Traumatic Brain Injuries or PTSD?

[image: an upgraded Personal Armor System for Ground Troops helmet with Operation Helmet-supplied kit--cost is $87 for old models, $56 for newer ones.]
I think Blue Girl might have more to say about this, but here's what we know so far:

A new military study published Wednesday in the New England Journal of Medicine says soldiers who suffered concussions in Iraq were not only at higher risk of developing post-traumatic stress disorder and depression, but also that the depression and PTSD, not the head injuries, may be the cause of ongoing physical symptoms.

Five percent of the 2,500 soldiers surveyed by Walter Reed Army Institute of Research said they had concussions in which they lost consciousness during combat. Forty-four percent of these soldiers ended up with PTSD.

Researchers were surprised to find symptoms normally associated with concussions -- headaches, dizziness, irritability and memory problems -- were actually related to PTSD or depression.

"It isn't the combat exposure or physical injury, it's the PTSD that seems to drive these symptoms. That's a surprise," said Joseph A. Boscarino, Ph.D., who studies PTSD at the Geisinger Center for Health Research in Danville, Pennsylvania. "You would expect they would have these other symptoms related to traumatic brain injury, that maybe they have a permanent injury, but it's explained by whether they have PTSD or depression."

About 8 million American adults have PTSD. A 2003 New England Journal of Medicine Study found that 15 percent to 17 percent of Iraq and Afghanistan veterans were suffering from PTSD, and more than 60 percent of those showing symptoms were unlikely to seek help because of fears of stigmatization or loss of career advancement opportunities.

As of June 30, 2007, the Department of Defense reported 3,294 soldiers in Iraq and Afghanistan suffering from traumatic brain injuries, or TBIs. Bomb blasts caused nearly 70 percent of those TBI cases.

Dr. James Kelly, a neurology professor at the University of Colorado and a co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues.

"I think if people misunderstand or overextend beyond what this survey shows, they could dismiss true brain injury features as psychological only," Kelly said. "It would be a terrible disservice to our military for that to happen."

Kahlor is worried this study will make it harder for soldiers to get appropriate medical care.

"The military doesn't want to diagnose people with brain injury," he said. "So what they'll do is play it off as PTSD as the sole injury for everyone, because PTSD and traumatic brain injury have very similar symptoms," he said. "The disability [compensation] is a lot higher for traumatic brain injury. What the military is saying is, you can't be diagnosed from a brain injury unless you get better from PTSD. It's kind of like a paradox."

First of all, citing a study from 2003 is WAY out of date. The larger IEDs used against our troops are causing a more severe type of brain injury, obviously. The different vehicles being used, such as the MRV and the Stryker, are helping, but is it enough. And then there was the campaign called Operation Helmet. Here's something from their site, which you could visit and support if you choose to:

Jan 21, 2008: Received a request from a Marine Reserve unit (155 Marines) headed back into combat...and unable to use the 'GI' pads at all, so have reverted to the un-protected form of combat helmet. We MUST NOT let this happen. While we're pressuring Congress and the military to do what's right, we need an urgent fund-raising campaign to outfit these troops before they reach their combat assignment. PLEASE HELP WITH YOUR DONATIONS IF YOU CAN.

Which outrage do you want--that a Marine reserve unit is going into Iraq in 2008--nearly five years since the start of the goddamned war--WITHOUT adequate headgear? Our military health care system finding a way to get rid of people and not pay benefits??? Now, why would the military do something like that?

Remember when the military started going after people who had "personality disorders" that were really manifestations of PTSD? How could you blame them? It was a fantastic way of getting rid of people and cutting costs!

But instead of sending Town to a medical board and discharging him because of his injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's wounds were actually caused by a "personality disorder." Town was then booted from the Army and told that under a personality disorder discharge, he would never receive disability or medical benefits.

Town is not alone. A six-month investigation has uncovered multiple cases in which soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder, then prevented from collecting benefits. The conditions of their discharge have infuriated many in the military community, including the injured soldiers and their families, veterans' rights groups, even military officials required to process these dismissals.

They say the military is purposely misdiagnosing soldiers like Town and that it's doing so for one reason: to cheat them out of a lifetime of disability and medical benefits, thereby saving billions in expenses

Here's the original link to WWTC [where Blue Girl spends some of her valuable time] Your government. Acting like a craven HMO. You gotta love it when they pull this kind of thing. All that stands between them and their goals is exposing their attempts at shortchanging Veterans.

Taking a step to right a wrong

[Cross-posted from Watching Those They Chose]

There is a travesty occurring in our midst, and my Senators are doing something about it.

Yesterday, Missouri Senators Christopher (Kit) Bond and Claire McCaskill joined forces to sponsor an amendment to the National Defense Authorization Act for FY 2008 that would temporarily suspend the Pentagon’s use of Regulation 635-200, Chapter 5-13: “Separation Because of Personality Disorder” discharge for combat veterans, pending a thorough and comprehensive review of the current procedures and the establishment of an independent discharge review board. They were joined by additional co-sponsors Barack Obama, Barbara Boxer and Patty Murray.

Senator Bond was the only Republican to sign on, and this Missourian gives him a standing ovation for putting sound policy and the welfare of those who step up to serve ahead of politics.

"Abuse of personality disorder discharges is inexcusable. This amendment will put a stop to these discharges until we can fix the system," said Senator Bond. "The men and women who put their lives on the line to defend our freedom have earned a debt of gratitude from all Americans that we will never be able to pay in full. The very least we can do is take care of their battle wounds, whether physical or mental, and ensure they receive the treatment and benefits they deserve."

The abuse of the 5-13 is especially insidious, because it is being used to deny combat veterans the benefits and care we owe them. A Soldier, Sailor, Airman or Marine discharged under Regulation 635-200, Chapter 5-13 stands to lose all benefits. They can not collect disability pay; even for life-altering injuries sustained in combat; nor are they entitled to medical care through the VA for those very combat injuries.

In a prepared statement, Senator McCaskill said “We have no greater obligation to those who serve our country in the Armed Services than to ensure they get the care they’ve been promised. We cannot stand tall and proud as Americans if we allow one single service member to go without the benefits they deserve due to a misdiagnosis. Far too many combat troops serving in Iraq and Afghanistan are returning with mental health injuries that bear the potential for misdiagnosis, and we need to do all we can to prevent that from occurring.”

(Click to enlarge)

The use of the 5-13 has skyrocketed in recent years, rising precipitously as the occupation of Iraq takes its toll. G.I.’s who are seriously affected by PTSD and traumatic brain injuries (TBI) the signature injury of this conflict, have been discharged from service under the 5-13, which implies a pre-existing condition – even when they have received service commendations, been allowed to reenlist, and received reenlistment bonuses – only to find out when they are out-processing that they will have to repay thousands of dollars of their reenlistment bonuses. The bonuses carry with them a commitment to serve the entire enlistment. If it is not served, they leave with no benefits, no care for their injuries, and in debt for the portion of their bonus that the military paid and did not get service for.

I could go on for pages. I really could. I have. (See here, here, here, here, and here) But if a picture is worth a thousand words, the video of those who have been screwed over by this sickening scam should be worth a thousand calls to the Senate switchboard. Here is the number (202) 225-3121.



After serving honorably and going to war, they are simply thrown away.

Makes you proud to be an American, doesn’t it?

Are we journalists? We strive to be.

Crossposted unedited from WTWC

While everyone frets over whether or not bloggers are journalists, I know that my Republican Senator’s staff regards our enterprise here as such.

Today Senator Kit Bond’s office sent a letter to his colleagues asking them to add their signatures to another letter, this one to Secretary of Defense Robert Gates, demanding that the issue of the 5-13 discharge be investigated and obvious abuses set right. (apologies to the senators office. I had problems with the .pdf and the google docs are not nearly as pretty.)

The abuse of the 5-13 Discharge is an issue because bloggers made it such (examples here and here) after a piece in The Nation, How Specialist Towne Lost His Benefits. We seized on the issue, as we had the larger mental health issues for returning GI’s and the understaffing of Vet Centers. (See here, here, here, here, here, and here). We kept bringing it up until it gained traction, even though the mainstream media largely ignored the issue, and continues to do so.

“Bloggers have helped bring the necessary scrutiny to this important issue.” Said Shana Marchio, Communications Director for Senator Kit Bond (R-MO). “Bloggers offer folks a new medium to get their information and news. Their importance in the debating and sharing of ideas should not be discounted. At the same time, the relationship between bloggers and members of Congress and their spokespeople is an evolving one. Both sides are learning who to trust and how to interact. As a part of the Fourth Estate, it is essential that professional bloggers adhere to the ethics and professional conduct standards that traditional members of the media follow as their role in information sharing continues to grow. Also, I do believe that bloggers will only be come more important in coming elections and it’s important to start a dialogue.”

This is all new territory for everyone. But I think I know why the best source I have in Washington is the Communications Director for my Republican Senator. She is 30 years old. Where blogs and the internet are concerned, she instinctively “gets” it because she grew up with technology. I may have policy disagreements with my Republican Senator – but credit where credit is due. He was smart enough to hire a young person with that innate sense for press second six years ago, and promote to communications director from within.

On the trust issue, everyone has to be prepared to get burned once or twice. But getting burned is part of the bargain when you blaze a trail. So we move forward cautiously. The importance of the free exchange of information is only going to gain in importance. As it does, the issues will work themselves out.

Bloggers do not have the immediate access that reporters working the Washington bureaus have, nor do we have the resources to do a lot of original reporting. All we really have are our wits and our words...and our word. Because that is the irrefutable dynamic, the blogs represent a truly new, and meretricious, form of media, and we will earn exactly the amount of credibility and respect that we deserve.

Standing Up for Soldiers

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“Combat stress and its impact on our soldiers and their families is a serious problem that continues to grow. Reports that our military is unprepared or unwilling to deal with Post Traumatic Stress Syndrome or other mental health problems are unacceptable. Being unprepared for these problems is no excuse for inaction. It is our duty to take care of the brave men and women who have answered the call to duty," Senator Kit Bond.

“Our men and women returning from war should receive mental health care equal to the physical medical care they are given, and anything less is unacceptable. It took this country 15 years after Vietnam to look at the mental health needs of veterans. We can’t do that to another generation of soldiers.” Senator Claire McCaskill

A bipartisan senate panel on Thursday sent a letter to the General Accountability Office (GAO) requesting a review of the mental health care afforded our veterans in light of a flood of damning reports on conditions at Walter Reed and Ft. Carson. (Since I mentioned Fort Carson, let me say: IG – Fort Carson. - NOW!)

The Senators who have stood up for our veterans by sending this letter are Kit Bond (R) and Claire McCaskill (D) of Missouri, Tom Harkin (D-IA), Barack Obama (D-IL), Barbara Boxer (D-CA), Daniel K. Akaka (D-HI), Patty Murray (D-WA), Barbara Boxer, (D-CA), Bernie Sanders (I-VT) and Joe Lieberman (I-CT).

Senators Bond, Boxer and Obama get credit for being ahead of the curve on this issue. They have consistently expressed their concerns on mental health and the returning soldier. I wish to thank them for taking up the issue, and also for their steadfast persistence in pursuing it and demanding it get the attention it deserves.

Kudos to all of the Senators of both parties for requesting the GAO review of mental health services. This is a vital and firm first step to rectifying a travesty of abuse, neglect and mistreatment of Veterans by the Department of Defense. Abuse of the 5-13 discharge needs special attention. Especially those issued at Fort Carson.

Remember, folks, I read the GAO reports so you don’t have too. This is definitely one I am looking forward to. (But the white paper I really want to see is an Inspector General’s report on Fort Carson…)

[Cross-posted from Watching Those We Chose]

Which is worse: When outrages take place, or when they no longer surprise you?

There is an insidious abuse of troops taking place in the shadows, and it needs to be exposed to strong overhead light.

It is the use of the 5-13 discharge to cull injured troops from service and deny them future benefits through the VA. A 5-13 is a psych discharge. It brands the veteran as having a personality disorder, an Axis II disorder in the Diagnostic and Statistical Manual of the American Psychological Association. Personality disorders are deemed pre-existing conditions, and therefore the military is absolved of all future responsibility to those veterans.

Take the story of Specialist Jon Town, reported by Joshua Kors in the April 9 issue of The Nation.

Jon Town has spent the last few years fighting two battles, one against his body, the other against the US Army. Both began in October 2004 in Ramadi, Iraq. He was standing in the doorway of his battalion's headquarters when a 107-millimeter rocket struck two feet above his head. The impact punched a piano-sized hole in the concrete facade, sparked a huge fireball and tossed the 25-year-old Army specialist to the floor, where he lay blacked out among the rubble.

"The next thing I remember is waking up on the ground." Men from his unit had gathered around his body and were screaming his name. "They started shaking me. But I was numb all over," he says. "And it's weird because... because for a few minutes you feel like you're not really there. I could see them, but I couldn't hear them. I couldn't hear anything. I started shaking because I thought I was dead."

Eventually the rocket shrapnel was removed from Town's neck and his ears stopped leaking blood. But his hearing never really recovered, and in many ways, neither has his life. A soldier honored twelve times during his seven years in uniform, Town has spent the last three struggling with deafness, memory failure and depression. By September 2006 he and the Army agreed he was no longer combat-ready.

But instead of sending Town to a medical board and discharging him because of his injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's wounds were actually caused by a "personality disorder." Town was then booted from the Army and told that under a personality disorder discharge, he would never receive disability or medical benefits.

Town is not alone. A six-month investigation has uncovered multiple cases in which soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder, then prevented from collecting benefits. The conditions of their discharge have infuriated many in the military community, including the injured soldiers and their families, veterans' rights groups, even military officials required to process these dismissals.

The number of 5-13’s coming down has ballooned. It has reached the point where they would have us believe that the Army took an entire Division of hinky, psychologically damaged troops in recent years. Even with the number of waivers that have been issued to meet recruiting quotas (17%) that stretches credulity.

Not surprisingly, Fort Carson is at the vanguard of soldier abuse and neglect. Again. For cryin’ out loud, can we get an IG on-post please? Preferably a hardass. I mean, what the hell is it going to take? You hear a tale of soldiers being abused by the system, you won’t have to listen long before you hear “Fort Carson” in that conversation. And this scandal is no exception. The command culture there once again sets the bar for fecklessness and mendacity as low as it has ever been.

Inspector General.

Fort Carson.

Now.

Got that?

Okay.

Now that we have settled that, let’s talk about Feres v U.S., the 1950 Supreme Court decision that protected military medical professionals from civil suit. Because of this ruling, there is no recourse of accountability for mental health professionals who mislead vulnerable and compromised troops.

Who will be the courageous congressperson who will sponsor the legislation that gives the troops the right to seek civil remedy for professional malfeasance at the hands of military health professionals?

In the meantime, since legislation moves slowly, Senator Bond needs to move forward with his threat and launch a congressional investigation into the abuse of 5-13 discharges to avoid fulfilling responsibilities to wounded and damaged troops. And every single 5-13 discharge that has been processed in the last four years should be thoroughly reviewed, and those found to have been misdiagnosed should have their benefits restored, retroactively.

We have 535 elected officials. Will just one stand up for what is right here?

[Originally posted at Watching Those We Chose.]