SFTT News: Highlights for Week Ending June 30, 2017

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

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

How Much of a Threat Does Russia Pose?
Nato defence ministers are reviewing progress in what’s known as the alliance’s “enhanced forward presence” – its deployment of troops eastwards to reassure worried allies, and deter any Russian move west. “Russia would like us to think that its current militarization and preparations for conflict are a response to Nato doing the same, but it’s simply not true.”That’s the view of Keir Giles, director of the Conflict Studies Research Centre, and probably Britain’s leading watcher of Russian military matters. “Russia’s enormously expensive reorganization and rearmament program,” he told me, “was already in full swing well before the crisis over Ukraine, while Nato nations were still winding down their militaries.  Read more . . .

Kim - North Korea

President Trump Provided Military Options for North Korea
President Donald Trump has been given revised options on how to handle the growing threat of North Korea, at least one of which includes a military response in the event of a nuclear or ballistic strike against the U.S., two military experts told CNN.  U.S. National Security Adviser HR McMaster confirmed that the U.S. military was ready and said the threat from North Korea was far more urgent than in the past. “What we have to do is prepare all options because the President has made clear to us that he will not accept a nuclear power in North Korea and a threat that can target the United States and target the American population,” McMaster said Wednesday, CNN reported.  Read more . . .

“Bad Paper” Veterans to Receive Mental Health Support from the VA
The Department of Veterans Affairs announced Thursday that it would begin offering emergency mental health services starting July 5 to veterans with other-than-honorable discharges – following through on a departmental change that VA Secretary David Shulkin promised in March. The change acknowledges the population of veterans has been denied needed care, but it doesn’t go far enough, according to a report released last week from Brown University and a statement from Vietnam Veterans of America, which has advocated for years on behalf of “bad paper” veterans.  Read more . . .

Service Dogs and Veterans

VA Policy on Service Dogs Remains a Study in Process
“I would say there are a lot of heartwarming stories that service dogs help, but scientific basis for that claim is lacking,” said Michael Fallon, the VA’s chief veterinary medical officer. “The VA is based on evidence based medicine. We want people to use therapy that has proven value.” Yet the VA’s efforts to study the possible benefits of service animals have been plagued with problems. Congress mandated a study in 2010, but the VA suspended it just months after it began, when two of the dogs in the study bit the children of veterans. The study restarted in 2012 but was again stopped because of issues with the dog’s health and training. A new study is underway and the VA is now recruiting veterans to participate. But it isn’t expected to be finished before 2019.  Read more . . .

Objective Test to Diagnose PTSD?
Australia’s Medibio, which is working on an objective test for the diagnosis of mental health disorders, reported promising results for a noninvasive diagnostic tool for post-traumatic stress disorder. PTSD affects 3.5% of the U.S. adult population, according to the National Institute of Mental Health. But this figure jumps dramatically in veterans, to anywhere between 11% and 30%, according to the Department of Veterans Affairs. PTSD diagnosis, like that of other mental health disorders, depends on patient-reported and physician-observed symptoms. In order to be diagnosed with PTSD, a patient must experience four different types of symptoms for at least one month. Medibio seeks to “revolutionize” the diagnosis and treatment of mental health with noninvasive, quick, and objective diagnostic tests for PTSD and other disorders.  Read more . .

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

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


SFTT News: Highlight for Week Ending Jun 7, 2017

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

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Syrian Military Threatens Coalition Forces on Border
Forces loyal to the Syrian government have threatened to retaliate with force after the U.S. military struck their positions on multiple occasions. A military alliance fighting the Islamic State militant group (ISIS) and other insurgents on behalf of Syrian President Bashar al-Assad and his allies in Iran and Russia issued a statement Wednesday containing five points of criticism after U.S. warplanes carried out strikes against their fighters on Tuesday. The U.S. argued that Iran-backed militants had approached too closely a Special Forces base in the Syrian region of al-Tanf near the Iraqi and Jordanian borders, prompting the U.S. to launch its second such attack in three weeks against pro-Assad forces.  Read more . . .

Veterans with PTSD

Treating PTSD at the Department of Veterans Affairs
The Department of Veterans Affairs has greatly expanded its treatment programs for mental health problems overall, and for post-traumatic stress disorder in particular, said Dr. Harold Kudler, acting assistant deputy under secretary for Patient Care Services at the VA. In fiscal 2016, the VA provided mental health treatment to 1.6 million veterans, up from 900,000 in 2006, Kudler said. Of the overall figure, 583,000 “received state-of-the-art treatment for PTSD,” including 178,000 who served in Iraq and Afghanistan, he added.   Read more . . .

European Military Command Center Moves Forward
The European Union approved a new military command center for foreign training missions on Thursday after Britain dropped its opposition, the latest step in EU efforts to integrate its militaries and defense industries. A day after the European Commission offered 1.5 billion euros ($1.68 billion) a year in support of Franco-German plans for greater EU defense cooperation, all 28 EU governments agreed for the command center in Brussels to run training missions in Somalia, the Central African Republic and Mali. EU foreign policy chief Federica Mogherini said in a statement the decision was “a very important operational decision to strengthen European defense”.   Read more . . .

Senate Passes VA Reform Bill
The Senate approved bipartisan legislation by voice vote Tuesday to reform civil service protections at the Department of Veterans Affairs. The legislation, dubbed the “Department of Veterans Affairs Accountability and Whistleblower Protection Act” would make it easier to fire federal employees, including executives. The legislation follows numerous scandals at the VA in recent years, most notably the manipulation of waiting lists for veterans, with patients dying while waiting for treatment.  Read more . . .

Secretary Shulkin Announces Shift in Electronic Records
In a move that’s been long-discussed and much anticipated, Veterans Affairs Secretary David Shulkin announced his intention to move VA to a commercial, off-the-shelf electronic health record and turn the page on a new chapter toward achieving interoperability with the Defense Department. VA will abandon its own, existing Veterans Information Systems and Technology Architecture (VistA) and adopt MHS Genesis, the same EHR system that DoD is deploying. All patient data will reside in one common Cerner Millennium system.  Read more . . .

Crisis in PTSD Drug Development Leads to Other Treatment Alternatives
Only two medications – sertraline (Zoloft, Pfizer) and paroxetine (multiple brands) – are currently approved by the US Food and Drug Administration (FDA) for the treatment of PTSD. Although these drugs and a few others have modest effect sizes, they are not as effective as trauma-focused psychotherapies, as reported in a recent review, which, Dr Davis said, factored largely into the pivotal clinical guidelines shift. Although the results reflect the potentially robust efficacy of psychotherapy, they also underscore the need for better medications, a sentiment that Dr Davis and her colleagues on the working group noted in a consensus statement.  Read more . . .

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

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


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.


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.


SFTT News Highlights: Week Ending May 26, 2017

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

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Nato Logo

At NATO Speech President Trump Scolds Leaders
At a NATO summit in Brussels, President Trump marked the unveiling of memorials of the Berlin Wall and the Sept. 11 attacks with a speech that, among other things, told gathered NATO leaders their levels of defense funding are “not fair” to U.S. taxpayers. Trump also omitted any clear statement of support for Article 5, the NATO mutual-defense pledge — something other leaders had been hoping to hear. The Associated Press described Thursday’s speech as an “unprecedented one-two punch” that “further rattled” an already anxious Europe. And at home, one Democratic leader called the remarks “condescending” and an “embarrassment,” while Republican Sen. Rand Paul said he applauded Trump’s stance.  Read more . . .

U.S. and Russia Military Increase Communication Over Syria
The United States and Russia have increased communication to avoid warplane accidents in the skies over Syria as Islamic State militants lose territory and the air space becomes more crowded, a top U.S. Air Force official said on Wednesday. In 2015, the Russian and U.S. militaries agreed to create a communication link and outline steps their pilots could take to avoid an inadvertent clash over Syria. Senior U.S. military officials have stressed that there was a need to enhance communications as the fight against Islamic State intensified.  Read more . . .

Elderly Veterans Face Cuts In New VA Budget
Veterans Affairs officials on Wednesday defended plans to strip tens of thousands of dollars in unemployment benefits from elderly veterans as responsible reforms to the department’s growing budget, but opponents promised to fight the idea. Included in President Donald Trump’s $186.5 billion VA budget for fiscal 2018 — a nearly 6 percent boost in discretionary spending from this year — are plans to dramatically cut the department’s Individual Unemployability program.  Read more . . .

AK-12 Kalashnikov

New Kalashnikov Assault Rifle Proposed by Russians
Brace yourselves: It looks like Kalashnikov Concern, the weapons manufacturer behind the iconic AK-47, will end up arming the modern Russian warfighter for future conflicts with a brand new addition to its AK family of assault rifles by the end of 2017, Army Recognition reports.  Read more . . .

VA Accountability and Reform Bills Moves Forward in Senate
Senate Majority Leader Mitch McConnell, R-Ky., said Thursday that reforming veterans’ care would be a top priority for lawmakers when they return to Capitol Hill the first week of June. Lawmakers will take up legislation to increase accountability within the Department of Veterans Affairs and protect its whistleblowers.”We know many challenges remain in ensuring that veterans have access to the care they need and deserve at the VA, but this legislation will further improve our ability to meet our commitment to them,” McConnell said.  Read more . .

Six PTSD Resources You Should Know About
Veterans have a variety of resources to turn to when they have concerns about post-traumatic stress disorder, or PTSD. Symptoms of the disorder don’t necessarily indicate PTSD and some reactions to stress and trauma are normal conditions. Mental and physical distress, difficulty sleeping, and disturbing thoughts, feelings, or dreams are among the signs. The best way to find out if you suffer from PTSD is through a medical professional, who can then advise treatment options. Doctors and online resources may identify the problem and help with the necessary treatment available.  Read more . . .

PTSD Medications May Increase Dementia Risk
Patients with post-traumatic stress disorder may be at increased risk of dementia, particularly if they are taking psychotropic medications, a new study finds.Researchers from the University of Iowa came to their conclusions by analyzing the data of more than 3 million veterans.They found that veterans with post-traumatic stress disorder (PTSD) were at much higher risk of developing dementia than those without the condition, but that the risk varied depending on the medications they were using.Study co-author Dr. Thad Abrams, of the Department of Epidemiology at Iowa, and colleagues recently reported their findings in the Journal of the American Geriatrics Society.  Read more . . .

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

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


SFTT Military News: Week Ending May 19, 2017

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

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Secretary of Defense Weighs In on War with North Korea
U.S. Defense Secretary Jim Mattis said on Friday that any military solution to the North Korea crisis would be “tragic on an unbelievable scale” and Washington was working internationally to find a diplomatic solution. North Korea has defied all calls to rein in its nuclear and missile programs, even from China, its lone major ally, calling them legitimate self-defense.  Read more . . .

Military Handgun M-9 handguns

Could the US Military Purchase Handguns Online?
The Defense Department may start doing a whole lot more online shopping in 2018, if Republican Rep. Mac Thornberry has his way. The Texas chairman of the Armed Services Committee unveiled new legislation Thursday that aims to cut costly bureaucratic red tape at the Pentagon by allowing the military to buy everything from pens to treadmills from business-to-business sites such as Staples and Amazon. That would free the federal government’s biggest bureaucracy from using its current “expensive” and “onerous” contracting and scheduling process to buy its commercial goods, according to Thornberry.  Read more . . .

Large Number of Troops Separated for Misconduct had PTSD
Nearly two-thirds of the 91,764 U.S. troops who were separated from the military for misconduct in a recent four-year period had been diagnosed with post-traumatic stress, a traumatic brain injury or another condition that can lead to misconduct, according to a report released Tuesday, raising questions about the Pentagon’s treatment of combat veterans. The Government Accountability Office found that the Defense Department needs to take action to make sure that commanders appropriately consider medical conditions when weighing what to do with service members facing misconduct allegations. Some 57,141 troops were separated from the service despite a potentially relevant diagnosis between 2011 and 2015, and 13,283 of them received other-than-honorable discharges that could prevent them from receiving care from the Department of Veterans Affairs, the report said.  Read more . . .

Improper Payments at VA Continue to Grow
The Department of Veterans Affairs cost taxpayers $5.5 billion dollars in improper payments last year, according to a new report by the Veterans Affairs Office of Inspector General published Monday. An improper payment is any payment that “should not have been made or that was made in an incorrect amount under statutory, contractual, administrative, or other legally applicable requirements,” according to the report. The findings, published on May 15, reported an increase in improper payments from $5 billion in 2015 to $5.5 billion in 2016. It also found that two VA programs failed to keep their rate of mistaken payments below 10%, and six of its programs failed to meet reduction targets set last year.  Read more . . .

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

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


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.


First Steps to Overhaul the Department of Veterans Affairs

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Dr. David Shulkin continues to impress by tackling some rather entrenched “special interest” groups within the Department of Veterans Affairs (“the VA”):

– Personnel;

– Infrastructure

Earlier this week, VA Secretary Shulkin informed a Congress that he was considering closing some 1,100 underutilized VA facilities.  The Associated Press reports that:

Shulkin said the VA had identified more than 430 vacant buildings and 735 that he described as underutilized, costing the federal government $25 million a year. He said the VA would work with Congress in prioritizing buildings for closure and was considering whether to follow a process the Pentagon had used in recent decades to decide which of its underused military bases to shutter, known as Base Realignment and Closure, or BRAC.

“Whether BRAC is a model that we should take a look, we’re beginning that discussion with members of Congress,” Shulkin told a House appropriations subcommittee. “We want to stop supporting our use of maintenance of buildings we don’t need, and we want to reinvest that in buildings we know have capital needs.”

Last week, President Trump signed an Executive Order protecting VA whistleblowers from retaliation in a quest by the VA to shed incompetent employees.

Department of Veterans Affairs

While these measures may seem rather insignificant given the overall size and reach of the VA, they could mark an important change in the direction of the VA to help respond to the needs of Veterans.

The VA has evolved into a mammoth organization intent on serving the needs of all Veterans and their families.  Roughly 60% of the VA’s $180 billion budget (2017 budget) is allocated to mandatory benefits programs.

The VA’s discretionary budget of $78.7 billion is allocated to a variety of Veteran services,  but by far, is the the $65 billion allocated to medical care facilities.   Despite regular reports of shortcomings at VA facilities, the Rand Corporation recently (2016) reported that “the Veterans Affairs health care system generally performs better than or similar to other health care systems on providing safe and effective care to patients.”

While it appears that many Veterans – quite possibly the vast majority – receive quality health services from the VA, many Veterans complain about the timeliness and quality of service provided to them.

Like other healthcare providers in the private sector, the VA has determined what health events are covered, the type of coverage provided and where the health services are administered.

One program that has come under particular attack is the Choice Program, which gives Veterans access to medical services in the private sector if the VA can’t dispense services within 30 days or a VA facility is not located within 40 miles of the Veteran.

At his confirmation hearings, now VA Secretary David Shulkin, requested that Congress expand the coverage of the Choice program and eliminate many of its administrative constraints.  Needless to say, changes in the Choice program would certainly provide a greater number of Veterans with access to private sector care.

In cases of emergency, even minor improvements to the Choice program could be of major benefits to Veterans.

Nevertheless, these changes do not provide Veterans with access to alternative therapy programs not currently approved by the VA.  As SFTT has reported on numerous occasions, PTSD is currently treated with demonstrably ineffective “approved” treatment procedures while far better and less-intrusive programs like hyperbaric oxygen therapy (HBOT) are widely used with success throughout the world.

In effect, there are a number of activities within the VA that can best be performed by third-party services.  In fact, integrating these services with community resources may prove to be more of a long term benefit to the Veteran and his or her family.

Stand for the Troops remains hopeful that Secretary Shulkin and the dedicated employees of the VA will find the right balance in helping Veterans recover their lives.


Hyperbaric Oxygen Therapy (HBOT) to Treat Veterans with PTSD

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Veterans and casual observers continue to be mystified why the Department of Veterans Affairs (the “VA”) continues to insist on failed therapy programs to treat Veterans with PTSD.

Dr. David Cifu, the senior TBI specialist in the Department of Veterans Affairs’ Veterans Health Administration, argues that Veterans treated with Cognitive Behavioral Therapy and Prolonged Exposure Therapy are receiving the best therapy possible to treat PTSD.   There is no reliable third-party verification to support Dr. Cifu’s bold assertion.

More to the point, Dr. Cifu dismisses  other treatment alternatives arguing that there is no scientific basis to support them.  In particular, Hyperbaric Oxygen Therapy (HBOT) has been singled out for particular disdain by Dr. Cifu.

Specifically, the VA concluded their trial “study” with the following observations:

“To date, there have been nine peer-reviewed publications describing this research,” Dr. David Cifu, VA’s national director for physical medicine and rehabilitation recently told the Oklahoman. “All the research consistently supports that there is no evidence that hyperbaric oxygen has any therapeutic benefit for symptoms resulting from either mild TBI or PTSD.”

Frankly,  there is voluminous scientific evidence that HBOT is both a viable and recommended treatment alternative for Veterans suffering from PTSD and TBI.

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy or HBOT is available at many privately-owned hospitals in the United States and around the world.  There is compelling scientific evidence that HBOT reverses brain damage.

In fact, HBOT is the preferred therapy of  the Israeli Defense Forces (“IDF”) for service members with head injuries.  Frankly, this assertion alone trumps any argument to the contrary by Dr. Cifu.

In its most simple form, HBOT is a series of “dives” in a decompression chamber (normally 40) where concentrated oxygen is administered under controlled conditions by trained physicians.  There is clear and conclusive evidence that brain function improves through the controlled application of oxygen.  In effect, it stimulates and may, in fact, regenerate brain cells at the molecular level.

HBOT Brain Functionality Over Time

In addition, HBOT is far cheaper to administer than currently approved programs at the VA.   Maj. Ben Richards argues that all Veterans with PTSD and TBI could be treated with HBOT for less than 10% of the VA budget allocated for pharmaceuticals.

More to the point, the annual VA treatment costs for Veterans with PTSD and TBI are roughly $15,000. For this annual expense, many Veterans could receive HBOT.

Dr. Figueroa asks, What are we Waiting For?

Almost 3 years ago, Dr. Xavier A. Figueroa, Ph.D., in an article entitled “What the <#$*&!> Is Wrong with the DoD/VA HBOT Studies?!!” clearly sets forth a compelling scientific argument why Veterans with TBI and PTSD should be treated with HBOT.

Found below is a summary of Dr. Figueroa’s conclusions (footnotes removed):

A large fraction of the current epidemic of military suicides (22+ service members a day take their lives) are more than likely due to misdiagnosed TBI and PTSD. Although the DoD and VA have spent billions (actually, $ 9.2 billion since 2010) trying to diagnose and treat the problem, the epidemic of suicide and mental illness are larger than ever. Drug interventions are woefully inadequate, as more and more studies continue to find that pharmacological interventions are not effective in treating the varied symptoms of TBI or PTSD. In many cases suicide of veterans have been linked through prescribed overmedication.

HBOT is a safe and effective treatment with low-to-no side effects (after all, even the DOD accepted the safety of HBOT back in 2008). Access to HBOT is available within most major metropolitan centers, but the major sticking point is money. Who pays for the treatment?  Those that are willing to pay for it out-of-pocket and state taxpayers picking up the tab for brain-injured service members forced back into society without sufficient care (or forced out on a Chapter 10, when it should have been treated as a medical condition).

The continued reports of studies like the DoD/VA sponsored trials allow denial of coverage and provide adequate cover for public officials to claim that more study needs to be done. As we have seen, the conclusions of the authors of the DoD/VA sponsored studies downplay the results of effectiveness. There are sufficient studies (and growing) showing a strong positive effect of HBOT in TBI. More will be forthcoming.

The cardinal rule of medicine is “First, Do No Harm”. With HBOT, this rule is satisfied. Now, by denying or blocking a treatment that has proven restorative and healing effects, countless physicians and organizations, from the VA to DoD, Congress and the White House, could be accused of causing harm. Never mind how many experiments “fail” to show results (even when they actually show success). Failure to replicate a result is just that…a failure to replicate, not a negation of a treatment or other positive results. You can’t prove a negative and there are many clinical trials that do show the efficacy of HBOT.

The practice of medicine and the use of HBOT should not be dependent on the collective unease of a medical profession and the dilatory nature of risk adverse politicians, but on the evidence-based results that we are seeing. Within the VA, there are hard working physicians that are trying to change the culture of inertia and implement effective treatments for TBI and PTSD, using evidence based medicine. Unfortunately, evidence-based medicine only works when we accept the evidence presented to us and not on mischaracterized conclusions of a single study (or any other study). Our veterans, our citizens and our communities deserve better than what we are currently giving them: bad conclusions, institutions too scared to act in the interests of the people it serves and too many physicians unwilling to look at the accumulated evidence.

Indeed, it is time to for Dr. Shulkin to rid the VA of Dr. Cifu and embrace cost-effective treatment therapies which provide some hope for Veterans with PTSD and TBI.


VA Secretary David Shulkin: Glass Half Full?

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Department of Veterans Affairs (“the VA”) Secretary, Dr. David Shulkin means well, but it is not surprising that his leadership is being undermined by the same chronic conditions that have plagued other VA Secretaries.

Dr. David Shulkin, VA Secretary


This week brings yet three more examples of the chronic problems facing the VA:

The VA still can’t FIX the Suicide Hotline

Secretary Shulkin Needs Senate Approval to Fire VA Employees

VA Dropping Veteran Caregivers from Their Rolls

Indeed, this litany of weekly crises is not dissimilar from scandals that have surfaced under the leadership of other VA secretaries.

What follows is a well-choreographed skit designed to reassure the public and Veterans that all is well in the Music Man’s River City.

“New Crisis” at the VA attracts national media;

VA Secretary assures Congressional subcommittee that problem will be fixed;

Congressmen get public facetime preaching to the converted;

– VA Secretary Shulkin sulks back to his office to prepare for next week’s Congressional hearing;

VA Labor Union blocks any constructive legislation that would allow the Secretary Shulkin to implement much-needed change within the VA.    Why?  Just ask J. David Cox, President of the American Federation of Government Employees, who once threatened a VA Secretary with “physical violence” for suggesting a change to the status quo.

For those who have followed this same tragic charade for many years, it is clearly evident that the VA is too big to succeed.  In the words of Nassim Taleb, the VA is fragile.


The VA has become a bureaucracy that answers only to itself and is not responsive to the needs of Veterans.  Frankly, the VA has lost its way and very little will change unless the VA is broken down into far smaller manageable components.

While smaller components of the VA will invariably fail, A SMALLER AND LESS CENTRALIZED VA WON’T COMPROMISE THE FULL MISSION.  

Will “change you can believe in” actually take place?  I think not, considering the entrenched political interest in maintaining the status quo and the patronage of a large block of voters represented by J. David Cox.

As presently configured, there is no possible way that the VA can fulfill President Abraham Lincoln’s promise: “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.

As argued on several other occasions, the VA should be reconfigured to concentrate on those Veteran functions which require centralization.  All other activities should be assigned to smaller VA components or outsourced (with supervision) to the private sector.

For instance, the VA centralized suicide crisis line makes little sense.   Aside from the fact that the crisis line is currently non-responsive (and has been for a long period of time), it seems evident that we should allocate responsive resources far closer to a high-risk Veteran.

Let’s face it, few jumpers have been talked down off the ledge by a Call Center.  If you want to deal with high-risk Veterans in urgent need of support, get human resources to them as quickly as possible.  THINK LOCAL and COMMUNITY-BASED SERVICES.

While this more decentralized approach may not resolve the current Crisis Center problems, it would be far easier to manage and control at a local level.  Better yet, high-risk Veterans will benefit from a far more responsive human touch by local communities that truly care.

For Veterans, BIG IS NOT BEAUTIFUL!   Many Veterans see a largely unresponsive institution that seems more preoccupied with statistical adherence to protocol than positive patient outcomes. Wouldn’t it be wonderful if we could turn that perception around?

From the perspective of the VA, it is a lot easier to say that “we need more resources to deal with current shortcomings,” rather than face the reality that the VA has become a dysfunctional bureaucracy.

The Titanic

The ability to turn around the “Titanic” VA was lost many years ago.  Going forward, we must chop down the VA into far smaller component “passenger ships”  with accountability and leadership that can truly effect meaningful change.

Sure, one or more of these smaller components may fail, but not ALL Veterans will be held hostage by the continued failure in leadership of an INSTITUTION THAT IS TOO BIG TO SUCCEED.


SFTT Military News: Week of April 7, 2017

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

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

US Military Options in Syria
Trump said that Tuesday’s attack “crossed a lot of lines” for him and that his “attitude towards Syria and Assad has changed very much.” And Trump told some members of Congress that he’s considering military action in Syria in response, a source familiar with the calls told CNN on condition of anonymity. Trump has not yet spelled out what his administration will do, if anything. But inevitably, speculation is focused on whether he might embark on military action where former US President Barack Obama did not. So what are the possible military options for the US in Syria?  Read more . . .

Budget Gridlock Could Harm Military
Lawmakers must finalize a budget for the remainder of fiscal 2017 by the end of April or trigger a partial government shutdown. In recent days, talk of a continuing resolution to fund the government through the end of September has slowly built in the halls of Congress, raising concerns among defense officials who say that would cause tremendous funding headaches for the military.  Army Chief of Staff Gen. Mark Milley warned that with the U.S. facing foreign threats and wars against terrorism, it is no time to risk national security by closing the year with a continuing resolution or returning to statutory budget caps.  Read more . . .


Being a Military Advisor in the Middle East is Not Easy
Americans are currently advising Iraqi troops in a vicious fight against ISIS in Mosul, and the United States has almost doubled, to nearly 1,000, the number of U.S. soldiers and Marines on the ground in northern Syria just in the past month. But training local fighters is a risky job that’s hard to do right, especially in the Middle East, which is splintered into groups with conflicts that go back centuries. Those divisions can be religious (Sunni vs. Shiite), ethnic (Arab vs. Kurd) and national (Turkey vs. Syria). An advisor’s job is made all that much harder by the fact that the divisions overlap.  Read more . . .

Taliban to Focus on Vulnerable Provinces in 2017
“There will be an increase in attacks in those provinces that are on the verge of collapse,” Taliban spokesman Zabihullah Mujahid told Stars and Stripes. While in the past the group had single units covering several provinces, Mujahid said: “This year, we have a unit for every province in the country.” The ability to control the capitals of Afghanistan’s 34 provinces appears to be the barometer that U.S. and NATO forces use to measure success in the Afghan conflict. Occupying a capital has been a top priority of the Taliban, and some fear this could be the year they finally succeed.  Read more . . .

Common Antibiotic Helps Inhibit Fear Memories
Researchers from University College London and the University of Zurich recently discovered a startling side-effect of the common antibiotic doxycycline – it can disrupt and suppress the formation of fear memories in the brain. This fascinating discovery could not only lead to novel treatments for PTSD, but also offers scientists a clue to how the brain forms lasting fear and threat memories.  Read more . . .

Can Ayahuasca Reduce Dependence on Addictive Drugs?
Combat-related PTSD is notoriously difficult to treat and in theory ayahuasca can work as a form of drug-assisted exposure therapy. When traumatised people repeatedly avoid fear-inducing situations this only serves to maintain and reinforce the deeply ingrained conditioning that underlies their illness. The idea is that by dredging up traumatic memories and exposing them to conscious awareness within a safe, controlled environment, ayahuasca allows the brain to reassess and extinguish conditioned fear responses.  Read more . .

J. David Cox

J. David Cox

Legislation Needed to Fire Incompetent Employees at the VA
A bill to give Department of Veterans Affairs Secretary David Shulkin authority to quickly fire incompetent employees faces a major battle in the Senate, although it has his backing and has already passed the House. Shulkin came out in favor of the legislation after realizing he couldn’t immediately fire an employee caught watching pornography at work.  While the VA Accountability First Act of 2017 passed the House, only 10 Democrats voted in support.  The ranking member of the House Committee on Veterans Affairs, Democratic Rep. Tim Walz, voted against the bill.  Read more . . .

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

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