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Tag Archive: Posttraumatic stress disorder


Vets, Docs Worry Fort Hood Shootings Will Deepen PTSD Stigma

The word “PTSD” had barely left the mouth of Fort Hood’s commander late Wednesday when, across the nation, many veterans with those symptoms and doctors who treat the malady understood they faced a renewed battle: a resurgence of the stigma that comes with that diagnosis.

The Fort Hood tragedy –- 16 wounded and four killed, including identified shooter Ivan Lopez, a soldier being evaluated for PTSD –- is precisely the type of event that makes combat veterans cringe. Many worry they’ll be further mislabeled as dangerous time bombs, as the next to snap, and that post-traumatic stress will again be misrepresented and misunderstood as a condition that sparks public, violent outbursts.

“That is not what post-traumatic stress is or what it does,” said Ingrid Herrera-Yee, a clinical psychologist in the Washington, D.C. area who treats veterans diagnosed with Post Traumatic Stress Disorder and other mental health issues as well as their family members and civilians. Her husband, Army National Guard Staff Sgt. Ian Yee, spent three combat deployments in Iraq and Afghanistan.

“Yes, there is anger and irritability (associated with PTSD), but it’s usually internalized. You’re more likely to see it as someone who is withdrawn, anxious and numb, who’s lost interest in life. Some veterans explain it to me this way: ‘The last thing you want is to go out and lash out,” said Herrera-Yee, adding: “Just like any victims of a trauma –- rape or domestic violence -– they can become fearful of their surroundings, but they’re not going to react angrily toward their surroundings. For them, it’s all about avoidance.”

“You’re more likely to see it as someone who is withdrawn, anxious and numb, who’s lost interest in life. Some veterans explain it to me this way: ‘The last thing you want is to go out and lash out.'”

For years, Pentagon brass and branch commanders have urged troops and veterans to seek mental-health help if they feel the need, while repeating the message that, if they do see a doctor, they will not be viewed as weak but as strong. That campaign seems to have finally dented the macho-military mantra that every soldier can handle his or her own business. Many veterans are turning to doctors to begin addressing post-service anxiety issues, often fueled by repeated or long deployments.

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Disabled vet kicked out of Houston restaurant over service dog

by Drew Karedes / KHOU 11 News

Posted on February 27, 2014 at 9:54 AM

Updated Thursday, Feb 27 at 9:54 AM

 

HOUSTON — A U.S. Army and Navy veteran says he was told he had to leave a west Houston restaurant because of his service dog.

Aryeh Ohayon says it happened Tuesday at the Thai Spice Buffet II restaurant in the 2500 block of South Voss Road.

Ohayon called Houston Police and waited inside the restaurant.

He claims the officer who responded made him feel even worse.

“I told him what my disabilities were. That’s when he said, ‘you’re not blind’,” recalled Ohayon. “[He said] ‘I don’t see why you need the dog.’”

Ohayon served this country for 23 years.

He says the memories from his more than two decades of service have led to depression and PTSD, both of which his service dog Bandit is there for.

“He’s the alert if I start to have a panic attack or start to go into a flashback mode,” said Ohayon.

 

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Houston police kick out veteran with service dog from restaurant

Published time: February 27, 2014 20:24

Reuters / Richard Carson

Reuters / Richard Carson

A Houston, Texas, police officer allegedly kicked a US Army and Navy veteran out of a local restaurant for bringing in a service dog on the grounds that he wasn’t actually blind.

According to local news outlet KHOU, Aryeh Ohayon served in the US military for 23 years. Ohayon said his service dog, named “Bandit,” helps him deal with the lingering effects of depression and post-traumatic stress disorder (PTSD), especially if he begins to suffer from panic attack or a flashback linked to his prior experiences.

The incident began when Ohayon entered a Thai restaurant for dinner and was denied service by the manager. The veteran called police to clear up the situation, but he said the responding officer only denigrated his condition.

“I told him what my disabilities were,” Ohayon told KHOU. “That’s when he said, you’re not blind. [He said] I don’t see why you need the dog.”

“It feels like your service and experience that you’ve done to defend and uphold the Constitution and protect this country have been belittled,” he added.

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National Organization for Women NOW activists taking action!

Violence Against Women in the United States: Statistics

Despite the fact that advocacy groups like NOW have worked for two decades to halt the epidemic of gender-based violence and sexual assault, the numbers are still shocking. It is time to renew our national pledge, from the President and Congress on down to City Councils all across the nation to END violence against women and men, girls and boys. This effort must also be carried on in workplaces, schools, churches, locker rooms, the military, and in courtrooms, law enforcement, entertainment and the media. NOW pledges to continue our work to end this violence and we hope you will join us in our work.

MURDER

In 2005, 1,181 women were murdered by an intimate partner.1 That’s an average of three women every day. Of all the women murdered in the U.S., about one-third were killed by an intimate partner.2

DOMESTIC VIOLENCE (Intimate Partner Violence or Battering)

Domestic violence can be defined as a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over an intimate partner.3 According to the National Center for Injury Prevention and Control, women experience about 4.8 million intimate partner-related physical assaults and rapes every year.4 Less than 20 percent of battered women sought medical treatment following an injury.5

SEXUAL VIOLENCE

According to the National Crime Victimization Survey, which includes crimes that were not reported to the police, 232,960 women in the U.S. were raped or sexually assaulted in 2006. That’s more than 600 women every day.6 Other estimates, such as those generated by the FBI, are much lower because they rely on data from law enforcement agencies. A significant number of crimes are never even reported for reasons that include the victim’s feeling that nothing can/will be done and the personal nature of the incident.7

THE TARGETS

Young women, low-income women and some minorities are disproportionately victims of domestic violence and rape. Women ages 20-24 are at greatest risk of nonfatal domestic violence8, and women age 24 and under suffer from the highest rates of rape.9 The Justice Department estimates that one in five women will experience rape or attempted rape during their college years, and that less than five percent of these rapes will be reported.10 Income is also a factor: the poorer the household, the higher the rate of domestic violence — with women in the lowest income category experiencing more than six times the rate of nonfatal intimate partner violence as compared to women in the highest income category.11 When we consider race, we see that African-American women face higher rates of domestic violence than white women, and American-Indian women are victimized at a rate more than double that of women of other races.12

IMPACT ON CHILDREN

According to the Family Violence Prevention Fund, “growing up in a violent home may be a terrifying and traumatic experience that can affect every aspect of a child’s life, growth and development. . . . children who have been exposed to family violence suffer symptoms of post-traumatic stress disorder, such as bed-wetting or nightmares, and were at greater risk than their peers of having allergies, asthma, gastrointestinal problems, headaches and flu.” In addition, women who experience physcial abuse as children are at a greater risk of victimization as adults, and men have a far greater (more than double) likelihood of perpetrating abuse. 13

Read, Inform and  Support Women Here

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Women and Violence

Violence affects the lives of millions of women worldwide, in all socio-economic and educational classes. It cuts across cultural and religious barriers, impeding the right of women to participate fully in society.

Violence against women takes a dismaying variety of forms, from domestic abuse and rape to child marriages and female circumcision. All are violations of the most fundamental human rights.

In a statement to the Fourth World Conference on Women in Beijing in September 1995, the United Nations Secretary-General, Boutros Boutros-Ghali, said that violence against women is a universal problem that must be universally condemned. But he said that the problem continues to grow.

The Secretary-General noted that domestic violence alone is on the increase. Studies in 10 countries, he said, have found that between 17 per cent and 38 per cent of women have suffered physical assaults by a partner.

In the Platform for Action, the core document of the Beijing Conference, Governments declared that “violence against women constitutes a violation of basic human rights and is an obstacle to the achievement of the objectives of equality, development and peace”.

Incest, Rape and Domestic Violence

Some females fall prey to violence before they are born, when expectant parents abort their unborn daughters, hoping for sons instead. In other societies, girls are subjected to such traditional practices as circumcision, which leave them maimed and traumatized. In others, they are compelled to marry at an early age, before they are physically, mentally or emotionally mature.

Women are victims of incest, rape and domestic violence that often lead to trauma, physical handicap or death.

And rape is still being used as a weapon of war, a strategy used to subjugate and terrify entire communities. Soldiers deliberately impregnate women of different ethnic groups and abandon them when it is too late to get an abortion.

The Platform for Action adopted at the Fourth World Conference on Women declared that rape in armed conflict is a war crime — and could, under certain circumstances, be considered genocide.

Secretary-General Boutros-Ghali told the Beijing Conference that more women today were suffering directly from the effects of war and conflict than ever before in history.

“There is a deplorable trend towards the organized humiliation of women, including the crime of mass rape”, the Secretary-General said. “We will press for international legal action against those who perpetrate organized violence against women in time of conflict.”

A preliminary report in 1994 by the Special Rapporteur, Ms. Radhika Coomaraswamy, focused on three areas of concern where women are particularly vulnerable: in the family (including domestic violence, traditional practices, infanticide); in the community (including rape, sexual assault, commercialized violence such as trafficking in women, labour exploitation, female migrant workers etc.); and by the State (including violence against women in detention as well as violence against women in situations of armed conflict and against refugee women).

In the Platform for Action adopted at the Beijing Conference, violence against women and the human rights of women are 2 of the 12 critical areas of concern identified as the main obstacles to the advancement of women.

Commitments by Governments

Governments agreed to adopt and implement national legislation to end violence against women and to work actively to ratify all international agreements that relate to violence against women. They agreed that there should be shelters, legal aid and other services for girls and women at risk, and counselling and rehabilitation for perpetrators.

Governments also pledged to adopt appropriate measures in the field of education to modify the social and cultural patterns of conduct of men and women. And the Platform called on media professionals to develop self-regulatory guidelines to address violent, degrading and pornographic materials while encouraging non-stereotyped, balanced and diverse images of women.

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Laws on violence against women

The U.S. Congress has passed two main laws related to violence against women, the Violence Against Women Act and the Family Violence Prevention and Services Act.

The Violence Against Women Act (VAWA) was the first major law to help government agencies and victim advocates work together to fight domestic violence, sexual assault, and other types of violence against women. It created new punishments for certain crimes and started programs to prevent violence and help victims. Over the years, the law has been expanded to provide more programs and services. Currently, some included items are:

  • Violence prevention programs in communities
  • Protections for victims who are evicted from their homes because of events related to domestic violence or stalking
  • Funding for victim assistance services like rape crisis centers and hotlines
  • Programs to meet the needs of immigrant women and women of different races or ethnicities
  • Programs and services for victims with disabilities
  • Legal aid for survivors of violence
  • Services for children and teens

The National Advisory Committee on Violence Against Women works to help promote the goals and vision of VAWA. The committee is a joint effort between the U.S. Department of Justice and the U.S. Department of Health and Human Services. Examples of the committee’s efforts include the Community Checklist initiative to make sure each community has domestic violence programs and the Toolkit to End Violence Against Women, which has chapters for specific audiences.

The Family Violence Prevention and Services Act

The Family Violence Prevention and Services Act (FVPSA) provides the main federal funding to help victims of domestic violence and their dependents (such as children). Programs funded through FVPSA provide shelter and related help. They also offer violence prevention activities and try to improve how service agencies work together in communities. FVPSA works through a few main ways:

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Bleeding Ex-Girlfriend Shooting Target At NRA Conference Promotes Violence Against Women (IMAGE)

5:39 am4 commentsViews:

zombie_girlfriend

This is so offensive in so many ways, I don’t know where to begin. During Houston’s NRA Conference last week, a vendor was promoting shooting targets. One target looked so much like President Obama, it had to be taken off display. However the one ‘token’ female target called ‘Ex’, to represent an ex-girlfriend, that bleeds when you shoot her, was allowed to stay. It apparently met the NRA decency guidelines.

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The Stories Out There are Lies, but the Truth?

 

By Gordon Duff, Senior Editor

Veterans Today

Over 550,000 Americans can’t own firearms because of “mental incompetence.”  21% of those are veterans. 

Editor:  A note I think is needed; the article below will describe a “dual system” for establishing broad mental disability, enough to deny weapons rights.  It is very important that veterans carefully review this article in its entirety.  If veterans avoid needed care because of misinformation or the very real threat outlined below, it would not only be a disaster but one that groups like the American Enterprise Institute wish to bring about.  This article isn’t the “end all,” but a sign that veterans need to remain vigilant in maintaining their rights.

Stories about “new letters” or a “new law” are total bunk.  The law that authorizes gun seizures for those “adjudicated mentally ill” was passed in 1997 but nothing was said about it for over 15 years.  The law that is “in force” is the same one every gun owner in America is subject to, the question that is on every weapons background check and has been for many years.

Why bring it up now, why lie about it?  Why victimize veterans with vicious scares and rumor mongering?

The wild stories are being used to terrify vets and are, in fact, preying on veterans, particularly those with PTSD.  It isn’t just vets, nearly half of the police officers and firefighters in the US suffer from varying degrees of PTSD.

Will they be disarmed also?  You forget, of our men and women in combat, nearly 40% of them carry an active diagnosis of Post Traumatic Stress with most under current treatment though both armed and in combat as we go to press.

Mac McClelland
Mother JonesVia  Sott.net

© Photos by Brady Fontenot
Katie, Caleb, and Brannan Vines

Brannan Vines has never been to war. But she’s got a warrior’s skills: hyperawareness, hypervigilance, adrenaline-sharp quick-scanning for danger, for triggers. Super stimuli-sensitive. Skills on the battlefield, crazy-person behavior in a drug store, where she was recently standing behind a sweet old lady counting out change when she suddenly became so furious her ears literally started ringing. Being too cognizant of every sound – every coin dropping an echo – she explodes inwardly, fury flash-incinerating any normal tolerance for a fellow patron with a couple of dollars in quarters and dimes. Her nose starts running she’s so pissed, and there she is standing in a CVS, snotty and deaf with rage, like some kind of maniac, because a tiny elderly woman needs an extra minute to pay for her dish soap or whatever.

Brannan Vines has never been to war, but her husband, Caleb, was sent to Iraq twice, where he served in the infantry as a designated marksman. He’s one of 103,200, or 228,875, or 336,000 Americans who served in Iraq or Afghanistan and came back with PTSD, depending on whom you ask, and one of 115,000 to 456,000 with traumatic brain injury. It’s hard to say, with the lack of definitive tests for the former, undertesting for the latter, underreporting, under or over-misdiagnosing of both. And as slippery as all that is, even less understood is the collateral damage, to families, to schools, to society – emotional and fiscal costs borne long after the war is over.

Like Brannan’s symptoms. Hypervigilance sounds innocuous, but it is in fact exhaustingly distressing, a conditioned response to life-threatening situations. Imagine there’s a murderer in your house. And it is dark outside, and the electricity is out. Imagine your nervous system spiking, readying you as you feel your way along the walls, the sensitivity of your hearing, the tautness in your muscles, the alertness shooting around inside your skull. And then imagine feeling like that all the time.

Caleb has been home since 2006, way more than enough time for Brannan to catch his symptoms. The house, in a subdivision a little removed from one of many shopping centers in a small town in the southwest corner of Alabama, is often quiet as a morgue. You can hear the cat padding around. The air conditioner whooshes, a clock ticks. When a sound erupts – Caleb screaming at Brannan because she’s just woken him up from a nightmare, after making sure she’s at least an arm’s length away in case he wakes up swinging – the ensuing silence seems even denser. Even when everyone’s in the family room watching TV, it’s only connected to Netflix and not to cable, since news is often a trigger. Brannan and Caleb can be tense with their own agitation, and tense about each other’s. Their German shepherd, a service dog trained to help veterans with PTSD, is ready to alert Caleb to triggers by barking, or to calm him by jumping onto his chest. This PTSD picture is worse than some, but much better, Brannan knows, than those that have devolved into drug addiction and rehab stints and relapses. She has not, unlike military wives she advises, ever been beat up. Nor jumped out of her own bed when she got touched in the middle of the night for fear of being raped, again. Still.

“Sometimes I can’t do the laundry,” Brannan explains, reclining on her couch. “And it’s not like, ‘Oh, I’m too tired to do the laundry,’ it’s like, ‘Um, I don’t understand how to turn the washing machine on.’ I am looking at a washing machine and a pile of laundry and my brain is literally overwhelmed by trying to figure out how to reconcile them.” She sounds like she might start crying, not because she is, but because that’s how she always sounds, like she’s talking from the top of a clenched throat, tonally shaky and thin. She looks relaxed for the moment, though, the sun shining through the windows onto her face in this lovely leafy suburb. We raise the blinds in the afternoons, but only if we are alone. When we hear Caleb pulling back in the driveway, we jump up and grab their strings, plunging the living room back into its usual necessary darkness.

Katie and Brannan Vines

The Vineses’ wedding album is gorgeous, leather-bound, older and dustier than you might expect given their youth. Brannan is 32 now, but in her portraits with the big white dress and lacy veil she’s not even old enough to drink. There were 500 people at the ceremony. Even the mayor was there. And there’s Caleb, slim, in a tux, three years older than Brannan at 22, in every single picture just about the smilingest motherfucker you’ve ever seen, in a shy kind of way.

Now, he’s rounder, heavier, bearded, and long-haired, obviously tough even if he weren’t prone to wearing a COMBAT INFANTRYMAN cap, but still not the guy you picture when you see his “Disabled Veteran” license plates. Not the old ‘Nam guy with a limp, or maybe the young legless Iraq survivor, that you’d expect.

It’s kind of hard to understand Caleb’s injuries. Even doctors can’t say for sure exactly why he has flashbacks, why he could be standing in a bookstore when all of a sudden he’s sure he’s in Ramadi, the pictures in his brain disorienting him among the stacks, which could turn from stacks to rows of rooftops that need to be scanned for snipers. Sometimes he starts yelling, and often he doesn’t remember anything about it later. They don’t know exactly why it comes to him in dreams, and why especially that time he picked up the pieces of Baghdad bombing victims and that lady who appeared to have thrown herself on top of her child to save him only to find the child dead underneath torments him when he’s sleeping, and sometimes awake. They don’t know why some other guys in his unit who did and saw the same stuff that Caleb did and saw are fine but Caleb is so sensitive to light, why he can’t just watch the news like a regular person without feeling as if he might catch fire. Some hypotheses for why PTSD only tortures some trauma victims blame it on unhappily coded proteins, or a misbehaving amygdala. Family history, or maybe previous trauma.

Whatever is happening to Caleb, it’s as old as war itself. The ancient historian Herodotus told of Greeks being honorably dismissed for being “out of heart” and “unwilling to encounter danger.” Civil War doctors, who couldn’t think of any other thing that might be unpleasant about fighting the Civil War but homesickness, diagnosed thousands with “nostalgia.” Later, it was deemed “irritable heart.” In World War I it was called “shell shock.” In World War II, “battle fatigue.” It wasn’t an official diagnosis until 1980, when Post Traumatic Stress Disorder made its debut in psychiatry’s Diagnostic and Statistical Manual of Mental Disorders, uniting a flood of Vietnam vets suffering persistent psych issues with traumatized civilians – previously assigned labels like “accident neurosis” and “post-rape syndrome” – onto the same page of the DSM-III.

But whatever people have called it, they haven’t been likely to grasp or respect it. In 1943, when Lt. General George S. Patton met an American soldier at an Italian hospital recovering from “nerves,” Patton slapped him and called him a coward. In 2006, the British Ministry of Defence pardoned some 300 soldiers who had been executed for cowardice and desertion during World War I, having concluded that many were probably just crippled by PTSD.

Granted, diagnosing PTSD is a tricky thing. The result of a malfunctioning nervous system that fails to normalize after trauma and instead perpetrates memories and misfires life-or-death stress for no practical reason, it comes in a couple of varieties, various complexities, has causes ranging from one lightning-fast event to drawn-out terrors or patterns of abuse – in soldiers, the incidence of PTSD goes up with the number of tours and amount of combat experienced. As with most psychiatric diagnoses, there are no measurable objective biological characteristics to identify it. Doctors have to go on hunches and symptomology rather than definitive evidence. And the fact that the science hasn’t fully caught up with the suffering, that Caleb can’t point to something provably, biologically ruining his life, just makes him feel worse. It’s invalidating. Even if something is certainly wrong – even if a couple of times he has inadvisably downed his medication with a lot of booze, admitting to Brannan that he doesn’t care if he dies; even if he once came closer to striking her than she ever, ever, ever could have imagined before he went to war­ – Caleb knows that a person whose problem is essentially that he can’t adapt to peacetime Alabama sounds, to many, like a pussy.

“Somebody at the VA told me, ‘Kids in Congo and Uganda don’t have PTSD,'” Caleb tells me angrily one day.

You can’t see Caleb’s other wound, either. It’s called traumatic brain injury, or TBI, from multiple concussions. In two tours, he was in at least 20 explosions – IEDs, vehicle-borne IEDs, RPGs. In one of them, when a mortar or grenade hit just behind him, he was thrown headfirst through a metal gate and into a courtyard. His buddies dragged him into a corner, where he was in and out of consciousness while the firefight continued, for hours. When it was over, they gave him an IV and some Motrin, and within hours, he was back on patrol. The Army has rules about that sort of thing now. Now if you’re knocked unconscious, or have double vision, or exhibit other signs of a brain injury, you have to rest for a certain period of time, but that rule didn’t go into effect in theater until 2010, after Caleb was already out of the service. He wasn’t diagnosed for years after he got back, despite Brannan’s frantic phone calls to the VA begging for tests, since her husband, formerly a high-scoring civil-engineering major at Auburn University, was asking her to help him do simple division. When Caleb was finally screened for the severity of his TBI, Brannan says he got the second-worst score in the whole 18-county Gulf Coast VA system, which serves more than 50,000 veterans. But there’s still a lot about brain damage that doctors, much less civilians, don’t understand.

“I guess we’re just used to dealing with people with more severe injuries,” a VA nurse once told Brannan upon seeing Caleb.

Unlike PTSD, secondary traumatic stress doesn’t have its own entry in the DSM, though the manual does take note of it, as do many peer-reviewed studies and the Department of Veterans Affairs. Symptoms start at depression and alienation, including the “compassion fatigue” suffered by social workers and trauma counselors. But some spouses and loved ones suffer symptoms that are, as one medical journal puts it, “almost identical to PTSD except that indirect exposure to the traumatic event through close contact with the primary victim of trauma” is the catalyst. Basically your spouse’s behavior becomes the “T” in your own PTSD. If sympathy for Caleb is a little lacking, you can imagine what little understanding exists for Brannan.

Secondary traumatic stress has been documented in the spouses of veterans with PTSD from Vietnam. And the spouses of Israeli veterans with PTSD, and Dutch veterans with PTSD. In one study, the incidence of secondary trauma in wives of Croatian war vets with PTSD was 30 percent. In another study there, it was 39 percent. “Trauma is really not something that happens to an individual,” says Robert Motta, a clinical psychologist and psychology professor at Hofstra University who wrote a few of the many medical-journal articles about secondary trauma in Vietnam vets’ families. “Trauma is a contagious disease; it affects everyone that has close contact with a traumatized person” in some form or another, to varying degrees and for different lengths of time. “Everyone” includes children. Which is something Brannan and Caleb lose not a little sleep over, since they’ve got a six-year-old in the house.

Katie* Vines, the first time I meet her, is in trouble. Not that you’d know it to look at her, bounding up to the car, blondish bob flying as she sprints from her kindergarten class, nice round face like her daddy’s. No one’s the wiser until she cheerfully hands her mother a folder from the backseat she’s hopped into. It contains notes about the day from her teacher.

“It says here,” Brannan says, her eyes narrowing incredulously, “that you spit on somebody today.”

“Yes ma’am,” Katie admits, lowering her voice and her eyes guiltily.

“Katie Vines.” Brannan was born here in Alabama, so that’s drawled. “Wah did you do that?”

Her schoolmate said something mean. Maybe. Katie doesn’t sound sure, or like she remembers exactly. One thing she’s positive of: “She just made me…so. MAD.” Brannan asks Katie to name some of the alternatives. “Walk away, get the teacher, yes ma’am, no ma’am,” Katie dutifully responds to the prompts. She looks disappointed in herself. Her eyebrows are heavily creased when she shakes her head and says quietly again, “I was so mad.”

Brannan and Katie’s teacher have conferenced about Katie’s behavior many times. Brannan’s not surprised she’s picked up overreacting and yelling – you don’t have to be at the Vines residence for too long to hear Caleb hollering from his room, where he sometimes hides for 18, 20 hours at a time, and certainly not if you’re there during his nightmares, which Katie is. “She mirrors…she just mirrors” her dad’s behavior, Brannan says. She can’t get Katie to stop picking at the sores on her legs, sores she digs into her own skin with anxious little fingers. She is not, according to Brannan, “a normal, carefree six-year-old.”

Different studies of the children of American World War II, Korea, and Vietnam vets with PTSD have turned up different results: “45 percent” of kids in one small study “reported significant PTSD signs”; “83 percent reported elevated hostility scores.” Other studies have found a “higher rate of psychiatric treatment“; “more dysfunctional social and emotional behavior“; “difficulties in establishing and maintaining friendships.” The symptoms were similar to what those researchers had seen before, in perhaps the most analyzed and important population in the field of secondary traumatization: the children of Holocaust survivors.

But then in 2003, a team of Dutch and Israeli researchers meta-analyzed 31 of the papers on Holocaust survivors’ families, and concluded – to the fury of some clinicians – that when more rigorous controls were applied, there was no evidence for the intergenerational transmission of trauma.

I asked the lead scientist, Marinus van IJzendoorn of Leiden University, what might account for other studies’ finding of secondary trauma in vets’ spouses or kids. He said he’s never analyzed those studies, and wonders if the results would hold up to a meta-analysis. But: “Suppose that there is a second-generation effect in veterans, there are a few differences that are quite significant” from children of Holocaust survivors that “might account for difference in coping mechanisms and resources.” Holocaust survivors “had more resources and networks, wider family members and community to support them to adapt to their new circumstances after a war.” They were not, in other words, expected to man up and get over it.

We await the results of the 20-year, 10,000-family-strong study of impacts on Iraq and Afghanistan veterans’ kin, the largest of its kind ever conducted, that just got under way. Meanwhile, René Robi­chaux, social-work programs manager for US Army Medical Command, concedes that “in a family system, every member of that system is going to be impacted, most often in a negative way, by mental-health issues.” That was the impetus for the Marriage and Family Therapy Program, which since 2005 has added 70 therapists to military installations around the country. Mostly what the program provides is couples’ counseling. Children are “usually not” treated, but when necessary referred to child psychiatrists – of which the Army has 31. Meanwhile, the Child, Adolescent and Family Behavioral Health Office has trained hundreds of counselors in schools with Army children in and around bases to try to identify and treat coping and behavioral problems early on. “We’re better than we were,” Robi­chaux says. “But we still have a ways to go.”

Of course, the Army only helps families of active-duty personnel. It’s the Department of Veterans Affairs that’s charged with treating the problems that can persist long past discharge. But “if you asked the VA to treat your kids, they would think it was nonsense,” says Hofstra’s Motta.

When I asked the VA if the organization would treat kids for secondary trauma, its spokespeople stressed that it has made great strides in family services in recent years, rolling out its own program for couples’ counseling and parenting training. “Our goal is to make the parents the strongest parents they can be,” says Susan McCutcheon, national director for Family Services, Women’s Mental Health, and Military Sexual Trauma at the VA; according to Shirley Glynn, a VA clinical research psychologist who was also on the call, “for the vast majority of people with the secondary traumatization model, the most important way to help the family deal with things is to ensure that the veteran gets effective treatment.” In cases where children themselves need treatment, these VA officials recommended that parents find psychologists themselves, though they note “this is a good time [for the VA] to make partners with the community so we can make good referrals.” Or basically: “You’re on your own,” says Brannan.

Brannan sent Katie to the school therapist, once. She hasn’t seen any other therapist, or a therapist trained to deal with PTSD – Brannan knows what a difference that makes, since the volunteer therapist she tried briefly herself spent more time asking her to explain a “bad PTSD day” than how Caleb’s symptoms were affecting the family. When I visited, Katie was not covered by the VA under Caleb’s disability; actually, she wasn’t covered by any insurance at all half the time, since the Vineses aren’t poor enough for subsidized health care and the Blue Cross gap insurance maxes out at six months a year. She’s never been diagnosed with anything, and Brannan prefers it that way. “I’m not for taking her somewhere and getting her labeled. I’d rather work on it in softer ways,” like lots of talks about coping skills, and an art class where she can express her feelings, “until we have to. And I’m hoping we won’t have to.” Certainly she seems better than some other PTSD vets’ kids Brannan knows, who scream and sob and rock back and forth at the sound of a single loud noise, or who try to commit suicide even before they’re out of middle school. Caleb spends enough time worrying that he’s messing up his kid without a doctor saying so.

Brannan is a force of keeping her family together. She sleeps a maximum of five hours a night, keeps herself going with fast food and energy drinks, gets Katie to and from school and to tap dance and art, where Katie produces some startlingly impressive canvases, bright swirling shapes bisected by and intersected with other swaths of color, bold, intricate. That’s typical parent stuff, but Brannan also keeps Caleb on his regimen of 12 pills – antidepressants, anti-anxiety, sleep aids, pain meds, nerve meds, stomach meds – plus weekly therapy, and sometimes weekly physical therapy for a cartilage-lacking knee and the several disintegrating disks in his spine, products of the degenerative joint disease lots of guys are coming back with maybe from enduring all the bomb blasts, and speech therapy for the TBI, and continuing tests for a cyst in his chest and his 48-percent-functional lungs. She used the skills she learned as an assistant to a state Supreme Court justice and running a small newspaper to navigate Caleb’s maze of paperwork with the VA, and the paperwork for the bankruptcy they had to declare while they were waiting years for his disability benefits to come through. She also works for the VA now, essentially, having been – after a good deal more complicated paperwork, visits, and assessments – enrolled in its new caregiver program, which can pay spouses or other family members of disabled vets who have to take care of them full time, in Brannan’s case $400 a week.

At home after school, she makes Katie a pancake snack and then, while Katie shows me the website for a summer camp that teaches military spy skills, Brannan gets back to work. Because she also helps thousands of other people – measured by website and social-media interactions – through Family of a Vet, a nonprofit created “to help you find your way, find the information you need, and find a way not only to cope with life after combat…but to survive and thrive!” Brannan founded the organization in 2007, after panicked Googling led her to the website of Vietnam Veteran Wives (VVW) when Caleb returned from his second tour. Life after the first tour had been pretty normal. “Things were a little…off,” Caleb was edgy, distant, but he did not forget entire conversations minutes later, did not have to wait for a stable mental-health day and good moment between medication doses to be intimate with his wife, and then when he finally tried, pray to Christ for one of the times when it’s good sex, not one of the times when a car door slams outside and triggers him, or the emotion becomes so unbearable that he freezes, gets up, and walks wordlessly out the door.

All that didn’t happen until after the second tour. Brannan was in a terrible place, she says – until she talked to Danna Hughes, founder of VVW. Danna had been through much of the exact same turmoil, decades ago, and had opened a center to help get Vietnam vets benefits and educate their spouses and communities about their condition. “What choice do I have?” Brannan asks about running her own organization. “This is the only reason I am well. People care when you tell them. They just don’t know. They want to help and they want to understand, so I just have to keep going and educating.”

Today she’s fielding phone calls from a woman whose veteran son was committed to a non-VA psychiatric facility, but he doesn’t want to be at the facility because he, a severe-PTSD sufferer, was already paranoid before one of the other resident loons threatened to kill him, and anyway he fought for his fucking country and they promised they wouldn’t abandon him and he swears to God he will have to kill himself if the VA doesn’t put him in with the other soldiers. Another veteran’s wife calls from the parking lot of a diner to which she fled when her husband looked like he was going to boil over in rage. Another woman’s husband had a service dog die in the night, and the death smell in the morning triggered an episode she worries will end in him hurting himself or someone else if she doesn’t get him into a VA hospital, and the closest major clinic is four hours away and she is eight and a half months pregnant and got three hours of sleep, and the clinic’s website says its case manager position for veterans of Iraq or Afghanistan is currently unstaffed, anyway.

The phone never stops ringing. If it does for 14 seconds, Brannan writes an email to help get whatever someone needs, or publishes a blog post about her own struggles. Caleb was not amused the first time one of these posts went live. But now he’s glad she didn’t ask him his permission. “I’d have said no,” he tells me on the couch one day. It’s a brief emergence from his bedroom – he’s been “sleeping or hiding,” Brannan describes it, 20 or so hours a day for a few days. He leans forward to put his glass of orange juice on the table; it takes many, many long seconds for him to cover the few inches; today, like most days, he feels “like a damn train ran over me.” “But because of the feedback she got, I know that other people were going through the same shit I was. And she’s helping people.” His face softens. “She’s got a good heart. She’s always been like that. I’m glad she’s doing it,” he says again, and shrugs, because that’s the end of that story.

Read Full Article Here

Veterans News Now

About 25 percent of homeless Americans are veterans-131,000 according to VA statistics-and more than 75 percent have a mental disorder, often PTSD. The National Coalition for Homeless Veterans has noted that Iraq veterans are already beginning to show up in that population.

Wake up, Peter.

 

Stop kidding yourself that words matter to them.

 

You chose the wrong profession.

 

 

by Anthony Lawson

 

Hello Peter,

When are you and your co-veterans going to learn that no one in government gives, as an American might say: “…a good god-damn about you and your comrades” who fought so valiantly for your country?

This is because they don’t give a “good god-damn about America” per se, they only care about themselves and their own agendas which is to fill their pockets with the kinds of profits that only a country on a constant war footing can generate.  Who the enemy is doesn’t really matter, as long as there is an enemy.

Patriotism is a word that rolls off their tongues like they roll out wads of notes to pay for luxuries for themselves and their families, while the families of those who suffer death and horrendous injuries for their profits mean less than nothing to them.

Wake up, Peter.  Stop kidding yourself that words matter to them.  You chose the wrong profession.  You should have become a Wall Street banker or bought some shares in the armaments industry if you wanted a reward out of the wars that are being constantly fought in the name of “Homeland” Security.  What a joke that phrase is.  The more wars they launch, the less secure the “Homeland” becomes and so the vicious circle goes around and around.

I feel really sad when I read your emails, because you are not going to get anywhere pleading with these people.  They are the scum of the earth and will never give an inch unless they are forced to do so at the points of the guns that they are so desperately trying to make sure will never, ever be pointed at them.

 

Read Full Article Here

Animal Advocacy

Animal Rescue Stories  :  Protection – Goodwill – Humanity

In Love Again

In Love Again

It’s happened again. I’m in love. It doesn’t matter that he is shorter and older than me. Or that he has a crooked jaw (obviously broken at an earlier time) or just one ear (after a botched ear cropping), I’m in love and love is blind. I was taking food to my local shelter and found him there waiting for me. He was in the bottom row with the other dogs that had been at the shelter too long, and headed to places unknown. All that matters is that Griff (Griff N. Doore) now lives with me. Happily ever after!

Lori Evans-Eldridge
Lake Orion, MI

Boo Boo

Boo Boo

I was walking along the beach with my 3 grandkids, and there was a group of older teenagers with a tiny, 1 1/2 pound chihuahua puppy at one spot. The kids wanted to pet her, and the teenagers informed me that they were there to “leave her where the fat cats live” because the owner’s mom wouldn’t let him keep her. This is an area by the beach where dozens of feral cats live. I picked her up and held her shivering body against my neck, and she licked my chin all the way home. Our terrier loved her and there was no question she was going to be ours. We have had her a year now and she’s definitely one of us, happy and healthy and totally hyper!

Toni-Jo Menasco
Port Hueneme, CA

Last Chance Juliette

Last Chance Juliette

Each of my fosters hold a special place in my heart. After transitioning to their forever homes I can only hope I will get to see a picture or receive an update from their loving families. In the case of Juliette, a young lab/retriever mix that was deemed “last chance” at a local kill shelter, I will have the honor and pleasure of following her progress for a lifetime. Juliette was tested and chosen to become a service dog for an amazing young girl with autism named Angelina.

A nonprofit organization, Dream Acres for Autism Inc., approached the rescue I foster for, Pet Rescue by Judy, seeking a potential service dog for Angelina. Juliette and a few others were selected, tested in skill and temperament, and considered as potential service dogs. When I received the call that Juliette was chosen, I was so excited! I spent the next few weeks with Juliette polishing basic commands, manners, and getting her adoption arrangements in place.

Placement day was something I will never forget. When Angelina met Juliette for the first time, it was love at first sight. It could not have been a better fit! Since that day, Juliette has been working towards her service vest with Angelina, her Grandmother Peggy, and her amazing trainer, Ellen. Last weekend I was fortunate to be able to attend Juliette’s Stage One testing and witnessed their hard work pay off. Juliette earned her Service Dog vest as well as the legal rights and protection given to these special canines in society. Juliette will now be appointed a trainer from Service Dogs of Florida, Inc. who will assist in training Juliette with skills specific to Angelina’s needs. Seeing how Juliette has touched so many lives makes all the hard work of fostering puppies worth every minute!

Patricia Infurchia
Astatula, FL

"15 dogs in 15 minutes" by Bill Foundation, CA

“15 dogs in 15 minutes” by Bill Foundation, CA

In August, a shelter volunteer notified Bill Foundation about a Rottweiler mix that had given birth at the shelter four days earlier. She and her 6 puppies were at risk of being euthanized because the shelter simply didn’t have the resources to care for them.

We set out for the shelter early the next morning. A block away from the shelter, we spotted a dog tied up in chains, covered in her own feces and urine. Someone had left her there knowing the shelter would ultimately find her. People often do this to avoid paying the $25 fee to surrender their pet. We freed her from the chains and agreed she would come home with us. And we named her Cassidy.

Once we arrived at the shelter, we told them we were there for the mama and her six 5-day day old puppies, but we were notified that the babies were only three days old. We realized we were talking about two different litters. A minute later, we met a young terrier and her six puppies. Knowing this family’s fate, we couldn’t leave them behind, so we promised mama we would come back later that day for her entire family.

Isabella, the Rottweiler mix, proved to be a gentle, loving soul. She, along with her 6 babies, and Cassidy left the shelter with us and headed to our vet to receive the care they needed while awaiting foster.

And we kept our promise to Willow, the young terrier, and her six puppies and returned for them later than day.

All 15 dogs are happy, healthy and awaiting their forever homes.

In 15 minutes we rescued 15 dogs… With your support, we can save 15 times more lives.

““It takes a village to save a dog””

Bill Foundation, Beverly Hills CA

Annie Hart
Beverly Hills, CA

Your Actions Here Fund Food And Care For Rescued Animals.

Crossroads News : Changes In The World Around Us And Our Place In It

Community  :  The Human Mind – Therapy – Costs of War

Scores of recent Texas war veterans have died of overdoses, suicide and vehicle crashes, investigation finds

Uncounted Casualties: Part I
Jay Janner
Kimberly Mitchell weeps at the grave of her husband, Chad Mitchell, at the Houston National Cemetery. Chad, an Iraq War veteran, was one of hundreds of former service members from Texas who have died not in a war zone but after returning home. He died of an accidental overdose in 2010. SPECIAL REPORT

Related

How 266 Texas veterans died photo
Robert Calzada
Sources: U.S. Department of Veterans Affairs, Texas Department of State Health Services, analysis by Statesman Investigative Team

By American-Statesman Investigative Team

They survived the battlefields of Iraq and Afghanistan. But they did not survive the homecoming.

A six-month American-Statesman investigation, which paints the most complete picture yet of what happened to Texas’ Iraq and Afghanistan veterans who died after leaving the military, reveals that an alarmingly high percentage died from prescription drug overdoses, toxic drug combinations, suicide and single-vehicle crashes — a largely unseen pattern of early deaths that federal authorities are failing to adequately track and have been slow to respond to.

The Statesman obtained autopsy results, toxicology reports, inquests and accident reports from more than 50 agencies throughout the state to analyze the causes of death for 266  Texas veterans who served in operations Enduring Freedom and Iraqi Freedom and were receiving Department of Veterans Affairs disability benefits when they died.

The Statesman investigation, which relied on 345 fragmentary death records provided by the VA — as well as obituaries and interviews with veterans’ families — reveals a phenomenon that has mostly been hidden from public view.

The investigation found that:

  • More than 1 in 3  died from a drug overdose, a fatal combination of drugs or suicide. Their median age at death was 28 .
  • Nearly 1 in 5  died in a motor vehicle crash.
  • Of those with a primary diagnosis of post-traumatic stress disorder, the numbers are even more disturbing: 80  percent died of overdose, suicide or a single-vehicle crash. Only two of the 46  Texas veterans of the Iraq and Afghanistan operations who had a PTSD diagnosis died of disease or illness, according to the newspaper’s analysis.
  • The 345 Texas veterans identified by the VA as having died since coming home is equal to nearly two-thirds of the state’s casualties in Iraq and Afghanistan. But that only includes veterans who have sought VA benefits, meaning the total number of deaths is likely much larger.

The investigation highlights the problem of prescription drug overdose among veterans, which has received scant attention compared to suicides: Nearly as many  Texas veterans died after taking prescription medicine as committed suicide. VA prescriptions for powerful narcotics have skyrocketed over the past decade  even as evidence mounted that such painkillers and PTSD make a dangerous combination. In effect, experts say, the military and VA exposed an especially vulnerable population to a flood of powerful drugs.

Although the VA has conducted limited studies into how Iraq and Afghanistan veterans are dying, it has not detailed their individual causes of death, a shortcoming critics say prevents it from understanding the full scope of the problems facing those who fought over the past decade.

“This is the data we’ve been looking for,” said state Sen. Leticia Van de Putte, D-San Antonio, who chairs the Senate’s Veteran Affairs and Military Installations Committee. “We know very well the numbers of active-duty (deaths), but what we don’t know is what happens once they separate from the military.

“Unless we know the extent of the problem, people don’t tend to act on things,” Van de Putte said. “I’m hoping people will be appalled … and feel compelled to take action.”

The deaths represent a fraction of the nearly 53,000 Texas veterans of the conflicts who had applied for disability benefits as of 2011, and veterans groups say most former combatants re-integrate into the civilian world without major trauma. Yet the autopsy reports and investigation narratives obtained by the Statesman paint a mosaic of pain, desperation and hopelessness among a significant number of Texas veterans.

Among them were:

  • Chad Mitchell, 40,  a veteran of seven  overseas deployments who had settled in Austin after leaving the Navy. He died in September 2010  with a half-dozen prescription drugs in his system, including anti-anxiety medication and powerful painkillers oxycodone and methadone prescribed by physicians in a private pain clinic and VA doctors. Mitchell suffered from PTSD, chest pain from an earlier operation and nerve pain from a shoulder injury in Iraq.
  • Justin Languis, a 31-year-old  veteran of Iraq who shot and killed himself in January 2011 at the Fort Hood memorial wall commemorating fallen soldiers of the 1st Cavalry Division. Languis had deployed with the division twice, serving as a combat medic during the battles of Fallujah and Najaf and surviving an improvised explosive device blast that left him injured. Several soldiers from his units were killed during the deployments, their names etched in the wall where Languis committed suicide.
  • Paul Norris, a 24-year-old Army veteran, who died when he lost control of his Honda Civic and slammed into a rock wall along an El Paso street. Police said Norris was speeding; his father said his son was usually a cautious driver and believes his son was experiencing a flashback to his time in Iraq when he lost control of his car.

Meaningful results

The newspaper’s findings show that deaths from suicide and overdose were far higher among the veterans receiving VA benefits than for the overall state population: The percentage of suicides was nearly five times  higher, while the percentage of deaths from overdose and toxic drug combinations was 5.3  times as high. Controlling for age and gender, the differences remained: Among males under 35, for example, the percentage of veterans who died from overdoses was 2.6 times  the general population percentage, while the percentage of suicides was 1.6 times higher.

Former State of Texas  epidemiologist Dennis Perrotta said that although differences between the groups — mostly male war veterans with medical ailments, versus a much more diverse overall population — account for some of the discrepancies, the results are nevertheless meaningful. The newspaper’s findings also are echoed by broad data compiled by the Texas Department of State Health Services that indicate elevated levels  of suicide and overdose among veterans under the age of 35.

VA officials said that because they don’t have access to all individual causes of death, they couldn’t verify the newspaper’s numbers or determine if they mirror causes of death for young veterans nationally.

“These are important conclusions, but I would caution against applying them nationwide or VA-wide,” said spokesman Mark Ballesteros, adding that the VA is working to address gaps in its data collection and is planning a mortality study based on 2010 death records.

VA officials say it’s difficult to obtain individual causes of death because local authorities aren’t required to give the VA that information. The agency can get causes of death from a federal database called the National Death Index, but that data is hampered by a two-year lag. In 2008, the department ran its list of Afghanistan and Iraq veterans in the VA system through the index in order to study suicides, but it has not publicly released a comprehensive breakdown of causes of death.

“We don’t do a very good job of tracking these folks,” said U.S. Rep. Bill Flores, R-Waco, who sits on the House Committee on Veterans’  Affairs .  “I would like to see a little more action and less talking.”

In many of the cases reviewed by the Statesman, veterans of Iraq and Afghanistan died in relative anonymity. Unlike those who die during active duty, the veterans’ deaths often aren’t noted in press releases. Some did not even get an obituary in their local newspaper, including about one-third of those who committed suicide.

In Austin, a 44-year-old veteran  who left the Navy in 2007 was buried in Travis County’s pauper’s cemetery after dying of a self-inflicted gunshot wound in October 2007 . (The Statesman is not identifying veterans who died of overdose or suicide whose families could not be reached.) His body wasn’t discovered until neighbors noticed fliers piling up by the door to his North Austin apartment.

Inside, police found a mostly empty bottle of rum and a .380 handgun under his hand. In the closet, they found a bag of medical records that revealed a lengthy battle with psychological problems.

Colleen Rivas  of New Braunfels, whose husband, Ray, took his life in 2009, said her husband and his comrades who have died since returning home deserve to have the circumstances of their deaths investigated, in hopes of finding ways to reduce the death toll among veterans.

“They had a life; they had a story,” she said. “They were soldiers, and they mattered. And they all left behind someone who loved them.”

Data difficulties

Eleven years after the first troops entered Afghanistan  and two years after combat operations ended in Iraq, the nation still does not know how its fighting men and women are dying after they come home. No governmental entity follows the fates of the hundreds of thousands of veterans who aren’t enrolled with the VA  — nearly  half of all recent veterans.

Part of the problem stems from data limitations: Many studies on veteran deaths rely on the National Death Index, a database maintained by the Centers for Disease Control and Prevention  using state death records. But death certificates, including those in Texas, only reveal whether the deceased has ever served in the armed forces — which means active-duty service members are mixed in with veterans. Death certificates also can underreport suicides and drug overdoses, experts say.

Although the CDC’s National Violent Death Reporting System  can identify veterans who die from suicide or other violent causes, only 18  states make reports to the system. The CDC estimates that expanding to all 50 states would cost $25 million, which Congress has not yet appropriated.

But critics say the VA, too,  lacks the will to produce a comprehensive view of veteran mortality, which researchers say could conceivably be achieved by matching the names of veterans receiving VA care against the National Death Index.

“If VA looked into veterans’ deaths, then VA would find answers,” said Paul Sullivan, veteran outreach manager for the Bergmann & Moore law firm and former head of Veterans for Common Sense . “Then VA and Congress would be forced to act.”

Last year, after the San Francisco-based Bay Citizen reported that since 2007, more service members have died after returning home than in combat, VA officials told the news organization they had no interest in determining causes of death for every veteran, insisting the agency already had a handle on the problems.

The Bay Citizen used information from a little-known VA database that compiles information on the deaths of veterans receiving disability benefits. The database, however, does not track causes of death.

Through a Freedom of Information Request to the VA based on that death database, the Statesman received basic information on 345 Texas veterans who had served during the Iraq and Afghanistan conflicts, had received VA benefits and had died between January 2003 and  October 2011.

Using publicly available information from genealogy websites, obituaries and other sources, the newspaper was able to identify more than 300 of the veterans, then turned to local sources such as medical examiners and police reports to determine the causes of death of 266  of the veterans.

Military personnel records obtained by the Statesman indicate the list included a small number of veterans who didn’t deploy to Iraq or Afghanistan, but they are still considered participants in the conflicts by the VA.

The analysis revealed:

  • 47 veterans died from drug overdoses or a toxic combinations of drugs — 40  of them after taking prescription medications. Five  overdosed on heroin or cocaine and had no prescription drugs in their systems. One  died after huffing aerosol refrigerant and another after ingesting the illegal stimulant Ecstasy.
  • All but seven  of the veterans who died from drugs were under age 35. The first to die was a 23-year-old Army veteran from the Houston area who overdosed on cocaine, hydrocodone and alprazolam, most commonly known as Xanax, two years after he deployed as one of the first soldiers into Iraq .
  • Another 45 veterans committed suicide; 32 of them were under 35. The first suicide victim was also a veteran of a 2003 deployment to Iraq, a 26-year-old Army veteran from North Texas who killed himself in 2005. Researchers said the true number of suicides might be higher because medical examiners and justices of the peace are often reluctant to declare overdoses a suicide without definitive proof, such as a note.
  • And 50 veterans, or 18 percent of the total, died in motor vehicle crashes, 35 of which were single-vehicle crashes. About half of those involved speed or alcohol, according to accident reports from the Texas Department of Transportation. Veterans groups and experts  say that although vehicle accidents are also common among young civilian men, reckless behavior and vehicle crashes are a recognized phenomenon among returning service members.

The deaths also included four veterans who died after returning to Iraq or Afghanistan as civilian contractors. Among them were victims of a helicopter crash and a suicide bombing.

And despite revolutionary advances in battlefield medicine that have increased the survival rate for wounded service members, at least four  of the Texas veterans on the newspaper’s list died of war wounds years after leaving the battlefield. They include Merlin German, a 22-year-old San Antonio Marine who survived a 2005 bomb blast in Iraq that left him with burns over 97 percent of his body. German endured more than 100 surgeries and was dubbed the “Miracle Marine” before he died following a skin graft operation in 2008.

Researchers said the analysis gives what might be an unprecedented look at veterans’ mortality.

“The VA really doesn’t know” the full picture of how veterans are dying, said B. Christopher Frueh, a PTSD expert at the Menninger Clinic in Houston who previously worked as a researcher at the VA for 14 years. “I don’t know anyone who has really (tracked individual causes of death) for a large cohort of veterans.”

VA officials say they are hopeful that better cooperation with the Department of Defense and individual states will help them better study the fates of the nation’s veterans. The VA is pushing all 50 states to improve reporting of veterans’ deaths, although death certificate limitations will continue to bedevil researchers.

And perhaps most importantly,  the Department of Defense will soon merge computer databases with the VA, which VA officials say will give them the capability to track veterans outside of its system as well.

Those who work closely with veterans say that, given the many struggles they see among returning soldiers, the Statesman’s numbers look familiar.

“I am not shocked or surprised in any shape or form by that,” said Tom Tarantino, chief policy officer for the Iraq and Afghanistan Veterans of America.

Still, Tarantino  said the federal government has failed to plan for the needs of returning service members.

“We basically ignored the fact that we had people coming home from war to an antiquated health system not set up for this,” he said. “It was a health care support system designed for peace.”

Mental health woes

The VA says it has responded to the extraordinary needs of returning soldiers as best it can. It has added new treatment programs, adjusted drug prescription protocols and conducted leading-edge research into pain control, PTSD and other issues confronting veterans of the recent conflicts. The agency spends about $70 million a year on suicide prevention alone, with plans to increase funding each year through 2014. The VA’s overall mental health budget has grown 39 percent since 2009 to about $6 billion.

Yet there also is compelling evidence the agency did not anticipate the magnitude of mental health problems among Iraq and Afghanistan veterans.

In 2011, the VA said that, in more than 9 out of 10 cases, it gave first-time veteran patients a full mental health evaluation within 14 days, as required by policy. Yet an April 2012 audit by the Office of Inspector General  found the claim was dramatically inflated and the VA actually evaluated fewer than half of its clients in a timely manner. The Inspector General calculated the average wait time for a full mental health evaluation was twice as long as it should be.

The report cited insufficient medical personnel as a major reason for the long waits — a common refrain. Although the VA increased its mental health staff 46 percent between 2005 and 2010, a recent survey found 71 percent of VA clinicians still felt short-staffed. Psychiatrists, especially, were in low supply.

Some family members contacted by the newspaper said medical delays were a frequent frustration for veterans before they died.

In 2010, 22-year-old Clint Dickey drove from College Station to Waco to try to see a VA doctor for back pain caused by an injury he suffered in Afghanistan. They gave him an appointment for four to six weeks later. He died of an accidental prescription drug overdose a few days later.

His widow, Samantha, suspects her husband’s pain became so bad that he obtained oxycodone without a prescription.

“If he hadn’t been ignored, he would have never gotten to this point,” she said. “I think the checks and balances on our soldiers after they get back is absolutely disgraceful.”

This summer, the VA in effect conceded it was falling short and announced that it would hire 1,600 new clinicians to meet the soaring demand for mental health services.

Last month, President Barack Obama issued an executive order requiring the VA to come up with a plan to address another long-standing problem: getting crucial mental health services to veterans in sparsely populated rural areas, where patients can face a choice between traveling long distances for treatment or going without in-person counseling.

In Franklin County, a rural area between Dallas and Texarkana where a 31-year-old Marine veteran killed himself in 2008, veterans service officer Steve Austin  said the county’s veterans are about an hour’s drive  from the nearest VA-sponsored mental health counseling. “We’re in a void here,” he said.

Treatment risks

The VA also has struggled with balancing the benefits of strong prescription drugs with their risks. Mirroring trends among civilian physicians, VA doctors over the past decade wrote dramatically more prescriptions for powerful painkillers — hydrocodone use  among veterans jumped more than sixfold  between 2001 and 2011, according to records the Statesman obtained under the federal Freedom of Information Act.

Yet recent research has demonstrated that what doctors once thought they knew about the addictiveness of the powerful prescription painkillers was wrong.

“The research shows they’re highly addictive, especially using them in young adults,” said Andrew Kolodny, chairman of the psychiatry department at Maimonides Medical Center in Brooklyn, N.Y., and president of Physicians for Responsible Opioid Prescribing.

The VA said it has responded by changing its prescribing protocols, reducing use of the drugs and bolstering education efforts. In 2010, however, nearly a quarter of VA patients still received an opioid prescription, according to a VA study.

Complicating the prescription drug problem has been the presence of PTSD. Recent reports show more than a quarter of returning Iraq and Afghanistan veterans have been diagnosed with the disorder.

A study published earlier this year in the Journal of the American Medical Association found that soldiers with PTSD were both more likely to be prescribed narcotic painkillers and to misuse them.

“Treating PTSD is complicated,” said Catherine Coppolillo, a staff psychologist at Clement J. Zablocki VA Medical Center in Milwaukee. Responding to so many different symptoms “is like trying to build a house during an earthquake.”

Dickey’s family and friends said he had a solid foundation for a new life. Dickey had started classes at Texas A&M University, and he and Samantha had gotten married and gone on a tropical honeymoon. Samantha said her new husband, although in physical pain and battling PTSD, talked about it being one of the happiest chapters in his life.

“We were having a spectacular time,” she said.

At Dickey mother’s house in Waco, pictures of her youngest of four children line the walls. Beverly Dickey says that when her son arrived home from war, she figured he was safe. His death, she said, has altered every part of her life, down to the prayers she says for the troops.“I ask that the Lord protect them while they’re over there, bring them home safely — and cast out their demons when they’re home.”


BY THE NUMBERS

266

The number of Texas veterans that the American-Statesman was able to determine causes of death for by using local sources such as medical examiners and police reports

47

The number of veterans on the Statesman’s list of deceased veterans who died from drug overdoses or a toxic combination of drugs, including three suicides.

  • 40 of those veterans died after taking prescription medications.
  • 6 veterans died from illegal drugs such as heroin or cocaine.
  • 1 veteran died after huffing aerosol refrigerant.

45

The number of veterans on the Statesman’s list of deceased veterans who committed suicide.

  • 32 of those veterans died were 35 or younger.
  • Researchers said the true number of suicides might be higher because medical examiners and justices of the peace are often reluctant to label overdoses a suicide without definitive proof, such as a note.

50

The number of veterans on the Statesman’s list of deceased veterans who died in motor vehicle crashes.

3.8 million

The number of prescriptions for narcotic pain pills that military doctors prescribed in 2009.

420,000

The number of veterans out of 5 million from all wars receiving treatment from the VA identified as having substance abuse issues in 2010.

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Studies examine health consequences of meltdown, damage to Fukushima nuclear power plants in Japan

by Staff Writers
Chicago IL (SPX)

DISASTER MANAGEMENT

File image courtesy AFP.

The results of two studies in the August 15 issue of JAMA report on the psychological status of workers at the Fukushima nuclear power plants in Japan several months after the earthquake and tsunami in March 2011, and the amount of internal radiation exposure among residents of a city north of the power plant that experienced a meltdown.

As reported in a Research Letter, Jun Shigemura, M.D., Ph.D., of the National Defense Medical College, Saitama, Japan, and colleagues examined the psychological status of Fukushima workers 2 to 3 months after the disaster for symptoms of general psychological distress, including posttraumatic stress response (PTSR). The study included all full-time workers from the Daiichi plant (n = 1,053; plant experienced meltdown) and Daini plant (n = 707; plant experienced damage but remained intact) in May and June 2011.

Using a self-report questionnaire, the researchers assessed sociodemographic characteristics and disaster-related experiences, including discrimination/slurs because the electric company that managed these plants was criticized for their disaster response and the workers have been targets of discrimination. Measures of general psychological distress included feeling nervous, hopeless, restless/fidgety, depressed, and worthless in the last 30 days.

Of 1,760 eligible workers, 1,495 (85 percent) participated (Daiichi: n = 885 [84 percent]; Daini: n = 610 [86 percent]). The authors found that compared with Daini workers, Daiichi workers were more often exposed to disaster-related stressors. Experiencing discrimination or slurs was not statistically significantly different between groups (14 percent vs. 11 percent). The researchers found that general psychological distress and PTSR were common in nuclear plant workers 2 to 3 months after the disaster.

“Daiichi workers had significantly higher rates of psychological distress (47 percent vs. 37 percent) and PTSR (30 percent vs. 19 percent). For both groups, discrimination or slurs were associated with high psychological distress and high PTSR. Other significant associations in both groups included tsunami evacuation and major property loss with psychological distress and pre-existing illness and major prop�erty loss with PTSR.”

Study Finds Low Levels of Radiation Exposure to Residents of City North of Meltdown
In another Research Letter, Masaharu Tsubokura, M.D., of the University of Tokyo, and colleagues conducted a study to gauge the level of radiation exposure to residents of the city of Minamisoma, located 14 miles north of the Fukushima Daiichi nuclear plant. “Release of radioactive material into the air, water, and soil raised concern about internal radiation exposure and the long-term risk of cancer in nearby residents,” they write.

Many residents were evacuated after the meltdown, but by August 2011, approximately half had returned. A voluntary screening program for levels of cesium, known to be representative of total internal radiation exposure, was conducted between September 2011 and March 2012 for all residents ages 6 years or older.

Total cesium exposure was converted into committed effective dose (sievert, Sv). Common dose-limit recommendations for the public are 1 mSv or less. A total of 9,498 residents enrolled in the study, 24 percent of the registered population on August 15, 2011.

The sample consisted of 1,432 children and 8,066 adults. A total of 3,286 individuals (34.6 percent) had detectable levels of cesium, including 235 children (16.4 percent) and 3,051 adults (37.8 percent). Committed effective doses were less than 1 mSv in all but 1 resident (1.07 mSv).

“To our knowledge, this is the first report on internal exposure to cesium radiation after the Fukushima Daiichi nuclear plant incident. In this sample, exposure levels were low in most adults and children tested and much lower than those reported in studies years after the Chernobyl incident. Even the highest levels of contamination observed are below the thresholds for the administration of Prussian blue [an antidote used in the treatment of cesium poisoning],” the authors write.

The researchers note that because this screening program started 6 months after the nuclear power plant disaster, higher exposure levels might have been detected earlier, and that it is not possible to ascertain whether the low levels of exposure were due to low ongoing exposure or decay from high exposure values.

“Because data were collected from volunteers, the results may not be representative of the entire population in contaminated areas. No case of acute health problems has been reported so far; however, assessments of the long-term effect of radiation requires ongoing monitoring of exposure and the health conditions of the affected communities.”

 

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