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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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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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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