The Department of Veterans Affairs and Service Dogs

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The Department of Veterans Affairs (“the VA”) receives considerable public criticism for its failure to provide service dogs to Veterans with PTSD and TBI.

As reported earlier by SFTT, the VA provides service dogs to blind Veterans, but has balked at providing service dogs to Veterans who are less than totally physically disabled.  The recurring argument from VA spokespeople is that there is a lack of “clinical evidence” to support the benefits of service dogs.

service dogs for Veterans

Consider this testimony by Dr. Fallon of the VA:

“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.”

The argument is a brief synopsis of Dr. Fallon’s testimony to the House Subcommittee and Government Reform provided in April, 2016.

Dr. Fallon’s testimony and defense of the VA’s status quo is similar to the testimony of Dr. David Cifu on PTSD therapy and Dr. Alvin Young (aka Dr. Orange) on the lethal side effects of Agent Orange used on the deforestation of Vietnam.

The VA has set itself up as “judge and jury” to determine what range of medical services it will provide to Veterans.  Any “new” therapy that has not been blessed by “evidence based medicine,” is summarily dismissed by the gatekeepers at the VA.  In fact, the VA often uses spokespeople and expensive long-term clinical studies to avoid providing much needed therapy to Veterans.

Furthermore, there is strong evidence to suggest that the DoD purposely manipulated testing procedures on hyperbaric oxygen therapy (“HBOT”) to produce clinical outcomes more to their liking.

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

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

Veterans Affairs Fails at PTSD

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

While the general public and Congressional leaders may buy the pitch from VA Spin Doctors, Veterans are seeking other forms of therapy outside of the VA.  The problem is that few can afford to do so.

The Case for Service Dogs for Veterans

Training a service dog is relatively expensive.  Most estimates suggest that the cost of training a service dog to be in the neighborhood of $20,000.  The training of a dog can last some five months after the dog reaches maturity (about six months) to another 18 months depending on the rigorousness of the training.  In addition to training the dog, the Veteran needs to spend a considerable amount of time with the service dog to develop an effective relationship.

As we reported earlier, Maj. Ben Richards spent seven weeks in intensive training with his new service dog, Bronco.  According to Ben, it was about 4 hours of training a day (generally in the morning) and a few weekend sessions.  Taking into account “training the Veteran” could add considerably more to the overall cost.  For those interesting in learning more about the steps involved in training a service dog, I refer you to this excellent FAQ provided by Psychiatric Service Dog Partners.

While the VA currently does authorize the use of service dogs for Veterans, many State and charitable organizations have sprung to the support of Veterans.  In addition to Ben’s heartwarming story, many other Veterans have benefited from the companionship of service dogs.

Several organizations like 4PawsforAbility and Train a Dog and Save a Warrior,- SFTT Rescue Coalition Partner – are actively training and providing service dogs to Veterans.  These organizations and several others rely on the generous contributions of others to support our Veterans.

While the VA continues to study the benefits of service dogs, new results are not expected until 2019.

One might justifiably ask why it takes the VA 9 years to study the benefits of service dogs for Veterans with PTSD (yes, Congress mandated a study in 2010), but Dr. Fallon and the VA spinmasters will provide you a compelling answer if you are naive enough to buy it.

Based on the sound work of many charitable organizations training service dogs, it is beyond reasonable for the VA to soft-peddle its failed therapy programs and help these struggling organizations provide service dogs to Veterans.  Wouldn’t it help provide “real” evidence to support their long overdue study?

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Veterans with PTSD: The VA Way or the Highway

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

Department of Veterans Affairs

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

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

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

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

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

FAKE NEWS from the VA on Veterans with PTSD

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

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

– Cognitive Behavioral Therapy (“CBT”)and,

– Prolonged Exposure Therapy (“PET”).

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

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

REALITY CHECK at the VA

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

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

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

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

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

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

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

Finding a Middle Ground for Veterans with PTSD?

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

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

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

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

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

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

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

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How the VA Callously Treats Veterans: A National Disgrace

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As we reported earlier, Veteran Eric Bivins committed suicide after being unable to find the support and care he needed from the Department of Veterans Affairs (“the VA”).

Found below are a moving – AND MOST SAD – series of videos by Kimi Bivins, Eric’s spouse which describes her experiences with the VA in attempting to find the proper care for her husband.

Kimi’s experiences with the VA are not dissimilar from my own and countless of others who have sought care from the VA. I agree with Kimi that it is a “national disgrace,” yet the VA continues to remain largely unaccountable for their callousness and disdain in treating our brave warriors.

I would encourage readers to watch these powerful videos to understand the frustration and agony of a loved-one in dealing with the VA.

Kimi’s YouTube videos are presented in a more or less chronological order, with limited commentary by me other than to clarify certain expressions.

Published on March 23, 2016. Kimi’s Initial PRIVATE Appeal for Help.

Published on March 10, 2016. Kimi’s Frustration on Getting VA Paperwork

Published on March 18, 2016. Eric in a VA Facility

Published on March 23, 2016. Eric is Coping, but Life is Still Very Difficult

Published on April 13, 2016. Eric at Independent Treatment Facility.

Published on May 15, 2016. Eric is Better, But Seeks Therapy Outside the VA

Published July 11, 2017. After Eric’s Suicide

While many will be shocked by these series of videos, it is far too commonplace within the VA.

Before Eric’s suicide he had been accepted into a program to receive hyperbaric oxygen therapy or HBOT.  I credit HBOT with saving my life and enabling me to begin the long road to recover my life.

It is sad that some uninformed doctor at the VA would shatter Eric’s dream of life-changing therapy by parroting the VA’s institutional bias against HBOT.

Dr. David Cifu and his cronies at the VA and the DoD have done their upmost to discredit HBOT and other alternative therapies to support the failed VA programs of Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”).

Failed VA therapy programs to treat PTSD have been documented numerous times by credible independent studies.   And yet, VA spokespeople still parrot the same stale party line.  Veterans with PTSD and TBI are not deceived and have abandoned the VA in droves.

It sickens me to watch these tragic videos of Kimi documenting her fruitless attempt to navigate the uncaring bureaucracy of the VA.  In my estimation, Kimi’s videos should be mandatory training for all employees at the VA.

While the VA provides much needed comfort to thousands of Veterans, those Veterans with PTSD and TBI need to look elsewhere for REAL therapy.

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Meet Maj. Ben Richards and Bronco, his Service Dog

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

Maj Ben Richards and Service Dog Bronco

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

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

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

After the service dog has successfully completed his training, the certified service dog is then introduced to his/her human companion.  Ben spent seven weeks in intensive training with Bronco.  According to Ben, it was about 4 hours of training a day (generally in the morning) and a few weekend sessions.

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

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

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

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

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

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

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

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

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

Our brave men and women in uniform deserve better.

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Did the VA Hook Veterans on Opioids?

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Recent information suggests that 68,000 Veterans are addicted to some form of opioid (hydrocodone, oxycodone, methadone and morphine).  The VA argues that “more than 50 percent of all veterans enrolled and receiving care at the Veterans Health Administration are affected by chronic pain, which is a much higher rate than in the general population.”

Oxycontin and PTSD

According to the Center for Investigative Reporting obtained under the Freedom of Information Act,

. . . prescriptions for opioids surged by 270 percent between 2000 and 2012, leading to addictions and a fatal overdose rate that was twice the national average.

Citing a VA Office of Inspector General’s report, the Center for Ethics and the Rule of Law (CERL) said: “Between 2010 and 2015, the number of veterans addicted to opioids rose 55 percent to a total of roughly 68,000. This figure represents about 13 percent of all veterans currently prescribed opioids.”

The American Society for Addiction Medicine reports these startling facts on the opioid epidemic currently sweeping the U.S.

– Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.

– From 1999 to 2008, overdose death rates, sales and substance use disorder treatment admissions related to prescription pain relievers increased in parallel. The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

While evidence provided by the Center for Controlled Disease and Prevention (CDC) suggests that the use prescription opioid painkillers has fallen some 41% since its peak in 2010, some 33,000 Americans died last year from addiction to opioids.  The addiction to prescription painkillers like Vicodin (hydrocodone) and Percocet (oxycodone) are rampant in the U.S.

The VA and Prescription Drugs for PTSD

For well over 5 years, Stand for the Troops (“SFTT”) has been reporting on the Department of Veterans Affairs (“the VA”) fascination with potent prescription drugs to treat Veterans with PTSD.

Despite the VA’s dismal record in effecting any meaningful change in patient outcomes, a cocktail of prescription drugs (generally opioids) are often the last resort since the VA’s Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) treatment programs have proved largely unsuccessful.

In what continues to be standard SOP, the VA perseveres in treating the symptoms of PTSD without offering any compelling life-changing treatment alternatives.  In effect, the VA is tacitly admitting “we don’t have a clue,” while arguing that they are providing the best therapy available and to seek funding for new “clinical” studies that address symptoms and not causes (i.e. cannabis, for instance) of PTSD and TBI.

In our research (mostly anecdotal but with those “in the know”), SFTT discovered that many Veterans treated with prescription opioids for PTSD would become violent and often suicidal.  In fact, they would often either discard these potent drugs (“flush them down the toilet”) or sell them on the black market to civilians.

One former Veteran explained that his colleagues would often grind up oxycontin pills into a powder and sell it on the black market for approximately $500 a month.  So prevalent was this behavior, that the government forced a large pharmaceutical company to produce oxycontin only in gel.  The result:  sales at the pharmaceutical company dropped 60% once the black market disappeared.

Personally, I think the FDA and the pharmaceutical industry effectively colluded into turning many Veterans and a large percentage of our population into junkies.

The Rationale?:  The level of addiction in the U.S. and easy access by the public to potent prescription drugs is simply unprecedented if compared to other countries.

How to Fix the VA’s Opioid Credibility Problem

It is sad to read the daily stories of spouses and loved ones deal with ravages of PTSD.  A few days of reading the Facebook page of “Wives of PTSD Vets and Military” will give you some idea of the ravages of the silent wounds of war.

Sure, we can continue to medicate these Veterans and military personnel with prescription drugs to deal with the symptoms, but I would far rather see an attempt to reverse the causes of debilitating brain injury rather than mask the symptoms.

There are several noninvasive solutions used by other countries.  First and foremost is hyperbaric oxygen therapy or HBOT that is widely used by the IDF.  For reasons that seem incomprehensible, the DoD claims that there is no scientific evidence to suggest that HBOT is effective.

Gosh, there doesn’t seem to be much evidence that suggests that prescription opioids, Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT) are effective either.  Yet, the VA continues to push it’s stale and misleading agenda that it is providing our Veterans with the best available treatment programs.

Surely, we can do better than “talk the talk.”  Let’s look for real solutions.  If it can’t be found in the VA, let’s give the private sector an opportunity to help our brave Veterans.

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What do NFL and Military Helmets Have In Common?: Not Much!

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Like many, I am moved by the tributes paid to military Veterans and active service members at NFL games.  Nevertheless, both the NFL and the military have come under sharp criticism regarding the number brain injuries suffered on both the playing field and battlefield.

chronic_traumatic_encephalopathy

Both the NFL and military have stonewalled the problem for many years, but it now appears that the NFL is taking action to introduce a “safer” helmet in the hope that they can reduce concussions and permanent brain injuries for professional athletes. Hopefully, better protective gear will work its way through college and high school football programs.

The Vicis Zero1 helmet has now been purchased by 25 NFL teams and will be introduced during the 2017 season. According to initial press releases:

In testing against 33 other helmets to measure which best reduces the severity of impact to the head, the Vicis ZERO1 finished first. Included in the study were helmets from Schutt and Riddell, which currently account for approximately 90 percent of helmet sales.

Vicis was founded by neurosurgeon Sam Browd and Dave Marver, former CEO of the Cardiac Science Corporation, with the goal of reducing the high rate of concussions in football. While it would take years of play and further studies to conclusively prove that they’ve been successful, the studies show that they’re on their way to making an impact.

Found below is a video explaining how this helmet helps provide additional protection to football professionals:

While the safety requirements for battlefield and football helmets differ significantly, it does appear that the NFL has acted a lot quicker than the military to protect its professionals.

Reducing brain injuries at their point of origin is far preferable to treating neurological damage to sensitive brain cells in the aftermath.

The US Army – and other DoD components – have long been aware that current helmets offer battlefield personnel little protection against IED devices typically found in Afghanistan and in the Middle East.  Indeed, SFTT has been reporting on various studies by the military embedding sensors into military helmets.

According to my calculation, the US Army has over 10 years of sensor data to draw on.  Surely, this is sufficient to draw some conclusions and develop a better-designed helmet capable of providing additional protection against concussive brain injury.

While the military continues to “study” the issue, it is encouraging to see the NFL to take action.  Frankly, I don’t buy the NFL sales pitch that the league rushed in to protect the health and safety of its players.  If true, they would have done so long ago when the NFL first started studying brain injuries.

As the New York Times reported earlier, the NFL leadership buried extensive “concussion” evidence collected between 1996 and 2001 to deflect potential claims by former NFL players who had suffered brain damage.

As we have seen in the case of body armor,  DoD leadership and the NFL have much in common:  a strong propensity to hide the facts from their employees and the public at large.

While one can find many faults in the way the NFL leadership has acted “to protect the safety of its players” and the integrity of their franchise, NFL teams are now treating brain injuries far more seriously than the DoD.

In addition to helmets, several NFL teams are now treating players with suspected brain injury with hyperbaric oxygen therapy (HBOT).    Sadly, the Department of Veterans Affairs continues to block the use of HBOT in treating Veterans with PTSD and TBI.

Could it be that DoD personnel charged with evaluating HBOT therapy failed to employ the proper protocols in 2010 clinical testing procedures?  If so, why?

SFTT remains hopeful that both the VA and the DoD will act quickly to introduce helmets that afford more protection to battlefield personnel and approve HBOT as an acceptable treatment procedure for PTSD and TBI.

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Hyperbaric Oxygen Therapy (HBOT) by Grady Birdsong

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Hyperbaric Oxygen Therapy HBOT Grady BirdsongGrady Birdsong, a USMC Veteran from Vietnam, has co-authored a book with Col. Robert Fisher (USMC – Ret) that deals with hyperbaric oxygen therapy (“HBOT”) entitled “The Miracle Workers of South Boulder Road:  Healing the Signature Wounds of War.”

The book is a 2016 Best Book Awards finalist and details how HBOT helps reverse the damage of traumatic brain injury.   In a must-hear interview, Grady Birdsong explains his experience with HBOT (and now his advocacy)  to Jerry Fabyanic on his “Rabbithole” program at KYGT in the Idaho Springs/Denver area.

Grady Birdsong spikes up interest in hyperbaric oxygen therapy with a down-to-earth radio interview with KYGT Radio with the following introduction:

In our advocacy campaign to make this clinic and treatment known, I had the good fortune of being interviewed on KYGT Radio over the weekend by Jerry Fabyanic on his “Rabbithole” program in a mountain town close to Denver. He has so graciously provided me with a link to that interview about our book. We most gratefully appreciate his voice and his audience at KYGT in the Idaho Springs/Denver area. Likewise my close friend and veteran Marine, David T. “Red Dog” Roberts, 1st Bn, 4th Marines, Delta Company in Vietnam and his Doc, Corpsman, Kenneth R. Walker produced two songs that are complementary to this advocacy of healing the signature wounds of war. You will hear them in the interview.

CLICK HERE for the entire and very educational 50+ minute podcast.

SFTT has long recommended the use of hyperbaric oxygen therapy or HBOT to treat Veterans with the symptoms of PTSD and TBI.  There are many studies that prove conclusively that the supervised application of HBOT helps improve brain function and restores cognitive abilities.

While Mr. Birdsong points out the many restorative benefits of HBOT, follow-up supervision is recommended to help deal with some of the symptoms of PTSD.

Sadly, in many online forums dealing with the ravages of PTSD, most military families are unaware of the benefits of regular supervised “dives” in HBOT chambers.  I would argue that the Department of Veterans Affairs has purposely discredited the use of HBOT in treating PTSD and TBI to promote their own failed agenda and the prevalent use of addictive prescription drugs.

One only needs to listen to the likes of Dr. David Cifu, Senior TBI Advisor to the Department of Veterans Affairs, to see the cynicism and blatant disregard for clinical evidence adopted by the VA against HBOT.   One can only speculate why, but HBOT seems to offer Veterans a far better solution than the cocktail of drugs served up by the VA.

Found below is a very moving and instructional video by Grady Birdsong of a young woman who “recovered her life” from the “signature wounds of war” with the use of HBOT:

Thanks to the effort of Grady and many other dedicated Veterans, we can all join together and help Veterans reclaim their lives. It is simply the right thing to do!

Nevertheless, the benefits of HBOT will not be widespread until the restrictive and self-serving barriers to this treatment are adopted and encouraged by the VA. Secretary Shulkin of the VA wants change to occur at the VA.  What better way to demonstrate his commitment to reducing Veteran suicides than by embracing HBOT to treat PTSD?

If you want to learn more about how HBOT can be used in treating PTSD and TBI, I suggest that you purchase The Miracle Workers of South Boulder Road:  Healing the Signature Wounds of War.  Share it with family and friends to encourage them not to give up hope on our brave Veterans.

For those tired of watching the lives of loved one end in pain, depression and hopelessness; write Dr. Shulkin and members of Congress and ask for action.  Don’t allow naysayers and self-serving bureaucrats like Dr. Cifu block Veteran access to HBOT.

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Saluting our Veterans on Memorial Day

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Memorial Day

As we gather together to celebrate Memorial Day, I am struck by the outpouring of love and heartfelt admiration for the men and women in uniform – past and present – who have served our country so valiantly.

Often overlooked as we celebrate Memorial Day are the spouses, family and loved ones who continue to support Veterans and active duty personnel with debilitating injuries.

Stand for The Troops would like to acknowledge these courageous men and women who labor on so courageously in providing daily care to loved ones who are no longer quite the same person they were before combat.

On this Memorial Day, SFTT would like to list several organizations that continue to provide great service to our Veterans, particularly those suffering from Post Traumatic Stress Disorder (“PTSD”).

Hyperbaric Oxygen Therapy (“HBOT”)

The Department of Veterans Affairs (“the VA”) continues to block the use of hyperbaric oxygen therapy or HBOT in treating Veterans with PTSD.  Nevertheless, Dr. Paul Harch and many others continue to provide FREE or greatly discounted treatment to Veterans suffering from PTSD.

More to the point, Dr. Harch and many other evangelists go out of their way to promote the benefits of using HBOT to treat PTSD.    On this Memorial Day weekend, SFTT remains hopeful that Dr. David Shulkin, Secretary of the VA, will begin providing Veterans with better treatment alternatives, such as HBOT.

It is time to rid the VA of institutional dogma based on self-serving agendas and seek real solutions that help Veterans with PTSD and their loved ones.

Archi’s Acres, Escondido California

Karen and Colin Archipley have dedicated their lives to helping Veterans recover their lives by providing training in “sustainable organic agriculture.”  At Archi’s Acres, students receive a six-week course in hydroponics, drip/micro irrigation, environmental control, soil biology, composting and much more.

We tip our hat to both Karen and Colin for having the imagination and perseverance to help provide Veterans with an opportunity to acquire new skills on their road to recovering their lives.

Wives of PTSD Vets and Military

I often come across some inspirational stories of families coping the ravages of PTSD on a Facebook Page entitled “Wives of PTSD Vets and Military.”  While depression and a sense of helplessness affects many Veterans (active duty personnel), their caregivers often bear the brunt of their frustration.

There are many similar Facebook Page support groups such as “PTSD:  The Wives Side,” but all provide some useful advice in helping loved ones cope under circumstances that are most difficult to comprehend.

This Memorial Day my thoughts and prayers go out to caregivers that do much of the heavy day-to-day lifting,

This is not an easy journey.  Frankly, we must move beyond coping and do everything possible within our power to help our brave Veterans recover his or her life.  Only by doing so, will we be able to recover our own.

On this Memorial Day, I wish all resilient warriors the strength and courage to continue to support our Veterans.

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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.

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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.

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