Thursday, January 12, 2012

Veterans issues: PTSD, MST, burn pits


Glenn Kessler (Washington Post) awards Barack Obama One Pinocchio for his claims about the military budget. Well good. He's deserved several Pinocchios since day one. Back on March 4, 208, Isaiah found 3 Pinocchios in "Pinocchio Obama."

Meanwhile TBI and PTSD are signature wounds of the Iraq War and the Afghanistan War. Not all veterans have either (or both) but some do. For those who do, James Dao (New York Times) reports, "For thousands of combat veterans, driving has become an ordeal. Once their problems were viewed mainly as a form of road rage or thrill seeking. But increasingly, erratic driving by returning troops is being identified as a symptom of traumatic brain injury or post-traumatic stress disorder, or P.T.S.D. -- and coming under greater scrutiny amid concerns about higher accident rates among veterans." And Dao explains that those without TBI or PTSD may also having driving issues for other reasons (and that driving issues have been noted in veterans from Vietnam and the first Gulf War).

Dao opens with Iraq War veteran Susan Max. And Laura Unger (Lousiville Courier Journal) observes that "almost 15 percent of today's active-duty troops are women;" however, health service for women continue to lag. For example, "VA hospitals don't provide obstetrics, for example, and most don't offer mammograms on-site. Medical centers on U.S. military bases, meanwhile, transfer women to civilian doctors for certain high-level care." In addition women who serve often face what H. Patricia Hynes (Truthout) calls another battlefield:

These same women have found themselves, concurrently, caught in a second, more damaging war - a private, preemptive one in the barracks. As one female soldier put it, "They basically assume that because you are a girl in the Army, you're obligated to have sex with them." Resisting sexual assault in the barracks spills over to the battlefield, according to many women veterans, in the form of relentless verbal sexual harassment, punitive high-risk assignments and the morbid sense that your back is not being watched.

The double trauma of war and sexual assault by "brothers-in-arms" within a culture of impunity for perpetrators may explain why a 2008 RAND Corporation study [1] "found that female veterans are suffering double the rates of depression and post-traumatic stress disorder [PTSD] than their male counterparts." Patricia Resick, a psychiatrist who researches PTSD in women for the Veterans Administration (VA), asserts "sexual trauma is a more significant risk factor for PTSD than combat or the types of trauma that men generally experience." Resick adds that sexual trauma, unlike combat trauma, is caused by people who are supposed to bond with you and protect you, and that betrayal by those you need to trust with your life deepens the harm.

Military sexual trauma (sometimes referred to as MST) is so extreme that it is even more likely to cause PTSD in women than civilian sexual trauma ­­- because of military culture.

Sexual assaults happen to women and to men serving in the military. If you've attended or followed Congressional hearings during the wars, you're aware that three Secretaries of Defense have sworn that they take the issue seriously; however, their words have not translated into actions. The three are Donald Rumsfeld, Robert Gates and Leon Panetta (Panetta serves currently and hasn't been in the post for a year yet). The government's inability to address the problem is one of the main reasons there is a lawsuit currently. Susan Burke's Burke PLLC is representing military and former military sexual assault victims in Cioca et al v Rumsfeld and Gates, the court papers were filed in February of last year. To read up on that lawsuit, click here (and link also has audio options). And, on this topic, as December (and 2011) came to a close, Senator Amy Klobuchar's office issued the following:

U.S. Senator Amy Klobuchar (D-MN) announced today that President Obama has signed into law provisions she and Senator Susan Collins (R-ME) authored supporting survivors of sexual assault in the military as part of the National Defense Authorization Act. The Klobuchar-Collins provisions will require the Department of Defense to develop a coordinated policy to ensure the preservation of documents connected with sexual assault reports in the military and provide full privacy and identity protection for the victim. In addition to the provisions, Klobuchar also included an amendment requiring the Department of Defense to guarantee storage of most documents connected with reports of sexual assaults in the U.S. military for an estimated 50 years.

"If an American in uniform suffers the horrific trauma of sexual assault while fighting for their country, they shouldn't have to fight to receive care and pursue justice," Klobuchar said. "This important legislation will now become the law of the land and help ensure survivors of sexual assault have the support they need and deserve."

"Senator Klobuchar's amendment is an important milestone in continuing efforts to establish a sound DOD policy for records preservation vital to veterans seeking VA benefits for conditions related to military sexual trauma (MST)," said Donald L. Samuels, National Commander of the Disabled American Veterans. "The veterans community salutes her leadership and determination on this important issue."

"VFW applauds Senator Klobuchar for her efforts to provide improvements within VA and DOD in cases of sexual assault documentation -- She has been at the forefront of the fight for MST victims. Her amendment will help provide many victims the evidence to validate claims for VA disability for MST," said Ray Kelley, Legislative Director for the Veterans of Foreign Wars (VFW).

Until today there has been no coordinated policy across the U.S. service branches to ensure the preservation of medical and other reports connected with sexual trauma. Each service branch has been left to develop its own policy, resulting in inconsistent recordkeeping and frequent destruction of records. Long-term preservation of records can help a victim seek medical and disability assistance, and certain records can also be used as evidence in a later crime involving the same perpetrator.

In recent years there has been an increase in reports of sexual assaults in the military. According to the Department of Defense, there were 3,158 official reports of sexual assaults in the military in 2010. Because most incidents are not reported to a military authority, the Pentagon estimates this number represents only 13 to 14 percent of total assaults -- making the total estimated number of sexual assaults in the military over 19,000 in 2010.

Research has shown that sexual trauma not only hurts the victims, but can also take a toll on their fellow servicemembers by severely undermining unit cohesion, morale, and overall force effectiveness.

Klobuchar's and Collins' Support for Survivors Act, much of which is included in the National Defense Authorization Act, will:

· Require the Department of Defense to develop a policy to ensure the preservation of documents connected with reports of sexual assault and sexual harassment in the military.

· Ensure full privacy and identity protection for both the victim and the perpetrator, if known.

· Grant the VA access to documents only at the request of a servicemember, for the purpose of assisting with the processing of a disability compensation claim.

· Allow the Department of Defense to review the data (but not the names of the individuals mentioned in the reports) to improve research and reporting.

Senator Klobuchar's efforts to support military sexual assault victims have been supported by the Disabled American Veterans, The American Legion, AMVETS, the Iraq and Afghanistan Veterans of America, the Paralyzed Veterans of America, the Veterans of Foreign Wars of the United States, and the Wounded Warrior Project. The Support for Survivors Act was also endorsed by the Service Women’s Action Network.


And finally, next month, the first ever scientific symposium will be held in New York.

1st Annual Scientific Symposium on
Lung Health after Deplyoment to Iraq & Afghanistan
February 13, 2012

sponsored by
Office of Continuing Medical Education
School of Medicine
Stony Brook University

Health Sciences Center, Level 3, Lecture Hall 5
Anthony M. Szema, M.D., Program Chair
Stony Brook
Medical Center

This program is made possible by support from the
Sergeant Thomas Joseph Sullivan Center, Washington, D.C.


* Register with your credit card online at:

* Download the registration form from:
fax form to (631) 638-1211

For Information Email:

1st Annual Scientific Symposium on
Lung Health after Deployment to Iraq & Afghanistan
Monday, February 13, 2012
Health Sciences Center
Level 3, Lecture Hall 5

Program Objective: Upon completion, participants should be able to recognize new-onset of lung disease after deployment to Iraq and Afghanistan.

8:00 - 9:00 a.m. Registration & Continental Breakfast (Honored Guest, Congressman
Tim Bishop

9:00 - 9:30 Peter Sullivan, J.D., Father of Marine from The Sergeant Thomas Joseph
Sullivan Center, Washington, D.C.

9:40 - 10:10 Overview of Exposures in Iraq, Anthony Szema, M.D., (Assistant
Professor of Medicine and Surgery, Stony Brook University)

10:10 - 10:40 Constrictive Bronchiolitis among Soldiers after Deployment, Matt
King, M.D. (Assistant Professor of Medicine, Meharry Medical College,
Nashville, TN)

10:40 - 11:10 BREAK

11:10 - 11:40 Denver Working Group Recommendations and Spirometry Study in
Iraq/Afghanistan, Richard Meehan, M.D., (Chief of Rheumatology and
Professor of Medicine, National Jewish Health, Denver, CO)

11:40 a.m. - Microbiological Analyses of Dust from Iraq and Afghanistan, Captain Mark

12:10 p.m. Lyles, D.M.D., Ph. D., (Vice Admiral Joel T. Boone Endowed Chair of
Health and Security Studies, U.S. Naval War College, Newport, RI)

12:10 - 12:20 Health Care Resource Utilization among Deployed Veterans at the White
River Junction VA, James Geiling, M.D., (Professor and Chief of Medicine,
Dartmouth Medical School, VA White River Junction, VT)

Graduate students Millicent Schmidt and Andrea Harrington (Stony Brook
University) present Posters from Lung Studies Analyzed for Spatial
Resolution of Metals at Brookhaven National Laboratory's National
Synchrotron Light Source

1:20 - 1:40 Epidemiologic Survey Instrument on Exposures in Iraq and Afghanistan,
Joseph Abraham, Sc.D., Ph.D., (U.S. Army Public Health Command,
Aberdeen Proving Ground, MD)

1:40 - 2:10 Overview of the Issue Raised during Roundtable on Pulmonary Issues
and Deployment, Coleen Baird, M.D., M.P.H., (Program Manager
Environmental Medicine, U.S. Army Public Health Command)

2:10 - 2: 40 Reactive Oxygen Species from Iraqi Dust, Martin Schoonen, Ph.D.
(Director Sustainability Studies and Professor of Geochemistry, Stony
Brook University)

2:40 - 2:50 BREAK

2:50 - 3:15 Dust Wind Tunnel Studies, Terrence Sobecki, Ph.D. (Chief Environmental
Studies Branch, U.S. Army Corps of Engineers Cold Regions Research
and Engineering Laboratory, Manchester, NH)

3:15 - 3:45 Toxicologically Relevant Characteristics of Desert Dust and Other
Atmospheric Particulate Matter, Geoffrey S. Plumlee, Ph.D. (Research
Geochemist, U.S. Geological Survey, Denver, CO)

3:44 - 4:15 In-situ Mineralogy of the Lung and Lymph Nodes, Gregory Meeker, M.S.
(Research Geochemist, U.S. Geological Survey, Denver, CO)

Continuing Medical Education Credits

The school of Medicine, State University of New York at Stony Brook, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The School of Medicine, State University of New York at Stony Brooke designates this live activity for a maximum of 6 AMA PRA Category 1 Credit(s)TM. Physicians should only claim the credit commensurate with the extent of their participation in the activity.

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