New Protocol to Provide Early Brain Injury Detection

By Christen N. McCluney
Special to American Forces Press Service

WASHINGTON, March 16, 2010 – The Defense Department is rolling out a new set of guidelines for the treatment of mild traumatic brain injury among servicemembers in combat areas.   “We’re morphing from a symptom-based approach in theater to an incident-based approach,” a senior official said yesterday during a “DoDLive” bloggers roundtable.   “The tenet behind this is we strongly believe that early detection and early treatment decrease the complaints of post-traumatic brain injury after sustaining an injury,” said Kathy Helmick, interim senior executive director for traumatic brain injury and director of TBI clinical standards of care at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.   The new protocol will go into effect soon and will make head injury evaluations mandatory for servicemembers who have been involved in incidents such as being close to explosions or blasts. In the past, Helmick explained, servicemembers simply decided for themselves whether to report symptoms. Moving forward, the medical staff will check everyone involved in such incidents.    read more

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VA doctors see more veterans with noncombat neck, back or joint problems

By LINDSAY WISE
HOUSTON CHRONICLE
March 4, 2010, 6:16AM

Anthony Clark used to think nothing of running two miles in 14 minutes. Now the 44-year-old Iraq war veteran can’t walk without pain. “It’s a total life change,” said Clark, who developed severe back and shoulder problems while serving as an Army sergeant in Iraq in 2003.  “Physically, I can’t run,” he said. “I very much enjoyed hiking, working out, driving — you know, traveling. I try to do things and I can’t. It’s very limited. It’s kind of depressing because those are the things I really like to do.”  The pain became so bad that Clark left his retail inventory job to concentrate on physical therapy at Michael E. DeBakey VA Medical Center in Houston. He’s not alone. More than half of returning veterans evaluated at the medical center on Holcombe have been diagnosed with similar back, neck and joint pain from overuse or accidents, said Dr. Drew Helmer, lead primary care physician at the hospital’s clinic for Iraq and Afghanistan veterans. “We tell our primary care physicians: ‘If you see a returning veteran and they don’t tell you about one of these things, they just forgot to mention it,’ ” Helmer said. “We all have back problems, but I think it rises into really an epidemic level in this population.”  A recent Johns Hopkins study found that the top reasons for medical evacuation from Iraq and Afghanistan are musculoskeletal and connective tissue disorders, not combat injuries.  Researchers examined the records of more than 34,000 military personnel evacuated from Iraq and Afghanistan between January 2004 and December 2007. They found that 24 percent of the service members had musculoskeletal or connective tissue disorders, compared to 14 percent who had suffered combat injuries.   read more

Shinseki: US will fix broken VA disability system

By KIMBERLY HEFLINGThe Associated Press
Monday, February 22, 2010; 10:43 AM

CHILLICOTHE, Ohio — Veterans Affairs Secretary Eric Shinseki said he’s making it a top priority this year to tackle the backlog of disability claims that has veterans waiting months – even years – to get financial compensation for their injuries.  Among those waiting for relief are sick Vietnam and Gulf War veterans to whom the former Army commander feels an allegiance and who have long felt ignored. “I’m a kid out of the Vietnam era, I just have enough firsthand knowledge of folks walking around with lots of issues. If there’s a generation of veterans that have had a tough row to hoe, it’s the Vietnam generation,” said Shinseki, 67, in an interview with The Associated Press as he traveled through snowcapped mountains in Ohio and West Virginia between meetings with veterans. Shinseki, a former Army chief of staff who had part of a foot blown off when he was a young officer in Vietnam, was unapologetic about a decision he made in October to make it easier for potentially 200,000 sick Vietnam veterans who were exposed to the Agent Orange herbicide to receive service-connected compensation.   read more

Lejeune water report had no mention of benzene

By Kevin Maurer – The Associated Press
Posted : Wednesday Feb 17, 2010 17:22:16 EST

WILMINGTON, N.C. — An environmental contractor dramatically underreported the level of a cancer-causing chemical found in tap water at Camp Lejeune, then omitted it altogether as the Marine base prepared for a federal health review, an Associated Press review has found.  The Marine Corps had been warned nearly a decade earlier about the dangerously high levels of benzene, which was traced to massive leaks from fuel tanks at the base on the North Carolina coast, according to recently disclosed studies.  For years, Marines who served at Camp Lejeune have blamed their families’ cancers and other ailments on tap water tainted by dry cleaning solvents, and many accuse the military of covering it up. The benzene was discovered as part of a broader, ongoing probe into that contamination.   read more

Study Suggests More Veterans May Be Helped by Talking About Killing

By JAMES DAO
Published: February 13, 2010

The act of killing is as fundamental to war as oxygen is to fire. Yet it is also the one thing many combat veterans avoid discussing when they return home, whether out of shame, guilt or a deep fear of being misunderstood.  But a new study of Iraq war veterans by researchers in San Francisco suggests that more discussion of killing may help veterans cope with an array of mental health problems stemming from war.  The study, published last week in The Journal of Traumatic Stress, found that soldiers who reported having killed in combat, or who gave orders that led to killing, were more likely to report the symptoms of post-traumatic stress disorder, alcohol abuse, anger and relationship problems. The study was based on data from health assessments conducted on about 2,800 soldiers who returned from Iraq in 2005 and 2006.  Shira Maguen, a psychologist at the San Francisco Veterans Affairs Medical Center and the principal investigator on the study, said the results suggested that mental health professionals need to incorporate killing more explicitly into their assessments and treatment plans for veterans. That would include finding ways to discuss the impact of killing, in public forums and in private treatment, to reduce the stigma and shame, she argued.   read more

Report slams flaws in DoD sex assault program

By Karen Jowers – Staff writer
Posted : Saturday Dec 5, 2009 8:22:44 EST

The Pentagon office charged with oversight of military sexual assault prevention and response policy is not doing an effective job — and responsibility should be placed, at least temporarily, directly in the hands of the deputy secretary of defense, a task force has recommended.  The report by the Defense Department’s Task Force on Sexual Assault in the Military Services, based on 15 months of work and interviews with more than 3,500 people at 60 locations around the world, said the department’s Sexual Assault Prevention and Response Office is not providing policy or oversight for key responsibilities, or interacting with military officials in the field who are accountable on this issue.  Defense officials should revamp the office and provide the expertise necessary to lead and oversee its primary missions of sexual assault prevention, response, training and accountability, the task force said.  Defense Secretary Robert Gates has 90 days to review, comment on and send the congressionally-mandated report to Capitol Hill. The 176-page report was submitted Dec. 1.  “Our recommendations highlight the need for institutional change to more effectively prevent sexual assault and address related issues,” task force co-chair Louis Iasiello said in a statement. “Doing so is not only ethically and morally correct, but also essential to military readiness — all the more critical at this time.”  read more

2 studies: PTSD is chemical change in brain

By Kelly Kennedy – Staff writer
Posted : Thursday Dec 10, 2009 6:26:52 EST

Two new studies seem to provide more evidence that post-traumatic stress disorder is a chemical change in the brain caused by trauma — and that it might be possible to diagnose, treat and predict susceptibility to it based on brain scans or blood tests.  In one study, Christine Marx, of the Duke University Medical Center and Durham Veterans Affairs Medical Center, wondered why PTSD, depression and pain often occur together.  Researchers already knew that people with PTSD show changes in their neurosteroids, which are brain chemicals thought to play a role in how the body responds to stress.  Previous animal studies showed that blood neurosteroid levels correlated to brain neurosteroid levels, so Marx measured the blood neurosteroid levels of 90 male Iraq and Afghanistan veterans. She found that the neurosteroid levels correlated to symptom severity in PTSD, depression and pain issues, and that those levels might be used to predict how a person reacts to therapy as well as to help develop new therapies.  Marx is researching treatment for people with traumatic brain injuries using the same kind of brain chemical, and early results show that increasing a person’s neurosteroid level decreases his PTSD symptoms.  read more