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MARCH 31, 2011

Concussion Restoration Care Center
Premier Issue!!
Below, the Staff of the CRCC
• Letter from the OIC • Mission Statement • What does the CRCC do? • Where We’re Headed • Stories from our Heroes • By the Numbers - CRCC data At le! - the staff of CRCC
Back Row: LCDR Ditto, CDR LaBrie Front Row: HM3 Woodberry, LCDR Clark, CDR Sams, CDR Frantz, HN Tissier, CAPT Schauer, HA Garcia, HN Roach, HM1 McGee, LT Norris

In this Issue

LETTER FROM THE OIC Hello all, My name is Earl Frantz and I am a Sports Medicine and Family Medicine Physician. I am currently an Independent Augmentee as the Officer in Charge of the Concussion Restoration Care Center here at Camp Leatherneck, Afghanistan. The purpose of this news letter is to do a monthly update on what we are doing out here. Since this is the first news letter, I will give an outline of our staff and our mission. Every month we will give updates and new events happening, including results of our data collection, so you, can see in real time the fruits of our labor. The one thing that stands out to everyone who works here is the uncommon bravery and valor of the patients we are blessed to serve. Thus there will be a story or two about these real American heroes. This promises to be a special, unique and rewarding deployment for all of us, and I look forward to working and growing with each and every one of you. CDR Earl Frantz, DO, USN




MARCH 31, 2011

The CRCC gives the best possible care to our marines, sailors, and ISAF counterparts and returns them to duty in the most efficient, safe manner. This includes: • Concussion Care • Sports Medicine • Family Medicine • Mental Health • Physical Therapy • Occupation Therapy • Manipulation • Acupuncture We provide our warriors with current evidence-based care like ANAM testing, occupational and physical therapies, psychological evaluations and awareness training on things like sleep hygiene, acupuncture, counseling, home exercise based programs, and education all geared toward returning that warrior to duty as soon as possible in the safest manner .

underlying mood disorders, as well as developing coping and healing activities using group therapy sessions, sleep hygiene education, and cognitive behavior therapy The OT/PT work in tandem with our team providing vestibular rehabilitation for concussed patients as well as customized splinting for upper extremity injuries. Physical Therapy provides evaluations for co-morbid musculoskeletal conditions associated with concussion, like cervical neck strain. The staff corpsman help bring all this together providing first line contact with our warriors and directly assisting the providers in check-in, assessment, evaluation, testing, and follow up.

WHERE ARE WE HEADED? The CRCC is a proof of concept of specialized care in the field and is observing trends that may mold and shape the way we do business in the future. We are compiling an extensive amount of data on ALL concussed patients (over 160 Our Family and Sports Medicine physicians metrics) so we may answer critical questions on the recovery and prognosis of our wounded are the foundation of the group utilizing a warriors; for example, can we identify high risk holistic approach. They identify any outliers with co morbid conditions and treat accordingly. patients and place them in a low risk MOS? A dedicated research psychologist assigned Our Sports Medicine Docs also offer non from the in-theater research team is currently operative muscle skeletal care. They also leading the effort in this data collection and conduct trend analysis and research which will analysis. shape the future by establishing new protocols. These physicians spearhead training in the The CRCC is developing an extended care management of concussion and heat injury for facility to house concussed warriors, providing other providers in theater. an ideal living environment in the field to Our Mental Health specialists work with the maximize their recovery and return to full duty. warriors to identify early PTSD and/or
CHAIN OF COMMAND The CRCC is led by CDR Earl Frantz, MC, USN under CDR Christensen, MSC, USN, CO Alpha Surgical Co. The CRCC is located near 2nd Maintenance BN, CLR-25 in the 2nd MLG Compound, Camp Leatherneck.



STORIES FROM OUR HEROES the room to be re-assessed. Within moments he found himself and his superiors Semper Fidelis! We are very fortunate to work in the thrust to the ground secondary to a blast. Despite CRCC where we see this uncommon virtue embodied suffering shrapnel wounds and symptoms of a in our patients on a daily basis. We typically see young concussion, he took charge of enlisted Marines in our clinic the situation, directed the MedEvac of injured who have suffered a personnel and attended to concussion from an IED the loss of one of his NCO’s. blast while convoying in an MRAP or while dismounted Ultimately he was MedEvaced to the hospital on foot patrol. We recently for his shrapnel wounds and had an infantry Company concussive symptoms, then Commander, a Marine seen in our clinic the Captain whisk through our following day. His one and clinic. Less than 24 hours only concern was getting prior to presenting he was back to his men who needed with other senior leaders assessing a compound taken him in this dire hour. If he was experiencing any in a battle with the Taliban. lingering symptoms, it’s He noted evidence of a doubtful he would tell us – possible IED and ordered loyalty to his men took SPOTLIGHTPHYSICAL THERAPY The CRCC Physical Therapist provides musculoskeletal evaluation and condition education including realistic expectations for return to duty for both patients and their chain of command. Specific treatment plans are designed to address injuries while appropriately stressing healing tissues to allow a more rapid return and maximizing physical function. Injuries sustained due to IED exposure are evaluated and appropriately addressed which eases apprehension and concern. Gunshot wounds and shrapnel injuries are closely managed to maximize functional outcome. In-theater management allows rapid evaluation, rehabilitation, and return to full operational duties. Typical sports injuries are evaluated and managed in close proximity to the unit. This practice retains the fighting force in country, minimizes downtime, and facilitate return to full function. - CDR Shane Vath, MSC, USN

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precedence to his well being. He dutifully completed our concussive exercise stress test, declared he was symptom free and respectfully asked to be discharged from the clinic. Those of us who spend our days ‘behind the wire’ stand in awe of such loyalty “Loyalty to his in the face of personal men took danger. Our Marines live and breathe the virtue of Semper precedence to Fidelis. We consider ourselves his well-being.” blessed to care for the few and the proud. - CDR Richard “Rick” Sams, MC, USN

“In-country management allows rapid evaluation, rehabilitation, return to full operational duties and unit reintegration.”




MARCH 31, 2011 Mailing Address

" Since the the inception of CRCC in August of 2010, more warriors have returned to their units following injuries. The The CRCC has been collecting data from before Aug graph below illustrates the CRCC’s effectiveness in 30th 2010, reflecting the work preventing MedEvac for and success of our team. treatable conditions out of To date, 1533 of 1569 theater. patients seen have been returned to full duty (RTFD), a " Through the data, you can see the positive impact of the 97.7% retention rate! CRCC’s services to the warriors Other services are equally and the benefit to sustained impressive: operations. Muscle/Skeletal 794/801 = 99% RTFD Mental Health 103/108 = 95% RTFD Concussion: 378/406 = 93% RTFD

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• CDR Earl Frantz - Officer in Charge, Sports Medicine and Family Medicine Physician • CAPT Judy Schauer - Sports Medicine and Family Medicine Physician • CDR Richard Sams - Family Medicine Physician • CDR Walter LaBrie - Clinical Psychologist • LCDR Daniel Clark - Clinical Manager, • CDR Shane “Seth” Vath Physical Therapist • LCDR Kathleen Ditto Occupational Therapist • LT Michael Okasinski Psychiatrist • HM1 Jason McGee- Leading Petty Officer • HM3 Brian Woodberry General Duty Corpsmen • HM3 John Tissier - General Duty Corpsmen • HM Stephen Roach - General Duty Corpsmen • HA Josiah Garcia - General Duty Corpsmen