, the rouge… you’re out of the CFL now, so you can admit it’s a weird rule.

Ryan

Yeah, it makes the game unique, that’s for sure.

Brian

Yeah. Especially when I speak to my friends down south. They’re like, “You guys have a football league?” Then they look into it like, “What the heck is that?”

Ryan

Yeah, the Americans don’t like things that are different [laughs].

Brian

For yourself, you’re not coming here because this is something you heard about. This is something that’s happened.

Ryan

Yes, it’s something that I’ve lived through personally, through the struggles of post-Afghanistan. Looking back, obviously back then there was no conversation on head injury at all. It was just, shake your head and get back in the game, and if you have a concussion, they had some protocols, like go sit in a dark room, but nowhere near—  I would say the information almost doubles every year on what we know about the brain, and we’re just learning more and more and more about the effects of head injury on the brain.

The important point here is that I think we do a good job with what people would think is a traumatic brain injury where someone’s knocked unconscious, where there’s a brain bleed, where there’s penetration of the skull, and then they’re in the pipeline to do physiotherapy to help to get their brain functioning again, but what we’re overlooking are these repeated blows to the head throughout a lifetime. Whether it’s sport, military, we’re obviously going to be talking about that, but I think that’s something that’s not on a lot of people’s radar screen.

Brian

The first thing that put me down was pugil fighting, and for those that don’t know what that is, yes, the army still trains with bayonets. Some people will laugh at that, but it’s the truth. Now, do we poke each other? No, we get the world’s biggest Q-tip and we basically wallop each other with it. If you’ve got a really safety-conscious outfit you’re working with, well then there might be padding and helmets. Not always.

Ryan

Well, right. When I took the Close Quarter Battle instructor course, what they did, which was brilliant actually, is all morning they would take us to the obstacle course and they would just drill us into the ground and we would do casualty work. So when we did our pugil stick fighting in the afternoon, we did it tired. We were really tired when we did it. So stuff like that is smart, but going off into a unit and just spending the Friday afternoon beating each other up…

Brian

If I’m tracking, you’re saying that you got tired so you’re not hitting each other with so much force.

Ryan

That’s right, yeah. It’s a good way to do it. Now, there are still some pretty good shots in there but we know this from football, that a football helmet doesn’t protect your brain from that. It protects it from obviously getting penetrated by something but it doesn’t stop the concussion and a bigger helmet and more padding— that doesn’t work.

Brian

So here I am, I’m on an armory floor and we’re pugil fighting. And again, this Q-tip, I’m 5’1”, it’s like 5’0” feet. It’s got red tape on one end, which is the butt, and then it’s got yellow tape on the other, which is the bayonet. I get out there and there’s a couple of drills you’re supposed to do. It’s not just a wild melee but it kind of is.

Ryan

It can turn into that.

Brian

I win my first round. I’m chest out, I’m the man. Win the second one against a guy that’s a lot bigger than me. Now I’m king of the mountain… if you could insert some words in there on top of that [laughter]. I walked out on the third one and I don’t think that match was on for four seconds. I was on the ground, I was out, the ambulance was on the way. I was staring up at people that I recognized but I didn’t know exactly who they were. I was released from hospital about a day and a half later.

The next thing you know, I’m going down to the medic because we were about to start workup training and I was given a clean bill of health, off to Bosnia. Years later when I started asking about, “Hey, what’s going on? [I have] headaches, neck pain, all this,” the answer I actually got was, “Well, you got better. You got good enough to deploy, so how bad could it be?” I’m watching as I’m saying this and Laryssa’s eyes are starting to realize, “You guys do what to each— what the— what are you beating each other up with Q-tips for?!”

Ryan

And there’s no pre-test. They can’t determine that. If there’s no pre-test that you do and then a cognitive test that you do, how can they say that you’ve gotten better or not gotten better? These are types of things that we should be talking about and I’ll reference, I think pugil stick fighting is excellent. It’s great for a lot of things and it comes down to coaching. Do you have to hit in the head? No. You’re teaching people to fight with a bayonet. I’m an instructor. There are things besides hitting the head, because then people start focus on hitting the head, and then it turns into that.

Brian

Would you rather us use bayonets?

Ryan

Right. Well, when we were doing it, for instance, obviously you paired people up of a similar size, and if a bayonet strikes the chest in some type of lunge, well, okay. The fight stops. That’s probably a kill shot or something. So there’s ways of coaching that beyond just going there and it turns into a bar room brawl.

Brian

Laryssa, your eyes just got a little wide there about a minute ago as we’re talking about beating each other up with Q-tips.

Laryssa

Yes and I think I was curious a little bit, Ryan, about your— we touched on your career in the CFL and you’ve just skimmed around your military experience. I think that’s something that I just wanted to explore a little bit because you mentioned lifetime of injury and head injury. So I’m just curious about what came first, your experience in the military, just so folks— you and I just had the chance to meet each other yesterday, but for folks to understand a little bit more about your experience. And then I do have a question about those injuries and people either just saying, “Well, you’re good now,” or to shake it off, but yeah. If you can tell us more about you.

Ryan

Yeah, I think what happens, when I went through training I obviously was exposed to weapon signatures from the 84mm, from the 25mm, and don’t forget also us bouncing around in the back of light armoured vehicles. We did pugil stick fighting in training as well and then that doesn’t really stop and it’s actually worse for NCOs (non-commissioned officers). I was an officer, so I get away from that but still, as an officer I was exposed to it was exposed to all kinds of head injury, and we sometimes focus on— like Brian and I were talking [about] yesterday— we focus on the person that’s firing the weapon, and anyone that’s fired an 84mm before will be like, “Yeah, we know. It almost tears your head off.” But don’t forget, you’ve got a number two on the 84mm. You always have a number two with you. Then you have an ARSO— an assistant range safety officer— they’re all getting it.

If you take someone that’s been in the ranks, they’ve been a Private, they’ve been a Corporal, which they shoot way more because that’s their job— my job is to deploy the weapon system— their job is to shoot it. Then they become a Corporal and they start training to become a Master Corporal to become an ARSO in a range, then as a Master Corporal, they’re in an ARSO range as a Sergeant. It’s not until they’re a Warrant Officer, but they’ve had all this exposure. Not to mention, just think of all the other things. They could very well have been paratroopers. You don’t land softly, you come down like a lawn dart. How many of them are whacking their heads?

Brian

Your helmet keeps following you till it hits your head.

Ryan

Right. There you go.

Laryssa

We were talking earlier about that cumulative effect that could also be a traumatic brain injury. It’s not necessarily just that one specific incident or accident. It sounds like the picture you’re painting for me is that there’s pugil stick fighting, which is over the course of a career as you’re developing that skill and that training, but also all of these other things that are just drops in the bucket, another drop in the bucket, another drop in the bucket. Then on top of that, maybe there is the fall out of the back of a vehicle or a blast injury.

Ryan

Oh, yeah. And don’t forget, a lot of the doors that are on these, they’re heavy. I know of a girl who got hit by a metal door. It’s an environment where there’s danger. I think a lot of people, too, may listen to this and go, “Oh, we have to get rid of pugil stick fighting.” No, it’s not that. It’s letting commanders know and letting people in leadership know that, look, we always talk about there’s a general… well, how long does it take to train a Warrant Officer that’s in the military for 20 years? [chuckles] Well, 20 years. Right? And so that’s when you’re going to start seeing these cumulative effects.

Then what happens is they go in, they start because it’s easier now for people to come forward to start saying, “Hey, I think I’m having some problems here. I need to speak to somebody.” But nobody’s identifying the head injuries. So now they started to get treated for PTSD and they get all these pharmaceuticals and nothing’s working and they get frustrated and they can’t— that can lead to all kinds of problems because the side effects of anxiety and depression are similar, but the treatments are different. There are different treatments.

Brian

There’s a couple of things you said I want to pick up on here. I’m going with the most bare-bones honesty, shooting the 84mm is fun, right?

Ryan

Yes, absolutely [chuckles].

Brian

Here’s the thing. If someone were to approach a soldier and say, “Hey, do you want to go to a rifle range again?” To most people that have never fired, they’re like, “Okay, yeah, I get to go shoot!” For most soldiers, it’s like, “Oh, I’ve got to clean that gun again? Seriously?”

Ryan

It becomes a job.

Brian

It actually becomes a bit of a pain in the butt over time. But that’s not the same with these things. You ever offer a soldier, you go, “Oh, you shot two. There’s more ammo. You want to put another couple down?”

Ryan

They will.

Brian

Absolutely. I’d do it now. If you and I could slap on a uniform, we’d do rock paper scissors to see who was number one or two and we would start shooting. Every day we’d do that.

Ryan

That’s why leadership is important, because the troops are just going to be like, “Yeah, let’s go do it!”

Brian

Yeah. I’ve never seen a soldier say, “No, I don’t want to do the coolest thing in the world.”

Ryan

I just want to pile on there so I don’t forget that we’re talking combat arms specific because we’re combat arms specific. The Navy bouncing around in the ship, I’ve heard of Navy guys have told me getting strapped in and bouncing around in the ship because the ocean can toss a huge ship around and the Air Force, the G forces that the pilots are facing, or the people on the ground that are around the border blades of choppers. This isn’t just a combat arms thing.

Brian

You mentioned the door. We’re not talking about the door in your kitchen cabinet. We’re talking about a 240-pound door designed to keep out a blast that’s trying to kill that tank or that carrier. When you don’t do it right and that hatch comes down on your pumpkin, or what else has happened is people’s seats have actually pushed them up into the metal. There are all kinds of ways this happens. I like the fact that you’re admitting that a good army is still going to pugil fight tomorrow. It’s going to shoot its weapons. It’s not going to not do that. We’ve got to do these things because if we don’t, then we’re sending people into circumstances where they’re not trained, they’re not ready.

Ryan

Right. Let’s take breaching. Do the breachers need to be right by the breach in training every single time it goes off? I don’t have the expertise in that. I’ll let the commanders decide that because I know when you breach, you want to get in as soon as possible. These are the conversations you need to start having.

Brian

When you’re breaching, you’re actually taking advantage of the concussion you just created and you want to be the next thing that happens to them. They got concussed and now you are in there on top of them dominating the room.

Ryan

Right. The other side of that is commanders saying, “Well, this is how I got here.” They don’t want to change that. I get that. You’ve also got instructors now that are peeing blood because they’re exposed to the blast as well. It’s like, again, what is the cost associated with training someone in the Special Forces that’s doing that? It’s not only a cost in training, but they have a special skill set. That’s why they’re there. We want to be able to save that and give them a long career and give them a life after the military as well.

Laryssa

Can I ask you to shift gears a little bit, because we’ve been talking about a number of mechanisms for people to sustain a traumatic brain injury, but can I ask you, Ryan, when did you first notice symptoms? When did you start to suspect? We haven’t had a chance to explore this earlier. Many Veterans are diagnosed with other physical or mental health conditions before TBI is even considered.

Brian

Comorbidities.

Laryssa

Comorbidities. Yes, wondering when you first started noticing symptoms. What were they?

Ryan

First of all, there was no education on it. I didn’t know until Tim Fleiszer, who played in the CFL for 10 years and he’s the director of the Concussion Legacy Foundation Canada, which is the umbrella organization for Project Enlist and the work that I’m doing right now with the military. And we met through a mutual coach— Sonny Wolfe, he coached me at Acadia— Sonny’s from Montreal. They ran into each other and he said, “Hey Sonny, do you know somebody on the military side because we’re trying to branch into the Canadian military?” He goes, “Yeah, I got someone for you.” Tim and I met and his first question to me over lunch was, “What’s going on in the military? Is there head injury?”

And I’m like, “Are you kidding me? Are you—” but obviously someone from the outside doesn’t know that. In and around that time and in the years before that, I started making myself the connection between these football players that I knew growing up and were my heroes and getting diagnosed with chronic traumatic encephalopathy (CTE), following that story and seeing the same behaviours and the same stuff happening with Veterans. I’m like, “There’s got to be a connection here.”

Where it really hit me was— and this was after the fact— but I was being treated for post-traumatic stress. Nobody looked at any of my head injury. This is a guy who’s played professional football and been in the infantry. No one even asked the question and just went immediately to, “Here’s a bag full of medications, now go talk to a psychologist.” I found that whole process, not only did the medication not work. It was frustrating because I was trying to express that it’s not working and the psychiatrist wasn’t listening to me to the point where the mother of my children had to step in and literally fire her because they just kept piling meds on and none of it was working.

That made me reject the system. It made me reject the Western medicine model. So that’s the position I was in. It wasn’t until I started having that conversation and started really focusing on what would eventually become our Operation Brain Health, which I know we’re going to talk about. When I really started focusing on that health, found a psychologist that I resonated with that basically said in the interview, “If you’re on a lot of medication, I can’t treat you. I need to get into your heart, I need to get into that space.”

Western medicine has been great for me in a lot of ways, but I know where that disconnect was. And as soon as I started treating my mental health challenges physically with physiotherapy, with exercise, with nutrition, with cognitive reserve, like using my brain, being social… soon as I started focusing on those things, I started to get a lot better, a lot better. At one point in time, I was able to get down to one pharmaceutical medication, which— okay, sure. Again, I’m not knocking pharmaceutical medication. What I’m knocking is the lack of diagnosis, the lack of understanding of, “Wait a second, this isn’t working. Maybe we need to look at something else.”

Brian

One of the things that is in my background here, I remember when I came back from overseas I was having a lot of problems. Of course, into the doctor you go and you start going through the process. What I find shocking now is, nine years after that was the first time someone started to look at my history from a physical damage point of view to my head. I’m baffled by that. I think we need to be at a place where we’re almost making a little bit of an assumption here.

You talked about [how] the Warrant Officer takes 20 years to get there. Well, say you get there in 12, which is actually pretty quick. What have you accumulated over that time? This is one of the things that happened to me was why I came back and I was having trouble, of course all the questions I went through were about what I just went through. What happened to you in Afghanistan? Of course, I’m answering the questions, “Well, here’s how it went.” No one ever, even to this day asked me what was the cumulative effect of all the things that went “bang” and knocked you in the head from 1994 all the way up until this point.

That’s where I think we need to get to in some ways is like, yes, I want to push science. Absolutely. I want to lean forward and advance whatever the next thing is but I really believe when we look at people and we try to figure out if there was a catastrophic event while we’re going to examine your head, no, let’s get there. But I think we need to be in a place where we’re looking at a 10-year career and we’re assuming damage will have been accumulated.

That’s some of the stuff we’ve talked about and I think from a football perspective, how many hard tackles did you take from elementary school the first time you played football to the time you left and you’d lose count? That’s what we need to be looking at.

Ryan

Yes, exactly. I think also, since we’re talking about Veterans, we’ll talk about Veterans that are struggling with their mental health, giving them things that they can do so that they are preparing themselves for their therapy, whatever that therapy may be. What’s your 50% or your 25%? What are you going to be putting into that, that’s going to help you recover from what you’re dealing with?

Then you can let the professionals sort out, okay, is this coming from head injuries, but the challenges, like you just said, it’s still not even on a lot of doctors’ radar screen. That’s why the Concussion Legacy Foundation is developing an education package for medical doctors to start bringing this issue to light and start saying, yes, look at this.

Brian

We don’t think we’re acting in an arrogant point of view when we say we have something to educate doctors on.

Ryan

No, not at all.

Brian

I’m not going to teach them a thing about medicine, physiology. That’s them. But what I want to do is I want to give them the back picture. I want them to get a vision of who I am and what I’ve been through over the entirety of my career and then they can look at it and go, “Well, okay, maybe we should start testing for this.”

Ryan

We are speaking with Veterans Affairs, we are speaking with the Department of National Defense, stuff is happening. Stuff’s moving in regard to this. It’s moving slower than I want it, but I think that it’s going in the right direction anyways. Like you said, it is about education. These are really smart people, obviously, and they listen.

When I started showing them videos of Afghanistan and them watching someone shoot an 84mm, watching people beside the M777 watching a building getting demoed and seeing the blast wave come across and hit the troops that are standing in the trench, they’re protected from the blast, but are they protected from that blast wave? Then they start going, “Oh, wow, okay. We see where this is occurring,” but then again, now you’ve got— that’s the people that are in the space, that are in the head injury mental health space, and then you’ve got general practitioners right there that are trying to plug holes in the dam. The medical system is stressed right now and it’s triage. How do you train doctors in this because they’re busy? This is all the stuff that we’re trying to figure out.

Brian

I think there’s also some general understandings too. If you would take us back to the ’90s and some 25 year old walks into a hospital and says, “I’ve been blown up in a war,” you might think that he’s making it up. Well, they’re not. They really have happened. We have 20 year old Veterans in this country. We’ve got 23 year old Veterans on their second tour and that guy to me— I think I’m looking at a teenager that’s a war Veteran and that’s almost going back to a 1950’s style of thinking.

Well, now we start adding to the whole brain discussion. One of the things that we’ve mentioned— you certainly have as one of your main topics you’re tackling— you call it Operation Brain Health, I would say, “How do I make sure that the guy that sits down in that doctor’s office is as ready to be helped as he can possibly be?” Let’s go there. If I’m the guy going through some therapy, I’m going through some treatment, I’m going to the doctor, what do you coach people to do to make sure they’re as healthy to be helped as they possibly can?

Ryan

Well, call it living a healthy lifestyle but what does that mean? We broke it down into four pillars just to simplify it. That’s exercise, nutrition, sleep, cognitive reserve. Most people, when you fix your exercise and your nutrition, your sleep gets better. For obvious reasons you fix your exercise and nutrition, your brain starts working better. What those pillars mean to everybody is something completely different. I’m not saying when I say exercise, I’m not saying you need to join a CrossFit gym or go be an Olympic lifter or be a body builder— I’m saying it could be something as simple as walking every day. The importance of that, getting fresh air and it might be as simple as that.

If you can’t exercise for whatever reason then see a physiotherapist but to say that, “Well, I can’t exercise because I’m injured or I can’t,” no, you have to do some type of movement. You have to move your body and we can go down the rabbit hole on each of those pillars but something like sleep for instance. Everybody knows sleep hygiene; everybody knows you shouldn’t be staring at the TV up until bedtime or watching the news or putting on, sorry for the term, war porn. Getting your central nervous system all ramped up to go to sleep doesn’t make sense. Everybody knows what to do, you just got to do it.

Cognitive reserve means, yes, it means training the brain. I like music for that and for a whole bunch of things. Cognitive reserve also means besides the brain games and training your brains and maybe going to physiotherapy to do ocular work, it also means being social. It also means maybe doing some volunteer work. Now, you may need to get there, that might be a pillar that’s a bridge too far for you right now but the Veteran themselves can exercise.

There’s no such thing as a drive-by fooding. You decide what goes in your mouth, so pick a nutrition plan and follow it and see if it works for you. Fix your sleep. We all know that, and if you’re going to be popping all kinds of pills to fix your sleep, well guess what? Eventually the pills stop working.

Laryssa

Tell me a little bit more about the cognitive reserve. Is it a way of stimulating different parts of the brain? You talk about playing music and things, but tell me a little bit more about it.

Ryan

It’s defined quite broadly and again it can mean different things. For me, I get a lot of the cognitive reserve piece out of music because when I’m playing the guitar, my left hand’s doing something, my right hand’s doing something different. I’m trying to sing between the notes, where’s the pauses? I sometimes play harmonica. It also makes me social because I go out and I play with other musicians at open mics and I promote music for Vets, like any type of music for Vets. I don’t get stuck on the guitar. The Veteran wants to play the piano or they want to play the violin, it doesn’t matter.

There’s a way of taking something that is obviously good for your brain but it’s also tied to something because again, if you’re going to isolate, one of the most dangerous things is isolation. We know that. So say it’s woodworking you want to get involved in and then you just isolate in your shop. Then part of that is that isolation, that’s the practice part I guess, but then you could turn that into going out and doing that with Veterans and something and maybe in peer support and have some type of a new mission, a new task, a new purpose in your life and you can do that through the cognitive reserve pillar.

Again, each of them can mean something a bit different. It doesn’t mean, “Oh, this is what exactly cognitive reserve is”. These are all easily looked up on the internet as well but I can tell you from experience in peer support over the years when someone’s falling off, I always go right back to the, “Okay, are you doing those four things on a daily basis?”

Brian

I wonder if as we are going through this discussion, it’s almost a little bit scary. You’re the mom of a reservist. You’ve got a young lad there that’s embarking on what we’re just describing is potentially injurious.

Ryan

What happened before is a lot of people that join us are athletes. They were athletes before, they played hockey or rugby or soccer. Soccer’s a culprit for head injury that people overlook all the time, but young kids heading that ball is a problem.

Laryssa

Exactly. We don’t want to talk about the motocross accident. Thanks for bringing it up.

Brian

Part of the whole experience is that you’ve got this daunting task when you look at your career. I’m going to do all these things and then what someone’s telling me is like, okay, the best thing I can do is healthy living. Like, thanks, but it is true. I’ve gone through other health concerns over the last couple of years. The same thing’s true there. The best version of that patient sitting on that bed is what I want to deliver to the docs. Then, hey guys, hands off because I don’t know what to do from here but I do know how to do that part.

Ryan

Right now, if you’re struggling, if the treatments that you’re under, if they’re not working okay, that’s okay but turn the evaluation on yourself. Are you exercising, are you watching what you eat, how’s your sleep, what are you doing in the cognitive reserve space? Assess yourself on that.

Then from there, and I’ve seen this happen so many times that when Veterans start focusing on those things, they use less medication. Whether it’s cannabis, whether it’s pharmaceuticals, whatever medication they’re using, they start using less of it because they don’t need as much. That also forces a conversation because when you start focusing on yourself like that, we can start talking about within those four pillars, we can start talking about, hey, you need to have an encounter with yourself to heal these old wounds. It’s going to be a lot easier to do that if you’re physically prepared for that.

One thing I do after my psychologist meeting each week when I see her is I get up and I go for a walk. I’ve got to move that energy because sometimes they’re heavy, but you got to find a way to go move it, get that energy moving it, and that’s best done through exercise. We hear it all the time. Exercise is the best antidepressant. It is. I can’t tell you how many times I’m freaking out in my house, anxious or depressed, and I go for this long walk and I come back, I’m like, what the heck was I even— what was I anxious about? Something as simple as a walk can change your whole day. It can literally change your whole day.

Brian

One thing that you mentioned earlier I want to pick up on, I certainly want to leave people with this in their mind is, we’re not talking about you have to have 20 years in the Infantry for this to happen to you. In fact, it might actually be someone in your family. A car accident can do this. Absolutely. We were going up to the north, so I was actually flying up to Mazar-i-Sharif, a town up in the north [in Afghanistan], well known as one of the hottest places in the world. I remember we clocked it in at 56 degrees in the shade.

Ryan

Very nice.

Brian

And unpleasant. And in some other day, I’ll talk to you about what the Porta Potty’s were like. We’ll leave that one aside. We land up there. It’s hot. We landed in a place called Camp Marmal, a runway like you’d find in Toronto, basically, with a little more dust on it. Then we went over to this place called Maymana. When we hit the ground, I thought we broke the plane.

Now, of course, I’m not an Air Force guy. I have no idea what stress a heart can take, but I thought we crashed. No, it was just a hard landing. That experience sticks with me because in some of the work I’ve been able to do at Atlas, I’ve been able to remind people, smashing into the ground for hard tactical landings, that can cause injury.

You’ve mentioned the door slamming on to you. One of the gentlemen that’s helping us on one of our research projects has brought up small boat teams in the Navy. Every time that craft, at whatever knots it’s traveling, I’ll go with fast, they get a number and I don’t even know what a knot is. But they’re hitting those waves and just slamming and it’s coming up through their heels, up through their spine, and what’s on top of that? I really want people that are listening to this to realize, whoa, I didn’t have to be in Afghanistan. It’s not about shooting the 84. It’s anything that can cause these injuries.

Ryan

When we have soccer players that are demented in the UK that played in the World Cup, they don’t even remember the games. They’ve done tests for CTE on soccer players and found stage 3, which is equivalent to the football players in the NFL. Start doing that self-assessment and say, yeah, no one’s asked me about this. I played soccer all my life and then I joined the military. Or I was in the Navy and then start thinking about, okay, I don’t know what it’s like to be— I wasn’t in the Navy, but I know talking to people in the Navy, oh yes, they identify with it right away. They’ve got weapon systems that they’re firing as well, Air Force as well. You start asking yourself that question.

I do want to offer that Project Enlist does offer a support line. You can go and it’s basically a patient navigation system where people can go and they can sign up and they can get sent to wherever they live. A physiotherapist gets the proper assessments done and get the proper treatment if that’s the course of action.

Brian

If there’s a Veteran or people that are around them, their Family, their close personal friends, and they’ve got some questions and they want to know more about what you know, where would you direct them?

Ryan

They can reach me through projectenlist.ca. They can go to the support line. Anyone can fill that out, whether it’s a loved one or a caregiver, it doesn’t matter. They can fill that information out. I can be reached through projectenlist.ca. We’re on Facebook as well as on Instagram.

Brian

We’re going to stay connected and keep working together. If they reached out to us at the Atlas Institute, we’d find a way to make that connection.

Ryan

Yes, for sure.

Brian

We’re at this place where science will push, and we’re going to help push it. Awareness, that’s where we need to be. I really hope that when there’s a Vet out there, and there’s people that live with them and people that love them, and is running up against the wall, “this treatment isn’t working, I’m trying to get better, but I’m not getting better,” that I hope that they can see this as something that maybe we ought to look at that.

For those people out there that are medical practitioners, clinicians, what have you, I really hope that you can hear this, and just start looking at this a little sooner. If we have no new science, but when a guy comes in front of you, when a woman comes in front of your table and says, “I served in the Canadian Forces, I served in the RCMP,” I would really like it to be a reflex, that you start thinking about what’s going on to that brain.

Ryan

Yes. For the Veterans that are out there, peer support is so important. Get involved in peer support. It really does help. It really does help.

Laryssa

I did have the two last questions that I wanted to ask. One of them was, maybe you just touched on it, what’s one thing that you wish more Veterans knew about TBI?

Ryan

The physical treatment and what they can do themselves, instead of looking out, and maybe what they can actually do themselves on a daily basis to have their brain perform better. It’s about getting the brain to perform better. So yes, we’re talking about performance, but again, we’re not talking about you competing against anybody else, you’re competing against yourself. Wherever you are along those four pillars, that’s okay. Just keep doing it. Just keep trying to improve on that on a daily basis.

Laryssa

What’s one thing that you wish more Families knew about traumatic brain injury?

Ryan

That’s where the best information comes from. They need to be involved in this conversation equally, because someone who’s suffering potentially, like a Veteran suffering from a brain injury may not be able to even figure this out. I’ve gone online with Veterans and help them fill out the form. They can’t process the information. So it might be a caregiver doing that.

Then the caregiver starts going in and starts seeing the information and it probably starts to help them identify, “Oh, yes, okay, that’s why he or she is acting or behaving in this manner.” Everyone needs to be involved in this conversation, not only the, let’s call them the patient, but everyone that’s surrounding that, for sure.

Brian

I want to thank you for being here. You came down from Montreal at our request. This is expertise. There are a lot of forms of experts out there, but getting yourself ready to be helped is what you can do. I really think from the Family perspective, because we’re all in the brotherhood if you will, I think I’ve got a better vision now, of what might be going on with that guy that’s disconnecting, the hermiting.

It’s just another thing for me to start considering. It’s also another thing to give people hope because when you’re struggling, when you’re trying to get better, man, there was a while that I was trying to just protect my job. I would say I was fine, and everything’s good to go. There was a period where I was really trying to get better. Then I’m retraining and I’m going through the vocational rehab, and it’s not working. Man, that was when I was at a tough point in my life.

I wish I’d known then that there were people on the file, that someone cares, that other people like sport and people that deal with accidents are also looking at it going, “Hey, what do the Veterans have to say about this?” It actually makes me feel a lot better to know that.

Ryan

Oh, definitely. Veterans in this country have a voice in this space. The voice is the leadership that Veterans bring to it. Athletes always respect that, and athletes and Veterans work very well together. We think this is a crisis beyond Veterans. It’s a crisis with kids, our kids should not be getting hit in the head below the age of 14, and maybe that it’s going to push higher. This ties into a bigger piece of the Canadian public health, it’s not just for Veterans.

Brian

You can find Ryan at projectenlist.com. Is that where they’re able to find you?

Ryan

Correct.

Brian

And if they speak to us at the Atlas Institute, will certainly help out. Thanks.

Ryan

Awesome. Thank you, guys.

Laryssa

Pleasure.

Ryan

Appreciate it.

Laryssa

Thank you.

Ryan

Thank you.