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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IDF and VA Part Ways on Efficacy of HBOT in Treating PTSD

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Treating Veterans and Active Duty personnel suffering from TBI or PTSD with Hyperbaric Oxygen Therapy (“HBOT”) has always been regarded as “black magic” by both the VA and the DoD.   In fact, earlier this year, 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.”

Conversely, the Israel Defense Forces (“IDF”) uses HBOT as a matter of course in treating personnel for traumatic shock.  Roughly 120 patients a day are treated at the The Sagol Center for Hyperbaric Medicine and Research in Israel.    In fact, many U.S. military veterans are now seeking treatment at the Sagol Center since they cannot receive treatment from the VA.

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”.

It is hard to imagine that the VA and DoD don’t have the same commitment to the life and well-being of military Veterans as the IDF, but the facts suggest otherwise.

Should Vets Have Access to HBOT from the VA?

I suppose that the overriding question is how two nations at the forefront of international terrorism with state-of-the-art medical capabilities have widely different views on the efficacy of HBOT in treating Veterans suffering from PTSD and TBI.

Equally disturbing is the growth of HBOT treatment facilities in the United States which are attached to private clinics and hospitals.    In fact, HBOT is currently reimbursed under Medicare Part B for certain conditions.  It remains unclear whether this treatment is approved for reimbursement for Vets suffering from PTSD and TBI.

Despite VA and DoD “tests” to the contrary, there is an abundant of evidence worldwide that HBOT is effective in treating brain injury and restoring brain function by administering concentrated oxygen under controlled conditions.  To argue otherwise is just plain foolish and self-serving.

Many have argued that the adoption of HBOT in treating Veterans would cut into the earning of Big Pharma, who continue to insist (read lobby) for a cocktail of opioids and antipsychotic medication.    As a former military officer, I find it difficult to accept this premise; however, I now feel compelled to accept the obvious:  the VA procurement process and treatment of Veterans is seriously flawed and, perhaps, criminally negligent.

In my opinion, the only way to destigmatize the use of HBOT for treating Veterans is for the VA to approve reimbursement for Veterans seeking treatment outside of the VA.  Will this happen?  Probably not. I would argue that it is highly unlikely that Vets with receive HBOT given the entrenched position of Big Pharma within the FDA, VA and Federal government.

For those who need more evidence on the efficacy of HBOT, please listen to this very informative video clip by Maj. Ben Richards, a U.S. Military Academy graduate, who underwent the HBOT treatment with Dr. Paul Harch:

Can we deprive our Veterans of this effective and relatively inexpensive treatment? If the answer is “No,” then contact your Congressman and Senator demanding action.

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“I’m Just Saying…” by Jim Magee

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Congratulations on being nominated for Secretary of Defense, Mr. Panetta.  Or should I say my condolences on being nominated for Secretary of Defense?

I’m just saying —- DOD isn’t the CIA.  You’ll need all of your considerable skills in your new job.  You’re the right guy to deeply cut the enormously high DOD budget. You’ve been in the Office of Management and Budget, been the White House Chief of Staff, been in Congress and run the CIA, so you know how Washington works. DOD’s nearly three quarters of a trillion dollar budget is going to get cut, really cut. There will be no hiding behind black programs as you did at CIA; no assumptions that the 535 members of Congress who think they know what DOD should do, and how much they need in resources to do it, that they can be handled by a classified briefing or a few phone calls.  The demands for cuts in the DOD budget will go well beyond the reasonable demand that we stop spending $2 billion a week trying to bring a 13th century country like Afghanistan into this century; risking the lives of 100,000 soldiers and Marines in a country with no strategic relevance to US security. But the good news is that the DOD budget is ripe for cutting.  I’m just saying — cut immediately and cut a couple hundred billion dollars deep.

There are numerous programs that you can cut immediately and not adversely impact US security. Here are a few:

Terminate the Littoral Combat Ship (LCS) Program

The Navy says that its ships will have to stay at least 100 miles from a potentially hostile shore because of the anticipated proliferation of shore-to-sea, high speed, anti-ship missiles.  Yet, DOD has recently approved procurement of 20 LCS ships that are specifically designed to operate in this very same littoral environment, well within the 100 miles from shore, the very area in which the Navy claims their ships cannot operate in because of this deadly threat.  Oh yeah, you’ll also note that the Navy didn’t program any money for the “mission modules” that each LCS needs to be effective. Basically, we’re buying ship’s hulls, but not the offensive or defensive capabilities needed of a warship. 

Terminate the Joint Light Tactical Vehicle (JLTV) Program

The taxpayers will love you for killing this corporate welfare program.  With a truck fleet in the Army of 266,000 trucks, one truck for every two soldiers, we don’t need and certainly cannot afford the JLTV.  I’m just saying that a 30,000-50,000 lb JLTV isn’t light. Have you seen one of the huge prototypes? Fifteen feet high, ten feet wide; envision a marginally slimmer MRAP.  Expensive?  Consider that the last Jeep we bought (M151) costs the taxpayers $18,000 each. We replaced that Jeep with the Humvee for about $48,000 each; then we up-armored the Humvee for about $160,000 each.  And now the Army reports that the JLTV could cost around $800,000 each with GFE.   Over three quarters of a million dollars for a Jeep replacement for which there is absolutely no evidence that the trucks in the Army and Marines current fleet (Humvee’s, MRAPS, etc.) cannot do what the industry hopes the JLTV can do!  I’m just saying —- if industry wants to continue development of the JLTV, let them do so on their dime, not the taxpayers.

Don’t start the Ground Combat Vehicle (GCV) Program

 I’m just saying —- this son of the Future Combat System (FCS) Program is a dog that won’t hunt.  Kill it now until the Army can identify what it wants, and industry can demonstrate what they have that satisfies those wants.

Reduce Military Headquarters Personnel

Cut personnel in every headquarters above Army Corps, Navy Fleet, Numbered Air Force and Marine MEF levels by one fourth, focusing the cuts on GS-12’s and above civilians, officers at or above Major/LtCdr, and enlisted personnel at or above E-7.  In the 1980’s, US Army Gen Bernard H. Rogers, former USCINCEUR and NATO’s SACEUR, used to refer to such headquarters as “echelons above reality.”  Today’s DOD echelons above reality are the vastly overstaffed Service headquarters (HQMC, HQ-DA, HQ Air Force, OPNAV); all Services’ “Forces Commands”; all Theatre or Specified Command headquarters, (EUCOM, PACOM, CENTCOM, SOUTHCOM, NORTHCOM, TRANSCOM, STRATCOM and AFRICOM), as well as their theater Service component headquarters; all twenty-eight (28) Defense Dept agencies, and lastly and particularly the unbelievably staffed beyond all reality 20,000 person (+) headquarters of your DOD staff and the enormously inefficient and overstaffed Organization of the Joint Chiefs of Staff (OJCS).

Change the Military Procurement Process

If you truly want to make an impact, save the taxpayers from throwing good money after bad, and get the immediate attention of DOD and their bosom buddies in the defense industry:  take control of the Defense procurement morass by announcing an immediate policy that “DOD will no longer fund the development of new systems until after their benefits have been demonstrated to DOD in the prototype stage.”  I’m just saying —- If the military-industrial complex has a better system or weapon for DOD, let them build a prototype and demonstrate it to DOD before any taxpayers’ money is committed to its further development and procurement.

I’m really just saying —- welcome aboard (you poor bastard), and good luck!

Respectfully,

Jim Magee

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Budget Cuts and the DoD’s Priorities

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The Secretary of Defense has proposed cutting $78 Billion out of the DoD budget over five years.   That’s $78 Billion, or less than $20 Billion a year.  Are you kidding me — why even bother with such a miniscule amount?   Anyone with even a brief, passing knowledge of the DoD over the last 2 decades has to be amused that the national media has viewed this proposal as a “substantial cut.” With an enormous DoD budget that exceeds THREE QUARTERS of a TRILLION DOLLARS a year, a reduction of $20 Billion a year is almost a rounding error!

After the first Gulf War (Desert Storm) the DoD budget was less than $350 Billion per year. It is now over $830 Billion per year.  When you deduct the cost of our wars in Afghanistan and Iraq, DoD still spends over $549 Billion per year.  What justifies this level of spending, after you deduct war costs?  Answer – No one can rationally justify it.  Let’s consider what we’re getting for our Defense budget:

First — you are not going to find anything being spent on procuring better “troop” gear.  That ship has sailed, as Congress’ wire brushing of the DoD procurement brass during the early stages of the Iraq War for their utter incompetence in providing adequate numbers and quality of body armor, armored vehicles and HUMVEE armor upgrades, a better fitting helmet, etc. ran its course.  By 2007, the DoD, Army and Marine procurement weenies had successfully scurried to get the troops what they should have had before we kicked off the Iraq War.  In the process, they got Congress off their backs.  They have since retreated into their normal state: disinterest in things for the troops; high interest in big dollar programs.

Now — Let’s look at what DoD’s funding.

The Army, having spent almost two decades and hundreds of billions of dollars on the Future Combat System (FCS) and produced nothing deployable – or even useful – other than an engine, has been cancelled.  It has been reborn and been renamed, I think for the second time in eighteen months, and is now called the “Brigade Something or Other.”  Same focus, though, a “family of networked vehicle systems.”  Can you say son-of-FCS?   Will they ring a bell when they spend their first hundred billion dollars?  Who knows, but mind my words, any time a Service addresses anything that is wrapped in wording as a “Family of XXX” needs to be viewed as a program that doesn’t know what it wants to develop; has no earthly idea what the “Family” will cost, or what will constitute a success.   Think of it as a corporate annuity plan to feed the greed and thirst of the military industrial complex with more of your tax dollars!

The Air Force now wants to develop a new manned bomber.  To do what?  Since we can put a missile’s warhead into a 55 gallon drum from thousands of miles away, why – pray tell – do we need another manned bomber?  Isn’t our $2 Billion per copy B-2 good enough?  Is the $750 Million per copy B-1 inadequate?  The $800 Million per copy F-117 Stealth Aircraft is somehow unusable?  The B-52’s are still flying after almost 60 years of service, and seem to be upgradeable forever.  What is it that these manned bombers, our ballistic missiles, cruise missiles, and our unmanned UAV systems cannot do that justifies throwing money away after another manned bomber?  Beats me.  But hey, they’re the Air Force.  These are the same guys that gave us the F-22, which at $400 million a copy, this high speed, low drag “air dominance” miracle machine cannot deploy into “an electrically contaminated environment,”  like over Iraq or Afghanistan.  Doesn’t matter to the Air Force, they want more of them.  Oh yeah, they also want a thousand of their variant of the F-35 Joint Strike Fighter, rapidly gaining on the F-22 in the cost overrun sweepstakes.  I find it remarkable that the best fighters the Air Force and Navy still get their hat and ass handed to them in Red Flag and Top Gun Exercises by fighter bombers built in the 1960’s: updated A-4’s and F-5’s.  Hey guys, it’s the ordnance and avionics, not the airframe.  But what do I know.

The Navy’s and Marines’ procurement priorities need no explanations.  They are unexplainable. At best they are an enigma, at worst they are a rip-off of the taxpayer. No one with an IQ greater than half their body temperature can make sense of why the Navy wants to buy what it wants to buy.  For example, even though no aircraft carrier (CV) has been successful in avoiding being sunk by day two in any force-on-force exercise in the past few decades, we are still buying nuclear powered CVs at $20 Billion each, counting their air wing’s aircraft.  Yet, the adversary that routinely sinks them, a diesel submarine, similar to the subs on loan from one of our NATO allies, has not appeared in a Navy budget request in almost 50 years.  Probably because diesel boats just aren’t sexy enough and would be tantamount to admitting that our CV’s are vulnerable.  Why should we buy an inexpensive diesel submarine, when we can spend $3 Billion on a nuclear powered Virginia class submarine, instead?

We’re deeply into the enigma area when the Navy articulates their rationale for the buy of ten Littoral Combat Ships (LCs) of two very different designs, from two different manufacturers.  When the Navy is arguing against buying amphibious class ships to land Marine forces on hostile shores, they claim that the threat to these ships from shore launched high velocity missiles so severe that it will require the amphibious ships to operate at least 100 miles from the shore, or risk being sunk.  Ok, I get that.  BUT – the LCS class ships are specifically justified for operations within the “littoral,” that sea zone well inside the 100 mile threat that the Navy paints as too deadly for Navy ships. The LCS case gets even less credible when you note that the Navy has not requested any funding for anti-submarine warfare (ASW), anti-air warfare (AAW), or any other “mission modules” that the Navy says will make the LCS useful.  This folly is comparable to a fire department buying a fire truck without buying its ladders, hoses, or pumps.  The Navy seems to believe that spending a mere $7 Billion for ten nice LCS hulls, but no mission modules, is wise.  An enigma or a rip-off? You tell me. It’s just money.

The Marines finally cancelled their Expeditionary Fighting Vehicle (EFV), an armored landing craft designed to move Marines from ship to shore at high speed, and then provide them with an armored fighting vehicle when ashore.  The Marines spent almost 17 years and $14 Billion trying to make this pig fly in the ship-to-shore phase. If the threat to the amphibious ships, from which the EFV is to deploy, does require them to operate beyond the 100 mile mark from the shore, the EFV couldn’t carry enough fuel to get from ship to shore, and still carry Marines.  The Marines are now going to fund the search for the son-of-EFV. If 20 years couldn’t get the EFV to be mission ready, the Marines won’t find a suitable replacement in this decade.  Hey guys, save the money from the son-of-EFV search, and look at buying smaller, commercial hovercraft to ferry Marine vehicles from ship-to-shore, and to upgrade or replace the fighting vehicles the Marines use once ashore.

Lastly, if DoD wants to cut their big spending beyond what I noted above, consider the following:

  • DoD should order the Navy and Air Force to reduce their uniformed and civilian personnel numbers by 5% each year for the next 5 years.
  • DoD should order each of their DoD agencies to reduce their uniformed and civilian personnel numbers by 5% each year for the next 5 years.
  • DoD should order each Service and each DoD agency to cut 10% of their 2011 budget allocation for the following year, each year for three years; For example:  The Army will only get 90% of their 2011 allocation as their 2012 funding; 90% of their 2012 allocation for 2013 , etc.
  • Order each Service and each DoD agency to submit in 60 days their list, in detail, of what programs they want to reallocate money from or to to make up for the 10% funding deduction in 2012.  Budget submissions for 2013 and 2014 must reflect these reduced allocations when submitted in 2012 and 2013, respectively.

Only then will we see what is really “essential,” and what is just “wanted.”

Col. Jim Magee, USMC (Ret.)

Jim Magee is a retired Marine infantry colonel and a combat veteran with extensive experience in special operations, intelligence and acquisitions. He commanded the first Marine Corps light armored vehicle battalion, and after retiring headed the design team for the Interceptor Body Armor system. He has held a wide variety of senior positions in the defense industry, and continues to serve as a consultant to companies in both the US and allied nations.

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Military Body Armor Tests: Incompetence or Corruption?

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In yet another glaring example of sloppy body armor test procedures, the Inspector General says that the US Army “cut corners” when testing body armor according to Richard Lardner of the AP.  This is not the first time – nor is it likely to be the last – that SFTT and major news organizations have reported on the systemic failure of the US Army and DoD to follow established test procedures when evaluating protective gear fielded by our young men and women serving in Afghanistan and Iraq.  

Granted, military vests cost the taxpayers only $434 million, but wouldn’t be nice to think that the military officials who our troops and their families rely upon to provide them with effective body armor would insure that this vital piece of protective gear is properly tested?  

As readers of SFTT are aware, SFTT has chronicled a litany of military procurement and testing failures of those entrusted with providing our troops with best combat equipment possible.

Body Armor Recall

Body Armor Plate Recalls

Congressional Inquiry into Body Armor and Vehicle Safety

GAO recommendations on Body Armor Testing

Broken Military Procurement Process

Congressional Inquiry into Defective Military Helmets and no-bid contract awards

Flaws in M2 and M4 endanger troops in Afghanistan

DODIG sites fault in spare parts for M2 in Afghanistan

Well over a year ago,  SFTT filed a request under the Freedom of Information Act to obtain  forensic evidence of the reliability of ceramic platesused by military troops killed in action with wounds to their upper body.  At every step of the way, SFTT has been stonewalled by DoD lawyers.  It is clear that our military brass doesn’t want the “truth” to get out, because it is fearful that “we (the public) wouldn’t be able to handle the truth.”  Indeed, I am beginning to wonder if any of the beltway bureaucrats really care about the well-being and safety of our troops in the field.

Given the level of scrutiny this flawed body armor has received over the past four years, there are only two possible explanations: gross incompetence or corruption.  The Secretary of Defense and the Secretary of the Army have an obligation to publicly discipline those responsible for engaging in flawed tests and those that defended these test procedures when presented with incontrovertible evidence that test results were seriously flawed.    In a civilian court of law, I would expect nothing less than a charge of  manslaughter.    It’s time to rid our military procurement system of sycophants and untrustworthy officers and civilian contractors who seem to have more interest in their next promotion or their pocket-book rather than the troops who defend our country so valiantly.

In a cycle of budget austerity, let’s get rid of these self-serving bureaucrats.  Enough is enough!

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Military News Highlights: December 10, 2010

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Report: Growing mental health problems in military

Never knew that the Department of Defense publishes a Medical Surveillance report , but even without the findings everyone knows that mental health problems are the number one health issue facing our troops.  That’s a no-brainer. The November report highlighted in this story by CNN points out the fact that mental health issues send male troops to the hospital than any other cause, and are the second highest for hospitalization amongst women troopers. “The Army was relatively most affected (based on lost duty time) by mental disorder-related hospitalizations overall; and in 2009, the loss of manpower to the Army was more than twice that to the Marine Corps and more than three times that to the other Services,” the report says. “The Army has had many more deployers to Afghanistan and Iraq and many more combat-specific casualties; it is not surprising, therefore, that the Army has endured more mental disorder-related casualties and larger manpower losses than the other services.”

 With some patience you can navigate to the MS Report site and review a decades worth of reports – rather startling data.  Consider that there is data that tracks the numbers of deaths (and by cause) within two years after

 Insecurity and Violence Spreads to Northern Afghanistan

Whack-a-mole.  Surge in the south, leave open the north.  Whack-a-mole. Reposition in the north, enemy withdraws south.  Whack-a-mole. NATO has called this “an extreme escalation” of militant activity.  Actually, it’s a simple supply and demand problem and an economy of force issue.  What was once a gunfight that only involved the Afghan provinces in the east to the south in Afghanistan is now a 360 degree fight, where all areas  require more US/NATO forces are evident to the threat and being exploited.  Coupled with criminality and a lackluster Afghan government, the northern (and western) provinces in Afghanistan have become a vacuum for the enemy to operate in with impunity.  Limiting their operations outside of major urban centers the Taliban and their confederates have been able to provide an alternative to the local populace for services, justice, and security, which “allows the instability to spread.”

 Sad to say that the only real option without any operational or strategic effect is to “whack-a-mole”.  In other words hit the enemy wherever and whenever they emerge – problem is, it’s apparent that there are insufficient US/NATO troops to cover and respond to the threat, and Afghan National Security Forces lack the capability to respond in kind as well.

 Following Up: When A Crew Chief Fights With His Rifle

 Warms your heart when you get to read about courage amidst the carnage, especially when these humble acts are by combat medic crew chiefs.

The award recommendation is below:

SGT Grayson Colby, United States Army, distinguished himself by extraordinary courage and dedication to the MEDEVAC mission on 01 June 2010, in support of Regional Combat Team 7 in Regional Command Southwest during Operation Enduring Freedom 10.

While performing MEDEVAC duty at Camp Dwyer, the crew of DUSTOFF 56 (Pilot in Command CW2 Deric Sempsrott, Pilot CPT Matthew Stewart, Crew Chief SGT Colby, and Flight Medic SGT Ian Bugh) conducted MEDEVAC mission 06-01R in central Marjeh. A dismounted patrol of Marines had come under fire, and one Marine was shot in the upper thigh. Within minutes DO56 launched from Camp Dwyer, knowing they were headed for a high threat area. No escort was available due to the multiple troops-in-contact ongoing across Helmand. The Marine would surely die if not evacuated quickly, so the crews acknowledged the risk and were authorized to launch.

As DO56 approached the point of injury, a firefight erupted on three sides of the aircraft. With no aircraft providing cover, the crew continued to the ground without hesitation, determined not to abandon the wounded. Seeing the location from which the friendly forces were engaging the enemy, SGT Bugh and SGT Colby exited the aircraft from the right door where the largest contingent of the Marine patrol was engaging the enemy.

As the two crewmembers egressed from the aircraft, a Marine came out of the tree line in front of them and signaled for them to stay low. SGT Bugh and SGT Colby sprinted 50 meters across the open field toward the Marine’s position where the patrol was locked in an engagement with the enemy. Reaching the raised road where the Marines were taking cover, SGT Bugh found that the unit had no means to transport the injured Marine and returned to the aircraft for a litter. SGT Colby immediately took a defensive position alongside the Marines and began to engage the enemy. With rounds cracking above his head and hitting the dirt around him, SGT Colby returned fire to the muzzle flashes that were approximately 200 to 300 feet in front of him.

When SGT Bugh returned to where SGT Colby was providing covering fire, they bounded as a team down the raised road with the firefight continuing around them. Reaching the wounded Marine, SGT Colby took his place in the line of Marines, replacing one who had left his position to aid his buddy. Again, SGT Colby returned fire with enemy rounds hitting around him. SGT Bugh and three other Marines carried the litter while SGT Colby remained in his position until they were clear of the road. He than followed them down the road providing rear security until reaching the aircraft. With the patient loaded and SGT Bugh and SGT Colby secure, DO56 departed towards Camp Dwyer. Once airborne, SGT Colby assisted SGT Bugh by starting oxygen on the wounded Marine as the aircraft raced back to the Dwyer Role II Hospital. The Marine went through intensive surgery at the hospital prior to being transferred to a higher level of care.

SGT Colby’s disregard for his own safety as he left the security of the aircraft to provide cover for SGT Bugh embodies the Warrior Ethos. His bravery resulted in a Marine’s life being saved. SGT Colby’s actions reflect great credit on himself, TF Shadow, TF Destiny, and the United States Army.

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Military News Highlights: December 2, 2010

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‘Progress Made’ In Afghanistan’s Helmand Province

When interviewed by . Generic drugs that do so should have the same therapeutic effect and therefore the same benefits as their brand-name counterparts, but at less cost.

“But let’s talk a little bit about Marja, because I know that’s one you’ve been following. If you could come over and visit today I would take you down to the district center, where across the street is a very nice restaurant that’s opened up – two dining rooms. You can get a really nice chicken dinner there. There’s three major bazaars in town, all three flourishing. All of the activity now – all the enemy activity in Marja’s been pushed to the perimeter, where a few lone insurgents creep back, usually at night, and try to intimidate some of the locals. And have not done a very good job of it.”

When asked to comment on Sanjin, heartland of the current bloodbath that has claimed the lives of at least 14 Marines assigned to 3rd Battalion, 5th Regiment since mid-September, General Mills made no mention of this sacrifice but commented that, “It’s been tough fighting. It continues to be tough fighting. I think that Sangin is Marja, perhaps five months ago. And we are going to remain focused on that mission up there, and we will win.”

When they start serving chicken dinners in Sangin, I guess the General can claim victory.

The following two news reports from the New York Times add to SFTT’s recent discussion on combat related and sports related head injuries and trauma and the stark difference between the actions taken by the sports industry and lack of action and non-prioritization of these type injuries taken by the Congress, DoD, and the Services.

Scans Could Aid Diagnosis of Brain Trauma in Living

If athletes are subject to chronic traumatic encephalopathy (CET) as a result of sustained head trauma, then it’s obvious that US troops are prone to CET in the future as well due to combat related head trauma.   In fact, Boston-based researchers have developed new imaging techniques that confirmed CET in athletes brains with a history of head trauma.  Currently, CET can only be confirmed through a specialized brain tissue examination after death.  So imagine if you can monitor CET and its symptoms and treat these injuries effectively.  Why wait until you are on the morticians slab to confirm the obvious?  While there is more work to be done with the initial positive results of this new type of imagining and study, the question that remains is whether or not this type of sports/medical science will ever transfer over to DoD and its medical services as it identifies, monitors, and treats troops suffering from TBI. Probably not given their track record.

Ward Calls League Hypocritical on Safety

Maybe Pittsburgh Steelers wide receiver Hines Ward is onto something in his criticism of the National Football League’s recent call and emphasis on safety.  Ward’s take is that the league only toughened its stance because of a pending desire to extend the season to 18 games.   If DoD, the services, and Congress ever wake up and start addressing combat related head injuries and trauma properly maybe it’s because they want to extend the time spent on the battlefield as well.  Nah, just because 2011 turned into 2014 and beyond in Afghanistan doesn’t mean that there is going to be new emphasis placed on improving helmets and reducing head injuries and traumas.  In Afghanistan, its all systems forward without these types of safety and quality of life considerations.  Why should we kid ourselves and believe there was a purpose for “extending the season”.

Department of Defense Headquarters Staff Comparisons (2000-2010)

Senator James Webb requested a pre-and post-9/11 staff comparison of Department of Defense, Services, and Combat Command Headquarter as he studies the Department’s recent decision to axe Joint Forces Command.   After nearly a decade, of the 17 reporting headquarters there has been approximately 11,000 civilian/military staff personnel billets added.  If you only take uniform personnel back into the fold you could man at least two Brigade Combat Teams – imagine that!  Read more from Tom Ricks.

Dragon EOD Squad Leader Sergeant First Class “William”

Just in time for the holidays.  Your very own toy-set of body armor, Advanced Combat Helmet, and an M-4 carbine!  Enjoy!

  • The set is outfitted in the newer ACH, with older style Interceptor body armor in woodland camouflage, and helmet with woodland camouflage cloth cover.
  • Weapon: M4 Assault Rifle or M4 Carbine with Infrared Pointer / Illuminator, Aimpoint optic sight, Forward Hand Grip, tactical light attached under the barrel, retractable / extendable butt stock and removable magazine.
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Military News you may have missed: November 8, 2010

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The narrative is set for the Administrations pending Afghanistan Policy Review slated for this December – who to believe whether sufficient progress is currently being made, the lack of viable options to address the ongoing threat that emanates from Pakistan’s tribal regions, and how soon will Karzai’s government be capable of providing security on its own?   The following news reports provide background on this Gordian Knot.

Some Skeptics Questioning Rosy Reports on War Zone

Highlights:

  •  The recent reports circulating in Washington’s national security establishment about the Afghan battleground of Marja show glimmerings of progress: bazaars are open, some 1,000 children are in school, and a new (and only) restaurant even serves goat curry and kebabs.  In Kandahar, NATO officials say that American and Afghan forces continue to rout the Taliban. In new statistics offered by American commanders in Kabul, Special Operations units have killed 339 midlevel Taliban commanders and 949 of the group’s foot soldiers in the past three months alone. At the Pentagon, the draft of a war assessment to be submitted to Congress this month cites a shift in momentum in some areas of the country away from the insurgency.
  • But as a new White House review of President Obama’s strategy in Afghanistan and Pakistan gets under way, the rosy signs have opened an intense debate at the Defense Department, the White House, the State Department and the intelligence agencies over what they really mean. Are they indications of future success, are they fleeting and not replicable, or are they evidence that Gen. David H. Petraeus, the top United States and NATO commander in Afghanistan, is simply more masterful than his predecessor at shaping opinion?
  • The debate centers on the resiliency of the Taliban and the extent to which the group can rebuild from the hammering it is taking. Most involved say that there are positive trends for the Americans, but that the real answer will not be clear until a new fighting season begins as the weather warms next year.  “The fundamental question is how deep is their bench,” said Bruce Riedel, a former C.I.A. official and now a senior fellow at the Brookings Institution, who led last year’s extended White House review of Afghan strategy that resulted in Mr. Obama’s ordering 30,000 additional United States forces to the country. “By next summer we should have a pretty good idea. If they’re having trouble replacing people that we’re killing on the battlefield, then we’re on the right track. But if by next summer they’re producing new cadres that are on the same order of quality, then we’re in deep trouble.”
  • A former C.I.A. official with longtime experience in Afghanistan said that the recent statements about American progress in Afghanistan reminded him of what was sometimes written about the Russians before they began withdrawing from Afghanistan in defeat in 1988, when they had been at war there for nearly 10 years. “I don’t find many people I talk to who really believe any of this,” he said.  The military’s more positive view is hardly monolithic; doubts also exist within its ranks. The Defense Department’s coming war assessment says that violence once again increased in Afghanistan in the past year, in large part because of the aggressive American military operations in the south, while Pentagon officials readily acknowledge that security has deteriorated in previously quiet areas of the north.
  • “It is certainly true that Petraeus is attempting to shape public opinion ahead of the December review,” said an administration official who is supportive of the general.  “He is the most skilled public relations official in the business, and he’s trying to narrow the president’s options.”  But national security officials across Washington are already saying that the December review will only tweak the policy, not change the strategy, and that the real assessment will come in July 2011, the deadline for the beginning of the withdrawal of American troops. “The bidding is still out,” the White House official said.

SFTT Analysis

  • If the data in December proves that the most effective means of reducing the threat has been through targeted Counter-terrorism (CT) operations versus Counter-insurgency (COIN) operations, then “a shift of strategy” to recalibrate CT with more resources and effort should be considered – ultimately reducing the threat through increased CT will provide more “security” to the populace which COIN strives for.
  • COIN will naturally continue but the focus should be on those areas where gains can be marginally made and be “tweaked” so that the Administration can “off-ramp” forces as scheduled in July 2011.  The “tweaking” in December 2010 should be made to support CT, not vice versa, which reports indicate is the objective.
  • Waiting until July 2011 to determine whether COIN is the proper strategy and then make a decision then may be too late to create the conditions for Afghan Security Forces to take the lead.

 U.S. concerns grow as militants move bases along Pakistan border

 Highlights

  • The U.S. has been trying to stamp out the Haqqani network, which attacks coalition forces in Afghanistan from its base in Pakistan’s North Waziristan region. Now its fighters, fleeing drone strikes, are setting up in the highlands of Kurram. The militant network that is a major Western adversary in Afghanistan is expanding its reach into tribal badlands outside its longtime sanctuary in Pakistan, a move that could complicate U.S. efforts to eradicate the group.
  • Pakistani tribal elders in the Kurram region along the Afghan border say large numbers of fighters from the Haqqani network, an ally of Al Qaeda, have been stationing themselves in the highlands of their rugged district and are demanding the freedom to move in and out of Afghanistan at will to carry out attacks in the neighboring country.
  • American military commanders regard the group as a major roadblock to concluding the nine-year war in Afghanistan. Though the U.S. has endorsed Karzai’s push for peace talks with insurgent leaders, many in Washington see the Haqqani network as inextricably linked with Al Qaeda and therefore irreconcilable.  Haqqani militants have long maintained bonds with Pakistan’s powerful Inter-Services Intelligence agency, which has allowed the insurgents to use the North Waziristan region as their nerve center. A dramatic increase in U.S. drone missile attacks on the network’s compounds and training centers there this fall has helped trigger the movement of the militants during the last two months, experts and Kurram tribal leaders say. Tribal elders in Kurram, who are sectarian rivals of the Haqqani network, say they believe the Islamic militant group views the snowcapped region as an ideal vantage point from which to launch forays into Afghanistan.  Haqqani movement into Kurram could force the United States to expand its missile strike campaign there, a move that might further inflame anti-American sentiment among Pakistanis who see the drone strikes as a gross violation of their country’s sovereignty. Right now, Islamabad tacitly allows the strikes against Al Qaeda, Taliban and Haqqani network targets in North and South Waziristan, and at times even facilitates those strikes with intelligence. 
  • Meanwhile, the appearance of Haqqani network fighters has exacerbated simmering sectarian frictions within Kurram. Large swaths of the region are populated by a Shiite Muslim tribe, the Turi, which has been fending off attacks from local Taliban for years. Like the Haqqanis, the Taliban is Sunni Muslim. The influx of Haqqani fighters has sparked fierce clashes with Turi tribesmen, said Musarrat Hussain Muntazir, a tribal elder.  After the fighting, Turi tribal elders began negotiations with a Haqqani contingent in hopes of ending a four-year, Taliban-imposed blockade of the only road that connects Turi lands in upper Kurram with the city of Peshawar, northwestern Pakistan’s major hub. The blockade has forced Turi villagers to take a circuitous, 230-mile trek into Afghanistan’s eastern provinces and then back into Pakistan in order to buy supplies or get to a hospital.
  • Pakistan, which regards the Haqqani group as a valuable hedge against Indian influence in a post-U.S. Afghanistan, has so far resisted repeated urgings from Washington to launch a major offensive against Haqqani network hide-outs in North Waziristan. A U.S. offer to Pakistan of $2 billion in military aid is seen by many as an incentive for Pakistan to mount an attack on the Haqqani network. Pakistan has told the U.S. it will eventually carry out that offensive, but only when it believes the time is right.  “I think they’ll start the operation,” said Hussain, the think tank analyst, “once every single fighter has moved out of North Waziristan and into Kurram.” 

SFTT Analysis

  • Too often the numerous threats to Afghan stability are labeled as “Taliban”, which can distort the “purpose” of the mission while failing to properly address the scope of the conflict – the Haqqani network is an example.
  • If it is true tha the Haqqani network is decamping from current safe-havens to the Kurram Agency, then critical intelligence and targeting resources that are currently fighting under economy-of-force constraints, may have to shift from the South to the East to counter the network while delicately balancing Af-Pak-US relations. 

Pentagon chiefs: Afghans can manage by 2014

Highlights 

  • Afghanistan should be ready to handle its own security by the year 2014, the top U.S. defense chiefs said Monday.  Defense Secretary Robert Gates and Joint Chiefs of Staff Chairman Adm. Mike Mullen said NATO should endorse the 2014 timeline proposed by Afghan President Hamid Karzai when the alliance holds its annual summit later this month. “As a target at this point that makes sense, so I am comfortable with it,” Mullen said. The 2014 date would give a symbolic deadline for ending the war and bringing most combat forces home. The war is already in its 10th year and unpopular in the U.S. and Europe.
  • U.S. responsibility will extend for years, Gates said Monday.  President Barack Obama and other NATO allies will consider plans for transition of security control at the November 19-20 summit in Lisbon, Portugal. Although Gates had once said he hoped a few districts could be transferred this year, NATO is now looking at beginning the process in the spring. U.S. officials say the war is beginning to turn around after two years of stalemate. Although eager to underscore that claim of progress by handing over some security control, military officials are worried about backsliding. The first districts to move under Afghan police and Army control will probably be in safer areas far from front line fighting in Helmand and Kandahar provinces.
  • Gates also said that although he welcomes preliminary talks between the Taliban and the U.S.-backed Afghan government, the insurgency isn’t likely to cut a deal unless it is weakened further. “The Taliban need to clearly see that the prospects for success have diminished dramatically, and in fact that they may well lose,” before senior leaders would be ready to negotiate a lasting political settlement, Gates said. That tipping point would be difficult to foresee at least until next spring, Gates added. The Taliban deny they are being beaten down.

SFTT Analysis

  • The fight in Afghanistan has metastasized to an all encompassing Afghanistan wide provincial 360 degree – north, south, east, and west.  Every province and every district.
  • The start of transferring a few districts to Afghan control was supposed to begin in 2010, but will not begin until spring 2011. If NATO/ISAF cannot hand off a “few” districts anywhere in Afghanistan until spring, then clearly this is another indicator that the “progress” being made is at odds with the reality on the ground.  Not a single district!
  • A “symbolic” deadline for ending the war and bringing most combat forces home by 2014 does not make sense nor should we feel “comfortable” about it.  A sooner date would force Karzai and the Afghan Security Forces to prepare for and accept responsibility for security.  2014 appears to be a Karzai proposal –when will the US and NATO stop coddling him and tell him “no” for a change?
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Bloody Sunday: 16 (US Troop Casualties) vs. 6 (NFL Player Casualties)

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 I follow football.  High School, College, Professional – all levels, all kinds. It’s a blood sport.  So there was no way I could ignore the blaring RSS feed headlines on Monday morning announcing that this past weekend’s games will be forever known as “Bloody Sunday.” Sports Illustrated football analyst Peter King reported that “Last Sunday could go down as a seminal moment in NFL history,” because of the injuries sustained on the playing field and the impact on future play, rules and equipment.  The Vice President of Operations for the NFL, Ray Anderson, said that “We’ve got to protect players from themselves” as a result of the violent day.

I also follow the war and the troops.  You know, the ones who allow us to watch sports on weekends without having to worry about some mushroom cloud or Mumbai-style attack here on American soil.  The ones out there protecting that freedom thing, right? 

But, “Bloody Sunday” in the NFL?  Six vicious and violent hits?  Four concussions?  A couple of broken bones?  Oh, my . . . especially compared to how “Bloody” it was in Afghanistan last week.  And compare the changes the NFL is making for head injuries sustained by players, to DOD’s lack of concern for frontline troops.

Since January 2010, on average, 15 troops have been wounded in Afghanistan every single day.  Every. Single. Day. Period.  Simply put, that’s a lot of bloody days.  This past Sunday, there were 15 wounded troopers, and sadly, one killed in action; that equals 16 casualties.  Bloody indeed!  But maybe last Sunday in Afghanistan was simply a bad day, so for some perspective, let’s add up all the casualties from last week.  On average, there were over 100 troopers wounded in action, and 18 US service members paid the ultimate sacrifice and were killed in action.  15 deaths resulted from IED strikes, and 3 deaths resulted from hostile fire.  Of the 15 deaths resulting from IED strikes, 4 were killed in one vehicle, 3 were killed in another, and 2 were sharing another vehicle when they were killed by IED’s.[1]  Statistics that detail the type and extent of the more than 100 wounds suffered are not available (or accurate).  However, we can pretty safely assume that the troopers that survived IED blasts in Mine Resistant Ambush Protected (MRAP) vehicles suffered some type of mild-to-severe brain injury—or at the least were concussed—and  that these injuries clearly outpaced those suffered by football players last week. 

I’m comparing head trauma in football and combat, because everyone involved is wearing a helmet.  And if on a given Sunday, the spike in head trauma injuries prompts immediate change in policy and a new commitment to equipment upgrades by the NFL—but not the Department of Defense—then it seems to me that we should all take notice.

So what actions did the NFL take? The concern from head injuries and concussions forced the NFL to impose huge fines on three players this Tuesday for dangerous and flagrant hits and warned the league that violent conduct will be cause for suspension.  It only took the NFL 48-flipping-hours!  And I guarantee that helmets, padding, chinstraps, buckles, screws and straps for every single NFL football helmet is being inspected by equipment maintenance personnel and will be carefully repaired, replaced or some new whiz-bang safety component will be added.  I also guarantee that any and all big-contract players who suffered the slightest head injury have received top-shelf medical care and will most likely be forced to sit out a game or two to protect their team’s “investment.”

So what was the response from the Pentagon after last week’s bloody fray in Afghanistan?  Not a peep except to update the casualty data base and keep issuing sub-standard Advanced Combat Helmets to troops.   From what the troops report to SFTT, some troops obviously get Medevac’ed out of theater due to the severity of their injuries; but some don’t.  And for those who weren’t, maybe the mission profile will allow them to take a one-day or two-day respite from being outside the wire.  But probably not, in line with the old adage, “Every man strengthen the north wall.”  Most ludicrous is the appalling fact that no comparison can be made between frontline troops and NFL players regarding the quality of available medical care, the amount of investment in science and technology to improve the equipment and the commitment to provide long term treatment for traumatic brain injuries.  Must be nice to play in the NFL, and that is the bloody truth!


[1] Department of Defense and icasualties.org data.

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DoD Shell Game?: You be the judge.

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DOD Shell GameCan anyone tell me exactly how many US servicemembers are currently deployed in Iraq and Afghanistan?  How about the number of Americans in uniform on 9/11? Or the number serving in uniform today?  Does anyone know the total number of servicemembers deployed to Afghanistan over the past 9 years?  Deployed to Iraq since 2003?  I’m asking these questions because all I’ve been hearing since “combat operations” ended in Iraq on September 1st is that “the troops are coming home.” Let’s take a reality check re: the number of troops still on the frontlines and then you decide if all the redeployment happy talk rings true.

When we first took stock of our military capabilities the day after 9/11, there were 1.37 million Americans serving in the military with just over 200,000, or about 15%, deployed overseas in static positions. The shell game since then has gone something like this:  The initial force deployed to Afghanistan in 2001 was 13,000 and increased to a stable force of 20,000 through 2005,  then increased to 23,000 in 2006, to 26,000 in 2007 and 2008, to 67,000 in 2009—and today Afghanistan fields approximately 100,000 US troops.  In 2003 the US invaded Iraq with approximately 175,000 boots on the ground; between 2004-2007, deployment averaged 150,000.  The 2007 troop “surge” increased the total to its peak strength of 197,000 and returned to approximately 150,000 by summer 2009.  Today, there are approximately 50,000 troops deployed in Iraq supporting Operation “New Dawn”. 

Taken as a whole, the number of troops deployed inside Iraq and Afghanistan over the past 9 years averaged approximately 225,000; the total today is 150,000.  This boots on the ground number does not include 28,000 personnel and logistic support assets deployed in Kuwait that has remained constant since 9/11.  Nor the requisite sea and air assets in the region supporting these operations, which totaled approximately 75,000 during this same period.  Even if we were to round down the numbers, we are still at 253,000 troops deployed supporting operations exclusively in Iraq and Afghanistan, while another 175,000 are deployed in static positions world-wide supporting other missions, contingencies and treaty obligations. 

The bottom line:  Don’t believe it when you hear “the troops are coming home,” because they’re not.  We still have 50,000 troops deployed in Iraq, 29,000 troops deployed in Kuwait, 100,000 troops deployed in Afghanistan, 75,000 airmen and sailors deployed in the region supporting operations and an additional 175,000 military personnel deployed world-wide.  We’re talking approximately 419,000 troopers deployed in perpetuity from an available end strength of 1.4 million—a third of available US combat power—or a sustained 50% increase since that fateful September day over nine years ago. 

But there’s more to consider.  Since 9/11, the Army has “grown” from 480,000 to 569,000, an 89,000 Soldier increase, while our beloved Marines have ratcheted up their numbers from 172,000 to 202,000 for a 30,000 Devil Dog increase.  Why does this matter?  Because we increased our boot end strength only 119,000 over nine years or less than 10% of our total force, while keeping over 35% of our total forces deployed at any given time during this timeframe.  And remember, the majority of the 35% total have been repeatedly deployed and engaged in combat operations. 

So again, no matter how you work the numbers, “the troops are coming home” is pure spin. The harsh reality is that the troops remain deployed and strategically exhausted. And while the drawdown in Iraq is welcome news,  for every two troopers the US drew down, one returned stateside, the other deployed to Afghanistan or elsewhere. 

As I reviewed these numbers from a host of open source and non-Wiki documents available on Department of Defense websites, I decided to fact check them with an inside-the-Pentagon planner who confirmed my math.  His take on the propaganda went something like this: “. . . deployment numbers are really like a shell game . . . try to follow the shell with one pea hidden underneath it . . we’re moving some over here, and there, and then over there, and then back again . . . repeat and distract the player with song and dance . . . and guess what?  Normally you would turn over all the shells and find at least one pea under one shell.  However, now the rules have changed and the powers-that-be will lift up all the shells, but hide the pea.”  He’s got that right, it’s a new shell game.  No one really knows how many troops are deployed, and no one really knows when they’re coming home.

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