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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VA Reluctantly Agrees to Provide HBOT to Veterans with PTSD

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In a carefully crafted message, “The Department of Veterans Affairs announced this week that it would begin offering hyperbaric oxygen therapy (“HBOT”) to some veterans with post-traumatic stress disorder, despite a lack of evidence that it works or being approved by the Food and Drug Administration as a treatment for PTSD.”

HBOT Therapy

The news was released by “Stars and Stripes” on November 30 in an article titled “VA to offer unproven hyperbaric oxygen therapy to vets with PTSD.”

The article is hardly a ringing endorsement of HBOT.  More to the point, Secretary Shulkin reportedly said on Wednesday that “the VA must ‘explore every avenue’ and ‘be open to new ideas.’”

Well, HBOT may be “new” to the VA, but this therapy has been around for decades and is used successfully around the world to treat patients with brain trauma.  The VA stigma exists because Dr. David Cifu and many other bureaucrats within the VA continue to push a stale agenda of ineffective and often dangerous therapies that don’t work.

In fact, this is one of the major reasons that Veterans with PTSD and TBI have sought treatment outside the VA.   Talking heads at the VA would like Veterans and the public to believe that HBOT is “snake oil,” but there is a long and detailed clinical trail of evidence that suggests otherwise.

Arguing that HBOT is “not FDA or DoD approved” rings a bit hollow after the President’s Report on Fighting Drug Addiction and Opioid Abuse states that “the modern opioid crisis originated within the healthcare system.”   

Let’s face it:  What do you do when evidence-based medicine is proved wrong?   Well, in this case, the Federal government will provide “the healthcare system” with billions of taxpayer dollars to fix the mess they largely created.   Sounds absurd, but you don’t even have to read the small print.

While SFTT is thrilled that Dr. Shulkin has decided to part ways with the orthodoxy of failed VA therapies to treat Veterans with PTSD, it will be years before all Veterans will receive the lifesaving benefits of HBOT.   Furthermore, it is likely that the VA and DoD will again manipulate test protocols to produce treatment outcomes that produce inconclusive results.

Will HBOT work in all cases?   Of course not, but life-changing outcomes are far more likely with HBOT than the only two failed programs currently offered by the VA:

  • Prolonged Exposure Therapy (“PE”) and,
  • Cognitive Processing Therapy (“CPT”)

In any event, we hope that doctors within the VA system will not be so dismissive of HBOT that it leads to another Veteran suicide like Eric Bivins.  For those who want a first-hand look into the travesty of the VA system, follow this painful trail of systemic abuse by Eric’s widowed spouse, Kimi.

Our brave Veterans deserve more and SFTT would like to thank Secretary Shulkin for taking this important first step.

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Points of View: Al Jazeera on Treating Veterans with PTSD

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There was a time when many considered Al Jazeera to be a voice of Middle Eastern terrorists.   Whether it was or not is a matter of conjecture, but most would now agree that Al Jazeera has morphed into a credible news organization.

In an era of conflicting points of view, “alternative facts,” political agendas and outright lies; it is difficult to find common ground or agreement on any issue.  As such, it is surprising that Reem Shaddad of Al Jazeera has written such an insightful article on the plight of US Veterans entitled:  “The Battle Within:  Treating PTSD in Military Veterans.”

Department of Veterans Affairs

While one could nitpick some of her conclusions, it is difficult to refute the argument that within the Department of Veterans Affairs (“the VA”) “the McDonaldisation of mental healthcare is a problem.”

” . . . if you go to any VA in the country, you’re going to probably get cognitive processing therapy or cognitive behavioural treatment (actually, prolonged exposure) because those are the evidence-based practices that they use. It’s like if you go to any McDonald’s, a cheeseburger is going to be the same.”

Yep, the VA only serves two flavors of milkshakes (chocolate and vanilla) to treat Veterans with PTSD:

  • Cognitive Processing Therapy, and
  • Prolonged Exposure Treatment.

More to the point, if the VA’s two PTSD therapy programs don’t work, its doctors are likely to prescribe a cocktail of potent drugs to keep the Veteran’s symptoms in check.   This is hardly the outcome our brave warriors and their families should expect.

For an organization that prides itself on providing “evidence-based” medical treatment to Veterans, the GAO and the Rand Corporation have found that these programs resulted in negligible benefits for Veterans with PTSD.   In effect, “evidence-based” medicine seems to apply to every “alternative” therapy program other than the failed programs mandated by the VA.

As distinguished members of medical profession talk about “evidence-based” medical programs to treat PTSD, one can only wonder how warriors with the symptoms of PTSD in the distant past coped without the benefit of clinical trials.

Mind you, acupuncture seems to be have successful for some 2,000 years without the benefit of clinical trials.    The benefits of oxygen therapy programs have been around for centuries and there have been many documented therapy programs listed since as early as the 1930s.    Nevertheless, the folks at the VA – headed-up by chief spokesperson, Dr. David Cifu – still dispute the benefits of hyperbaric oxygen therapy in treating Veterans with PTSD.

Despite efforts by Reem Shaddad and many others to expose the hypocrisy within the VA,  Veterans with PTSD and TBI will need to seek help outside the VA.

SFTT is not convinced that there is a “silver bullet” to cure PTSD and TBI, but it is abundantly clear that the two PTSD therapy programs mandated by the VA are not effective.  For this reason, SFTT endorses a far wider use of alternative therapy programs to provide Veterans with a “real” choice over the VA’s failed programs.

Sure, there will be some “snake-oil” peddlers and charlatans that seek to take advantage of Veterans, but it is unlikely to be nearly as severe as the opioid epidemic perpetrated by the “evidence-based” healthcare system.

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HBOT: A PTSD Therapy for Veterans that Works

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This Saturday (November 11, 2017), Fox TV will air a broadcast on how Hyperbaric Oxygen Therapy (“HBOT”) is helping hundreds – if not thousands – of Veterans with PTSD and TBI.

This special program will be aired on Veterans’ Day. The video below was prepared by The National Hyperbaric Association to demonstrate that “real” therapy is available to the tens of thousands of brave warriors suffering from PTSD and TBI.

HBOT is a proven therapy widely used around the world for patients suffering from brain trauma. Sadly, the folks at the Department of Veterans Affairs (“the VA”) are still peddling the same stale “evidence-based” therapy programs to Veterans that do not work:

  • Prolonged Exposure Therapy (“PE”) and,
  • Cognitive Processing Therapy (“CPT”)

As SFFT reported earlier, PE and CPT “have been largely ineffective in reversing brain damage to Veterans suffering from PTSD and TBI. And yet, the spokespeople steadfastly defend these therapies and argue that other therapies ‘lack evidence’ to justify their endorsement, read ‘funding.’”

“The VA has very little evidence to show that PE and CPT therapy programs have done much to reduce the incidence of PTSD symptoms among Veterans against the “gold-standard” standardized PCL-M tests currently used by the VA. The chart below illustrates the point (50 is considered base level):

Prolonged Exposure Cognitive Process Therapy

Aside from being very expensive to administer, the ‘evidence based medicine’ supporting the effectiveness of PE and CPT programs currently administered by the VA is SADLY LACKING.”

It is most interesting to note that the VA has done everything possible to discredit HBOT to promote their own failed therapies.   In many cases it has led to tragic consequences, such as the recent suicide of Eric Bivins.

What Does the VA Have Against HBOT?

It is difficult to understand the VA’s hardline against HBOT, particularly when the overwhelming statistical “evidence” clearly demonstrates that the VA’s own therapy programs are severely flawed.  Furthermore, this is the same institution that hooked Veterans on opioids (and indirectly fueled a national epidemic) based on flawed clinical trials.

Dr. David Cifu Testifying

Dr. David Cifu, the Dr. Orange of PTSD at the VA?

How many more times do we have to listen to Dr. David Cifu testify before Congress that he (read “the VA”) knows best when treating Veterans with PTSD?   It is ironic to note that in David Cifu’s quest to discredit hyperbaric oxygen therapy, his employer (Vincent Viola – once tapped to be Secretary of the Army) is alleged to treat his racehorses with HBOT.

Clearly, Vincent Viola knows a bit more about the benefits of HBOT considering that Always Dreaming won the Kentucky Derby this year.

One might ask why thoroughbreds get the benefit HBOT while Veterans are denied HBOT at the VA?  I don’t know the answer, but I suspect that the “serious” money lies in new clinical trials and “breakthrough” drugs peddled by Big Pharma.

Or is it the VA’s special take on insanity?:  Providing Veterans with the same battery of lame therapy programs and psychotic drugs, but hoping for a more positive outcome.”

It is sad to see our Veterans being sold down the river by less-than-candid mouthpieces of a rudderless VA, but the truth is as clear as the Presidential report on Fighting Drug Addiction and Opioid Abuse.  Look no further than the damning statement: “the modern opioid crisis originated within the healthcare system.”

If you think that common sense and a desire to genuinely help our Veterans with PTSD and TBI will manifest itself soon – you are likely to be disappointed.

As they say at the Beltway Racetrack, “the fix is in!”

If you genuinely want to help our brave Veterans, write your Congressmen (and women) and Senators and State and Local representatives.  Also, do take the time to learn the benefits of hyperbaric oxygen and give generously to SFTT and the National Hyperbaric Association to support our brave Veterans.

Veterans Day is more than waving the flag.  Don’t let the festering sore at the VA continue to kill hope among our Veterans and their loved ones.

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Veterans with PTSD: The VA Way or the Highway

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It is easy to find fault with the Department of Veterans Affairs (“the VA”), particularly when it comes to Veterans with PTSD.

Department of Veterans Affairs

Secretary of Defense, Robert McNamara, tried to employ body count statistics to assess our progress in the war in Vietnam.  Similarly, the VA has erected a statistical house-of-cards to deceive Veterans and their loved that the VA has the answers for Veterans coping with PTSD and TBI.

Like McNamara, the VA “knows what is best for Veterans” and has erected insurmountable statistical barriers to prop up their failed strategies.  In effect, the VA is telling Veterans:  “It is my way or the highway!

Paraphrasing a joke: “The VA uses statistics as a drunk uses a lamppost — For support rather than illumination.”

Sadly, it is no laughing matter when we consider the thousands of combat Veterans suffering from PTSD and TBI.  More importantly, reflect on the often tragic consequences for their families and loved ones.

While Congress and the public continue to be seduced by the steady stream of assurances that the VA provides the best possible care to Veterans with PTSD and TBI, the FACTS tell a far different story.

FAKE NEWS from the VA on Veterans with PTSD

Found below is a video of Dr. David Cifu, Senior TBI Specialist at the VA, testifying before a Congressional Committee:

The VA continues to push a stale and failed agenda that states that the only two effective treatment therapies offered by the VA are:

– Cognitive Behavioral Therapy (“CBT”)and,

– Prolonged Exposure Therapy (“PET”).

As these “therapy” programs have failed miserably according to independent studies (see below), the VA has “coped” with the problem by prescribing a lethal concoction of prescription drugs which treat the symptoms of PTSD rather than deal with the underlying problem.

And we wonder why we have an opioid epidemic in this country?

REALITY CHECK at the VA

While Dr. David Cifu continues to entertain a Congressional Committee on the efficacy of the VA’s protocols, experience for yourself one woman’s harrowing experience with the VA which eventually led to husband’s suicide:

The story of Kimi Bivins is not the exception to the type of treatment Veterans with PTSD receive at the VA. Based on many similar stories, the VA is failing our Veterans and their loved ones.

I encourage readers to read Kimi’s harrowing description of what actually takes place at a VA facility.

While the folks at the VA casually dismiss anecdotal stories, VA claims that Veterans receive the best therapy possible is simply not supported by the evidence.

No less of an authority that the National Academies of Sciences (Medical Division) reported in a 2014 study entitled “Treatment for POSTTRAUMATIC STRESS DISORDER in Military and Veteran Populations,” that CBT and PET barely made a statistical dent in providing Veterans with PTSD any lasting improvement in their condition.

Consider Maj. Ben Richards‘ compelling evidence documenting the failed experiments at the VA in helping Veterans with PTSD.

Standing behind a well-entrenched bureaucracy of statistical inaccuracies and dogma, the VA goes out of its way to discredit other treatment alternatives. Consider this bitter “scientific” debate between Dr. Cifu and Dr. Paul Harch on the efficacy of hyperbaric oxygen therapy or HBOT in treating PTSD and TBI.

Finding a Middle Ground for Veterans with PTSD?

With so little known about the brain and how to treat trauma, it seems absurd for the VA to insist that they have all the answers.  The evidence clearly suggests that the VA doesn’t have a clue.

Nevertheless, the VA argues that “alternative therapies” that do not pass scientific scrutiny and FDA approval will not be endorsed by the VA.  As we have seen countless times – from body armor testing to hyperbaric oxygen studies – the DoD uses test protocols that deviate from accepted standards.

If the tests are flawed, one is likely to draw the wrong conclusions!

For the vast majority of Veterans with limited economic means, the VA is effectively making life and death decisions based on flawed testing and a reluctance to embrace other treatment alternatives.

This is probably done with the intent of protecting Veterans from charlatans and snake oil peddlers, but doesn’t it also block Veterans from receiving promising therapies from legitimate sources?

When dogma or “approved” therapies become the LAW, then it seems unlikely that much progress will be made to help our brave Veterans recover their lives.  The VA would do well to encourage Veterans to seek alternative therapies and provide an interactive sounding board for Veterans to voice their opinions on these programs.

Honesty and transparency and a willingness to accept mistakes is the sign of a responsive institution.   Today, the VA hides behind a dogma based on self-delusion and falsehood.

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Veteran Suicides: The VA Releases “New” Statistics

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The Department of Veterans Affairs (“the VA”) recently released a report showing state-by-state disparities in suicide rates among Veterans.  Sadly, the data tracks Veteran suicides rates through 2014 leaving a significant time gap in determining whether the trend in 20+ veteran suicides a day is improving.

Veteran Suicides

(U.S. Army photo by Stephen Baker)

The news media has been quick to seize on some of the notable anomalies in the data, some of which is highlighted below from PBS news:

  • Suicide among military veterans is especially high in the western U.S. and rural areas;
  • Suicide rates in Montana, Utah, Nevada and New Mexico averaged 60 per 100,000 individuals compared to the national average of 38.4 (overall in the West was 45.5);
  • Women veterans had a suicide rate 2.5 time higher than for female civilians;
  • A VA study (last year) found that veterans who received the highest doses of opioid painkillers were more than twice as likely to die of suicides than those receiving the lowest doses;  
  • 65% of Veteran suicides were age 50 or older. 

It is difficult to generalize from this somewhat dated report other than to say that Veteran suicide rates are considerably higher than the national average.

Furthermore, it would appear that the VA’s propensity to dispense potent prescription drugs – primarily opioids – may have contributed to high suicide rates among Veterans.

Just who is to blame for the opioid epidemic sweeping the United States?  Finger-pointing suggests that many are to blame for the epidemic, but new candidates emerge daily.

For instance, the New York Times recently reported that insurance companies may need to shoulder part of the blame for opioid abuse.  Why?

“Opioid drugs are generally cheap while safer alternatives are often more expensive.

“Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. “

Nevertheless, some institutions took measures far earlier to stem addictive drug treatment.   For instance, Mother Jones reports that: “Partnership HealthPlan, the main public insurance provider for Medi-Cal patients in rural Northern California, discovered an alarming trend: Many counties where Partnership operated had among the highest rates of opioid prescribing and overdose in the state. Hydro­codone was the top-prescribed medication among Partnership patients, who include more than 570,000 Medi-Cal recipients from the vineyards of Sonoma County to the redwoods on the Oregon border. In Lake County, a poor, rural area bordering Sonoma, enough opioid painkillers were prescribed in 2013 to medicate every man, woman, and child with opioids for five months, according to a report by the California Health Care Foundation.”

Unfortunately, the VA is largely unaccountable to anyone and Veterans have few affordable choices other than to rely on treatment options provided by the VA.  With a dismal track record in providing treatment for Veterans with PTSD, it is hard to see how any meaningful progress will be made by the VA in curbing VA suicides.

More disturbing is the thought that Veterans with PTSD incurred from the Gulf Wars and continued deployments in Afghanistan and Iraq will soon be approaching their 50th birthday.   If the VA statistics are credible that “65% of Veteran suicides are over the age of 50,” then we may actually see an uptick in suicide rates among Veterans.

Despite repeated assurances to Congressional Committees, Dr. David Cifu and his cronies at the VA don’t have a clue on how to treat PTSD.   Cocktails of lethal prescription drugs are clearly not the answer, but the VA’s blind insistence that Cognitive Behavioral Therapy and Prolonged Exposure Therapy are the only effective treatment programs is simply ludicrous.

Whatever the reasons, Veterans with PTSD and TBI may not really have a viable financial alternative outside the treatment barriers currently erected by the VA.

Even though the information is dated, the VA has done a good job illustrating the extent of the problem.  While one can draw many inferences from the data, it would be totally wrong to suggest that the VA has a handle on the problem and absurd to think that they have answers!

No wonder Veterans with PTSD and TBI have lost faith in the VA.

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What do the NFL and the VA Have in Common?

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Like the Department of Veterans Affairs (“the VA”), the NFL has eloquently side-stepped the effects of brain trauma caused my massive or repeated concussive events.

In a most disturbing study, the Journal of the American Medical Association has concluded that “110 of 111 NFL players were found to have chronic traumatic encephalopathy, or C.T.E., the degenerative disease believed to be caused by repeated blows to the head.”

Chronic Traumatic Encephalopathy or CTE

This should come as no surprise to most anyone who has followed repeated denials by NFL officials and team owners that repeated concussive events on the field of play lead to permanent brain damage.

Why?  The liability is simply too great and public outcry might hurt the lucrative revenue stream of the NFL, which is currently exempt from antitrust laws thanks to the largesse of Congress.

Personally, I don’t believe that the risk of brain injury will deter rabid fans from attending college or NFL games anymore than residents of Rome passed up an opportunity to attend a bloody spectacle at the colosseum.

Nevertheless, there is a strong grassroots effort to cut back on football programs for young children.  A recent news report from Tampa, Florida highlights the dilemma faced by parents whose 9 and 10 year-old children want to play contact football.

NFL Players and our Military Heroes

While NFL players have the opportunity to walk away from the sport they dearly love, the brave men and women who serve in our armed forces don’t have quite the same options.

More to the point, Veterans suffering from from PTSD and TBI have few possibilities given the VA’s limited menu of therapy options: Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT).   As the VA acknowledges, neither of these therapies has produced significant improvements in the well-being of Veterans.

To mask the their failure in treating PTSD and TBI, the VA has resorted to potent prescription drugs with unsettling side-effects.   In effect, treating PTSD and TBI has largely been a “loss loss” for Veterans with equally devastating results on their families.

What the VA and the NFL have in common is a culture of arrogance and denial based on a concerted and prolonged effort to hide the truth from those it purports to serve and protect.   In effect, the VA has told Veterans that “it is the VA way or the highway.”

Sadly, far too many Veterans have opted for the highway.

Dr. David Cifu and the Culture of Doom

Nowhere is this arrogance of the VA more manifest than in the pompous and self-serving performance by Dr. David Cifu, a consultant for the VA on PTSD and TBI, at a 2016 Congressional subcommittee:

Scholars in attendance were revolted by Dr. Cifu’s anecdotal and silly justification for why the VA’s policies and procedures for treating PTSD and TBI are so far out of touch with the latest scientific research.

Sadly, Dr. Cifu’s opinions reflect entrenched attitudes at the VA and deprive tens of thousands of brave Veterans the treatment they deserve to combat this debilitating injury.

While Dr. David Shulkin is cleaning house at the VA, he would do well to look at those like Dr. Cifu to determine if they are up to the task in reestablishing the credibility of the VA.

Veterans that talk to SFTT believe that the VA is useless in helping to address their problems with PTSD and TBI.

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Meet Maj. Ben Richards and Bronco, his Service Dog

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I had a delightful lunch yesterday with Maj. Ben Richards and Bronco, his service dog.  Also joining us for lunch were Eilhys England, Chairperson of Stand for the Troops (“SFTT”) and Dr. Yuval Neria, Director of the PTSD Research Program at Columbia Presbyterian.

Maj Ben Richards and Service Dog Bronco

I hadn’t seen Bronco (a labradoodle) before and was interested in learning how service dogs are trained.

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.  Ben spent seven weeks in intensive training with Bronco.  According to Ben, it was about 4 hours of training a day (generally in the morning) and a few weekend sessions.

Ben and Bronco have been constant companions for almost a year.  Ben mentioned that it is the first time in 9 years he has been able to sleep without facing the door of his bedroom.  Bronco will also wake him up if he has nightmares or if thunder is approaching which might threaten sleep and trigger an anxiety attack.

Bronco has allowed Ben to feel comfortable enough to attend movies and, in fact, he went to a museum in D.C. by himself for the first time in several years.   The museum visit brought a small to Ben’s face as he recalled that it was the first time he didn’t feel like he had to process potential threats without the attendant anxiety of not being able to do so fast enough.

Ben looked great and it was wonderful to re-establish personal contact with him again.  Ben is a brave warrior who has suffered his own particular demons and is intent on helping others recover their lives from the silent wounds of wars.

Ben’s service dog has brought much needed comfort, safety and stability to his life.

Sadly, the VA is “studying” the efficacy of service dogs in helping other Veterans with PTSD.  This study will not be available until 2019.

What the VA should actually be studying are its own failed programs of Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT) which the VA continues to tout as being so successful in helping Veterans with PTSD.

While VA administrators and consultants like Dr. David Cifu can continue to hoodwink Congressional committees with their disingenuous sales pitch, most Veterans have given up on the VA with their substandard and largely ineffectual services.

Many Veterans like Ben are gradually taking matters into their own hands despite threats by the VA to withdraw benefits.  Fortunately, many States, private hospitals and charitable institutions are rushing in to fill the void left by the VA.

Is it too much to expect that the VA step up to the plate and truly support Veterans rather than hand grants to people and institutions who are prepared to parrot a pollyanna party-line based on half-truths and downright lies?

Our brave men and women in uniform deserve better.

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Veterans with PTSD Knew that VA Opioid Prescriptions Were Wrong

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After many lives of many brave Veterans with PTSD have been lost, the State of Ohio has finally taken action against pharmaceutical drug companies for hyping opioids.

Opioids

According to the New York Times reporter,  

The State of Ohio filed a lawsuit on Wednesday against the pharmaceutical industry over the opioid epidemic, accusing several drug companies of conducting marketing campaigns that misled doctors and patients about the danger of addiction and overdose.

Defendants in the case include Purdue Pharma, Teva Pharmaceutical Industries, Johnson & Johnson, Endo Pharmaceuticals, Allergan and others.

Purdue, the maker of OxyContin, a time-release opioid, released a statement saying, “We share the attorney general’s concerns about the opioid crisis and we are committed to working collaboratively to find solutions,” and calling the company “an industry leader in the development of abuse-deterrent technology.”

As most Veterans treated by the Department of Veterans Affairs (“the VA”) are aware, opioids were the prescription of choice for Veterans suffering from PTSD.

Despite overwhelming evidence available to the VA and the Department of Defense (the DOD) that this was probably not a wise course of action, the VA persisted in treating the symptoms of PTSD with dangerous prescription drugs.

It is only now with opioid and drug addiction ravishing communities across the United States that some local and State governments are beginning to take action.  In the interim, thousands of Veterans with PTSD have suffered through over-medication with opioids by doctors at the VA.

More to the point, the VA continues to insist on dated and ineffective treatment programs for Veterans with PTSD and TBI.   Under the inept counsel of Dr. David Cifu, these same treatment therapies continue at the VA today.

It is difficult to predict when this tragic saga will end, but clearly there are no indications that the VA plans to make any substantial changes to current programs.  As such our brave Veterans will continue to receive the same flawed therapy and, most likely, a healthy supply of prescription drugs to mask the symptoms.

Where are our leaders in Congress and leaders within the VA to put an end to this tragedy?  Cynical though I am, I have a difficult time believing that Big Pharma political campaign donations would be the reason.

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Meet David Cox: Dr. “No” of VA Reform

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Meet J. David Cox, who many consider “Dr. No” of badly needed reforms within the Department of Veterans Affairs (“the VA’).

J. David Cox

J. David Cox

J. David Cox is President of the American Federation of Government Employees and is the person most likely to block any meaningful reform within the VA.  SFTT has had an eye on Mr. Cox who in the run-up to last year’s Presidential election, threatened the previous secretary of the VA with physical violence:

Cox was “prepared to whoop Bob McDonald’s a – -,” he said. “He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you,”

The new VA Secretary, Dr. David Shulkin, is rightly receiving favorable media coverage and support from both parties in Congress on his forceful new leadership.  In fact, the New York Times recently referred to Dr. Shulkin as a “Hands On, Risk-Taking ‘Standout.'”

The New York Times reports the following example of Dr. Shulkin’s responsiveness (and common sense):

After he first took the job, he grew concerned that the agency was not doing enough to prevent suicide after a news report showed high rates among young combat veterans. Suicide prevention leaders told him that they would put together a summit meeting to respond, adding that it would take 10 months.

Dr. Shulkin told them to get it done in one month. When his staff members pushed back, he pulled out a calculator and began quietly tapping, then showed them that during the delay, nearly 6,000 veterans would kill themselves. They got it done in a month.

“For me it was a very important day,” he said, remembering the meeting. “It taught our people you can act with urgency, and you can resist the temptation to say we work in a system that you can’t get to move faster. I think they learned that you can.”

Indeed, SFTT has greatly admired the decisiveness with which Dr. Shulkin has attacked two chronic problems with the VA:  A bloated infrastructure and the lack of authority to manage the VA’s large workforce.

While Congressional Republicans and Democrats have largely agreed on an “accountability” bill to support the firing of VA employees, J. David Cox argues that:

“Trampling on the rights of honest, hard-working public-sector employees is not the solution to holding bad employees accountable for their actions,” American Federation of Government Employees National President J. David Cox said. He said the bill would set up different standards for VA employees and other federal workers.

In fact, just recently it was reported that “a federal appellate court overturned the firing of Sharon Helman, who presided over a Phoenix VA Health Care System that left veterans waiting for weeks or even months for care while phony records were kept to show the agency was meeting its wait-time goals.”

Dr. David Shulkin, VA Secretary

While I hope that Dr. Shulkin has the fortitude to implement the bold changes he has outlined, the entrenched bureaucracy represented by David Cox and others, such as David Cifu, will continue to undermine his efforts.

The VA has simply grown too large to manage effectively.  Dr. Shulkin is right in arguing that the lives and well-being of Veterans are far more important than defending the rights of a few “bad apples” within the VA.  David Cox should embrace the vision of Dr. Shulkin and act in a manner which reflects well on the work ethic of the vast majority of VA employees.

Veterans, Veteran organizations and our elected officials should provide Dr. Shulkin with a clear mandate to bring about the much needed reform within the VA. Our Veterans, their family and friends and an appreciate public deserve no less.

J. David Cox would do well to join forces with Dr. Shulkin in this effort rather than taunt him.

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