Former ECU doctoral student Kristal Mills checks Benjamin McHugh’s ears before starting a vestibular and balance assessment. (Photos by Cliff Hollis)

Returning from war    
ECU receives $2.1 million in federal funds to improve health care and family support for military service personnel

By Crystal Baity
ECU News Services

Benjamin McHugh is adjusting to his new normal while searching for a cure for his dizziness.

The 23-year-old corporal suffered a blast injury in June 2010 while on patrol in Afghanistan after his four-man team hit an improvised explosive device or IED. A mild traumatic brain injury has left him with short-term memory loss, dizziness, constant headaches, and balance problems.

Through Operation Re-entry North Carolina, East Carolina University aims to study and treat the problems of combat Marines such as McHugh and thousands of other military service personnel. Officials announced today that ECU will receive a $2.1 million grant for Operation Re-entry North Carolina, or ORNC, through a five-year agreement between the university and U.S. Army.

The cooperative agreement from the U.S. Army Medical Research and Materiel Command will provide $2.1 million in the first year, which officially began Sept. 30, with an option of an additional $8.4 million in the remaining four years.

Operation Re-entry is a university-wide, multi-institutional research partnership in support of wounded warriors, veterans and their families, as well as the Military Health System and Veteran’s Administration providers who care for them. The work, which has been in the planning and preparation stages for three years, will advance the quality of health care and family support for military service personnel.

The lead principal investigator and project director is Dr. David P. Cistola, professor of clinical laboratory science and associate dean for research in the College of Allied Health Sciences.

The college is where McHugh was referred by his doctors at Naval Hospital Camp Lejeune to ECU’s speech and hearing clinic. There, he is being evaluated by Dr. Sherri Jones, an expert in inner ear disorders and associate professor of communication sciences and disorders.

Jones is conducting a clinical research project to pinpoint the damaged part of the complex vestibular and balance system to provide the best treatment possible.

“My hope is just to find out what’s wrong,” McHugh said. “If you can’t figure out the problem, you can’t fix it.”

McHugh is in physical therapy three times a week, and sees a neurologist, speech therapist and other rehabilitation specialists for his dizziness and other problems.

“I didn’t notice most of it at first,” he said. After returning to Camp Lejeune from his only combat deployment, friends noticed his lack of agility, his forgetfulness, his inability to walk straight ahead in a mall or restaurant. “They said, ‘what’s wrong with you?’"
McHugh sits in a rotary chair in ECU’s speech and hearing clinic as Mills prepares for his test.

ORNC addresses the three “R’s:” reintegration, re-entry and resilience of military personnel, Cistola said.

Some of the clinical treatment and research into traumatic brain injury and post traumatic stress disorder was already being developed in various departments when Cistola joined ECU in 2008 as associate dean of research for allied health sciences.

One of his duties was to build collaborative projects. He found a focus with eastern North Carolina’s heavy concentration of military bases and population of active duty and retired soldiers. His task was to bring it all together and keep the momentum going.

Already in place was the Training for Optimal Performance Program started by Dr. Carmen Russoniello in the psychophysiology lab and biofeedback clinic in the Department of Recreation and Leisure Studies.

A computer program called “Virtual Iraq” can recreate a soldier’s wartime experiences, from patrolling on a road to riding in a Humvee. Russoniello’s biofeedback training helps service members recognize and control their reactions in the simulated scenario, which they can use when they feel stressed or anxious in everyday life.

In the College of Human Ecology, child development and family relations experts have been holding workshops for families of reservists coping with deployment for the past four years. ECU interior design and merchandising students helped in the design of the wounded warrior barracks project at Camp Lejeune.

Studying the signature injury

Traumatic brain injury from blasts is the signature injury of today’s war, Cistola said, and causes concussion-like symptoms that often overlap with post traumatic stress disorder. Service members, many with lengthy and multiple deployments, are surviving physical injuries that they might not have in previous wars due to advances in protective gear and training.

In Jones’ lab, McHugh is put through a two-to-three hour comprehensive battery to evaluate his inner ear.

Part of the assessment involves strapping on an infrared video camera to record McHugh’s eye movements in response to computer-generated stimulation of his vestibular system while he sits in a rotary chair. Other tests require him to move his head or body in different positions, or wear electrodes on the skin overlying his neck muscles or at his ears. Some of the tests, done in silent, darkened control rooms, are so monotonous that he falls asleep.

Jones’ team has evaluated more than 100 Marines with blast-induced dizziness or other balance problems referred from Naval Hospital Camp Lejeune, and every week brings new referrals. ECU now has one of the largest databases on vestibular function following blast injury in the country, Jones said.

Already there are some unexpected preliminary findings.

“When a person is exposed to a blast, the theory was the pressure wave damages the air and fluid-filled organs, which the inner ear fits in that category,” Jones said.

But so far data shows that only a small percentage of individuals exposed to blast actually have inner ear damage. “If it’s not the inner ear, then what is it?” Jones said.