Farming As A Non-Pharma Rx For Veterans With PTSD

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While many Combat Veterans who suffer from Traumatic Brain Injury (TBI) and/or Post-Traumatic Stress Disorder (PTSD) follow conventional medical protocols involving high dosages of anti-depressants, others have discovered a more “natural” way to heal from invisible war wounds.

Through farming.

“It’s as natural as it gets,” says MAJ Ben Richards, SFTT Director of Veteran Affairs. “Working outside with your hands in the earth to help plants grow and feed people?  It doesn’t get much more rewarding than that for many survivors of wartime trauma.”

Just as farming is palliative for Combat Veterans, these civilian soldiers may be the cure for the farming industry.  While the suicide rates of American Veterans and American Farmers are both rising at unprecedented speed, the key to halting this acceleration may ironically lie within the symbiotic relationship between the two occupations.  Research shows that Veterans with PTSD feel a greater sense of purpose and community when working as farmers.

One of our partners, Archi’s Institute for Sustainable Agriculture (AiSA) offers courses in sustainable agriculture for Veterans and military service members that have not only afforded these men and women jobs, but have also ameliorated their PTSD symptoms.

“Our goal at Archi’s Institute is to provide Veterans who suffer from TBI and/or PTSD with the tools and knowledge they need to either start their own small hydroponic farms or to work for other farmers,” says Karen Archipley, Co-Founder and Marketing Manager (AiSA).  “We’ve seen Veterans who are struggling to function in their daily lives come to our Institute and not only learn skills that help them forge a new career path, but they also make friends and emotional connections, giving their lives renewed meaning.”

This new breed a warrior-farmer may be just what the “dying breed” of hands-on agriculture needs.

As we approach Memorial Day, please consider giving to Treatment of Ten, our fundraising initiative to send 10 Broncos for our integrative TBI/PTSD rehabilitative program, consisting of a non-prescription drug protocol, including organic farming among other therapies.

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Treatment of Ten Campaign Extension Until Memorial Day, May 28, 2018

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Guess what?

Because of you, the Treatment of Ten fundraising campaign is becoming a success.

We’ve raised almost enough funds to send one Combat Veteran to our medical facility in Idaho so that he can receive the treatments and therapies that he needs. Now, we need to send the other nine!

To do that, we’ve extended the campaign until Memorial Day because we’re determined to follow Hack’s “orders” to take care of his men and women who are forever on the tip of the sword, whether it be physically when in combat or mentally when at home. These ten Broncos whom we’re committed to help heal are struggling with Traumatic Brain Injury and /or Post-Traumatic Stress Disorder here at home, constantly reliving their tours in Iraq!

I’ve been reading some statistics, old and new that have re-broken my heart:

• About 7 or 8 out of every 100 people (or 7-8% of the population) will have PTSD at some point in their lives. About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma. About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%). Learn more about women, trauma and PTSD. (https://www.ptsd.va.gov/public/ptsd-overview/basics/how-common-is-ptsd.asp)

• Two-thirds of homeless Iraq and Afghanistan veterans in one major sample had post-traumatic stress disorder (PTSD) — a much higher rate than in earlier cohorts of homeless veterans, who have PTSD rates between 8 percent and 13 percent, according to a study in press in the journal Administration and Policy in Mental Health and Mental Health Services Research. (http://www.apa.org/monitor/2013/03/ptsd-vets.aspx)

• For many service members, being away from home for long periods of time can cause problems at home or work. These problems can add to the stress. This may be even more so for National Guard and Reserve troops who had not expected to be away for so long. Almost half of those who have served in the current wars have been Guard and Reservists. (https://www.ptsd.va.gov/public/ptsd-overview/reintegration/overview-mental-health-effects.asp)

• Another cause of stress in Iraq and Afghanistan is military sexual trauma (MST). This is sexual assault or repeated, threatening sexual harassment that occurs in the military. It can happen to men and women. MST can occur during peacetime, training, or war. (https://www.ptsd.va.gov/public/ptsd-overview/reintegration/overview-mental-health-effects.asp)

• One early study looked at the mental health of service members in Afghanistan and Iraq. The study asked Soldiers and Marines about war-zone experiences and about their symptoms of distress. Soldiers and Marines in Iraq reported more combat stressors than Soldiers in Afghanistan. This table describes the kinds of stressors faced in each combat theater in 2003:

• Soldiers and Marines who had more combat stressors had more mental health problems. Those who served in Iraq had higher rates of PTSD than those who served in Afghanistan. (https://www.ptsd.va.gov/public/ptsd-overview/reintegration/overview-mental-health-effects.asp)

• Thousands of men and women continue to risk their lives in the United States military to protect the freedom of citizens like me. Their psychological and physical well-being of every human being is important. It is particularly important to care for those who get injured while protecting all of us. Why not reach out and help us today to at least take care of our first cohort of 5 who served and sacrificed.
(https://www.psychologytoday.com/us/blog/curious/201409/11-reasons-combat-veterans-ptsd-are-being-harmed)

Let’s keep the needle moving. Please give today to help send the Broncos to Idaho.

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PTSD: Current Status, Key Challenges and Promising Treatments

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Yuval NeriaPost-traumatic Stress Disorder (PTSD) frequently occurs after the experience of traumatic events such as wars, disasters, acute medical events, and domestic violence. It is known as the signature disorder of combat and disaster.  Lifetime prevalence PTSD is substantial, estimated as approximately 8% in the United States, with a prevalence of about 4% in any given year  Among U.S. military personnel, frequently exposed to traumatic events, PTSD rates are even higher ranging from 19% to 22%. Military personnel are at higher risk for experiencing traumatic events, including exposure to combat, injury, loss, captivity, and sexual abuse. Consequently, PTSD is a common syndrome among veterans, and is frequently associated with functional impairment. Veterans with PTSD often suffer from a wide range of additional psychiatric symptoms including depression and substance and alcohol abuse.

PTSD symptoms are often persistent and disabling unless there is a timely targeted intervention. Symptoms of PTSD are wide-ranging and can affect trauma-exposed people in a number of debilitating ways. They include re-experiencing of the traumatic event (including intrusive thoughts, nightmares and flashbacks), avoidance of thoughts of the traumatic event and people, places, or other stimuli that evokes the trauma, changes in cognitions such regarding the world and yourself, hypervigilance, hyperarousal (including irritability, concentration difficulties, and disrupted sleep), and increases in troubling thoughts and negative feelings. PTSD is commonly associated with functional impairment, substance abuse, suicidal ideation, and increased utilization of medical care.

While a number of psychotherapies and pharmacotherapies for PTSD have been developed, research has consistently shown that more than one-third of PTSD patients never fully remit, even if treated. Meta-analysis of psychotherapy for PTSD has found short-term improvements compared to baseline only in about 50% to 60% of patients, with the majority continuing to have substantial residual symptoms. The efficacy of medication in PTSD is also unclear, with a critical lack of advancement in the psychopharmacologic treatment of the disorder. Only 20–30% of PTSD patients experience a complete remission following pharmacotherapy. Importantly, research has shown that among military personnel with PTSD, treatment reach is low to moderate, with a high percentage of service members not accessing care or not receiving adequate treatment.

Researchers in the field have raised a call to action to validate novel interventions that will improve treatment engagement and retention among veterans and family members. Here I would like to highlight three promising treatments that may address some of the above problems.

Attention-Bias Modification Treatment for PTSD:  Emerging research has demonstrated a relationship between biased attention to threat and PTSD.  Attention-bias relates to how people focus their attention; research shows that people with high levels of anxiety tend to focus on negative information in their environment. This knowledge has motivated the development of a novel therapy, attention-bias modification treatment (ABMT), currently provided at Columbia Psychiatry thanks to the generous support of SFTT. ABMT is designed to modify patients’ threat bias, i.e., change their attentional habits, with the use of a computer program. Participants with PTSD and attention bias towards or away from threat (documented by the dot probe task) undergo a 4-week (8-sessions) course of ABMT or an inactive Attention Control Program. Findings from this study are about to be published in the near future.

Interpersonal Psychotherapy for PTSD: Interpersonal Psychotherapy (IPT) is a time-limited, evidence-based treatment, has previously shown efficacy in treating major depressive disorder and other psychiatric conditions. Rather than focusing on the trauma, as in exposure based treatments, IPT focuses on the patient’s current life events and social and interpersonal functioning for understanding and treating symptoms. This treatment currently provided at Columbia Veterans Center, is a novel use of IPT as treatment for PTSD. Evidence from studies conducted at Columbia Psychiatry suggests IPT may relieve PTSD symptoms without focusing on exposure to trauma reminders. Hence, IPT offers an alternative for patients who avoid or do not respond to exposure-based approaches. Interpersonal Psychotherapy focuses on two problem areas that specifically affect patients with PTSD: interpersonal difficulties and affect dysregulation. The treatment help the patient identify and address problematic affects and interpersonal functioning, and to monitor treatment response.

Equine Assisted Treatment for PTSD. Equine-Assisted Therapy for PTSD (EAT-TSD) is a unique, group treatment that might reduce symptoms of PTSD, particularly individuals who encounter difficulty in more traditional treatments. In EAT-PTSD, a mental health professional and an equine specialist work together to guide participants with PTSD through a series of structured activities with a horse. Presently this treatment is studied at Columbia Psychiatry as part of the Man O War Project . It is an eight-week study aimed to examine how well EAT-PTSD works for veterans with PTSD. Treatment groups consist of 4-6 veterans at a time. 90-minute EAT sessions take place at the Bergen Equestrian Center in Leonia, New Jersey. Columbia Psychiatry provides transportation to treatment sessions. Treatment does not include riding horses. Through various interactive exercises with the horses, the veterans learn how their actions, intentions, expectations, and tone have an impact on their relationship with the horses (and ultimately with the people in their lives). Over the course of treatment, the equine specialist and the mental health professional assist veterans in drawing connections between what the horses may be doing, thinking, or feeling, and their own PTSD symptoms, increasing emotional awareness and ability to regulate emotions and behaviors, and learning to more effectively interact with the horses, and by extension other people as well.

Contributed by Dr. Yuval Neria
Stand For The Troops Special Medical Advisor
Professor of Medical Psychology, Departments of Psychiatry and Epidemiology
Research Scientist, The New York State Psychiatric Institute
Director of Trauma and PTSD Program, The New York State Psychiatric Institute
Director of Columbia-NYP Military Family Wellness Center
College of Physicians and Surgeons
Columbia University Medical Center

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The Unknown Soldier

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Released in 1968 by the Doors, the Unknown Soldier was considered an antiwar song and banned on many radio stations. The song, however was more of dig at the American media and the way that the Vietnam conflict was televised into our homes and became a part of our daily lives. The lyrics “Breakfast where the news is read/ Television children fed/ Unborn living, living dead/ Bullets strike the helmet’s head” portrays how the news of the Vietnam War was being presented to ordinary people.

Jim Morrison sings about how in the late 60’s American families stared at violent television images, watching a world far away where the unknown soldier is shot, yet life at home went on as usual.  The entire scenario seems to normalize the war. People were numb and continued to live their normal lives while their soldiers were dying. The fact that the soldier has no identity is also a strong message to the ignorance and lack of emotion that people had towards the men who were fighting ‘for them.’ And as we all know, the soldier who had no name came home to an unwelcoming party.

Today, military conflicts continue to play out daily on our televisions, our cell phone news feed and throughout social media.  This time those who are called to duty are welcomed home but soon forgotten by an overwhelmed VA and by the very people they serve. Today our veterans are faced with homelessness, mental health issueseducational hurdles, long waits and scandalous policies at the VA, and a military suicide rate of 22 a day.

It’s true that today’s veterans have never been more respected, unlike those who returned from Vietnam. But unlike Vietnam veterans many Americans have no personal connection to anyone who has served or is serving in the Armed Forces.  Many organizations have hit the media and social outlets to drum up support for Veterans in need but again, America’s eyes have glazed over to the  issues faced by our Veterans.  Even when it was discovered that a nonprofit claiming to help veterans at risk was misappropriating funds, there was little or no public reaction. And so, it seems the numbness prevails.

Forty years later the unknown soldier is the one struggling with PTSD. The unknown soldier is the one whose life was a daily pill that is now an addiction.  The unknown soldier is homeless. The unknown soldier is the one who suffers in silence. The unknown soldier is one of 22 each day that takes his own life.

Perhaps it’s time the unknown soldier had a name and America a plan to support those who served.

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Vietnam Combat Veteran Brian Delate Goes Back to Move Forward

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The post that follows comes from my dear friend Brian Delate who I first met in 1996. We were at a party at my daughter’s house, as Brian’s late wife Karen and my daughter were in graduate school together. I was immediately taken with both Brian and Karen, it was hard not to be. They were attractive and warm, funny and smart and they both loved movies, a passion we shared. Brian and I soon realized that we shared another passion, a commitment to helping veterans heal from the invisible wounds of war. As a Vietnam veteran, Brian knew, respected and came to love my late husband Hack and he always told me that if SFTT ever needed support, he would help us — and the veterans we strive to heal — in any way he could. In honor of Treatment of Ten, I asked Brian to write a piece for us. And he did. Beautifully and poetically. Thank you, Brian.  ~ Eilhys England Hackworth.

It is January 2013 and I am back in Vietnam as both an American Combat Veteran and a writer/performer of MEMORIAL DAY (when remembering makes you want to forget… and being forgotten makes you want to die…), a one-man show I enact.  In each performance, I must step into the limits of human experience, which for me is my time spent as a warrior in a specific war during a specific year: 1969-70.

I had visited Vietnam the year before.  In 2012, I stood on the hallowed ground, where death once danced wildly with (my) life, realizing that my invisible wounds of PTSD needed deeper exploration. I broke away from the group I was traveling with in Hanoi to spend 24 hours in Chu Lai – my area of operation where thousands of my fellow American soldiers were also stationed.  To “go back” was a challenge because as we all know Life Goes On. Or tries to. Once in Chu Lai, I saw some old hangars that are dormant, but now resemble something out of H.G. Wells’ Time Machine. The runways that were vibrantly active in 1969 are now barely discernible. In another few years they won’t be visible at all.

Now, in 2013, I am back in and around Chu Lai, with a driver, a translator and a cameraman. We drive around kind of hit-and-miss on different roads to see what I could remember. I forgot how very beautiful the beaches are. And for whatever reason, they are completely empty of people and development.  This absence intrigued me; what was I expecting? Wanting? Looking for, exactly? Life going on, perhaps?

We are on a mission of sorts. I had brought with me a snapshot of myself standing on a particular beach in a very striking cove-like area where I and another soldier saved a drunken infantry guy from drowning. In so doing, we all almost drowned. Very scary. I never imagined one of my near-death experiences during the Vietnam War would involve drinking and the ocean.

 

Having found the cove, my companions give me some time near to reflect and pray for all those who did not survive — and now, to my own surprise, I include the former enemy, the Vietnamese, their families, and their communities.

Believe me when I say how totally unthinkable this sentiment was at one time; I am surprised at my own compassion and ability to forgive.

At the end of this particular day in 2013, I stayed at a beautiful old Inn near Chu Lai for the night where I met an older, very fragile and very friendly Vietnamese man, who was one of the few Vietnamese I have met who admitted to fighting the communists. He expressed in very broken English the horrible aftermath for him and his family.  We connected emotionally, and at one point, he held my hand firmly, wept a little and thanked me for visiting. He then sent “good wishes” to the Americans.  This was just one “memorial moment” I experienced on my MEMORIAL DAY trip.

Days later, I complete two performances of my show with a singular astonishing result.  Once was at the University of Hanoi — college kids are college kids — meaning that they really do not care about the war. As they say repeatedly, “We’re tired of hearing about that war.”

In the other instance, we visited the Veterans Association of Vietnam (VAV) which is a high-level government agency with a new leader who can veto my performance in a second. In short, the stakes were high for me to knock their socks off.  The head of this agency was a Lt General (one of their war heroes) and he had three other senior officials with him along with our central government ‘minders’ and a couple of important representatives from the USA/Vietnam Society.

I got to do about 12 minutes of MEMORIAL DAY and it landed pretty powerfully on these men and women — they really got it. When I first met the General, we shook hands politely and we nodded. After I finished the piece, he immediately stood up, came over to me and, with great vigor, shook my hand hard. He then looked me in the eye and kept touching first his heart and then my heart with his fist, saying, through the translators, ‘We identify with the humanity.’

This surprised everybody. The other officials followed suit and the formalities disappeared and a load of personal sincerity and even some humor dropped into the room. My new friend on this trip, Pete, a former infantry captain, gave me a single line review — ‘You’ve got balls, man.’

A day or two later, we are at the Institute for Humanities and Social Sciences, where we would interact with a combination of their psychologists, veterans and students. Initially, there was the time-consuming formality of introductions and translations back and forth. Then Dr. Edward Tick (our leader and author of War and the Soul) gave a smart and informed speech, addressing what is known and has been gathered from both sides, with regard to the aftermath of the Vietnam War that took place here so long ago.

I sat next to one of their psychologists, also a Combat Veteran from circa 1970. He made very clear that everybody in his world (family, friends, immediate community, et al.) was involved with the fight against America. What really got my attention was how they dealt with returning soldiers. The family and the community shared the burden even more than the government.

There was an instance during the talk where one of the students questioned Dr. Tick’s assertion of the value of bringing American Veterans back to Vietnam — returning them to the scene of their trauma.

Dr. Tick has had tremendous success with helping hundreds of Veterans trust the healing benefits of one’s community and spirituality along with these kinds of “going back” visits.

I spoke up at this point because I was here last year in 2012, and at that time, instead of feeling some immediate kind of transformation, relief or release, I fell back into re-living many of the fears I had had during the war. I ended up re-experiencing some of the trauma versus working through it or purging it.

Let me explain.

While I was in the city of Hoi An in 2012, I was sitting in a very beautiful dining room at a very elegant hotel with my wife Karen.  We were having breakfast and a young waiter walked by.  He and I made eye contact. Immediately, an emotional tumor (as I have come to call them) erupted and I couldn’t stop it wailing. I had to get outside of the hotel in order to regroup.

Quick back story: As a young sergeant in 1969, after coming off of a rough night with my squad and not having slept for some time, I got into it with a young Vietnamese man.  We called them Cowboys. They were really just thugs — he spit in my direction and I went into a berserk rage and proceeded to beat him, almost to death. At one point, I left my body and felt like I was watching somebody else commit this violence. Finally, I could not pick up my arms to punch anymore, but this Cowboy kept trying to spit in my direction, even with one eye unattached and literally coming out of his head. After my maniacal behavior, I experienced another layer of deep self-loathing.

Anyway, back to 2012 and the hotel in Hoi An: After I was able to regroup, I went back into the dining room, sat back down with Karen and spoke about what had happened. As we continued to sit there, the same young waiter came by, smiled and asked me if I wanted more tea. This time nothing happened — we made eye contact once again, but in this instance a guilt-ridden memory was rapidly evaporating. It was like that scene in the film The Mission, where the DeNiro character endlessly drags his armor around as a form of punishment or penance, for having killed his brother. A native cuts the rope connecting him to the armor and he is free.

In that moment, after being triggered, re-living my trauma and then returning to breakfast, I experienced a significant purging that, in my opinion, would not or could not have taken place had I not been actively seeking more Meaning and Truth or Seeking what was Missing. I was replacing an old memory with a new memory, an important component to Healing.

In one of my last days in Vietnam 2013, I get to present a sample of my play at a Writer’s Conference with over a hundred Vietnamese writers and veterans in attendance. Some of what I present in the play does not need translation — it is a combination of specific movement with music that shapes a narrative of what it is like to prepare for combat, engage in that combat situation and then recover from combat. I use the overture from Tannhauser by Wagner, the music representing the sacred and the profane aspects of what Combat Warriors endure.

I want to mention that PTSD is a collective wound and a soldier/Veteran cannot carry that wound alone. If they try to, they will either collapse or the damage to the individual will never be healed and the casualties and hurt will continue to accumulate, affecting their family, friends, colleagues and community.

And lastly, the Greeks had this interesting insight on the — ‘Definition of Happiness – which is making full use of your powers along the lines of excellence.’ That does not mean living in any kind of perfection, but it is about living and living fully. That is what I am doing now and I am here to help my fellow Combat Veterans do the same thing.

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Hyperbaric Oxygen Therapy: Give Veterans a Chance with Ben Richards

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As sound-bite politicians and Department of Veterans Affairs (“the VA”) administrators (past and present) slug it out over the future direction of the VA, Maj. Ben Richards has put together a comprehensive 8-week program to treat 10 fellow Veteran warriors who suffer from PTSD and TBI.

Hackworth-Richards Fundraiser

The program is called the Treatment of Ten. SFTT, founded by the legendary war hero COL David “Hack” Hackworth, is helping to raise $150,000 to help these brave Veterans get the therapy they deserve.

Some of these therapies are currently denied Veterans at the VA because of their entrenched bias against Hyperbaric Oxygen Therapy (“HBOT”) and other alternative treatment therapies. Sadly, the VA treatment offered to our Veterans for PTSD and TBI is shameful as amply documented by previous articles and blog posts published by SFTT.

In his own words, Maj. Ben Richards describes his experiences with the VA and explains that there is hope for Veterans and their caregivers who suffer from terrible brain injury.  Sadly, this non-invasive therapy is not available at the VA and won’t be anytime soon.

Found below are some of the non-invasive therapies that these Veterans in the Treatment of Ten will receive over an eight week period at an HBOT facility in Idaho.

Hyperbaric Oxygen Therapy or HBOT
Hyperbaric oxygen therapy (HBOT) is a medical treatment which enhances the body’s natural healing process by inhalation of 100% oxygen in a total body chamber, where atmospheric pressure is increased and controlled. According to Harch Hyperbarics, “oxygen is transported throughout the body only by red blood cells.

Transcranial Magnetic Stimulation
Transcranial magnetic stimulation is a method in which a changing magnetic field is used to cause electric current to flow in a small region of the brain via electromagnetic induction. iTMS employs a safe, painless, and non-invasive brain stimulation technology to generate a series of magnetic pulses that influence electrical activity in targeted areas of the individual’s brain.

High Performance Neurofeedback
High Performance Neurofeedback or EEG Neurofeedback is a noninvasive procedure that involves monitoring and analyzing EEG signals read through surface sensors on the scalp, and uses the EEG itself to guide the feedback.

Low Level Light Therapy
LLLT (aka as PBM or Photobio Modulation) uses “red or near-infrared light to stimulate, heal, regenerate, and protect tissue that has either been injured, is degenerating, or else is at risk of dying.”

Cranial Electrical Stimulation
CES uses waveforms to gently stimulate the brain to produce serotonin and other neurochemicals responsible for healthy mood and sleep. Proven safe and effective in multiple published studies, the device is cleared by the FDA to treat depression, anxiety and insomnia.

Maj. Richards plans to use these results to develop a template for other communities and medical facilities to adopt the same procedures in helping Veterans cope with debilitating brain injury.

Your support is needed to help with fund this initial program. Unlike many other Veteran support programs, 100% of ALL contributions go to support the TREATMENT OF TEN. If you want to truly support Veterans, please make a contribution now by CLICKING THIS LINK.

Let’s give our Veterans a chance to reclaim their lives.

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The VA and Shulkin: “It Shouldn’t Be This Hard to Serve Your Country”

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Dr. David Shulkin has been pushed aside (read fired) as the Secretary of the Department of Veterans Affairs (“the VA”).  Without taking sides in what appears to be yet another partisan issue, Dr. Shulkin did a reasonably good job in bailing water in a sinking ship:  the VA.

David Shulkin

As such, it was with regret that we read Dr. David Shulkin’s self-serving departure editorial in the New York Times “it should not be this hard to serve your country.”   Indeed, many Veterans poorly served by the VA have felt the same.  But these Veterans, with a legitimate claim were rarely afforded space in the editorial section of the New York Times to discuss their grievances.

The title of the New York’s editorial says it all:  “David J. Shulkin:  Privatizing the V.A. Will Hurt Veterans“.   I am not sure that Dr. Shulkin would have titled his departure editorial this way, but clearly, the New York Times, David Shulkin and J. David Fox, the President of the American Federation of Government Employees, agree that privatizing the VA will harm Veterans.

SFTT is unaware of any compelling evidence that providing “privatized” care to Veterans would jeopardize the mission of the VA or add to the difficulties of Veterans.  Indeed, J. David Fox, seems more concerned about the rights of unionized VA employees than he does about Veterans.

While it is easier to frame the discussion as a debate about the merits of public or private healthcare,  SFTT has long argued that the VA is simply Too Big to Succeed.  It never has been a question of “ownership” or “control,”  it is simply a case of an institution that has become too large to manage effectively.  With over 18 million Veterans, it is unlikely that an overwhelming majority would agree that the VA is provides services that are “second to none.”

In fact, Dr. Shulkin claims that “the percent of veterans who have regained trust in V.A. services has risen to 70 percent, from 46 percent four years ago.  This is not exactly a ringing endorsement on how well the VA is fulfilling its mission.

There are many areas of the VA that fulfill President Abraham Lincoln’s promise:  “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.

But there are other areas in which the VA fell well short of fulfilling President Lincoln’s promise.

Specifically, SFTT has for years called into question the way the VA has treated Veterans with PTSD and TBI:  “the silent wounds of war.”  There is compelling evidence that the VA, through its administrators, has consistently lied to Veterans, their caregivers, Congress and the public on the effectiveness of treating Veterans with brain injury.

More to the point, the VA medical staff has been grossly negligent in providing Veterans with opioids to treat the symptoms of PTSD and TBI rather than offer any real treatment.  Was the VA complicit in fueling the opioid epidemic?

Political posturing on the benefits of public or private ownership doesn’t really help the hundreds of thousands of Veterans suffering from brain injury and their largely forgotten caregivers.

Changing of the guard will do little to fix the VA.  Only a true bipartisan effort to address the problems of the VA will help restore confidence in an institution with far greater promise than the actual results it delivers.

Thank you for your service Dr. Shulkin.

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Equine Therapy for Veterans with PTSD and TBI

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There is considerable anecdotal evidence that supervised exposure of Veterans with PTSD and TBI to horses helps restore a sense of well-being.  Nevertheless, an adequate number of controlled clinical experiments are lacking to determine whether equine therapy has any lasting benefits for Veterans suffering from brain injury.

Equine Therapy for Veterans with PTSD

As reported earlier, Dr. Yuval Neria is Professor of Medical Psychology at the Columbia University Medical Center and “Scientific Advisor” to Stand for the Troops (“SFTT”) is leading a clinical study for the Man O’War Project in the hope of developing adding more scientific credibility to the notion that exposure to animals helps Veterans with brain injury.

While Equine therapy is not as widely known within the Veteran community as service dogs, it is yet another non-invasive process to help Veterans recover from the “silent wounds of war.”

What is Equine Therapy?

According to CRC Health, “Equine Therapy (also referred to as Horse Therapy, Equine-Assisted Therapy, and Equine-Assisted Psychotherapy) is a form of experiential therapy that involves interactions between patients and horses.

How Does Equine Therapy Work?

Equine Therapy involves activities (such as grooming, feeding, haltering and leading a horse) that are supervised by a mental health professional, often with the support of a horse professional.

CRC Health goes on describe the therapeutic aspects of Equine Therapy, both during the activity and after the patient has finished working with the horse, the equine therapist can observe and interact with the patient in order to identify behavior patterns and process thoughts and emotions.

The goal of equine therapy is to help the patient develop needed skills and attributes, such as accountability, responsibility, self-confidence, problem-solving skills, and self-control. Equine therapy also provides an innovative milieu in which the therapist and the patient can identify and address a range of emotional and behavioral challenges.

What is the VA’s Position on Equine Therapy?

While acknowledging that there may be some benefits from Equine Therapy, the VA currently does not endorse the programs claiming that there is insufficient “evidence” to support the benefits of the therapy.  

How Much Does Equine Therapy Cost?

According to the National Center for Equine Facilitated Therapy (“NCEFT”) “the cost of twice daily feeding, individual grooming and exercise, stall cleaning, specialized supplemental grain, and session staffing (horse handler and therapist), comes out to between $115 and $300 a session, depending on the type of therapy,

Selected SFTT Posts on Equine Therapy

Equine Assisted Therapy for Veterans with PTSD

Equine-Assisted Therapy Seek Veteran Volunteers

Equine Therapy and Service Dogs for Vets

Additional Resources

Equine-Assisted Therapy

Man O’ War Project

Equine Therapy from CRC Health (Promotional)

Lessons to be Learned from Equine Therapy

National Center for Equine Facilitated Therapy

SFTT Position

While there currently is a lack of scientific or clinical “evidence” that Equine-Assisted Therapy helps Veterans with PTSD and TBi, there are strong indications that the “bonding” and responsibility required to handle a horse promotes “wellness.”    Whether this sense of well-being is sustainable outside of a controlled environment is yet to be determined.

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What Veterans with PTSD Should Know About Alternative Drugs

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Most every day there is a provocative news report suggesting that some “miracle drug” may help treat Veterans with PtSD and TBI.  If it is not a new drug, cannabis or ecstacy are often cited as “new” drugs that can help Veterans cope with  the debilitating symptoms of PTSD.

While many Veterans with brain injury and their caregivers hope that prescription medicine relief is on the way, the Department of Veterans Affairs (“the VA”) has a very poor track record in providing Veterans with the care that they deserve.  More to the point, prominent spokespeople for the VA – like Dr. David Cifu – give misleading information when they claim that the VA provides the best available treatment programs for PTSD and TBI.  This is simply not the case.

In fact, there are hundreds of stories documenting the frustration of Veterans with the staff of the VA.   The suicide of Veteran Eric Bivins as told by his wife is just one of many horrific stories of how doctors at the VA callously treat Veterans.

When all else fails (as it normally does), the VA prescribed drugs – in many cases, opioids.  Mind-altering drugs was to “go-to” choice for overworked VA medical personnel who still don’t know how to deal with, let alone treat brain injury.

While we all remain hopeful that drug relief is just around the corner, it seems likely that the new “miracle” drug will only deal with the symptoms of behavioral changes caused by PTSD and TBI.  Veterans consulted by SFTT  seek a permanent or semi-permanent solution that avoids invasive drugs.  Found below are questions Veterans and their caregivers should consider when thinking about using “alternative” drugs.

What Veterans Should Know About “Alternative” Drugs

There is much “buzz” in social media channels and even authoritative medical websites on important new breakthroughs on “drugs” to help Veterans with with PTSD and TBI.   Given the wide disparity in treating brain injury, it seems unlikely that marijuana, MDMA or others in clinical trial will provide a long term solution.

There is a vast difference between providing therapy that permits Veterans with PTSD and TBI to recover their lives than supplying prescription drugs which treats the symptoms.  As the public has painfully learned from the opioid epidemic, prescription drugs that treat only the symptoms can have detrimental side-effects.

VA’s Research on Alternative Drugs

The VA continues to help fund initiatives to identify less addictive drugs that help Veterans cope with chronic pain, depression and anxiety.  Clinical trials take several years to complete and there is a lengthy regulatory and review process to obtain FDA approval.

Selected SFTT Posts on Alternative Drugs

Opioids:  Bi-Partisan Incompetence in D.C.

The VA and Opioids:  The Finger-Pointing Begins

Marijuana and Veterans with PTSD

Genetics to Cannabis:  Implications for Treating PTSD

Veterans with PTSD Knew that VA Opioid Prescriptions Were Wrong

SFTT’s Position on “Alternative” Drugs

SFTT sincerely hopes that researchers and the medical profession will hopefully create a variety of new – and less addictive – drugs to treat Veterans with PTSD and TBI.  Nevertheless, members of the medical profession must clearly distinguish between drugs that treat “symptoms” and those that may offer long term remission from brain injury.  For reasons that are not entirely obvious, the VA does not make that distinction public. Sadly, the VA’s track record is not good in dispensing prescription drugs to Veterans with brain injury.  

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Alternative Treatment Options for Veterans with PTSD and TBI

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In an era of medical breakthroughs and diverse treatment options, it is most disappointing that the Department of Veterans Affairs (“the VA”) has so few treatment options for Veterans suffering from PTSD and TBI.

More to the point, the VA has gone out its way to suggest that non-VA approved alternative treatment therapies are little more than snake oil.  Instead, compromised doctors like David Cifu vigorously defend the status quo at the VA which has shown to be remarkably out-of-touch with the complications in treating brain injury.  Some, in fact, claim that the VA relied heavily on a lethal opioids to treat the symptoms of PTSD/TBI rather than the underlying causes.

Found below is a brief summary description of non-invasive treatments for brain-injury currently under review by SFTT.  Some therapies have ample clinical trial evidence of success, but others still rely on anecdotal evidence.  Based on SFTT’s experience, we believe that a combination of these therapies works best for the vast majority of Veterans suffering from brain injury.

Overview

Veterans with PTSD and TBI are limited to the number of therapy programs currently provided by the Department of Veterans (“the VA”).  In some cases, the VA claims that alternative therapy programs are not “evidence-based,” while other “therapies” are currently being studied by the VA.

Found below is a list of some of the more popular “alternative” therapies for treating PTSD and TBI.  Several are supported by strong clinical evidence, while others currently lack rigorous scientific backing.  Each program has a brief description with a hyperlink to more detailed information, scientific backing and anecdotal evidence.

Hyperbaric Oxygen Therapy or HBOT

Hyperbaric oxygen therapy (HBOT) is a medical treatment which enhances the body’s natural healing process by inhalation of 100% oxygen in a total body chamber, where atmospheric pressure is increased and controlled.  According to Harch Hyperbarics, “oxygen is transported throughout the body only by red blood cells.

Transcranial Magnetic Stimulation   

Transcranial magnetic stimulation is a method in which a changing magnetic field is used to cause electric current to flow in a small region of the brain via electromagnetic induction. iTMS employs a safe, painless, and non-invasive brain stimulation technology to generate a series of magnetic pulses that influence electrical activity in targeted areas of the individual’s brain.  

High Performance Neurofeedback

High Performance Neurofeedback or EEG Neurofeedback is a noninvasive procedure that involves monitoring and analyzing EEG signals read through surface sensors on the scalp, and uses the EEG itself to guide the feedback.  

Low Level Light Therapy  

LLLT (aka as PBM or Photobio Modulation) uses “red or near-infrared light to stimulate, heal, regenerate, and protect tissue that has either been injured, is degenerating, or else is at risk of dying.”

Cranial Electrical Stimulation   

CES uses waveforms to gently stimulate the brain to produce serotonin and other neurochemicals responsible for healthy mood and sleep. Proven safe and effective in multiple published studies, the device is cleared by the FDA to treat depression, anxiety and insomnia.

Equine Therapy  

According to CRC Health, “Equine Therapy (also referred to as Horse Therapy, Equine-Assisted Therapy, and Equine-Assisted Psychotherapy is a form of experiential therapy that involves interactions between patients and horses.

Transcendental Meditation Technique  

According to Wikipedia, the Transcendental Meditation technique is a specific form of silent mantra meditation developed by Maharishi Mahesh Yogi. It is often referred to as Transcendental Meditation, or simply TM. The meditation practice involves the use of a mantra and is practiced for 15–20 minutes twice per day while sitting with one’s eyes closed.

Service Dogs

A companion service dog program appears to provide comfort and support to Veterans with the symptoms of PTSD, including depression, nightmares and social anxiety. Service dogs are trained to anticipate anxiety attacks and nightmares.

Biofeedback

Biofeedback is the process of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will. Some of the processes that can be controlled include brainwaves, muscle tone, skin conductance, heart rate and pain perception.

Complementary Alternative Medicine  

The Mayo Clinic defines “complementary and alternative medicine (“CAM”) as a popular term for health and wellness therapies that have typically not been part of conventional Western medicine. Complementary means treatments that are used along with conventional medicine. Alternative means treatments used in place of conventional medicine.

Emerging Drug Therapy  

There is much “buzz” in social media channels and even authoritative medical websites on important new breakthroughs on “drugs” to help Veterans with with PTSD and TBI.   Given the wide disparity in treating brain injury, it seems unlikely that marijuana, MDMA or others in clinical trial will provide a long term solution.

SFTT Overview

Most of the “alternative” therapies listed above are noninvasive.  After years of supplying addictive and dangerous prescription to Veterans with brain injuries, SFTT strongly believes that there are more reliable and safer treatment alternatives of Veterans.  

 

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