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Ten years later: Evan Mettie, traumatic brain injuries, and parents who never give up

  • 6 min to read
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Denise Mettie, left, and caretaker Amanda Leighty guide Evan Mettie into his wheelchair using an overhead lift system at his home in Selah, Wash. on Thursday, May, 26, 2016. (MASON TRINCA/Yakima Herald-Republic)

SELAH — In his backyard, Dave Mettie points out low retaining walls built with the rocks he and his son Evan hauled out of a horse pasture 16 years ago.

He needs more rocks for more yard projects, he said, but he’s not too excited at the prospect of loading them himself.

He’s got more pressing matters.

January marked 10 years since Evan Mettie, now 32, suffered a traumatic brain injury when a roadside bomb exploded in Iraq, where he was serving as an Army specialist. The shrapnel that pierced his head damaged his brain stem, leaving him with locked-in syndrome: while he is cognitively aware, he is unable to move or communicate much beyond eye blinks and smiles.

The past decade has been a series of almost unfathomable peaks and valleys for Evan and his parents, as they’ve worked to secure the medical treatment he needed from a health care system that can be infuriating at the best of times.

They’ve seen countless doctors, specialists and other providers around the state and country; built a special addition on the house for Evan; educated themselves on the not-well-understood field of traumatic brain injuries, or TBIs; and spoken at a Senate hearing as part of a broader effort to plead with lawmakers on veterans’ behalf.

And they’re still working.

“In the beginning, we didn’t know anything,” Denise Mettie said last week in their Selah home. “We were trying to navigate a system that’s not navigate-able.”

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Dave Mettie comforts his son Evan Mettie during a check up at Cornerstone Medicine in Yakima, Wash. Thursday, May 26, 2016. (MASON TRINCA/Yakima Herald-Republic)

 

Shifting the system

The federal Department of Veterans Affairs came under fire two years ago when investigations revealed that veterans were suffering and even dying because of long wait times and false record-keeping at VA hospitals in Arizona and elsewhere.

Accusations of mismanagement mounted around the country, leading to some degree of overhaul within the system, including the new Veterans Choice program whereby some veterans, particularly in rural areas, can go outside the VA system to get medical care when VA options aren’t readily available.

The Metties know firsthand how frustrating the system is — and how helpless veterans and their families feel when trying to confront it, especially when they’re still reeling from the shock and devastation of the initial injury.

“Early on, of course, it’s a big learning experience ... navigating the sea of acronyms; who do we need to talk to, seemingly overlapping duties,” Dave said. “And everybody professing a real desire to dive in and help you, but you don’t really know what you need or where to get it.”

Denise has a whole book just of Army acronyms.

The Metties say the Wounded Warrior Project, a nationwide charitable organization that raises money for post-9/11 veterans, gave them an anchor to hold onto and helped guide them through those early years.

It was through the Wounded Warrior Project that Denise shared Evan’s story at that Senate hearing in 2007, including how the Army initiated Evan’s retirement so quickly after his injury that he lost access to crucial care options for active-duty servicemembers, something the Metties had no knowledge of at the time.

At VA facilities, she told lawmakers, Evan was the first TBI case from Operation Iraqi Freedom that the doctors had ever seen, and there was no treatment plan in place. Evan needed access to private facilities with greater understanding of his injury.

“It is unfair to deny us access to the same level of care that you would choose for your own children,” she testified.

 

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Evan Mettie's photo, which was taken right out of boot camp, is seen resting on an American flag, with signatures of his former Selah High School classmates wishing him well on his deployment, in his room in Selah, Wash. Thursday, May 26, 2016. (MASON TRINCA/Yakima Herald-Republic)

One step forward, two steps back

Since her testimony, after a lot of fighting and advocating and meeting with other veterans’ families and lawmakers, the Metties say things have improved — somewhat.

“Evan got more care; other soldiers got more care because of Evan’s experiences,” Dave said. “And we find, over a period of time, things have loosened up. There’s maybe a little more understanding from government agencies ... how soldiers need to get specialized care for things like TBI that are not understood or treated well, even within the government’s system.”

“It seems like we’re not being shut down quite so early in conversations about treatments we want to explore,” he continued. “I think things have just gotten a little more responsive than it was when we first got started.”

A big improvement has been the VA’s new home-based primary care program, which serves fewer than 20 vets in the Yakima area. Evan was enrolled about a year ago, and he gets a monthly visit from a VA nurse who advocates for him with the VA and coordinates with other members of the care team, including a dietitian, a pharmacist and a physician. The local VA clinic has also used telemedicine, connecting Evan with a doctor in Walla Walla via video chat.

Evan is now insured by the Army’s Tricare, which covers all VA care, and by Medicare, which he uses when he receives treatment in private facilities. The VA pays directly for Evan's 24/7 caregivers as well as some other services.

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Denise Mettie shares a laugh with her son Evan Mettie before heading off to Cornerstone Medicine in Yakima, Wash. on Thursday, May 26, 2016. (MASON TRINCA/Yakima Herald-Republic)

But still, not every treatment the Metties want is approved. An ongoing frustration is that, even though Evan suffered brain damage that affects his nervous system and range of motion, TBIs don’t count as spinal cord injuries, and he’s not allowed into any of the VA’s programs for spinal cord patients.

Most clinical trials for TBIs are designed only for mild cases, not severe ones like Evan’s.

And even after securing more consistent treatment and rehabilitation regimes, Evan’s journey has been full of setbacks.

The family is still recovering from a yearlong period in which Evan was hospitalized 18 times, presenting over and over with temperatures above 103 degrees, total body rigidity and high heart rate, stumping attempts at diagnosis.

It got to the point where he was having emergency episodes three or four times a month until the Metties finally convinced doctors that the problems stemmed from a recently relocated medicine pump, which was paining Evan’s hip. Last March, the doctors moved the pump back to its original location and the episodes stopped.

But the constant trauma to his system had erased all the progress he’d made in the previous years.

With regular physical therapy sessions, he had gotten to the point of being able to balance himself on his side while lying on a mat, and had gained better hand control. He was even able to shoot a Nerf gun at a target on occasion.

Not anymore.

“We’re just slowly trying to get back into his therapies,” Denise said.

Looking ahead

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Evan Mettie waits for the doctor at Cornerstone Medicine in Yakima, Wash. Thursday, May 26, 2016. Evan is cognitively aware and communicates with eye blinks and smiles. The scare on the left side of his face was result of piece of shrapnel that pierced his head when a roadside bomb exploded in Iraq leaving him in a locked-in syndrome. (MASON TRINCA/Yakima Herald-Republic)

The Metties are in this for the long haul. Denise quit her job at US Bank shortly after Evan’s injury to be his full-time advocate — though, in her naivete, she said, she originally believed she’d be back to work in just three months.

Dave is now retired, but stays involved with local school photo programs.

In the Evan-friendly addition to the house, which Denise calls his “man cave,” they’ve installed a sit-to-stand chair, a fold-down wall-mounted therapy mat, a quadriciser machine that simulates the movement of walking, and a ceiling lift that can move Evan from his bed to one of the other pieces of equipment.

The equipment they want now is a Tobii augmentative communication device, which translates eye tracking into words or phrases. Evan has practiced with a rental, but it’s going to take some paperwork to get the VA to buy one for permanent use. Denise estimates it’ll cost at least $25,000.

“We do not expect Evan to really go beyond where he is,” Denise said. “What I would love to see is maybe for him to start speaking. ... Just so that we would know more of what he really wants, is the big thing.”

But just because he’s lacking in words doesn’t mean he’s lacking in attitude, his parents say. When someone asks if he “can” do something, he’ll smile slyly as if to say, “Why yes, I can,” requiring them to rephrase: “Will you?”

“Evan has his ways,” Denise said. “He has all of his ways to still play jokes on people.”

Throughout the past decade, the Metties have relied on support from other families within the Wounded Warrior Project, keeping in touch via Facebook.

It helps to know people who understand what they’re going through, where everyone encourages one another to continue fighting.

“We still keep hope,” Denise said.

This story has been updated to correct details about payment for Evan's caregivers and to clarify that Dave Mettie is no longer substitute teaching.

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