Major Ben Richard’s at Bacon Brothers Concert

Posted by:

Dear Friends,

Major Ben Richards New York Times

This is to reintroduce the amazing Major Ben Richards, a true hero for our time and an amazing American.  He led his men bravely and nobly in Iraq, then returned home only to have to continue fighting for his mental, physical and emotional health.  Which leads to my painful confession:  I read the NY Times – and first encountered Ben in a powerful op-ed piece by Nick Kristoff that spoke to the terrible truth:  22 Vets commit suicide every day.  I beg you to stop and think about it.  We are talking over 7300 American heroes a year killing themselves as a direct result of their service to our country.

Tears streamed down my cheeks as I read about Ben Richards; I quickly reached out to Ben as soon as HBOT (hyperbaric oxygen) expert Dr Paul Harch agreed to pro bono treatment for Ben; based upon the miracles I’d read that Dr Harch achieved in his self-financed clinical trials treating Vets, I had a very strong feeling he could and would help.

Ben wisely went off to New Orleans for immediate treatment – thanks here to both Dr Paul Harch and his wife Juliette Licarini as well as a group of New Orleans area West Pointers who answered our SFTT President General John Batiste’s plea for housing and ancillary support donations.

After two sets of 40 HBOT dives (plus about 8 more on an as need basis), Ben, as a result,  has begun to reclaim his function and his life to the point he can write about it below.

And in fact, he is joining John and me in Washington, DC on stage at GWU’s Lisner Auditorium next Saturday, March 22, at 7pm where General Pete Chiarelli, former Army Vice Chief of Staff, will present him with the Purple Heart for his invisible TBI wound at the beginning of an incredible show headlined by  the wonderful bluesy rock of The Bacon Brothers (Kevin and Michael Bacon) Band, super comic Jim Breuer’s zany lovable humor, and the talented gifts of Buskin (my adopted bro and show-runner) & Batteau, Bucky Pizzarelli & Ed Laub and Tom Prasada-Rao.

All volunteering to benefit SFTT’s lifesaving work!

Tickets are purposefully very reasonable – we want all our present and future friends and supporters and those who might need our help to join us.  And if price is an issue, please do get in touch with Maura at sftt.org and we’ll try to help.

Over,

Warrior’s Widow

An Update from Major Ben Richards

It is dark outside now. Farrah and I have completed another evening’s bedtime ritual of teeth brushing and story reading. Our four children are finally all in bed. I am in the room in our home appropriately labelled as a den. It is dark in here, too. The lights in the room are off. My computer screen is dimmed so that I can just make out the words as I type them. There is a lamp, but I only turn it on when necessary and then only as long as needed.

The most proximate reason this self-imposed blackout is necessary is the three windows on one wall of the room. In daytime these windows offer a therapeutic vista of the trees and flowering bushes that accessorize the front lawn, the fluttering American flag that garrisons a post over-watching the driveway and farther on the ubiquitous Iowan cornfields and the few houses and outbuildings on our semi-rural lane– a location where we selected to live because of its paucity of windows compared to a typical neighborhood. As daylight retreats, each evening the windows abandon their therapeutic role to assume a more pernicious part, picking at the lock to a disordered part of my mind where my demons lurk. The doctors call it Post-Traumatic Stress Disorder (PTS). I call it Fear.

The problem is that at night I cannot see out of the windows but “they” can see in. “They” are sighting in for a headshot that will snuff out my life so quickly that I may never realize that I am dead. “They,” of course, do not exist. At least not today.  Not here.  The ordered part of my mind knows that, but there is a disordered part of my mind that I cannot convince. I have spent years working with professional assistance to persuade it, but that disordered part of me is still afraid.  Really afraid. A few times I have forced myself to stand in front of the window at night with the lights on in the room, silhouetted in the light for anyone to see, in a kind of self-imposed experimental exposure therapy. Like a game of chicken against myself. I always lose.  The sweat bears testimony.

They may not be here now, but I can assure you that years ago in a different place, they definitely were there.  It was a place where firefights were part of the daily commute, where there were more IEDs than STOP signs, more suicide bombers than taxi cabs, and wanna-be snipers pursued you with the persistence of a hunter stalking a prize buck.

I am not a particularly tough or brave person. A few years ago, I might have gone to great lengths to convince you otherwise, but I have had the privilege of knowing too many tough and brave men and women to now claim otherwise. One was my neighbor Vinny. A great man with a Puerto Rican heritage and a New York name, Vinny had served as a Force Recon Marine in Vietnam. Our adjacent homes backed into a few acres of woods. The occasional rain storm over the woods loosed the disordered, dark places in Vinny’s mind– unhealed by the decades– where the memories of mortal danger and survivor’s guilt mingled with images of monsoon-soaked woodlands.

Unlike Vinny, most of my traumatic experiences were set in the large cities of Baghdad and Baqubah. Woods and rain have no effect on me, but I struggle with windows. Every day for months I was surrounded by hundreds of windows, each a possible firing position for an al Qaeda or Jaysh al Mahdi terrorist. Almost every day we engaged in firefights with the often unseen insurgents behind those windows. So at night, safe in my own home, I still feel compelled to slink around the windows, often standing aside while closing a blind or curtain before moving across a room.

I admit to having been afraid before. There have been times when the my higher brain functions have been laid under siege by the nearby buzz of an angry swarm of AK near misses intermixed with the drumming staccato of machine gun fire against my Stryker’s armor and punctuated by the occasional sharp cracks of the high velocity bullets from Russian-made sniper rifles. Fear would begin to immobilize my limbs and freeze my ability to think.  For weeks after a suicide bomber exploded a sedan filled with explosives against my Stryker armored vehicle, I felt my knees weaken to the point of failure every time we drove past the site where the attack took place. Too many times I watched one of my troopers consumed within an explosive mushrooming pillar of burning black smoke and flame and been seized by the nauseating dread transmitted by the silence on the radio as I prayed for just one more miracle.

I was surprised to discover shortly after returning from Iraq that fear had found a way to follow me home. Fear had visited so often in Iraq that it had secured a foothold in my mind by disordering a part of my brain. The disordered parts of my brain still wanted me to be afraid of things– like windows– that the more ordered parts of my brain knew were no longer a threat. It didn’t help that a suicide bomber followed by another IED hit a few weeks later and had blown holes in my brain, severed neural pathways and substantially degraded my brain’s ability to deescalate the continuous onslaught of phantom threats.  A damaged brain left my mind unable to processes and evaluate the myriad of people and activities of daily life going on around me that the disordered part of my brain insisted were still threats.

Worse than the fear that accompanied personal danger was the terror I felt every time I heard the explosions of IEDs or rocket-propelled grenades followed by a rapid crescendo of small arms and machine gun fire indicating one of my platoons was in yet another firefight. I stare at the radio dreading a radio call reporting another one of my soldiers killed or wounded. The memories keep me awake late into the night when my non-visual senses come alert to intercept and evaluate every noise on guard against a threat lurking in the dark or the distant sound of battle.

My Troop occupied a small combat outpost. The concrete protective walls were not tall enough to block direct fire from every angle. The door of our home-made, plywood outhouse had several bullet holes in it. Mortar rounds occasionally landed inside the compound (fortunately the post was so small, most of them missed). At times we fought the enemy from our own walls.  We slept with weapons loaded and by our sides.

When fleeting sleep finally releases my mind from the battles of the past, the disordered parts of my mind create new ones to fight in my dreams. The scenery is pixelated by gruesome images I mentally recorded in Iraq. I have seen too many grotesque corpses.

There were the decomposing, decapitated victims of al Qaeda beheadings in Anbar. In Dora, there were the bloated bodies dumped in piles on the roadside and reeking in the summer heat. They were always discolored at the knuckles, knees and joints where the local Shiite militia/terrorists had used power drills to torture their victims in the basements of the neighborhood’s mosques before finally applying the drill to victims’ temples for the life-ending cut. In the upscale Baghdad neighborhood of  Adhamiya, there was a young man on the street in Baghdad with three bullets in his head, delivered only moments before by a US-provided 9mm pistol in the hands of Iraqi Army-uniformed Shia militiamen who controlled many of the Iraqi army and police units with the sanction and protection of Shiite political leaders. The “death breath” — actually the final exhalation as the cessation of life causes the lungs to collapse– makes a distinct sound that I can still hear years later.

In Diyala there was a block of body parts– the human detritus of an air strike I had ordered. Scattered among the homes and school yard were enough unique parts for at least seven people including a pale, lifeless face staring into the air attached to a dismembered torso with one arm and entrails oozing out from  where the hips would have been like a broken jar of grey fruit preserves. A street away I found a lone survivor lying on a floor carpeted with glass shards from the shattered windows  in the front room of an abandoned house. He was shaking and unintelligible from pain.  He was naked. His clothing had burned away revealing the third-degree burns across most of his body. His skin resembled a marshmallow that had caught on fire but then been quickly extinguished before being entirely blackened. I still think that the right thing to do would have been to shoot him in the head to bring a merciful end to his agony, but the law of war required me to subject him to further torture with no prospect of survival under the unskilled and callous hands of the Iraqi army medical evacuation and treatment system (and I am using the word “system” quite liberally here).

And then there were the bodies of our Fallen Heroes. They are sacred edifices in the ordered part of my mind. They haunt the other part.

Although the setting and imagery of the dreams changes, the theme is always the same- Fear. I am terrified by the dreams. The dream Fear is worse than the real fear. In Iraq I could control my Fear. In my dreams I cannot. I am not a warrior. I am coward. And I am afraid.

As I said, I am neither especially brave nor especially tough, but I was generally surrounded by men who were, so I often found it necessary to fake those virtues myself. My main ally in this deception, and probably the preserver of my life of on more than one occasion, was Anger. In the chemical pecking order of my mind’s chemistry,  Anger trumps Fear. I didn’t really recognize it at the time, but Anger put me back in charge. It enabled me to move my limbs, stand firm against fear and return fire.

I suppose Anger deserves my gratitude and appreciation, but it has become an unwelcome companion that I cannot persuade to leave.

Years later brain imaging revealed that the part of my brain that regulated emotion had also been physically damaged by the blasts I had survived in Iraq. The damage gave Fear more freedom in my mind at home than it had had in the combat zone. My friend and partner Anger was also on the loose, still ready to faithfully come to my aid whenever I felt I was losing control. The combination of a mind besieged by Post-Traumatic Stress and a brain substantially degraded by the damage from multiple “mild” traumatic brain injuries ensures those times are frequent and humiliating. The physical damage to my brain makes my mind resistant to, perhaps even impervious to, the contemporary “treat the symptoms” medical treatment protocols used by the DOD and VA.

The journey home  is taking much longer for me, and other veterans like me, than the day-long plane ride  that I thought would mark my transition from warrior back to husband and father. Unexpectedly, I have found the journey often feels too much like our combat patrols. I often feel  like I am under persistent and insidious attack by a domestic terror organization supported by our own government.  Like the terrorist I have battled before, the attacks have left a part of my mind disordered and ruled by Anxiety, which as far as I can tell feels awfully lot like Fear. This insurgent force calls itself the Department of Veteran Affairs.

Their personnel champion a perverted ideology best described as bureau-fascism– a belief system focused on preserving the prerogatives and privileges of the bureaucrat to the exclusion of personal and organizational accountability, public service, and competing  values to those of our American society such as the respect and gratitude the rest of our Nation shows to those who have served in uniform. Although mostly a medical organization, members are unbound by values or standards like the Hippocratic Oath– at least not when bureaucratic privilege is on the line.  “Delay, Deny and Hope they Die” are the tenants of their faith– Google it.

They use terror tactics including threats, intimidation and bullying. They operate in semi-autonomous cells that do not share information. They plan and conduct operations without regard to other cells while strenuously working to not give up any information or benefits to veterans without a protracted battle of attrition. They use this structure to ensure that the organization can never be compromised by attempts to make it accountable.  Like the shadowy insurgencies I fought in Iraq, there is no center of accountability where tormentors can be decisively engaged and brought to justice.

Is comparing the VA to terror groups like AQ fair? Perhaps there is an element of hyperbole, but one fairly made in the interest of truth and one which in no way understates the scale or depth of the problem.

I have never been as treated as poorly as I have by the VA. The problem extends beyond that frustrating maze of bureaucracy and paperwork. I left my first benefits appointment literally shaking with rage at how hostile and adversarial the doctor had been towards me. I have been bullied, threatened to have my benefits claims cancelled, denied needed care for wounds received in combat, accused of fabricating combat-related injuries that had been diagnosed by specialists and documented for years (note: the VA does not enter your military medical records into their record system nor does it provide them to your doctors and other health care providers, which in effect is the same as throwing them away). The way I have been repeatedly treated by the VA  has been  such a damaging experience that I can say without the slightest hyperbole that the Anxiety and Fear from contact with the VA is now worse than the Post Traumatic Stress Disorder that has ravaged my life. Contact unleashes a chemical barrage that destroys the fragile armistice I have worked weeks using every tool and device six years of therapy, counseling and treatment have provided to attain .  Anxiety, Fear and Anger are unleashed again to stalk each other through the no-man’s land of my mind.

The VA is an organization where “Thank you for your service” is a taunt, not an expression of gratitude. As far as I can tell, no one is responsible for helping you. Chains of responsibility form an impossible-to-unravel Gordian Knot that protects employees not only from any obligation to help but also from any accountability for negligence, misconduct  or unacceptable behavior. Those employees that may be willing are not empowered to help you. One VA-employed “patient advocate” told me the only thing she could do for me was give the address and phone number of my congressperson. The VA works in secret and denies patients any access to the people making decisions about their disabilities and benefits. I feel like the VA is as much my ally as the Iraqi police unit my unit was “partnered” with in Baghdad that regularly ambushed our patrols with IEDs they emplaced next to their checkpoints, or the Iraqi Army unit I shared a Combat Outpost with that was controlled by the Shiite insurgent group Jaysh al Mahdi. I had to emplace a machine gun position directed within our combat outpost  just to protect my soldiers from our “friends.”

According to my wife:  “When Ben has contact with the VA, I notice immediate and continued emotional and behavioral effects.  He becomes noticeably agitated and emotionally distressed in the days leading up to appointments at the VA.  After appointments he is physically and emotionally drained as well as having heightened PTSD symptoms.  When representatives from the VA contact him for any reason including scheduling appointments, discussing treatment or to discuss/determine benefits, he also becomes emotionally distressed.  After contact with the VA, it often takes days, sometimes weeks for these symptoms to decrease.  As his spouse, it is very discouraging and frustrating to recognize that an agency that claims to help veterans is actually causing emotional distress and acerbating Ben’s PTSD symptoms.   It makes the process of getting benefits tiresome, frustrating and hopeless.  After witnessing Ben’s reactions to the VA and our struggle to get his deserved benefits, I clearly understand how so many veterans end up living on the streets or committing suicide.  The system brings on feelings of frustration and despair.”

Are there any good people at the VA dedicated to helping veterans? Yes. I know a few. I suspect there are many more of them, but I have seen no evidence that any of them can do anything about the sick organizational culture that rules the VA.

The battle to keep the disordered part of my mind in check has been a costly campaign, costly not only to me but also to the non-combatants that are closest and most important to me – my wife and family.  With PTSD there is still an ordered part of my mind that knows the moment of danger has passed. That part of my mind gives me hope. I can make myself stand in front of a window at night – at least for a little while – because that part of my mind knows that no one is out there sighting in on my head. I can wake up from a nightmare and ground myself to the present reality of my wife sleeping peacefully beside me. There is no grounding technique for the VA, however. The nightmare is the reality.

I have already had to fight al Qaeda. In some ways, I am still replucating fighting that battle – and my family and I take a little more damage each and every day that I do.

I do not understand why I have to fight the VA as well.

0

President Obama and VA Claims

Posted by:

With great fanfare, President Obama “told a crowd of disabled veterans on Saturday that his administration has made headway with efforts to battle a longstanding backlog of disability claims.”

As reported in the Washingon Post, “’Today, I can report that we are not where we need to be, but we’re making progress,’” Obama said during a speech at a Disabled American Veterans’ convention in Orlando. “’In the last five months alone, it’s down nearly 20 percent.  We’re turning the tide.’”

If true, this is very good news indeed, but one needs to be rather skeptical if only recently the VA reversed course on Agent Orange disability claims from the Vietnam War.   Editor’s Note: That’s a hell of a VA backlog for a war that ended over 40 years ago.

Our research suggests that many of the 200,000 plus veterans suffering from Post Traumatic Stress have been misdiagnosed by the VA, received inadequate treatment, prescribed a cocktail of dangerous drugs or simply been ignored.

While I have no problem with the President taking credit for a statistical drop in the backlog of veterans seeking VA support, who is accountable to the tens of thousands of veterans from Iraq and Afghanistan who are jobless, often homeless and addicted to drugs and alcohol while they cope with the disabling consequences of PTS?

Personally, I would like the President to address the chronic problems faced by the many brave men and women who have served in harm’s way and not received the promised support they merit.   Brave leaders address the troops directly rather than stand behind a pulpit for a staged political event.

Sharing in the suffering of our brave warriors is now even more important the lauding their success.

0

PTSD Treatments

Posted by:

As the VA struggles to deal with the overwhelming number of cases of Veterans suffering from PTS, new approaches are beginning to manifest themselves.  From Equine therapy to Transcendental Meditation, no approach is being dismissed lightly given the clear evidence that prescription drugs have not proven to be successful in providing a long term cure.

SFTT is thrilled to count on the assistance of Yuval Neria (see below) is a Special Advisor to SFTT’s Medical Task Force.    We welcome his active collaboration.

Yuval Neria

Medical Center (CUMC Director of Trauma and PTSD Program, and a Research Scientist at the New York State Psychiatric Institute (NYSPI) …

While SFTT often focuses on the men and women suffering from PTS, it is clear that their spouses, children and immediate families are not immune to the terrible side-effects.

Study: PTSD affects veterans’ spouses, too – ksl.com

PTSD generic paxil 20 mg tablet affects veterans’ spouses, tooksl.comResearchers have know for some time that PTSD places relationships at risk, but this new research raises red flags for health risks for a spouse or partner. “It’s having an effect beyond the vet …

Military May Be Turning to Meditation for PTSD – PsychCentral.com

Military May Be Turning to Meditation for PTSD.  Military May Be Turning to Meditation for PTSD With its emphasis on developing tranquility, meditation may seem an odd fit for the military. But recent studies have shown that mindfulness …

0

PTSD update for Feb 2, 2013

Posted by:

New material surfaces daily on the internet and in user discussion forums dealing with the treatment of Post Traumatic Stress Disorder (“PTSD”). Regrettably, most of this advice is not supported by good clinical scientific studies or trustworthy explanation. The road to health and wellness is a long process and treatment procedures will be different based on the particular individual, the extent of the stress and his or her current social and financial circumstances.

SFTT or “Stand For The Troops” has put together an eminent circle of physicians, clinical psychologists and therapists to evaluate these promising treatments. While some of these emerging new techniques will appear on a regular basis on SFTT, visitors are firmly counseled to refer to their physician or primary care giver before altering treatment.

Found below are highlights of recurring themes as we mobilize forces to deal with the ravages of PTSD.

Cincinnati State, Cincinnati VA Medical Center to offer PTSD classes

Cincinnati State, in conjunction with the Cincinnati VA Medical Center, will offer two free classes this month on Post-Traumatic Stress Disorder (PTSD). The classes are geared toward the Emergency Medical Services community and other first responders.

See all stories on this topic »

PTSD taking a toll on returning veterans

He spoke last week, a day before attending Massachusetts funeral services for his friend, who had PTSD and served at Iraq’s Abu Graib prison during one of two deployments. “I don’t think he’d ever say, ‘Hey, I want to kill myself,’ but … certainly …

See all stories on this topic »

1

Maj. Ben Richards Hyperbaric Treatment Update

Posted by:

Yesterday evening, WWLTV.com in Louisiana carried a very moving “progress report” on

Maj. Richards’ tragic story was chronicled by New York Times columnist Nicholas Kristof who wrote an article in August entitled “War Wounds.”  For reasons that seem inexplicable to the average American, the Veterans Administration, the Defense Department and our government seemed to wash their hands of any responsibility of the injuries suffered by Maj. Richards.  Eilhys England, Chairperson of SFTT, immediately contacted Maj. Richards and put him in touch with Dr. Paul Harch (shown in the video below) who has been providing Ben with Harch Hyperbaric Oxygen Treatments pro bono.

We are thrilled that Maj. Richards has made so much progress and SFTT is most grateful to those West Point classmates, friends and colleagues who have generously contributed to a fund to support his family while undergoing this treatment.

While we don’t leave our troops behind on the battlefield, why should their needs be neglected when they return home? If you feel strongly about supporting our brave heroes like Maj. Ben Richards, consider becoming a member of SFTT. Your generous contributions help our team find and evaluate promising treatment programs so our brave heroes can reclaim their lives.

For only $35 a year you can stand with us and Stand for the Troops


Choose your Membership and click the button «Become a Member»:

Become a Member

For those who wish to submit your membership contribution by check, please make the check payable to SFTT and send to the following address:

SFTT
PO Box 11179
Greenwich, CT 06831

Members can opt to receive flash updates, a Membership card and a vehicle decal.   Members who donate $100 or more can request a complimentary T-shirt.

PO Box 11179  ?  Greenwich CT 068321  ?   203-629-0288   ?  www.SFTT.org

0

Opioids May Not Be Good for Treating PTSD. Really?

Posted by:

If the devastating implications weren’t so gut-wrenching, many of us would be rolling in the aisles with laughter.   Unfortunately, Karen Seal of the San Francisco VA Medical Center has sadly concluded that “the use of opiate pain medications in those patients (veterans suffering from PTSD) is, frankly, risky.”  According the Austin Statesman, “a growing body of research shows that PTSD and powerful prescription drugs can be a deadly mix.

“Six months ago, a study of 141,000 veterans of the Afghanistan and Iraq conflicts concluded that combining prescription opioids such as oxycodone and hydrocodone with PTSD was like pouring kerosene on a fire: Those with mental health diagnosis were nearly three times more likely to be prescribed opiates than veterans without PTSD. Worse, they were also much more likely to have poor outcomes, including overdoses.”

Almost anyone with half-a-wit could have reached the same conclusion several years ago.  In fact, SFTT has reported on many occasions that the prescription of opiates to those with PTDS symptoms has certainly exacerbated problems for veterans and may have turned these troubled warriors into junkies.  Why?   Institutional barricades have been erected to protect those complicit in providing improper treatment to tens of thousands veterans who certainly deserve better care.   Why should anybody be surprised that the government is now throwing another $100 million to help better diagnose PTSD.   Can we expect a better outcome?  If you think so, then you probably believe in the tooth fairly.

What about the 2006 study reported by the Austin Statesman quoting University of Washington pain researcher Mark Sullivan who wrote that the: “Use and abuse of opioids appears to be common in individuals with post-traumatic stress disorder.”   Wouldn’t it have been wiser to throw $100 million at alternative treatments for PTSD than for the VA and Defense Department to pretend they are  now doing something “right” because the pharmaceutical lobby was calling the shots all along.

I don’t mean to be cynical, but drugs are big business and the pharmaceutical companies that provide expensive, addictive and dangerous drugs have a vested interested in keeping the public and their Beltway puppets in the dark on the long term effects of these powerful drugs.  Who suffers?  The taxpayer and the brave young men and women who have sacrificed so much for this country.

If you want your voice to be heard, consider adding your voice to SFTT and help get our veterans the treatment they deserve.

0

A former Marine comments on the V.A.’s Shameful Betrayal

Posted by:

In a heart-breaking story by Mike Scotti entitle ” below:

QUOTE

THE Department of Veterans Affairs, already under enormous strain from the aging of the Vietnam generation, the end of the Iraq war and the continuing return of combat troops from Afghanistan, announced in April that it would increase its mental health staff by about 10 percent. But too many veterans waging a lonely and emotional struggle to resume a normal life continue to find the agency a source of disappointment rather than healing.

The new hiring is intended to address the infuriating delay veterans face in getting appointments. The V.A. says it tries to complete full mental health evaluations within 14 days of an initial screening. But a review by the department’s inspector general found that schedulers were entering misleading information into their computer system. They were recording the next available appointment date as the patient’s desired appointment date. As a result, a veteran who might have had to wait weeks for an appointment would appear in the computer system as having been seen “without a wait.” That allowed the agency to claim that the two-week target was being reached in 95 percent of cases, when the real rate was 49 percent. The rest waited an average of 50 days.

As a veteran of both Iraq and Afghanistan, I found that news maddening. While the schedulers played games with the numbers, veterans were dealing with mental wounds so serious that getting proper attention at the right time might have made the difference between life and death. Even worse was that the V.A. had failed twice before to change; the inspector general found similar problems in 2005 and in 2007. This suggests a systematic misrepresentation of data and an unwillingness to stop it.

Unfortunately, the problem goes even deeper. There are potentially hundreds of thousands of veterans who are struggling with post-combat mental health issues who never ask the V.A. for help. Some, hamstrung by fear of stigma, are too proud or too ashamed to ask for help. Others don’t ask because they’ve heard too many stories from peers who have received poor care or been ignored.

I have close friends who could no longer drive because of their lingering fears of roadside bombs. Others had gone to the V.A. because they had suicidal thoughts, only to receive a preliminary screening, a pat on the back, a prescription for antidepressants — and a follow-up appointment for several months later.

I’ve had my own struggle: in 2001 I was part of the initial force of Marines who landed in Afghanistan, and in 2003 took part in the heavy fighting of the first wave of the invasion of Iraq. Since coming home, I’ve had my mind hijacked by visions of the corpses of children, their eyes blackened, at the side of the road. I recall carrying the coffins of fallen brothers. I remember losing friends who probably knew exactly what was happening to them, as they bled out on the side of a dusty road in Iraq.

And I’ve felt the shame of having suicidal feelings. Like many others, I chose to hide them. Yet, even in the darkest days of my own post-traumatic stress, when I was considering choosing between making my suicide look like an accident or taking a swan dive off some beautiful bridge, I never considered going to the V.A. for help.

My image of the V.A., formed while I was on active duty, was of an ineffective, uncaring institution. Tales circulated among my fellow Marines of its institutional indifference, and those impressions were confirmed when I left Iraq for home. At Camp Pendleton, Calif., a woman with a cold, unfeeling manner assembled us for a PowerPoint presentation and pointed us to brochures — nothing more, no welcoming sign of warmth or empathy for the jumble of emotions we were feeling. Her remoteness spoke volumes to me of what I might expect at home.

To regain veterans’ trust, the V.A. must change its organization and culture, not just hire more people. First, its leadership must be held accountable for employees’ behavior, and anyone caught entering misleading data should be fired. The agency must reach out, with public awareness campaigns and with warmth, to veterans who may be suffering in silence. It must help reduce the social stigma that attaches to the mental health issues the veterans face.

Dedicated V.A. personnel run a suicide-prevention hot line, but it is only a temporary salve for emergencies. One impressive and highly effective alternative to the V.A.’s traditional treatment process is the Wounded Warrior Project’s Combat Stress Recovery Program, which emphasizes the importance of interpersonal relationships, goal-setting and outdoor, rehabilitative retreats and seeks to avoid the stigma associated with traditional treatment.

What this generation of veterans needs from the V.A. is a recognition that when the color of life has faded to gray, you need to talk to someone about it today, not weeks or months from now. We need America to acknowledge what war does to the young men and women who fight it and to share the message that dragged me out of the darkness: It’s O.K. if you’re not O.K.

Mike Scotti, a former Marine, is the author of “The Blue Cascade: A Memoir of Life After War.”

UNQUOTE

We hear you Mike.   Our thoughts – and action – are with you and the thousands of brave heroes who deserve proper treatment from the V.A.

2

PTSD and the VA: A Disservice to Disabled Troops

Posted by:

In an editorial opinion published in the New York Times on May 26th entitled ”

QUOTE

The Departments of Defense and Veterans Affairs have repeatedly promised to do a better job of handling the medical evaluations of wounded and disabled service members. Instead, they are doing worse.

The processing of disability cases is getting slower, not faster. Efforts to ensure a “seamless transition” out of the military are falling short. Men and women are languishing without treatment, struggling to readjust to civilian lives as they cope with post-traumatic stress disorder, brain injuries, drug addiction and other service-related afflictions. The system that should be producing reliable results is mired in delays and dissatisfaction.

A new report by the Government Accountability Office lays out the problem. In 2007, the two departments began combining their separate, complicated and cumbersome processes for disability evaluations into one system. The system is now in place worldwide, and officials from both departments promised the Senate Veterans’ Affairs Committee a year ago that it had become “more transparent, consistent and expeditious.”

But the accountability office found otherwise. It said processing times for disability cases had actually gone up — to an average of 394 days for active-duty troops and 420 days for National Guard members and reservists in 2011, well over the departments’ goals of 295 and 305 days. In fiscal year 2010, 32 percent of active-duty troops and 37 percent of Guard and Reserve troops completed evaluations and received benefits within established timelines. Last year, those figures fell to a dismal 19 percent and 18 percent.

What’s going on? The report says the causes are not fully understood, but it points to persistent staffing shortages, problems in collecting and reporting data, and differences among the service branches and between the Pentagon and the Veterans Affairs Department in the way cases are diagnosed and tracked. The accountability office says it will make recommendations later this year as it sees whether promised improvements are taking hold, including a hiring push by the Army — a huge source of processing bottlenecks — and the V.A.

Senator Patty Murray, chairman of the Veterans’ Affairs Committee, deserves credit for focusing attention on these and other failings in a series of hearings, including one last Wednesday that examined the bureaucratic delays. She also used the hearing to bring up disturbing reports that doctors at an Army base in Washington State had repeatedly — and wrongly — rejected soldiers’ legitimate post-traumatic stress disorder claims.

Wounded and disabled service members should not be forced to wait endlessly without treatment or benefits while the government evaluates their injuries. Nor should they have to battle their own government for honest treatment. The evaluations should be accurate, not consistently wrong. Ms. Murray noted on Wednesday that there were about 27,000 military personnel in the system, three times the number in 2010. Many more are on the way. “Clearly, much work remains to be done,” she said. She is right. There is no excuse for more backsliding and delay.

UNQUOTE

Enough “lip service” as Hack would say.  Let’s rollup our sleeves and help these brave heroes.

0

Are Opioid Prescriptions the Right Answer for treating PTSD?

Posted by:

In a series of alarming reports, the V.A. and medical profession are beginning to wonder if treating PTSD with Opioid prescription drugs is the right course of action.   Referring to V.A. records, U.S. Medicine reports that “more than 141,000 Iraq and Afghanistan veterans have been diagnosed with non-cancer pain. The prevalence of PTSD among that group is 32%, with 19% diagnosed with other psychiatric disorders.”

Of this group, “11% have been prescribed

U.S. Medicine goes on to report that “veterans with PTSD also were more likely to take higher opioid doses (22.7% vs. 15.9%), two or more opioids (19.8% vs. 10.7%) and concomitant sedative-hypnotic drugs (40.7% vs. 7.6%). Receiving prescription opioids was associated with adverse clinical outcomes for all veterans, but adverse effects were most pronounced in veterans with PTSD. Those outcomes included general wounds and injuries, accidents and overdoses, violent injuries and suicide attempts. While previous studies have shown that prescription opioids are more often prescribed for patients with psychiatric disorders, this trend was even more pronounced when the patient was diagnosed with PTSD.”

Lead author Karen Seal  of a recent study published in the Journal of the American Medical Association on the medication prescribed to veterans believes that the study results are troubling. ”The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.”

It is becoming clear that our military leaders are now beginning to realize that these addictive drugs may, in fact, exacerbate the problems associated with PTSD rather than treat them.   In fact,  Bob Brewin of Veterans for Common Sense reports that  “the Army Surgeon General’s office is backing away from its long-standing endorsement of prescribing troops multiple highly addictive psychotropic drugs for the treatment of post-traumatic stress disorder and early this month warned regional medical commanders against using tranquilizers such as Xanax and Valium to treat PTSD.

“An  Valium, could intensify rather than reduce combat stress symptoms and lead to addiction.

“The memo, signed by Herbert Coley, civilian chief of staff of the Army Medical Command, also cautioned service clinicians against prescribing second-generation antipsychotic drugs, such as Seroquel and Risperidone, to combat PTSD. The drugs originally were developed to treat severe mental conditions such as schizophrenia and bipolar disorder. The memo questioned the efficacy of this drug class in PTSD treatment and cautioned against their use due to potential long-term health effects, which include heart disorders, muscle spasms and weight gain.”

This greater awareness of the risk of prescribed opioids only confirms indications that SFTT has received from its sources “upwards of 80% of veterans suffering from PTSD also have an addiction problem.”     These new revelations are truly frightening and place a far greater sense of urgency in treating PTSD properly unless we plan on turning our brave veterans into addicts rather than cure them.

1

VA Care for Patients with PTSD

Posted by:

As military service members deployed in Iraq begin come home, the alarm bells are beginning to sound as the Veterans Administration (“VA”)  now seems over-stretched to deal with alarming number of cases of service members with PTSD.

According to a recently published Rand study, excerpts of which are reported  by Health Affairs, “There is a large and growing population of veterans with severe and complex general medical, mental, and substance use disorders including schizophrenia, bipolar I disorder, PTSD, and major depression. Substance use disorders may occur alone or in combination with any of these other diagnoses. Over the five-year study period, the population of veterans with mental and substance use disorders grew by 38.5 percent, with the largest growth occurring in veterans receiving care for PTSD. Half of the veterans with mental and substance use disorders also had a serious medical disorder. Study veterans also accounted for a much larger proportion of health care use and costs than their representation among all veterans receiving VA health care. “

The sad reality is that this report is based on statistics compiled by Rand for 2007 and, as such, the severity of the problem is likely to be far greater for veterans with additional deployments past 2007.

As Jason Ukman of the Washington Post reports, “the cost of medical care for veterans is expected to skyrocket in coming years.”   According to sources referred to by Mr. Ukman, “The number of veterans seeking mental health services has increased sharply. Last year, more than 1.2 million veterans were treated by the VA for mental health problems. In fiscal year 2004, the figure was roughly 654,000. The largest increase has been among veterans diagnosed with PTSD.”

The severity of this problem is already taxing over-stretched VA resources and is likely to increase as  troops in combat zones return home.  How we deal with these troubled warriors will say much about our military and political leadership.

1
Page 8 of 9 «...56789