The Fragility of the VA

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I just started reading Antifragile:  Things That Gain With Disorder by Nassim Taleb.   For those who may not be familiar with Mr. Taleb, he is Professor of Risk Engineering at New York University’s Polytechnic Institute and the author of the highly acclaimed The Black Swan.

Now it may seem a bit incongruous to examine the Department of Veteran Affairs (the “VA”) through the eyes of Nassim Taleb, but there are a number of clear signs that the VA is a BIG and IMPORTANT institution that has lost its way.  In effect, the VA is FRAGILE.

Found below is a superficial but effective video summary of Antifragile, which describes the process to analyze the fragility, robustness or antifragility of “almost everything about our world.”

In Mr. Taleb’s remarkable book, he joyfully examines the human body, science, biological and economic systems, business, medicine, regulation and even psychiatric well-being from the three types of exposure: fragile, robust and antifragile.

Without belaboring the point, there are many examples which clearly demonstrate that the VA is “fragile” if not broken. In fact, one could argue that the system is already in terminal decline propped up by self-serving bureaucrats to effectively deny proper medical care to our Veterans.

Fragility of the VA

While this conclusion is seen through the lens of Nassim Taleb in Antifragile, all one needs to do to reach a similar conclusion is to scan the countless unheeded GAO reports citing the failings of the VA or pour over the numerous Congressional hearings on the VA.   True reform of the VA has simply become a platform to promote self-serving sound-bites by politicians and VA bureaucrats.

I will focus on just a few observations from Mr. Taleb’s book which – in my opinion – makes the case:

SFTT has long argued that prescribing potentially lethal prescription drugs to Veterans with PTSD is both ineffective and dangerous. Consider this position under the optics of Mr. Taleb:

” . . . only resort to medical techniques when the health payoff is very large (say, saving a life) and visibly exceeds its potential harm . . . Otherwise, in situations in which the benefits of a particular medicine, procedure, or nutritional or lifestyle modification appear small – say aiming for comfort – we have a large potential sucker problem.”

Sadly, our brave Veterans and Jane and John Doe Public have been suckered big time by the VA.

Mr. Taleb effectively describes the propensity of the VA to prescribe drugs rather than promote other alternative therapy programs.  He goes on to say that “. . . pharmaceutical companies are under financial pressures to find diseases and . . .  and are looking for disease among healthier and healthier people, lobbying for reclassification of conditions, and fine-tuning sales tricks to get doctors to overprescribe.”

Doesn’t Dr. David Xavier Cifu fit the bill as an effective lobbyist for the pharmaceutical industry?  Unless I misunderstand, Dr. Cifu is suggesting that we should treat military personnel with concussions (or worse) with drugs and get them back to duty as quickly as possible.  His argument is based on his own personal experiences of having six concussions and that this is the treatment he prescribes to his family.

Despite being shunned by others in the medical profession, Dr. Cifu could be right.   The real question we should all ask is this:  What if Dr. Cifu is wrong?  In effect, Dr. David Cifu – as a proxy for the VA – is effectively condemning thousands of Veterans to the same flawed treatment procedure.

One might ask what treating PTSD by the VA has to do Nassim Taleb’s theory about Antifragility or Incerto?  Actually, a great deal.  Mr. Taleb would argue that fragile government bureaucracies like the VA are highly susceptible to arrogance and the inability to distance themselves from the predictive but flawed models they so vigorously defend.

Mr. Taleb would no doubt argue that it is better to have many “small” therapy programs that can fail rather than expose ourselves – and the lives Veterans they claim to support – to a potentially catastrophic mis-diagnosis.

With its $180 billion budget, it is now time to unravel this bureaucratic behemoth in the hope that more robust and, hopefully, antifragile therapy can emerge from a decentralized health management approach for our Veterans.   If we don’t move in this direction soon, the lives of hundreds of thousands of brave Veterans and their loved ones could be negatively affected.

Sure, there will be mistakes, but we won’t have all our eggs in one basket.  Are you listening, Dr. Cifu?  Let’s spare the VA and the brave Veterans that rely on its services the Black Swan effect.

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SFTT News: Week Ending July 8, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

President Obama Says 8400 Troops to Remain in Afghanistan
President Barack Obama gave up Wednesday on ending the war in Afghanistan during his term in office and said that at least 8.400 U.S. troops will still be on the ground for the next occupant of the White House to command.  With the Taliban resurgent under a new leader, and the Afghan army struggling to make headway, Obama bowed to the recommendations of his generals to shore up the Kabul government with a continuing U.S. and NATO presence along with billions in additional funding.  Read more . . .

President Barack Obama

 Veteran Daily Suicide Rate Now at 20
On average, 20 veterans a day committed suicide in 2014, a slight decrease from the previous government estimate, but federal health officials are cautious about concluding the suicide problem is getting better.  Rather, they say the Department of Veterans Affairs is relying on a more comprehensive database than ever before, making comparisons to prior studies difficult and possibly offering a truer snapshot than what was captured in the past.  Read more . . .

VA Secretary Corrects Statement on VA Wait Times
Veteran Affairs Secretary Bob McDonald on Tuesday took an “opportunity to correct” a comparison he made of the long wait for medical care at his agency’s facilities to lines at Disneyland. “If I was misunderstood, if I said the wrong thing, I’m glad that I have the opportunity to correct it,” he told MSNBC’s Andrea Mitchell. “I’m only focused on one thing, and that’s better caring for veterans. That’s my job, that’s why I’m here.”  Read more . . .

Nato Repercussions from Brexit
The dominant vibe in Warsaw is all about unity. The results are mostly pre-cooked. And there should be few surprises. With little dissent to speak of, in the next couple days NATO is expected to beef up its forces in its vulnerable frontline states in the east; forge closer ties with traditionally neutral Finland and Sweden; and upgrade the importance of cyber defense.  Read more . . .

Anemia Negatively Affects TBI Recovery
Approximately half of patients hospitalized with traumatic brain injuries are anemic, according to recent studies, but anemia’s effects on the recovery of these patients is not clear. Now, researchers from the University of Missouri School of Medicine have found evidence that anemia can negatively influence the outcomes of patients with traumatic brain injuries.  Read more . . .

Genetic Factors for Treating PTSD?
Individuals with trauma- and stress-related disorders can manifest symptoms of these conditions in a variety of ways. Genetic risk factors for these and other psychiatric disorders have been established but do not explain the diversity of symptoms seen in the clinic — why are some individuals affected more severely than others and why do some respond better than others to the same treatment?

DNA Research

“People often experience stress and anxiety symptoms, yet they don’t usually manifest to the degree that results in a clinical diagnosis,” says Allison T. Knoll, PhD, post-doctoral fellow at The Saban Research Institute of Children’s Hospital Los Angeles. “We felt that if we could understand differences in the severity of symptoms in a typical population, it might provide clues about clinical heterogeneity in patients.”   Read more . . .

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider becoming a member of Stand For The Troops.

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SFTT News: Week Ending July 1, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Lawmakers work on legislation to protect Reservist jobs 
The new bill, called the Justice for Servicemembers Act, would make it clear that Congress never intended that the old one, Uniformed Services Employment and Reemployment Rights Act, or USERRA, which dates to 1994, was voluntary — or something an employer coguarduld challenge in the courts, lawmakers and veterans groups said during a press conference on Wednesday.  Read more . . .

Abram A1 Tank

US Army turns to Foreign Suppliers to Protect Combat Vehicles
The US Army is turning to foreign systems for an interim solution for advanced protection for its combat vehicles against rocket-propelled grenades, anti-tank guided missiles and other threats.The service’s effort to rapidly integrate already developed solutions is heating up this summer as the Army tests out what will likely be four different solutions on M1 Abrams tanks, Bradley Fighting Vehicles and Stryker combat vehicles.   Read more . . .

Afghan Police Convoy Attacked
A twin suicide attack on a convoy of buses carrying police cadets killed 37 people and wounded 40 others on Thursday, an Afghan official said. The attack took place in Paghman district, some 20 kilometers west of the Afghan capital, Kabul, according to Mousa Rahmati, the district governor of Paghman. The first suicide attacker struck two buses carrying trainee policemen, and a second attacker targeted those who rushed to the scene to help and hit a third bus, Rahmati said. He said that four civilians were among those killed.  Read more . . .

VA Promises to do More to Prevent Veteran Suicides
According to a Veterans Affairs study released last month, nearly 14 percent of veterans reported suicidal thinking at one or both phases of the two-year study. Compared to a 2011 Centers for Disease Control and Prevention study that found 3.7 percent of U.S. adults reported have suicidal thoughts in the year prior, the rates in the VA study are high.   Read more . . .

PTSDcanna

Marijuana Provision Stripped from VA Funding Bill
A provision that would have made it legal for Veterans Affairs doctors to discuss medical marijuana with their patients in some states disappeared mysteriously from the final VA funding bill last week, just before the House approved the legislation by a 239-171 vote. But the measure is not completely dead, as a failure by the Senate on Tuesday to forward the Military Construction and Veterans Affairs funding bill for a vote provides an opportunity for the marijuana provision to be put back in.  Read more . . .

Military Ban on Transgenders Ends
Transgender people will be allowed to serve openly in the U.S. military, the Pentagon announced Thursday, ending one of the last bans on service in the armed forces. Saying it’s the right thing to do, Defense Secretary Ash Carter laid out a yearlong implementation plan declaring that “Americans who want to serve and can meet our standards should be afforded the opportunity to compete to do so.”  Under the new policy, by Oct. 1, transgender troops already serving should be able to receive medical care and begin formally changing their gender identifications in the Pentagon’s personnel system.  Read more . . .

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider becoming a member of Stand For The Troops.

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PTSD: More Drugs on the Way?

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In yet another example of how the Department of Veteran Affairs (“VA”) and DoD try to reinvent the wheel in search of a miracle drug to treat PTSD, Fox News reports that “TNX-102 SL, which contains the same chemical property as Flexeril” may soon be used in treating Veterans with PTSD:

An already-approved muscle relaxant may offer relief for U.S. military veterans and first responders suffering from combat-related post-traumatic stress disorder (PTSD). The Phase 2 trials of the drug, TNX-102 SL, which contains the same chemical property as Flexeril, identified a dose and administration method that statistically improved participants’ PTSD symptoms among several mental health indices.

The findings were announced this month at the American Society of Clinical Psychopharmacology Annual Meeting (ASCP), and could eventually lead doctors to unroll the first PTSD drug in more than a decade, said Dr. Harry Croft, Chief of CNS Studies at Clinical Trials of Texas. Croft, who has also headed the investigation of 60 similar clinical trials over the last 25 years, said current PTSD treatments either don’t address every individual’s range of PTSD symptoms, pose unwanted side effects, or have poor adherence rates. Thus, scientists have continued searching for new PTSD treatments.

According to the article, “no new PTSD drug has been approved by the Food and Drug Administration (FDA) since Paxil in 2001, and before that, Zoloft in 1999.”

the VA and drugs

While the VA has been dismissive of other proven old-fashioned therapy programs such as Hyperbaric Oxygen (“HBOT”), it appears that the VA has an unlimited research budget for new experimental drugs.  The pharmaceutical companies must be thrilled.

For many, especially Veterans seeking to reclaim their lives, it is difficult to fathom the “logic” of the folks at the VA, but it is hard to argue with a program administrator who places his or her interest ahead of the Veterans they should be serving.  It is difficult – read impossible – to have a discussion with someone who has all the answers.  Particularly so, if they are the wrong answers.

At a time when Congress is trying to determine whether the monolithic VA is the best way to provide help to Veterans,  it would appear that VA bureaucrats will continue to determine what drugs or therapy works best for Veterans.

In effect, Veterans – particularly those suffering from PTSD and/or TBI – will be denied access to alternative therapies in the private sector because the VA gatekeepers “know best.”

How many more Veteran suicides and disrupted lives do we need to say that this may not be the right approach?

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SFTT News: Week of June 24, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Transgender Ban in Military to be Lifted on July 1
In July 2015, the Pentagon announced a working group to study how to modify existing regulations to allow open transgender military service. The working group was expected to complete its review after six months and provide options for how to address the various regulations needed to be updated in order to allow for open service by transgender people.   Read more . . .

usarmy

Pentagon Will Not Disclose Battlefield Injuries
The Pentagon will not disclose the details of U.S. forces wounded in a battle against the Islamic State group, a stand that Secretary of Defense Ash Carter said was consistent with Defense Department policy in previous conflicts. “We made no change in policy with respect to disclosing information about wounded service members, none whatsoever,” Carter said Wednesday. This week, Pentagon Press Secretary Peter Cook said he would not provide details on whether four service members were injured in Syria earlier this month because it would aid the Islamic State group.  Read more . . .

Brain Study Helps Explain Some Veteran’s Agony
A new brain study may help explain the agonizing and puzzling symptoms suffered by so many combat veterans, from headaches to fuzzy thinking, military researchers reported Friday.  They found a unique pattern of scarring in the brains of men who died days or years after being in or near powerful explosions. The scarring doesn’t look like damage sustained by people with other types of brain injury, such as sports or car accidents, the team at the Uniformed Services University of the Health Sciences (USU) in Maryland said.  Read more . . .

Vietnam Medal of Honor Winner Recalls Trick
Army Capt. Paul “Buddy” Bucha faked out the enemy while leading a motley crew in Vietnam.The Medal of Honor recipient was hailed as a hero after he made North Vietnamese fighters believe his 187th Infantry Regiment was much bigger than it really was. The combination of bravery and cunning helped him earn the nation’s highest military honor, an award bestowed upon him by the president.  Read more . . .

U.S. Military at High Risk
Army Chief of Staff Gen. Mark Milley sounded the alarm that the US Army is currently in a state of “high risk” when it comes to being ready enough to defend the nation and respond to a large conflict.  “On the ‘high military risk,’ to be clear, we have sufficient capacity and capability and readiness to fight counterinsurgency and counterterrorism,” Milley said at a Senate Armed Services Committee hearing Thursday. “My military risk refers specifically to what I see as emerging threats and potential for great power conflict and I am specifically talking about the time it takes to execute the task … and the cost in terms of casualties.”  Read more . . .

Personal Fitness for Basic Training
The three PFT events are two minutes of push-ups, two minutes of sit-ups, and a timed 2-mile run. Your results from each event are assigned a score. Your age, gender and the amount of repetitions or time elapsed for each event determines your score. Unlike other military endurance tests the APFT is normally performed in normal workout gear. To graduate boot camp you must score 150 points or higher with at least 50 points in each event.   Read more . . .

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider becoming a member of Stand For The Troops.

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SFTT News: Week of June 17, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Protests to U.S. Military Presence in Okinawa
Tens of thousands of people on Okinawa protested Sunday against the presence of U.S. military bases on the Japanese island, many wearing black to mourn the rape and killing of a local woman in which an American contractor is a suspect.  Read more . . .

VA from SFTT

VA Gets Third Benefits Chief in Less than a Year
The acting head of the Veterans Benefits Administration is retiring, leaving the position he has held since his predecessor left under a cloud in 2015. Danny Pummill, a retired Army colonel who joined the Department of Veterans Affairs in 2010, had planned to retire in 2015 but stayed on as acting undersecretary of benefits after his predecessor resigned last October, VA said in a statement. Allison Hickey called it quits after a long period of criticism from lawmakers and veterans organizations, most recently for allowing VA senior executives to move into jobs that they reportedly coerced others leave.  Read more . . .

Iraqi Forces Reportedly Retake Fallujah
Iraqi special forces swept into Fallujah on Friday, recapturing most of the city as the Islamic State group’s grip crumbled after weeks of fighting. Thousands of trapped residents took advantage of the militants’ retreat to flee, some swimming across the Euphrates River to safety.   Read more . . .

Shrinking US Military is Here
Every year at this time, we see the same kind of headlines: “U.S. biggest military spender in the world.” They’re are all based on the release of the global military spending database, an annual report compiled by the Stockholm International Peace Research Institute (SIPRI).  What the headlines usually miss is that U.S. defense spending is going down while global military spending is going up. The fact that the U.S. spends more on defense than any other individual nation dramatically misses the point.  Read more . . .

Syrian President Assad Discusses Military Support with Russia
Russian Defence Minister Sergei Shoigu has met Syrian President Bashar al-Assad in Damascus to discuss “military cooperation” in Syria’s conflict, a bone of contention between Moscow and Washington.  Shoigu was sent by President Vladimir Putin for the unannounced meeting with Moscow’s long-time ally Assad on Saturday, the Syrian state news agency SANA said.  Read more . . .

Post Traumatic Stress on Veterans
Here’s a frightening statistic: Every day, some 22 American heroes take their own lives because of the stresses they experienced on the battlefield. Many more don’t seek treatment and find their lives spiraling out of control.  “60 Minutes” correspondent Steve Kroft will host “Combat Stress: Finding the Way Home,” a special radio hour exploring the impact of post-traumatic stress disorder on our nation’s veterans to be broadcast during Memorial Day weekend.  Read more . . .

Sebastian Junger Draft Proposal:  Non-combat options
Junger avoids proposing a comprehensive solution to the problem he presents in “Tribe.” But he told Military.com in an interview this month that one possible way to build a more cohesive society might be to create a different kind of draft: one in which some form of national service is mandatory for all eligible citizens, but the military is only one of several service choices, along with options like the Peace Corps and urban improvement projects.  Read more . . .

PTSDcanna

New Jersey Assembly Passes Legislation on Treating PTSD with Marijuana
The Assembly on Thursday passed legislation to allow qualified New Jersey residents with post-traumatic stress disorder to get medical marijuana treatment. The Democrat-led Assembly voted 55-14, with seven abstentions, sending the bill to the Senate for consideration.  Read more . . .

 

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Meet Dr. David Cifu: VA Gatekeeper for PTSD & TBI

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A reader of the SFTT Blog suggested that we “take a look” at Dr. David Cifu, Senior TBI Specialist in the Department of Veterans Affairs’ (“VA”) Veterans Health Administration. Found below is a short video clip of Dr. Cifu testifying at a U.S. Congressional Hearing on concussions in March, 2016.

For Veterans living with the effects of PTSD and/or TBI, I would find his testimony quite disturbing.

While it is unwise to draw conclusions from an edited video clip without the benefit of a full transcript of the proceedings, it is evident that Dr. Cifu has clear and strong convictions on how to deal with concussions. Furthermore, it was clear from the proceedings, that not every expert at the Hearing shared Dr. Cifu’s opinion on how to treat concussions.

A biographic extract from Virginia Commonwealth University states the following about Dr. Cifu:

In his 20 years as an academic physiatrist, he has been funded on more than 30 research grants and is the principal or co-principal investigator on eight current grants. He has delivered more than 425 regional, national and international lectures, published more than 165 articles and 65 abstracts and co-authored 20 books and book chapters. He has recently co-authored the patient and family focused self-help book, “Overcoming Post-Deployment Syndrome: A Six-Step Mission to Health.”

Now, I do not claim to be anything close to being an “expert” in analyzing  brain injury, but it strikes me that Dr. Cifu’s strong convictions on how to treat PTSD and TBI do not reflect the latest findings in brain-related trauma that SFTT reported last week based on new research by Dr. Perl.

In fact, with Dr. Cifu admitting to experiencing 6 concussions might – in itself – be considered a disqualifying event to hold such an important role within the VA.

While I have no reason to doubt Dr. Cifu’s integrity or sincerity, I have seen little evidence that Dr. David Cifu’s opinions on treating traumatic brain injury and PTSD have provided significant long-term benefits to Veterans to help them reclaim their lives.   In fact, many of the substance abuse problems affecting Veterans can be directly attributed to the VA for prescribing opioids and other pain-killers.

While it is all good and well to hold strong opinions, if those beliefs are wrong or even incomplete, many Veterans living daily with PTSD and TBI are at risk.  Does this make sense?

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Hyperbaric Oxygen: What the VA Doesn’t Want You To Know

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The gatekeepers at the Department of Veteran Affairs (the “VA”) remain intransigent in providing urgently need care to Veterans suffering from PTSD and/or TBI. Standard Operating Procedure (“SOP”) at the VA is to argue that FDA-approved clinical studies are needed to sanction treatment methods – regardless if these treatment alternatives have been used with success in many other countries for decades and, in some cases, hundreds of years.  

hyperbaric oxygen and the VA

Instead, the VA serves our Veterans a cocktail of potentially lethal prescription drugs that do carry the FDA’s “Good Housekeeping Seal of Approval.”   How is this possible when the Centers for Disease Control and Prevention (“CDC”) reports  an epidemic in addiction to prescription drugs?

Unfortunately, the VA’s SOP in prescribing these opioids to Veterans with PTSD and TBI hasn’t changed in many years.   Why?  Could it be that the benefits to Big Pharma outweigh the benefits of providing our Veterans with the treatment they merit?   I am most hesitant to ask this question, but I can think of no other explanation.

For instance, treating head injuries with Hyperbaric Oxygen Therapy (“HBOT”) has been around for decades.  It is the standard procedure provided to wounded soldiers and civilians with head injuries by the Israeli medical profession for decades.

This short video below is in Hebrew with English subtitles, but it provides a very compelling argument why our Veterans should have access NOW to HBOT while the bureaucrats and FDA twiddle their thumbs and continue to ingratiate themselves with Big Pharma lobbyists.

Gordon Brown  of Team Veteran argues that  “We need this type treatment in our VA and military hospitals instead of the DRUG therapy they are now using. Most TBI cases have been misdiagnosed as PTSD and drug treatment cause further complications for our veterans.”   Gordon’s views reflect my own and those of hundreds if not thousands of Veterans.

In fact, some hospitals in the private sector are taking radical steps to curtail the use of opioids in treating pain.  In an recent New York Times article, St. Joe’s hospital is implementing wide-ranging changes to comply with CDC recommendations:

“St. Joe’s is on the leading edge,” said Dr. Lewis S. Nelson, a professor of emergency medicine at New York University School of Medicine, who sat on a panel that recommended recent opioid guidelines for the Centers for Disease Control and Prevention. “But that involved a commitment to changing their entire culture.”

In doing so, St. Joe’s is taking on a challenge that is even more daunting than teaching new protocols to 79 doctors and 150 nurses. It must shake loose a longstanding conviction that opioids are the fastest, most surefire response to pain, an attitude held tightly not only by emergency department personnel, but by patients, too.

Is it too much for that lumbering behemoth VA to show the same sense of urgency?

I suppose we can continue to get distracted with the many other “big” issues facing our country, but providing our Veterans with proper therapy is one issue where Americans can easily unite.  Let’s not let the bottom line of Big Pharma distract us from that mission.  The brave men and women who have served our country deserve no less.

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Latest Developments on Treating PTSD

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Much has been written about the terrible long-term consequences of Post Traumatic Stress or “PTSD,” but there appears to be no clear way of treating PTSD.  Some argue that PTSD is best treated using “psychological” methods to treat the trauma while others argue that certain war-related events (i.e. IEDs) cause physiological changes in the brain.

treating ptsd

This dilemma makes diagnosing and treating PTSD so difficult.  Based on SFTT’s experiences, we have found that Veterans with symptoms of PTSD respond differently to various forms of therapy.   In short, there seems to be no definitive solution to a very serious problem which is now reaching epidemic proportions.

In a recent article published in the New York Times, medical scientists now believe that traumatic war-related events may actually cause physiological changes in the brain.

Quoting Dr. Daniel P. Perl, a neuropathologist who led a study for Lancent Neurology, evidence now exists that changes brain patterns:

Less understood is how the blast wave — the pulse of compressed air that shoots in all directions faster than the speed of sound and arrives before the wind — affects brain tissue after crashing through the helmet and skull. Blasts are also believed to compress the sternum and send shock waves through the body’s blood vessels and up into the brain. . .

The researchers examined the brains of the five veterans who had been exposed to blasts, and compared samples with those of 16 other veterans and civilians with and without brain injuries from military service or other activities. Scar tissue in specific locations of the cerebral cortex, which regulates emotional and cognitive functioning, was found only in the blast-injury cases.

Dr Perl and fellow researchers discovered the following changes in the brain following concussion like events:

Perl and his lab colleagues recognized that the injury that they were looking at was nothing like concussion. The hallmark of C.T.E. is an abnormal protein called tau, which builds up, usually over years, throughout the cerebral cortex but especially in the temporal lobes, visible across the stained tissue like brown mold. What they found in these traumatic-brain-injury cases was totally different: a dust-like scarring, often at the border between gray matter (where synapses reside) and the white matter that interconnects it. Over the following months, Perl and his team examined several more brains of service members who died well after their blast exposure, including a highly decorated Special Operations Forces soldier who committed suicide. All of them had the same pattern of scarring in the same places, which appeared to correspond to the brain’s centers for sleep, cognition and other classic brain-injury trouble spots.

Then came an even more surprising discovery. They examined the brains of two veterans who died just days after their blast exposure and found embryonic versions of the same injury, in the same areas, and the development of the injuries seemed to match the time elapsed since the blast event. Perl and his team then compared the damaged brains with those of people who suffered ordinary concussions and others who had drug addictions (which can also cause visible brain changes) and a final group with no injuries at all. No one in these post-mortem control groups had the brown-dust pattern.

Dr. Perl on Treating PTSD

While it will takes years of analysis and research to determine whether these neurological changes can be reversed, many Veterans will continue to suffer the “invisible wounds of war.”  Dr. Perl is justifiably worried:

 After five years of working with the military, he (Dr. Perl) feels sure, he told me (author Robert Worth), that many blast injuries have not been identified. “We could be talking many thousands,” he (Perl) said. “And what scares me is that what we’re seeing now might just be the first round. If they survive the initial injuries, many of them may develop C.T.E. years or decades later.”

This is not hopeful news, but at least we as a society are beginning to take PTSD seriously.  Hopefully, we will not try and bury the research in the way the NFL has sought to hide the effects of CTE on NFL players and downplay its significance to football fans who seem addicted to the violence of the spectacle.

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SFTT News: Week of June 10, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Tricare Fraud
A reported Tricare scheme in which users’ DNA was collected in exchange for gift cards and used to order expensive, unneeded lab tests could be the latest example of Tricare fraud — and a lesson in why beneficiaries should not give out their ID card or Social Security numbers in exchange for payment. A salesman working with a Texas-based laboratory that conducts genetic and drug screening enticed service members to be screened for a variety of illnesses and drugs by setting up makeshift clinics at strip malls near Fort Hood, Texas,   Read more . . .

New Combat Boots for Marines?
The Marine Corps is counting on honest feedback from troops who will wear and test four different tropical combat boot prototypes this summer at the Marines’ Jungle Warfare Training Center in Okinawa, Japan.  Officials with Marine Corps Systems Command told Military.com that about 400 Marines from the Hawaii-based 3rd Marine Regiment would test out the boots during a two-to-three week period of jungle combat training that will start within the next two months.  Read more . . .

motorcycle

Stealth Motorcycles for US Special Forces
Earlier this week, at the National Defense Industrial Association’s Special Operations Forces Industry Conference, two prototype stealth bikes were on full display. One bike — The Silent Hawk — was developed by Logos while the other bike –dubbed Nightmare — was developed by LSA Autonomy. Not surprisingly, both are hybrid bikes. The Silent Hawk in particular weighs 350 pounds, has a range of 170 miles, can reach a top speed of 80 mph and can store as much as 75 pounds of equipment. More importantly, when the bike is in “quiet mode”, the noise it emits is less than 55 decibels, which is to say about as loud as a normal conversation.  Read more . . .

VA Reform In the Air?:  Private Healthcare for Veterans
A Washington state lawmaker has proposed placing all Veterans Affairs Department medical facilities under a nonprofit entity and giving all new veterans access to private health care. Under the plan, current enrolled veterans would be able to choose where they get care while all new veterans would be automatically enrolled in the new VetsCare Choice, giving them access to private health care. Read more . . .

Russia Could Overrun Nato Forces in 60 Hours
RUSSIA could steamroll NATO forces in just 60 hours, a leading US defense official has warned amid rising tensions with the west. The alarming claim comes as Russia has deployed troops westward as part of its ongoing stand-off with NATO. US Deputy assistant secretary of defence for Russia, Ukraine, and Eurasia Michael Carpenter told a Senate Foreign Relations Committee hearing that the West and NATO were currently not ideally prepared to deal with a Russian threat.  Read more . . .

Taliban spokesman Zabiullah Mujahid

 

President Obama Gives More Authority to Target Taliban
President Obama has given U.S. military commanders in Afghanistan new authority to target the Taliban. Pentagon officials say the president is authorizing commanders to order airstrikes to support major Afghan offensives, NPR national security editor Phil Ewing reports, adding that the airstrikes must be “the deciding factor” in helping an offensive succeed.  Read more . . .

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