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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FAQ on Service Dogs for Veterans

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For some inexplicable reason, the Department of Veterans Affairs (“the VA”) has a “thing” about service dogs.  Despite an overwhelming amount of evidence that service or companion dogs help Veterans, the VA insists on studying this issue still further.  SFTT wishes the VA had taken the same level of precaution in prescribing OxyContin for Veterans with PTSD.

DoD photo by Erin A. Kirk-Cuomo (Released)

Service Dogs for Veterans with PTSD and/or TBI

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.

How Does it Work?

After the dogs reach maturity – normally 6 months – they begin an intensive 5 month training program designed to familiarize the service dog with elements of supporting a human being. For instance, the dog has to learn to navigate elevators and escalators and to respond to potential danger signals which could cause panic in the dog’s human companion.

A well-trained service dog is not distracted by peripheral events like the presence of other dogs or animals and will avoid eating food that has been dropped on the floor.

After the service dog has successfully completed his training, the certified service dog is then introduced to his/her human companion.  In general, Veterans will spend seven weeks in intensive – about 4 hours of training a day (generally in the morning) and a few weekend sessions.

How Much Does a Service Dog Cost?

While many Veterans obtain a service dog free thanks to the generous contributions of others, a properly trained service dog costs approximately $10,000.  To that cost must be added the opportunity cost of training with the service dog as well as upkeep and veterinary bills.

What is the VA’s Position on Service Dogs?

The VA provides service dogs for Veterans suffering from blindness and mental illness which limits their mobility.  Nevertheless, the VA “does not provide service dogs for physical or mental health conditions, including PTSD.”

The VA claims that “there is not enough research yet to know if dogs actually help treat PTSD and its symptoms.”   An independent study is being conducted to determine the benefit of service dogs, but the results of this study are several years off.

Selected SFTT Posts on Service Dogs

Veterans with Service Dogs:  Apparently not for Everyone

The Department of Veterans Affairs and Service Dogs

Service Dogs for Veterans:  The VA Still on the Fence

Maj. Ben Richards and Service Dog Bronco

Other Resources

Companions for Heroes (Promotional)

Patriot Paws (Promotional)

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Leaving No Warriors Behind

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We’ve got great news!

We recently kicked off TREATMENT OF TEN, a very important fundraising campaign hosted by YouCaring, which helps treat Combat War Veterans with Traumatic Brain Injury (TBI) and/or Post Traumatic Stress Disorder (PTSD).

I know that my late husband David “Hack” Hackworth would be very proud of our collective good work to “leave no man behind,” as he used to say.

Why TREATMENT OF TEN?

 Because our goal is help 10 Combat War Veterans regain the will to live. Invisibly wounded warriors such as those suffering from TBI and/or PTSD are 25 times more likely to commit suicide than their Veteran peers. So far, the VA and DOD have provided few effective treatment options at the national level for the majority of those afflicted with the physically and emotionally crippling side-effects of either brain trauma or PTSD.

With each $15,000 we raise, we can send ONE soldier to a residential facility in Idaho where each sufferer of TBI and/or PTSD will receive an innovative multi-modality TBI and PTSD treatment program that’s already restored our Director of Veteran Affairs, MAJ Ben Richards to “active duty” as a husband, father, PhD student and community member.

Together, we can send 10 Vets by May 4, 2018, the 13th anniversary of Hack’s death and the 20th anniversary of his legacy foundation, Stand for the Troops (SFTT).

That’s why we’re asking you to take a “stand for the 10 Broncos” who served in Troop 1-14 CAV during combat operations in Iraq under Ben and sustained brain injuries after hitting IEDs (improvised explosive device) or being attacked by IED-laden vehicles.

TREATMENT OF TEN combines most of the medical and alternative therapy protocols that SFTT has vetted and been supporting for years – from hyperbaric (HBOT) to Transcranial Magnetic Stimulation (iTMS) to equine therapy to Low-Level Light therapy (LLLT). But we hadn’t developed a way to facilitate the treatment plan in one location.

Until now.

Click here for more information on our TREATMENT OF TEN initiative and how you can help us help those who served.

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Purdue Pharma Reigns In the Opioid Peddlers

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In typical cavalier fashion, drug giant Purdue Pharma has decided to curtail the sale of OxyContin that has brought misery and death to tens of thousands addicted to opioids.

Purdue Pharma Oxycontin

Why it has taken so long for this scandal to end – particularly to families who have lost loved ones – is difficult to fathom.  Perhaps, the allure of bonuses for licensed drug peddlers or the irresistible pull of a higher stock price blinded this company from the inescapable evidence that it was hooking Americans on lethal drugs.

In a scathing article entitled “Pain Pill Giant Purdue Pharma to Stop Promotion of Opioids to Doctors,” by Jared Hopkins, Bloomberg reports that Purdue plans to cut half of its sales force and concentrate instead on “promoting the company’s opioid induced constipation drug, Symproic.”

Needless to say, State and local governments are mounting huge suits against the predatory marketing practices of Purdue.  No doubt, local governments will win major financial judgements against Purdue Pharma, but will there be any assets left after Purdue Pharma files for bankruptcy?  More importantly, how can you possibly place a value on the thousands of lives that have been destroyed by this toxic drug company that has done more damage to our society than all of the Colombian drug lords combined?

More importantly, PURDUE PHARMA DID IT WITH THE FULL SUPPORT AND KNOWLEDGE OF THE US GOVERNMENT.  

SFTT has been reporting on this shameful tragedy for well over five years.  We documented how Veterans received these powerful narcotics from the Department of Veterans Affairs (“the VA”) and flushed them down the toilet or crushed them into powder to sell them on the black market.

It is sad that the President’s Commission on Drug Addiction and opioid abuse finds that “the modern opioid epidemic originated within the healthcare system,” but it is CRIMINAL to entrust the resolution of drug addiction to the very same healthcare agents that created this problem.

While non-invasive treatment for PTSD and TBI like hyperbaric oxygen therapy are rigorously dismissed by the VA in favor of new drugs, Veterans are unlikely to find that their lives are restored to any semblance of what it was in the past.

It is hard to believe that Purdue Pharma has been aggressively peddling their toxic drugs in our backyard (Stamford), but it would appear that our healthcare system is rigged to encourage more abuses

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SFTT on Hyperbaric Oxygen Therapy or HBOT

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Of all the current “alternative” therapies reviewed by Stand For The Troops (“SFTT”), hyperbaric oxygen therapy or HBOT is clearly supported by evidence-based clinical trials and an abundance of evidence (both scientific and anecdotal) that it help reverse brain trauma.

What is Hyperbaric Oxygen Therapy (“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.

With HBOT, oxygen is dissolved into all of the body’s fluids, the plasma, the central nervous system fluids, the lymph, and the bone and can be carried to areas where circulation is diminished or blocked. The increased oxygen greatly enhances the ability of white blood cells to kill bacteria, reduces swelling and allows new blood vessels to grow more rapidly into the affected areas. It is a simple, non-invasive and painless treatment.”

How Does HBOT Work?

HBOT ChamberThe Mayo Clinic explains the HBOT procedure:  hyperbaric oxygen therapy typically is performed as an outpatient procedure and doesn’t require hospitalization. If you’re already hospitalized and require hyperbaric oxygen therapy, you’ll remain in the hospital for therapy. Or you’ll be transported to a hyperbaric oxygen facility that’s separate from the hospital.

 

Depending on the type of medical institution you to do and the reason for treatment, you will receive HBOT in one of two settings:

  • A unit designed for 1 person. In an individual (monoplace) unit, you lie down on a table that slides into a clear plastic tube.
  • A room designed to accommodate several people. In a multi-person hyperbaric oxygen room — which usually looks like a large hospital room — you may sit or lie down. You may receive oxygen through a mask over your face or a lightweight, clear hood placed over your head.

What is the VA’s Position on HBOT
Based on their own trials, the DoD and the VA insist that there is insufficient evidence to support the use of HBOT in treating Veterans with PTSD.  Nevertheless, the VA is currently conducting new HBOT trials at VA facilities in Oklahoma and California.

How Much Does HBOT Cost?

A one-hour “dive” in an HBOT chamber can cost anywhere between $200 and $1,800.  While prices tend to be lower at independent clinics, HBOT facilities tied to hospitals can charge more because HBOT treatment may be covered by medical insurance.  In the case of PTSD and TBI, an initial series of 40 dives is recommended to occur over a two-month period.

Selected SFTT Posts on HBOT

SFTT is convinced that there is overwhelming scientific evidence to support the use of supervised HBOT to help Veterans with PTSD and TBI.  SFTT has written extensively on this issue over the last several years.  Please find below suggested posts:

VA Reluctantly Agrees to Provide HBOT for Veterans with PTSD

HBOT:  A PTSD Therapy for Veterans that Works

What Does the VA Have Against HBOT?

IDF and VA Part Ways on Use of HBOT

Veterans with PTSD:  The VA or the Highway

Meet Dr. David Cifu: The VA Gatekeeper for Veterans with PTSD and TBI

Other Useful Third-Party HBOT Resources

Hyperbaric Oxygen Therapy

Harch Hyperbaric

National Hyperbaric Oxygen Association

Anecdotal Evidence in Support of HBOT

There is an overwhelming number of “stories” detailing the benefits of HBOT.  Found below are just a few that were posted on the SFTT website.

HBOT by Grady Birdsong

Kris Kristofferson and HBOT

Maj. Ben Richards and his HBOT Treatment

Summary

While no one will claim that HBOT or any therapy will work 100% of the time, the application of hyperbaric oxygen in a controlled and carefully monitored environment has produced significant improvements in patient outcomes.    More importantly, HBOT is a non-invasive procedure without the often unpredictable effects of addictive prescription drugs.  

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News for Veterans with PTSD or TBI: Week Ending 2 Feb 2018

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The Department of Veteran Affairs (the “VA”) struggles to provide effective therapy for Veterans with PTSD and TBI.  As such, SFTT has will now focus its attention on providing Veterans and their families cope with information on promising new alternative therapies to help brave warriors cope with brain injury.

The devastating effect of brain injury for hundreds of thousands of Veterans and their families cannot be underestimated.  While SFTT will focus primarily on “new” therapy programs, we will occasionally report on the very unsettling problems faced by Veterans and their families as they seek to recover their lives.

Some “alternative” therapies have already proven to be quite successful, but many others are not widely known to Veterans or the medical profession at large.   Even if these programs were endorsed or approved by the VA, treatment is often beyond the financial means of most Veterans.

While SFTT will let the “news” speak for itself, the science of treating brain injury is still in its infancy.  SFTT attempts to provide balanced reporting of the pros and cons of these emerging therapy programs but strongly encourages the reader to make up their own mind as to their efficacy.

Brain Injuries May Start at a Young Age

A recent article in the New York Times entitled, “Hits to the Head May Result in Immediate Brain Damage,” is troubling for families raising children where contact sports is often a way of life.

While the nature of brain injuries suffered by Veterans leading to PTSD and TBI are far different, the New York Times article suggests that there is still much to be learned in treating concussive events.

Chronic Traumatic Encephalopathy or CTE

SFTT has reported on several occasions that the NFL has been investigating a brain condition called chronic traumatic encephalopathy (“CTE”) which appears to be caused by repeated blows to the head causing a protein called tau to spread and kill brain cells.

For many years the NFL and the VA has tried to hide the effects of debilitating brain injuries from players and Veterans, but the evidence is now overwhelming that concussive events may cause irreparable damage to sensitive brain tissue and cells.

Many parents are already pulling their children from junior football programs and some soccer leagues now prohibit children below the age of 12 from “heading the ball” to avoid brain and neck injuries.  Just recently, star performer Justin Timberlake who will perform at halftime at the Superbowl announced that “my son will not play football.”

Shouldn’t this be a warning message to all parents?

Ketamine Could Help Veterans with PTSD

Promising “new” drugs materialize daily that claim to help Veterans cope with the symptoms of PTSD and TBI.  Ketamine, approved by the FDA many years ago for sedating people (but not approved for treating traumatic events) has become a popular treatment option for Veterans that have exhausted VA remedies.

The San Antonio Express News, reports that Ketamine “has achieved good results in clinical trials.”  It adds that “the military also is interested in its use . . . and that two health facilities will treat active-duty troops and veterans. The research is funded by the Department of Defense and the Department of Veterans Affairs.”

The San Antonio Express News adds that “clinics use the drug off-label, and protocols, staffing and dosing can differ widely from one clinic to the next.   Despite the lack of supporting clinical evidence, many seek ketamine for relief.  “Even at low doses it alters the senses. Critics say the effects of longtime use remain unknown and wonder if ketamine clinics put vulnerable patients at risk.”

SFTT Commentary:  As in all mind or sensory altering drugs, there are risks that are not fully understood by the medical profession.  SFTT continues to support noninvasive therapies, particularly over unregulated and untested drug options.

Army Research Laboratories and Helius Research Neurological Wellness

According to a press release from Aerotech News,

“The U.S. Army Research Laboratory and Helius Medical Technologies, Inc., from Newton, Penn., have partnered to expand on early research that could mean new interventions for improving Soldier readiness and resilience, as well as reducing symptoms of post-traumatic stress disorder, or PTSD.

“As part of a cooperative research and development agreement, or CRADA, ARL and Helius are launching a research program to investigate Helius’ Portable Neuromodulation Stimulator for the enhancing cognitive and psychological readiness and response through mindfulness meditation training. Helius is focused on neurological wellness.

“Researchers from both organizations will combine the use of the neuromodulator with mindfulness meditation training and assess participants’ neurocognitive performance and self-reported symptoms before and after training.”

SFTT Commentary:   While this joint research program seems promising, the Army Research Laboratory has often placed troop “readiness” ahead of troop safety.  SFTT hopes that this study will prove different.

SFTT readers are encouraged to drop us a line if they discover an interesting new therapy to treat PTSD or TBI or would like to share a public interest story.  SFTT can be reached at info@sftt.org.

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Happy 2018!

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Is it too late to wish you all a happy new year? We think not!

Here at SFTT we’ve been busy wrapping up our 2017 initiatives and planning for an even better 2018 with new programs and partners to help Veterans suffering from Traumatic Brain Injury (TBI) and Post Traumatic Stress (PTSD).

During the past year, Stand for the Troops, the Little Organization That Could and Has, hit a major milestone — we turned 20! Twenty, old enough to be a combat soldier which, in many ways we are. SFTT is at war helping American Veterans combat invisible war wounds.

In 2017, we fought for — and aided — our Veterans who suffer from TBI and PTSD by:

  • Securing educational grants 2017 for west coast Veterans wanting to pursue a career in sustainable agriculture and presently, a 2018 grant to continue this program is being reviewed. We’re also working to expand this program to make it available to Veterans on the east coast.
  • Helping fund Attention-Bias Modification Treatment for PTSD research at Columbia University and the New York State Psychiatric Institute by supporting the Principal Investigator, Dr. Yuval Neria. Dr. Neria’s other related projects establish innovative trauma care for Veterans and their family members, such as Man of War Project & Military Family Wellness Center.
  • Working in concert with the Knights of Columbus on The Frank Robotti Golf Classic where we raised awareness and funds for service dogs. We’ll be awarding money to a local service dog program soon.

In 2018 we plan to continue this good work while introducing a program that focuses on our co-founder, Col. David “Hack” Hackworth’s commitment to safeguarding frontline soldiers with more than lip service. Our new treatment plan, unveiled in the next few weeks, integrates proven medical and wellness therapies to effectively treat combat-related traumatic brain injury.

We’d love to hear from you so please drop us a line at info@sftt.org!

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Latest News for Vets with PTSD & TBI: 26 Jan 2018

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The Department of Veteran Affairs (the “VA”) continues to struggle to provide effective therapy for Veterans with PTSD and TBI.  As such, SFTT has decided to focus most of its attention on helping Veterans and their families cope with the ravages of the silent wounds of war.

The devastating effect of brain injury for hundreds of thousands of Veterans and their families cannot be underestimated.  While SFTT will focus primarily on “new” therapy programs, we will occasionally report on the very unsettling problems faced by Veterans and their families as they seek to recover their lives.

Some “alternative” therapies have already proven to be quite successful, but many others are not widely known to Veterans or the medical profession at large.   Even if these programs were endorsed or approved by the VA, treatment is often beyond the financial means of most Veterans.

While SFTT will let the “news” speak for itself, the science of treating brain injury is still in its infancy.  SFTT attempts to provide balanced reporting of the pros and cons of these emerging therapy programs but strongly encourages the reader to make up their own mind as to their efficacy.

Hyperbaric Oxygen Therapy or “HBOT”


Among the most promising therapies is hyperbaric oxygen therapy or “HBOT,”   Essentially, HBOT consists of a series of controlled dives in a compression chamber where Veterans receive oxygen under pressure.  Many independent research studies have confirmed the efficacy of HBOT, but the VA and the DoD have consistently claimed that there is limited evidence to sustain the assertion that HBOT helps to improve brain function.

Despite the VA’s policy, many countries use HBOT to treat brain injury.  In fact, the Israel Defense Forces (“IDF”) use HBOT to treat any concussive event for its military personnel.  SFTT has written often about the efficacy of HBOT.

Nevertheless, VA spokesperson Dr. David Cifu continues to claim that current VA program are more effective than HBOT.  The clinical evidence strongly suggests that Dr Ciful is misleading Veterans, Congressional subcommittees that oversee the VA and the public about the lack of efficacy of HBOT.   SFTT will fully address Cifu’s “misspeaks” and “questionable” scientific evidence at a later date.

Combat Veterans Coming Home with CTE

Not all news is “good news” for Veterans suffering from brain trauma.  There is now evidence that some Veterans suffering from PTSD may have CTE or  chronic traumatic encephalopathy .  The 60 Minutes Video which accompanies this article, highlights the painful story of one Veteran’s “discovery” that he had an incurable brain injury.

Chronic Traumatic Encephalopathy or CTE

SFTT has been reporting for months how the NFL has been dodging the nasty public relations surrounding CTE, but now (unsurprisingly) evidence suggests that this terrible degenerative disease of the brain may also be affecting Veterans who have been exposed to a series of concussive events.

MDMA for PTSD Enters Final Trials

According to an article published in Newsweek, the final round of clinical trials for MDMA assisted psychotherapy could lead the way for the United States to approve the drug for therapeutic use as early as 2021.

The third and final phrase of trials gets underway after the Food and Drug Administration (“FDA”) designated MDMA as a “breakthrough therapy” for post-traumatic stress disorder (PTSD) in August 2017, ensuring that it will work with advocates to complete the last phase quickly.

MDMA, or 3,4-methylenedioxy-methamphetamine, is an empathogen, meaning that it stimulates togetherness and trust among users. It also inhibits activity in the brain that treats fear and stimulates hormones that make people feel more connected. While some may refer to MDMA and ecstasy interchangeably, MDMA is the pure form of the drug, while ecstasy can be cut with unknown adulterants.

SFTT Commentary:   SFTT has written several times about the use of MDMA (aka “Ecstasy”) in treating PTSD.  While final trial results for MDMA will not be known for several years, it is worth remembering that drugs that treat behavioral or pain symptoms but produce no long-lasting improvement in brain function may not be cause for celebration.  Let’s face it, the President’s Final Report on Combating Drug Addiction (page 20) states quite clearly that “the modern opioid crisis originated within the healthcare system.”    Will another drug prove more effective?

Written Exposure Therapy “WET”

According to a press release by Marilynn Larkin for the Psych Congress Network, “Written Exposure Therapy (“WET”) is noninferior to first-line cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD) and can be delivered in fewer sessions, researchers say.”

WET involves writing about a traumatic experience under clinical guidance, using a structured format.

“Our study has important implications for clinicians, as it suggests that PTSD can be effectively treated using a much shorter, less burdensome intervention – i.e., five sessions, minimal face-to-face time with the therapist, no between-session homework assignments – than what is typically used in clinical practice,” Dr. Denise Sloan of National Center for PTSD, VA Boston Healthcare System, told Reuters Health.

SFTT Commentary:  The suggestion that WET is “noninferior to first-line cognitive processing therapy (“CPT”) is hardly a ringing endorsement.  Despite VA propaganda to the contrary, CPT has been largely unsuccessful in treating Veterans with PTSD.

SFTT readers are encouraged to drop us a line if they discover an interesting new therapy to treat PTSD or TBI or would like to share a public interest story.  SFTT can be reached at info@sftt.org.

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Will the VA Expand HBOT Therapy for Veterans with PTSD and TBI?

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As reported earlier, the Department of Veterans Affairs (“the VA”) is now providing hyperbaric oxygen therapy of “HBOT” on a trial basis to Veterans with PTSD and TBI.  This marks an abrupt turnaround within the VA that has repeatedly claimed that there is insufficient clinical “evidence” to support the use of HBOT in treating Veterans with brain injuries.

HBOT Therapy

The VA’s position reportedly stems from some 32 “inconclusive” studies on the effectiveness of HBOT in treating TBI and PTSD. Most recently, the 2015 DoD trial of HBOT concluded that there was a “lack of evidence” that HBOT helped Veterans with PTSD or TBI.

Col. Miller, the DoD project manager, “didn’t see any value in moving forward with more studies.”  As SFTT reported earlier, Col. Miller is an infectious disease specialist and not a brain trauma specialist.  Fortunately, he now works for the Gates Foundation focusing on his specialty: infectious disease.

The VA and the DoD go to great lengths to discredit the use of HBOT in treating Veterans with brain injury. Nevertheless, their arguments seem rather spurious against the almost overwhelming scientific evidence that HBOT is effective in helping to improve brain functionality.

Some in the medical profession have questioned whether test protocols in the DoD 2015 study were manipulated to produce the “inconclusive” outcome.  More to the point, how is it possible for the VA to continue to defend its ONLY two non-invasive therapy programs: Prolonged Exposure Therapy (“PE”) and, Cognitive Processing Therapy (“CPT”)?   Patient outcomes for these two programs have been shown by independent studies to be next to useless.

In fact, so abysmal have been therapy results that the VA used highly addictive prescription drugs to treat the symptoms of PTSD and TBI rather than provide any long term cure.  Indeed, the VA has no small role to play in contributing to the opioid epidemic which is now ravaging America.

Hopefully, the lack of any meaningful success in treating PTSD and TBI has forced the VA to accelerate its exploration of alternative therapies.  Hopefully, HBOT will soon be incorporated into the treatment options currently provided to Veterans by the VA.

While Dr. David Cifu and his cronies at the VA may continue to put out disingenuous statements regarding HBOT, it is widely used all over the world to treat trauma.  Specifically, HBOT is the “go-to” option for the Israel Defense Forces (IDF).   As reported in an earlier SFTT article, Daniel Rona, who has fought with both the IDF and US military states that in Israel:

“In essence, our mental attitude is that we must take care of ourselves and through that process little Israel has become a blessing for the rest of the world…we treasure our soldiers, young and old. They are our only defenders….no one else will fight our battles. You can imagine that every concussive event will be treated with HBOT !” . . .“the policy of the IDF is that life has the highest value and they are committed to use any treatment, in any case, to save a life”.

Furthermore, as Dr. Paul Harch and others have pointed out, there are many independent scientific studies confirming the benefits of HBOT.  Specifically, Dr. Xavier Figueroa has written a compelling argument suggesting that the VA has dropped the ball on HBOT research.

There is plenty of anecdotal evidence to suggest that Veterans are seeking treatment centers all across the United States.  In many cases, clinics are opening their doors to Veterans to help them recover from the silent wounds of war.  Nevertheless, the treatment can be quite expensive as remains out of financial reach for most Veterans.

While Veterans and their support givers cope with this devastating war wound, SFTT remains hopeful that HBOT and other alternative therapy programs will soon be adopted by the VA to help these brave Veterans recover their lives.

Found below is an old (2012) but compelling video (caution, it takes a while to load) from a TV Station in Louisiana (WWL.com) which shows the remarkable recovery of Maj. Ben Richards mental and motor skills after having received treatment from Paul Harch:

While HBOT may not be “right” solutions for all Veterans suffering from brain injury, it does seem a far more compelling treatment alternative to the ineffective programs currently offered by the VA. More to the point, HBOT is non-invasive which suggests that we won’t have a new generation of addicts to contend with given failed VA programs.

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HBOT for Veterans: Infrastructure Largely in Place

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As SFTT reported earlier, the VA will soon be providing a limited number of Veterans with access to hyperbaric oxygen therapy or “HBOT” at the VA’s Center for Compassionate Innovation (“CCI”) facilities in Texas and Oklahoma.

SFTT has yet to learn when these programs will begin or how many Veterans will be enrolled in these initial programs.  As important, SFTT and the HBOT community at-large is interested in learning how “test protocols,” “metrics,” and “clinical trials” will be set by the VA and DoD to determine the benefits of HBOT.

As one sorts through the often nasty exchanges between proponents of HBOT and the VA gatekeepers like Dr. David Cifu, one cannot be oblivious to the fact that the VA does not want to encourage the adoption of HBOT in treating Veterans with PTSD and TBI.

The VA’s claim is that “patient outcomes’ using HBOT are inconclusive based on VA and DoD trials.

Could it be – as many have suggested – that the test protocols were flawed to produce “inconclusive” test results?   From SFTT’s experience in monitoring the DoD, it would NOT BE THE FIRST TIME that test procedures have been deliberately modified to produce outcomes more to the liking of current military dogma.

Since the VA has no experience in using HBOTin treating Veterans with PTSD, it seems to make sense to use established experts in the industry like Dr. Paul Harch, members of the International Hyperbarics Association or The Sagol Center for Hyperbaric Medicine and Research in Israel which provides HBOT treatment to 120 patients a day and to the Israeli Defense Force (“IDF”) to agree on standardized test protocols and monitor results.

Many will argue that further HBOT tests are not required given the wealth research currently available.  In fact, found below is an extract from a Jan, 2017 report:

Xavier A. Figueroa, PhD and James K. Wright, MD (Col Ret), USAF Hyperbaric Oxygen: B-Level Evidence in Mild Traumatic Brain Injury Clinical Trials. Neurology® 2016;87:1–7 “There is sufficient evidence for the safety and preliminary efficacy data from clinical studies to support the use of HBOT in mild traumatic brain injury/ persistent post concussive syndrome (mTBI/PPCS). The reported positive outcomes and the durability of those outcomes has been demonstrated at 6 months post HBOT treatment. Given the current policy by Tricare and the VA to allow physicians to prescribe drugs or therapies in an off-label manner for mTBI/PPCS management and reimburse for the treatment, it is past time that HBOT be given the same opportunity. This is now an issue of policy modification and reimbursement, not an issue of scientific proof or preliminary clinical efficacy.”

While Secretary Shulkin is wise to proceed slowly, he must exercise extreme caution in allowing the naysayers within the VA any authority over the initial CCI HBOT trial programs.

HBOT Infrastructure in Place to Help Veterans

Assuming the VA leadership can get beyond the hurdles they largely created, Veterans with “mild TBI” and “persistent” PTSD should be able to quickly access hundreds of HBOT facilities across the United States.  With equipment already in place around the country in hospitals and private health clinics, there is no need to hold up treatment for Veterans to wait for the VA to outfit its facilities.

Follow this link to see a directory of currently active HBOT treatment centers around the country.

Clear treatment protocols and directives need to be established for each private clinic providing HBOT to Veterans.  HBOT is administered in a series of dives or sessions (usually between 28 and 40) over a 6 week to 2 month time frame.  Supervision by a trained clinician is required at each dive.  Clearly, a larger “dive chamber” capable of offering therapy to a number of Veterans at the same will help bring down the costs of HBOT.

Costs “per dive” or “session” vary significantly around the country.    Some hospitals charge $1,800 per session, but most private clinics offer this service at a cost of between $250 and $350 per dive.  Given the bargaining power of the VA, it seems most likely that a series of battery of dives can be accomplished for well under $10,000, which is less than half of what the VA currently spends on Veterans with TBI/PTSD.

As SFTT has stated on many occasions, HBOT is not the “silver bullet” to eradicate this silent wound of war, but many more Veterans with brain trauma will begin to be able to reclaim their lives with less reliance on VA prescription drugs that simply mask symptoms rather than provide any lasting improvement in brain functionality.

This could be a BIG DEAL for ailing Veterans and family members who provide our Veterans such caring support.

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