Treating Soldiers with Brain Injuries
http://thedianerehmshow.org/shows/2010-06-24/treating-soldiers-brain-injuries
U.S. Soldiers who are wounded, ill or injured attend a Warrior Transition Brigade event at Walter Reed Army Medical Center in Washington, D.C., Jan. 27, 2010. During the event, NASA astronaut and retired Army Col. Patrick G. Forrester presented the Warrior Transition Brigade flag that was flown over the International Space Station to the Soldiers for their military service.
U.S. Navy Petty Officer 1st Class Molly A. Burgess for The U.S. Army via Flickr
The military takes steps to improve care for soldiers with traumatic brain injuries, PTSD, and other complex psychological problems: The challenges of treating mental wounds among those returning from Iraq and Afghanistan.
Guests
Dr. Gregory O'Shanick
National Medical Director, Brain Injury Association of America, who specializes in neuro-rehabilitation and neuro-psychiatry and Chair-elect of the BIAA Board of Directors.
Daniel Zwerdling
Correspondent with NPR’s Investigative Unit who’s been reporting on TBI in a series co-reported with T. Christian Miller, of Propublica
Dr. S. Ward Casscells
John E. Tyson Distinguished Professor of Medicine and Public Health, and Vice President for External Affairs and Public Policy at the University of Texas Health Science Center at Houston. He is the former Assistant Secretary of Defense (Health Affairs).
Dr. Jonathan Sills
a staff psychologist in the VA Palo Alto Health Care System
Comments
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
I would like to point out "Daddy's Home", a picture book about PTSD, which helps parents explain to their children some of the difficulties they, as active military service members, may have reintegrating into civilian life.
You can view the entire book at: http://www.carolinanadel.com/PTSD/
The book has received good feedback from military spouses and professional therapists who work with military famlies.
Thank you!
Carolina
cnadel999@yahoo.com
Hi, I am sure you are already aware, but just up the street from you we are opening a major center today, the National Intrepid Center of Excellence:
http://moaablogs.org/message/2010/06/national-intrepid-center-of-excelle...
http://www.bethesda.med.navy.mil/
I will be very happy when this is no longer a growth industry.
Paul Cauchon
Kensington MD
Has your guest ever heard of Emotional Freedom Technique?
It sounds totally hokey but has produced incredible results, quickly, and without having to re-live any of the trauma. There are no side effects so there's no downside to trying it. Relief is immediate. You can learn to do this on your own from the website but its probably a good idea to try it out with someone else first. And its free.
Really, this is the coolest thing out there. I hope every vet learns this.
Heres the link http://www.eftuniverse.com/
Alison
I believe that the level of care for active duty personnel is good overall...
however when those Soldiers enter the VA, the care breaks down. They will be forced to attend whatever facility the VA has wherever that is and they won't be assisted by the Govt...but by the VA, which is still trying to save money by consolidating care into it's large metro facilities and not at VA hospitals out in the rural areas (hospitals the VA closed or attempted to close a few years back).
Hospitals should be in locals where Veterans actually live, not where the VA wants them to live!
Why do we find it necessary to have a parallel health delivery system just for veterans in the first place? Wouldn't it be vastly less expensive and more efficient to treat veterans in their community? Rather than build hospitals that are easily accessible only to a few, why not develop a physician "militarist" specialty, much like the "hospitalist", that could deal with those health problems that are unique to soldiers?
It seems that there are a great percentage of soldiers who are returning from the Middle East with PTSD.
Are the percentages higher in this war as compared to the Viet Nam War and/or WW II?
I'd also be interested in a comment regarding the PTSD that our allies suffer AND those suffered by our enemies in the Mid East, Viet Nam and WW II.
Is PTSD that we are seeing in our American soldiers particular to them because of any cultural differences or mostly from the "war experience"?
I am so appreciative of NPR's continued focus on this topic. However, the discussions tend to focus on persons with traumatic brain injury returning from Iraq and Afghanistan. My father, a vetran of the Vietnam war, has been diagnosed with frontal lobe dementia, which we believe to have been sustained in his service while an Airborne Ranger there. His dementia was very early onset --- in his mid-50's --- while judgement issues began to display much earlier. He is now 67 and has been in residential care for about three years. How is the military working to address historic cases? My mother went to the VA to try to establish his eligability for further benefit, and she was treated rudely and told there are things in his file the VA can't share. Are they attempting to deny a benefit? It sure feels that way... THANKS, shana
The Hill Country Religious Society of Friends (Quakers) and a group of veterans here in Kerrville, Texas are working to overturn a City Council resolution against a Homeless Veterans Project at our VA hospital. The project would provide housing, care, rehab, job training for those vets with TBI and PTSD.
We believe this project is essential to the well being and rehabilitation of our returning veterans.
Could your guests tell me if the project they are working on is connected with the VA's Homeless Project. If so, how?
As a retired psychologist, I am wondering how many soldier suicides are actually committed due to traumatic brain injury and trying to cope with it alone. Please comment.
Great comment, Marjorie --- thanks ;)
Returning military personnel are required to take an online survey to screen for post traumatic stress disorder. My father took this survey when he returned from deployment and it said that he had symptoms of PTSD and should see his health care service provider. I think it would be helpful if upon completion of the survey it would automatically link to an appointment with a service provider. My father never followed up and I think the whole family would have benefited had he seen someone for his PTSD. Many people may take the survey but what is it worth if nothing happens afterwards.
Great show and actual topic. Question for panel: Do you think that we need to look on new diagnostic tools that could serve as biomarkers for mild and moderate TBI victims?
In 1968, At Fort Knox, my husband was treated by
Dr. William Gault. He dianosed him with PTSD. He explained everything in detail to me and outlined what our lives would be like. And after 43 years of marriage we are still together thanks to his patience with us.
What is the general percentage of soldiers who come back from the Middle East War that integrate successfully back into our society without the expense of treatment from some effect caused by war?
I listened to Daniel Zwerdling's story and was furious at what I heard particularly when the Ft Bliss hospital commander stated "he hadn't heard a single complaint." He clearly doesn't understand what being a commander is all about. Were I the 3-star Mr Zwerdling interviewed from the Chief of Staff's office I'd have had that commander removed for cause. After 21 years as a military officer and 1/2 year in Afghanistan I find myself ever so disappointed in the leadership. Make no mistake; being assigned as a commander does not make one a leader. A leader would take the additional steps needed to truly understand the problem at hand.
Give an Hour is a nonprofit organization that has established a national network of mental health professionals who are providing free mental health services to the U.S. troops, their families, and communities affected by the current military conflicts in Afghanistan and Iraq. Give an Hour provides easy, accessible, confidential, and free care for however long it is needed.
Give an Hour has providers in all 50 states, Washington, D.C., Guam, and Puerto Rico. To locate a provider, visitors simply log-on to www.giveanhour.org and use the zip code search. If there is no provider in their area, visitors can contact Give an Hour at info@giveanhour.org and a provider will be located for them.
There are more than 5,000 providers ready to help our military with the psychological effects of war.
I do not think enough has been determined as to what the actual costs in dollars to our society are being caused by the effects to the American taxpayer as a result of this war.
Our own local hospital has had to treat mental patients that return damaged from the war. This has been a major factor in causing the expansion with the expense to our community to help in these treatments.
I'm not sure, but I do not think as much money in proportion, was spent on treatment in other wars.
Our government and its marketing effort to keep a "positive attitude" toward our military by the American public in our media has come at a high price to our economy.
As a result, the military and ALL its members are demanding, as a right, to receive first class services in all aspects of their lives.
If you are old enough to remember, we started the "volunteer army" because of so much protest to the draft during the Viet Nam War, not as a gradual process toward "peace in the world" reducing our need for military forces.
Now, our military is a giant "industry" that demands huge parts of our GDP while production jobs continue to bleed away from us.
Common, or in other words budgetary, sense would say we cannot have everything for our military. But like every part of public service, no one wants to give anything, only "be provided" with EVERYTHING they need and WANT.
When is this creative demand going to turn to the overriding need for America to produce more income through more employment, employment that can pay the bills not just a few hours a week, for the vast majority of Americans?
Bravo, Old Crows! I think your project is exactly the kind of thing I was suggesting by my question.
What explanation does your city council give for not allowing a Homeless Veterans Project and do they even have jurisdiction over a VA facility?
I can tell you they ARE trying to deny your father his benefits.
My father went through the same thing.
Ironically, he was an electrical engineer working in Washington, D.C., on defense contracts when he began to have neurological problems--difficulty balancing, impaired vision, numbness. He stumbled sometimes, leading to his employer to accuse my tea-totaling dad of drinking on the job! That forced him to seek treatment for the symptoms he was denying to himself.
Eventually he became blind and a specialist at Johns Hopkins recognized that his type of retinopathy was caused by the anti-malarial drugs he was taking as a WWII soldier in New Guinea. (He got malaria anyway)
No longer able to work and with us kids still in high school, my father tried to get compensation through the VA. It became a never ending, exhausting process. My father had an arsenal of civilian doctors willing to testify that his disability was caused by the drugs. Of course the VA would only accept diagnoses provided by VA doctors so another round of testing began. And, as you might suspect, not a single doctor would say that my father's disability was caused by his exposure in the military. He was not even allowed to bring in his records from the civilian doctors, I'm guessing so that they would not have to document their findings in the VA medical records.
I hope you have some good hiking boots, Shana, because trying to get help for your father from the VA will be an uphill battle all the way. Good luck, Shana.
I was wondering if the work of Bruno Chickly (hon DO) in Scottsdale, AZ is being taken into accout. Check out Chickly Institute of Health web site.
I'm a social worker, have experience working with people with brain injuries, and would love to work with our soldiers. I have gone to USA jobs.com and it is very diffucult to navigate through. I know in my heart I could really help these fine, brave soldiers!
There are many problems in treating PTSD and traumatic brain injuries.
1. Chronic lack of trained mental health personnel - they are better paid in civilian practices.
2. The stigma of PTSD or traumatic brain injuries is both real and perceived.
3. The military is an organization that recruits people to "break things." They do not have a culture that pays that much attention to unseen injuries no matter how debilitating. They do give a lot of lip service though.
4. There are so many agencies trying to scramble to get in the "PTSD" game with all the money that is available, there is a great deal of overlap, bureaucratic rivalry, and an inability to do the one thing well that they need to do; help the soldiers.
WebEMDR.com is a website offering the first internet self-directed therapy for PTSD and is available at no charge for members of the military, veterans, and their families.. Advisers include three-star Marine General (Ret.) Gary H. Hughey and the director of mental health research at the Cincinnati VA, Dr Tom Geracioti, an international expert on the treatment of PTSD. I suggest soldiers suffering from PTSD or PTSD symptoms visit the site.
Thank you for covering this very important topic. Traumatic Brain Injuries are a very serious, prevalent problem that warrants wider acknowledgement and accomodations by the military and non-military communities. As a civilian who spent five years recovering from a TBI, I fully support and appreciate the comments of your guests and the opening of this treatment center in Palo Alto, CA. Thank you also to the people who called in to the show.
An extremely important program. The listener who asked if WWII warriors were tougher....and perhaps many others...could use some education. In 1943 or early 1944 John Huston (while he was in the Army) made a documentary on sufferers of battle fatigue...men who came home with no diagnosable physical injuries but who could not talk, or walk, or who stuttered unendingly, etc. The film aired (in the middle of the night) over memorial weekend on TCM. Look for it, sorry I can't remember the name. Of course, it has an upbeat ending in which psychiatry cured everyone, but it very clearly shows the consequences of subjecting our young men (and now young women) to unremitting violence.
Ms. Rehm, a show on WWII "battle fatigue" and WWI "shell shock" would be very educational for your listeners. Thanks for today's show. My heart goes out to our soldiers and their families.
Thanks for your feedback, Marjorie :) Sadly, it is what I expected. My parents have been married for 43 years, and the woman my mom finally sat down with suggested my mom could not act on my dad's behalf... even though she holds his power of attorney! However, we're not girls who roll over, and are very fortunate, too, to have some friends in high places, so I'm sure we will work this out. My concern is as much for all of the young men and women returning from these latest wars who are more mild mannered, less educated and/or don't have a strong advocate and friends in high places. It's horrifying to think so many young men and women serving their country will be experiencing such stonewalling in addition to the very sad and debilitating effects of their brain injuries. The Armed Services of the US need to get their priorities straight or stop making false promises to enlistees.
Excellent show. There is another excellent resource for people thinking of suicide (or their loved ones), called the Wing Man Project. It was created by an active military man who served four tours in the gulf and saw first hand, the effects of same. As a psychologist who is always looking for ways to assist our military members and their families as they reintegrate into "normal" society, I was impressed by this project and even wrote a couple of the scripts for them, pro bona. The Wingman Project has evolved to include all military services and is located at the following website: wingmanproject.org.
6 years ago I had brain damage from West Nile Virus Meneningoencephalitis. Although I had insurance and complained of confusion (the only way I could describe the problems I was having) it took a full year to find a doctor who would get me tested for brain damage. The main problem seemed to be that the doctors I saw had some kind of stereotypical idea of brain damage and I could speak and wasn't drooling.
I strongly encourage the government to ensure treatment and care for brain damage! The year when I didn't know what was wrong was miserable for me and dangerous for others.
Thank you for doing this show, Diane!
Beth
Doug, your complaints about the cost to taxpayers for treatment of PTSD and TBI for our now returning soldiers is so misguided. Because the same level of treatment may not have been available for Vets of WWI , II and Korea and Viet Nam is not a reason to deny it to our soldiers returning today.
There are so many obvious differences on today's battlefields. The numbers of severely injured are so much greater due to advanced protective gear. Many of the injured returning today would have been coming home in caskets in earlier wars. The number of tours of duty are now so many leading to a prolonged exposure to battlefield stress. So whether the injuries are physical, mental or both, no treatment or other support should be considered too expensive.
Maybe someday we'll have government leaders who will be honest about the true cost of the war they are about to declare, and maybe someday we'll have a public who will demand such honesty and be less gullible. Until then the men and women who volunteered for the current wars, deserve the best of support. They can't be thanked enough !
The health care professionals caring for soldiers and veterans suffering from the effects of PTSD and TBI need a lot of support, as they are under great strain and can suffer from vicarious trauma. Reading and discussing literature together has been proven to support them in their work, increase their ability to empathize and care for patients, and decrease provider fatigue. 3 books that have been a tremendous help to the health care professionals treating veterans in Maine Humanities Council's Literature & Medicine program are: Jonathan Shay's books, "Achilles in Vietnam" and "Odysseus in America", which use Homer's Illiad & Odyssey to help explain the effects of combat stress on soldiers and examine the challenges of returning home to "normal life" after combat; Tim O'Brien's book, "The Things They Carried", has helped those who have not experienced combat better appreciate what their patients may have gone through. Both authors are speaking at a conference on trauma:
http://www.mainehumanities.org/programs/litandmed/index.html
I was licening to 1 of your callers about the vets from ww2 and Korea not suffering from ppsd as often as todays militery. Not so true my father worked at a state run Mental Hospital in Illinois when I was groing up.
The words were full of Vets suffering from sever ppsd. And bacause noone talked about it like we do today. The state of Illinois desided that they were all curred and removed them from the mental health system to cut cost. Not making this up check the facts if you like. Jacksonville Ill Mental health still has what is refered to as the old vets biulding.
Even as resantly as the Busch jr. administration there has been presure put on the VA not to diegnose PPSD to save money. And most vets still don't want to talk about war they want to get on with there lives