The Army is expected to issue a new policy in order to protect soldiers against undetected brain trauma and concussions they may suffer in combat, according to USA Today.
http://www.usatoday.com/news/military/2010-03-01-traumatic-brain-injury_N.htm
Under the prospective rule, the Pentagon will mandate that troops who are in the area of a bomb blast will be pulled out of duty for 24 hours and examined for mild traumatic brain injury (MTBI), even if they show no signs of trauma or insist they are unhurt.
During that 24-hour period, soldiers would be checked for double vision, headaches, ringing ears as well as having their short-term memory and concentration tested.
The proposed policy change stems from the fear that troops in Iraq and Afghanistan are suffering from MTBI following combat, but that this damage is not being detected.
The policy change, according to an official with the Defense and Veterans Brain Injury Center, is a major breakthrough in battlefield medicine “because it treats troops based on what happened to them, not just visible wounds,” USA Today reports.
In 2008 300,000 soldiers may have suffered brain injury, most following a bomb blast, one study estimated. Some 100,000 soldiers have been found to have MTBI since 2003.
It’s heartening to see that the military is taking real steps to protect our soldiers from every type of injury possible, even those affecting the brain.
Air Force unveils brain injury clinic in Alaska
Date: 3/19/2009
By RACHEL D’ORO
Associated Press Writer
ELMENDORF AIR FORCE BASE, Alaska (AP) — Behind Dan DeRosa’s smiling face lurks a dull headache that never goes away. He suffers from memory lapses and hears a shrill ringing in his ears akin to the lingering squeal of a heavy metal concert.
These are some of the unseen scars left by a roadside bomb in Iraq. But at the Air Force’s only traumatic brain injury clinic, the 26-year-old soldier is learning new skills to deal with the aftermath of the blast.
“I wouldn’t say my memory really is getting any better, but my ability to adapt to the fact that my memory’s really not getting any better has gotten a lot better,” said DeRosa, a sergeant assigned to Fort Richardson in Anchorage.
He is among 1,500 patients screened since the TBI Clinic opened at neighboring Elmendorf Air Force Base and one of 75 currently monitored on a regular basis.
The clinic was established in early 2007 at the Elmendorf hospital. Base medics and officials anticipated that some of the 3,500 paratroopers with the 4th Airborne Brigade Combat Team deployed to Iraq from Fort Richardson would return with the war’s signature wound.
Soon after the clinic opened, Army traumatic brain injury specialists were temporarily assigned to help the Air Force with returning soldiers.
The facility has since evolved with more services and staff experts including a case manager and a speech-language pathologist. It’s now among a growing number of treatment outlets within the departments of Defense and Veterans Affairs for military members with brain injuries and the post traumatic stress disorder that frequently accompany them.
The DOD’s health affairs office is assessing the Elmendorf clinic and many others. The DOD estimates that up to 20 percent of the roughly 1.8 million U.S. troops who have served in Iraq and Afghanistan have returned with brain injuries.
The vast majority of them suffer concussions such as those seen at the Air Force clinic, which also treats military members and relatives with brain injuries resulting from car crashes, hiking accidents and slipping on ice.
Without the Elmendorf service, the only options for Alaska-based troops would be facilities outside the remote state or long-distance programs by civilian providers, said Maj. Peter Osterbauer, a neurologist who heads the TBI clinic.
“It’s not just the one brigade that was going to come back,” Osterbauer said. “There’s going to be more in the future.”
Little more than a year after the 4th Brigade returned from Iraq, in fact, 3,500 of its paratroopers shipped out last month for an Afghanistan assignment.
Clinic officials say screening has improved to more accurately diagnose cases like DeRosa’s. But as with so many others hurt in Iraq and Afghanistan, his injury wasn’t immediately apparent after the initial shock of the June 2007 explosion.
DeRosa was driving a Humvee with three passengers outside Baghdad when the bomb went off beneath the engine, flinging the vehicle 50 yards into a ditch. No one was killed, he said, but one soldier suffered ruptured eardrums, another’s knee was damaged and the gunner flew through the turret “like a champagne cork.” DeRosa stumbled out of the Humvee with a broken arm and shrapnel wounds along the edge of his body armor.
DeRosa didn’t have time to dwell on his more long-term symptoms. He dismissed them as wartime stress. It wasn’t until after returning six months later that his problems became apparent, particularly after a long visit with his family in his hometown of Berkley, Mass.
“I started noticing things,” he said. “My hearing was not as good, I still had a headache, I wasn’t sleeping well, I wasn’t sure where I put my car keys.”
Back in Alaska, a post-deployment screening showed DeRosa needed to be checked out further by a battery of tests. Ultimately diagnosed with TBI, he became a patient at the Elmendorf clinic last spring.
DeRosa’s progress is monitored by Osterbauer. He meets three times a week with Maj. Ava Craig, an Air Force speech pathologist who said DeRosa has shown improvements in such areas as language, reader comprehension and concentration.
None of the medications prescribed for his headaches has worked, which makes DeRosa eligible for Botox injections, highly effective in treating headaches.
Botox has worked wonders for Staff Sgt. Gabriel Fierros, whose face and left eye were struck by shrapnel when his helicopter was shot down by small-arms fire outside Baghdad in April 2007.
The 28-year-old soldier from Marengo, Ill., spent seven months at Walter Reed Army Medical Center in Washington, recovering from a hard blow he compares to “a baseball bat to the face.” He also hears a high-pitched ringing in his ears, has memory problems and struggles with irritability, nightmares and other symptoms of post-traumatic stress.
He receives Botox every three months. In the latest round, Osterbauer delivered 18 injections to the front of Fierros’ head and another 10 to 15 in the back. Fierros took it stoically.
“When I first came here, I always had a headache. I was always worn out, tired. I couldn’t focus, couldn’t concentrate. I couldn’t remember my cell phone number, couldn’t remember how to get home,” he said. “Seeing the different specialists has helped a lot.”
Officials at Fort Wainwright in Fairbanks, 260 miles to the north, like the concept so much, they are planning to open up a similar TBI clinic near the post hospital within six months.
___
On the Net:
http://www.elmendorf.af.mil
http://www.usarak.army.mil/main
Copyright 2009 The Associated Press.
By RACHEL D’ORO
Associated Press Writer
ELMENDORF AIR FORCE BASE, Alaska (AP) — Behind Dan DeRosa’s smiling face lurks a dull headache that never goes away. He suffers from memory lapses and hears a shrill ringing in his ears akin to the lingering squeal of a heavy metal concert.
These are some of the unseen scars left by a roadside bomb in Iraq. But at the Air Force’s only traumatic brain injury clinic, the 26-year-old soldier is learning new skills to deal with the aftermath of the blast.
“I wouldn’t say my memory really is getting any better, but my ability to adapt to the fact that my memory’s really not getting any better has gotten a lot better,” said DeRosa, a sergeant assigned to Fort Richardson in Anchorage.
He is among 1,500 patients screened since the TBI Clinic opened at neighboring Elmendorf Air Force Base and one of 75 currently monitored on a regular basis.
The clinic was established in early 2007 at the Elmendorf hospital. Base medics and officials anticipated that some of the 3,500 paratroopers with the 4th Airborne Brigade Combat Team deployed to Iraq from Fort Richardson would return with the war’s signature wound.
Soon after the clinic opened, Army traumatic brain injury specialists were temporarily assigned to help the Air Force with returning soldiers.
The facility has since evolved with more services and staff experts including a case manager and a speech-language pathologist. It’s now among a growing number of treatment outlets within the departments of Defense and Veterans Affairs for military members with brain injuries and the post traumatic stress disorder that frequently accompany them.
The DOD’s health affairs office is assessing the Elmendorf clinic and many others. The DOD estimates that up to 20 percent of the roughly 1.8 million U.S. troops who have served in Iraq and Afghanistan have returned with brain injuries.
The vast majority of them suffer concussions such as those seen at the Air Force clinic, which also treats military members and relatives with brain injuries resulting from car crashes, hiking accidents and slipping on ice.
Without the Elmendorf service, the only options for Alaska-based troops would be facilities outside the remote state or long-distance programs by civilian providers, said Maj. Peter Osterbauer, a neurologist who heads the TBI clinic.
“It’s not just the one brigade that was going to come back,” Osterbauer said. “There’s going to be more in the future.”
Little more than a year after the 4th Brigade returned from Iraq, in fact, 3,500 of its paratroopers shipped out last month for an Afghanistan assignment.
Clinic officials say screening has improved to more accurately diagnose cases like DeRosa’s. But as with so many others hurt in Iraq and Afghanistan, his injury wasn’t immediately apparent after the initial shock of the June 2007 explosion.
DeRosa was driving a Humvee with three passengers outside Baghdad when the bomb went off beneath the engine, flinging the vehicle 50 yards into a ditch. No one was killed, he said, but one soldier suffered ruptured eardrums, another’s knee was damaged and the gunner flew through the turret “like a champagne cork.” DeRosa stumbled out of the Humvee with a broken arm and shrapnel wounds along the edge of his body armor.
DeRosa didn’t have time to dwell on his more long-term symptoms. He dismissed them as wartime stress. It wasn’t until after returning six months later that his problems became apparent, particularly after a long visit with his family in his hometown of Berkley, Mass.
“I started noticing things,” he said. “My hearing was not as good, I still had a headache, I wasn’t sleeping well, I wasn’t sure where I put my car keys.”
Back in Alaska, a post-deployment screening showed DeRosa needed to be checked out further by a battery of tests. Ultimately diagnosed with TBI, he became a patient at the Elmendorf clinic last spring.
DeRosa’s progress is monitored by Osterbauer. He meets three times a week with Maj. Ava Craig, an Air Force speech pathologist who said DeRosa has shown improvements in such areas as language, reader comprehension and concentration.
None of the medications prescribed for his headaches has worked, which makes DeRosa eligible for Botox injections, highly effective in treating headaches.
Botox has worked wonders for Staff Sgt. Gabriel Fierros, whose face and left eye were struck by shrapnel when his helicopter was shot down by small-arms fire outside Baghdad in April 2007.
The 28-year-old soldier from Marengo, Ill., spent seven months at Walter Reed Army Medical Center in Washington, recovering from a hard blow he compares to “a baseball bat to the face.” He also hears a high-pitched ringing in his ears, has memory problems and struggles with irritability, nightmares and other symptoms of post-traumatic stress.
He receives Botox every three months. In the latest round, Osterbauer delivered 18 injections to the front of Fierros’ head and another 10 to 15 in the back. Fierros took it stoically.
“When I first came here, I always had a headache. I was always worn out, tired. I couldn’t focus, couldn’t concentrate. I couldn’t remember my cell phone number, couldn’t remember how to get home,” he said. “Seeing the different specialists has helped a lot.”
Officials at Fort Wainwright in Fairbanks, 260 miles to the north, like the concept so much, they are planning to open up a similar TBI clinic near the post hospital within six months.
___
On the Net:
http://www.elmendorf.af.mil
http://www.usarak.army.mil/main
Copyright 2009 The Associated Press.
Better brain trauma testing urged for those at war
Date: 3/12/2009 6:14 PM
By KIMBERLY HEFLING
Associated Press
WASHINGTON (AP) — A group of doctors and scientists said Thursday the U.S. needs to devise a uniform test for traumatic brain injury to be performed on all troops who are exposed to a blast or other violent event in wartime.
Traumatic brain injury, or TBI, is often referred to as the signature wound of the Iraq war. Roadside bombs, vehicle accidents and other events have left hundreds of thousands of troops with such an injury.
Most are mild, and military medical officials have said an overwhelming majority heal without treatment. But Brig. Gen. Loree Sutton, the head of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, has said 45,000 to 90,000 troops have suffered more severe and lasting symptoms.
The recommendations to Congress on Thursday came from a conference last fall in Paterson, N.J., sponsored by a congressional task force on brain injuries. Reps. Bill Pascrell Jr. of New Jersey and Todd Platts of Pennsylvania are chairmen of the task force.
The group suggested that the assessment tool be used in wartime to determine if a soldier should return to duty. It also recommended improvements to traumatic brain injury research, better access to care and more resources for families of troops with TBI.
It asked Congress to spend $350 million on its recommendations to be overseen by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.
“We’re approaching this from every different angle possible,” Pascrell said. “We have a sense of urgency.”
Copyright 2009 The Associated Press.
By KIMBERLY HEFLING
Associated Press
WASHINGTON (AP) — A group of doctors and scientists said Thursday the U.S. needs to devise a uniform test for traumatic brain injury to be performed on all troops who are exposed to a blast or other violent event in wartime.
Traumatic brain injury, or TBI, is often referred to as the signature wound of the Iraq war. Roadside bombs, vehicle accidents and other events have left hundreds of thousands of troops with such an injury.
Most are mild, and military medical officials have said an overwhelming majority heal without treatment. But Brig. Gen. Loree Sutton, the head of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, has said 45,000 to 90,000 troops have suffered more severe and lasting symptoms.
The recommendations to Congress on Thursday came from a conference last fall in Paterson, N.J., sponsored by a congressional task force on brain injuries. Reps. Bill Pascrell Jr. of New Jersey and Todd Platts of Pennsylvania are chairmen of the task force.
The group suggested that the assessment tool be used in wartime to determine if a soldier should return to duty. It also recommended improvements to traumatic brain injury research, better access to care and more resources for families of troops with TBI.
It asked Congress to spend $350 million on its recommendations to be overseen by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.
“We’re approaching this from every different angle possible,” Pascrell said. “We have a sense of urgency.”
Copyright 2009 The Associated Press.
Purple Heart won’t be awarded for PTSD
Date: 1/8/2009
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
Vets sue CIA, Defense over military experiments
Date: 1/7/2009
By PAUL ELIAS
Associated Press Writer
SAN FRANCISCO (AP) — Six veterans who claim they were unwittingly exposed to dangerous chemicals and germs during government-sponsored Cold War experiments have sued the CIA, Department of Defense and other agencies.
The vets volunteered for military experiments they say were part of a program started in the 1950s to test nerve agents, biological weapons and mind-control techniques. They allege in their federal lawsuit filed Wednesday in San Francisco that they are in poor health today because of the experiments. They are demanding health care and a court ruling that the program was illegal.
The organization Vietnam Veterans of America is also part of the lawsuit, which seeks class action status on behalf of all participants who were allegedly exposed to unhealthful experiments without their knowledge.
Copyright 2009 The Associated Press.
By PAUL ELIAS
Associated Press Writer
SAN FRANCISCO (AP) — Six veterans who claim they were unwittingly exposed to dangerous chemicals and germs during government-sponsored Cold War experiments have sued the CIA, Department of Defense and other agencies.
The vets volunteered for military experiments they say were part of a program started in the 1950s to test nerve agents, biological weapons and mind-control techniques. They allege in their federal lawsuit filed Wednesday in San Francisco that they are in poor health today because of the experiments. They are demanding health care and a court ruling that the program was illegal.
The organization Vietnam Veterans of America is also part of the lawsuit, which seeks class action status on behalf of all participants who were allegedly exposed to unhealthful experiments without their knowledge.
Copyright 2009 The Associated Press.
VA quadruples payment to vets with brain injuries
Date: 9/23/2008 6:23 PM
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) _ The government is more than quadrupling monthly payments to some veterans suffering brain injuries, as the number of such war wounds mounts from the roadside bombings of Iraq and Afghanistan.
The new compensation is based on the assessment that even some troops who have the mildest form of traumatic brain injury could end up with chronic headaches, memory loss, anxiety or other symptoms that will hurt their chances of getting a job or job advancement — thus reducing their lifetime earnings by 40 percent.
In a regulation announced Tuesday by the Department of Veterans Affairs, officials changed the way they evaluate the injuries. Depending on the extent of their injuries, vets now can be judged up to 40 percent disabled in such cases. The previous rating of 10 percent for such injuries was set by a 1961 regulation.
The rating change means that an unmarried veteran, who now receives $117 monthly in compensation, could receive as much as $512. Extra money would also be calculated for troops with spouses and children.
Mild traumatic brain injury is basically a form of concussion that results from severe shaking of the brain after a blast. It can cause blurred vision, insomnia, irritability and other problems.
The VA change represents the “best judgment of medical experts about what the impact” of such injuries is and how best to evaluate veterans who come to the VA for help, said Tom Pamperin, a deputy director for the department’s compensation and pension service.
The change goes into effect in 30 days and those receiving compensation under the old system can have their cases reviewed.
Roughly 1.7 million American troops have served in Iraq and Afghanistan and a RAND Corporation study estimated early this year that up to 320,000 may have suffered a traumatic brain injury. Officials say that the vast majority of the cases are mild — and that most veterans recover in weeks or months. The new, higher disability rating is for the smaller percentage who suffer permanent damage, Pamperin said.
The extra disability compensation is expected to cost nearly $124 million through 2017. That’s based on the assumption that the number of troops who get such payments will rise steadily in the coming years to 5,100 for 2017 from about 800 new cases a year now, Pamperin said.
He said about 200 troops with brain injuries annually went to the VA before the start of the Iraq war, where insurgent use of roadside explosives and car-bombs has made brain injuries, amputations, burns and post-traumatic stress disorder the vast majority of wounds from the campaign. Insurgents are also increasingly using explosives in Afghanistan.
Officials believe compensation levels are already correct for troops with moderate and severe traumatic brain injury that can involve open head wounds.
Though most troops with the severe cases already can be rated at 100 percent disabled, an increase has been approved for additional care they might need. That is, a single vet who needs assisted care can get $3,145 a month compared to the current $2,527 payment.
___
On the Net:
Department of Veterans Affairs www.va.gov
Copyright 2008 The Associated Press.
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) _ The government is more than quadrupling monthly payments to some veterans suffering brain injuries, as the number of such war wounds mounts from the roadside bombings of Iraq and Afghanistan.
The new compensation is based on the assessment that even some troops who have the mildest form of traumatic brain injury could end up with chronic headaches, memory loss, anxiety or other symptoms that will hurt their chances of getting a job or job advancement — thus reducing their lifetime earnings by 40 percent.
In a regulation announced Tuesday by the Department of Veterans Affairs, officials changed the way they evaluate the injuries. Depending on the extent of their injuries, vets now can be judged up to 40 percent disabled in such cases. The previous rating of 10 percent for such injuries was set by a 1961 regulation.
The rating change means that an unmarried veteran, who now receives $117 monthly in compensation, could receive as much as $512. Extra money would also be calculated for troops with spouses and children.
Mild traumatic brain injury is basically a form of concussion that results from severe shaking of the brain after a blast. It can cause blurred vision, insomnia, irritability and other problems.
The VA change represents the “best judgment of medical experts about what the impact” of such injuries is and how best to evaluate veterans who come to the VA for help, said Tom Pamperin, a deputy director for the department’s compensation and pension service.
The change goes into effect in 30 days and those receiving compensation under the old system can have their cases reviewed.
Roughly 1.7 million American troops have served in Iraq and Afghanistan and a RAND Corporation study estimated early this year that up to 320,000 may have suffered a traumatic brain injury. Officials say that the vast majority of the cases are mild — and that most veterans recover in weeks or months. The new, higher disability rating is for the smaller percentage who suffer permanent damage, Pamperin said.
The extra disability compensation is expected to cost nearly $124 million through 2017. That’s based on the assumption that the number of troops who get such payments will rise steadily in the coming years to 5,100 for 2017 from about 800 new cases a year now, Pamperin said.
He said about 200 troops with brain injuries annually went to the VA before the start of the Iraq war, where insurgent use of roadside explosives and car-bombs has made brain injuries, amputations, burns and post-traumatic stress disorder the vast majority of wounds from the campaign. Insurgents are also increasingly using explosives in Afghanistan.
Officials believe compensation levels are already correct for troops with moderate and severe traumatic brain injury that can involve open head wounds.
Though most troops with the severe cases already can be rated at 100 percent disabled, an increase has been approved for additional care they might need. That is, a single vet who needs assisted care can get $3,145 a month compared to the current $2,527 payment.
___
On the Net:
Department of Veterans Affairs www.va.gov
Copyright 2008 The Associated Press.