The Common Ills: PTSD and other issues

Saturday, March 03, 2012

PTSD and other issues

Iraq War veteran Kevin Keller just got married to the doctor who treated him when he was wounded in Iraq. Kevin and Dr. Clay Walker are not only a same-sex couple, not only an interracial couple, but a couple of military veterans.

Kevin and Clay are characters in the Archie Comics universe. Ken Williams (San Diego Gay and Lesbian News) reports that the Life With Archie issue (number 16) featuring their wedding has sold out despite pressure from One Million Moms.

A few e-mailed wondering how they could get this issue since it's sold out?

1) It's not. I don't mean to spoil the wedding party but comic book stores don't get to return. In the pre-comic book store days, the rack jobbers would come through with the latest monthly comics, rip the covers of the now-old comics and carry those back while trashing the rest of the issue. But these days stores aren't allowed returns. So chances are if you have a local comic book store, they may have an issue or two left and you should phone first.

2) Four of you wanted to know about Archie's website. I have no idea and I'm so angry I'm not even including a link to that nonsense. I've wasted over an hour tonight trying to get it to work. You can visit the Archie's website and have the problem that four reported and that I experienced as well. They're encouraging you to download their successful Life With Archie issue for free. But you click on it and you're taken to app for Archie Comics. It doesn't work in iTunes. Ignore that. If you're wanting a digital copy of that comic right now, I think only Nook readers can get it. Nook is a Barnes & Noble notebook. I have Nook and I have Kindle. Kindle's from Amazon and I use it more for that reason; however, Amazon doesn't have the Life With Archie issue 16. It's $2.99 to purchase. It took maybe seven minutes before it showed up in "my library" on my Nook. I have stated you need a Nook. I know friends who buy Amazon books and keep them on their PC -- without a Kindle. That's fine. But this is graphics and I just had to update my Nook awhile back, to 1.4 I think it is, for color graphics. So I do not believe that you can download this to your PC from Barnes and Noble. I could be wrong. But unless you know otherwise, don't download it unless you have a Nook.

Turning to another topic, Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee. This week, in a Senate Budget Committee hearing, she raised an important issue to Secretary of Defense Leon Panetta:

Senator Patty Murray: Secretary Panetta, you know I spent a lot of time last year on the Joint- Select Committee on Defecit Reduction working with Democrats and Republicans to tackle some of the issues that you're talking about today. All of us went into the Committee knowing that sequestration would be a terrible outcome and we understood that, across the board, cuts to these programs middle class families and most Americans depend on would be bad policy. That was really the point of the bi-partisan triggers that Senator [Harry] Reid and Speaker [of the House John] Boehner agreed to -- they were supposed to be painful to push us towards a compromise. So I was really disappointed that despite the fact that we put a lot on our side, some pretty painful cuts out, we couldn't get to an agreement because we couldn't come to that shared sacrfice moment. I'm still willing to make those compromises needed to get to that. I hope everyone on both sides are because I think we're all really concerned about where that's going to go. But I -- I didn't want to focus on that today on my time, I wanted to ask you a question about an issue that has become very important and recently come to light at Madigan Army Medical Center in my home state of Washington. A number of soldiers had their behavioral health diagnoses changed from PTSD to other behavioral health disorders that didn't come with the same level of benefits. However, following, as you may know, an independent review at Walter Reed, a number of those diagnoses was changed back to PTSD. Obviously, this is really troubling. But what's even more troubling to me and to many service members and their family members in my home state and to a lot of people I've been talking to allegation that the decision to strip those soldiers of a PTSD diagnoses came from a unit at Madigan that seems to be taking the cost of a PTSD diagnosis into account when they were making their decision. Now there's an investigation going on into this but really, to me, one of the things that's clear is that oversight within the army and at the departmental level allowed this break from standard diagnoses process to go unchecked. So I'm really concerned about how the services handle non-PTSD behavioral health conditions like adjustment disorder where service members are administratively separated instead of going through the physical disablity process and I wanted to ask you given that an adjustment disorder is compensable, VA and DoD is required to use the VA's rating schedule, what is the reason for DoD treating adjustment disorder differently?

Secretary Leon Panetta: Well I was, uh, I was very concerned when I got the report about what happened at Madigan. And I think, uh, it-it reflects the fact that frankly we have not learned how to effectively deal with that and we have to. We-we-we need to make sure that, uh, that we have the psychiatrists, the psychologists and the medical people who can make these evaluations because these are real problems. I've met with men and women who have suffered this problem. Just met with a couple last night and they had to go through hell in order to be able to get the diagnosis that was required here. And that should not happen. So we are investigating obviously what took place but I've directed our Personnel Undersecretary to look at this issue and to correct it because it's unacceptable now to have the process we have in place.

Senator Patty Murray: Well I appreciate the attention given to this. It's going to take a lot of work. And I'm deeply concerned when someone comes home from war that they have to go through a diagnosis like this. It's hard enough after you've been told to "man up" during your time of service to then face the fact that you have PTSD -- and then to have that reversed and changed back and told there's nothing wrong with you is just devastating to these men and women and their families. So this is something I'm going to be following very closely. I want your personal attention on it. And I think that the issue raised at Madigan really shows us that we need to have a more clear, consistent guideline for clinical practices for diagnosing and treating PTSD.

Secretary Leon Panetta: I agree with that. I agree with that. Abosluetly. You're absolutely right.

Senator Patty Murray: I never want to hear anybody in any service say we're not going to give you a diagnosis of PTSD because we have a budget problem.

Secretary Leon Panetta: That's for sure.

Senator Patty Murray: Okay. Thank you very much.

Adam Ashton (The Olympian) reports on the facility and how it once had a sterling reputation:

Forensic psychiatrists at Walter Reed Military Medical Center in Maryland have overturned six Madigan diagnoses from last year, and the Army has invited more soldiers to come forward and seek new opinions.
Washington Democrats Sen. Patty Murray and Rep. Norm Dicks want to know if the Madigan doctors limited PTSD diagnoses in a misguided effort to save money.
Their fears are rooted in fall presentations by Madigan’s Dr. William Keppler in which he urged colleagues to be good stewards of taxpayer dollars. Keppler told them a single PTSD diagnosis could cost as much as $1.5 million over time.
Careers are on the line. Madigan commander Col. Dallas Homas is on administrative leave. Keppler is barred from working with patients. Another forensic psychiatrist resigned, citing her concern that “all the investigations are a charade as the outcome has been predetermined.”

Hal Bernton (Seattle Times) adds, "The Army Medical Command has a hotline available for soldiers and veterans who have been screened by forensic psychiatric teams since 2007 as part of the evaluation process for medical retirement. Soldiers and veterans with concerns about their diagnosis may call 800-984-8523." On the subject of PTSD, Barry R. Clausen pens a piece for the Anderson Valley Post trying to raise attention to what he sees happening in northern California:

Currently, nearly 300 California veterans are once again facing the same challenges from the VA as they did in 2006.
These military veterans have been diagnosed by the VA as Service-Connected for PTSD for Combat, Non-Combat and Military Sexual Trauma (MST) incidents. Some are currently receiving denials of authorization for their ongoing and continued individual psychotherapeutic sessions.
As one veteran stated, “PTSD is not like a cold or the flu, it does not go away, it is with you for the rest of your life. I have had dreams about the carnage and blood for over 40 years.”
It should be noted that apparently this is not a national program instituted by the VA and there is no one willing to step up to explain why this is happening just in northern California.
One veteran questions, “As this is just happening in Northern California, could we be the testing grounds to see what the VA can get away with nationally in the future?”

Christopher Curry (Gainesville Sun) explores the topic of PTSD and treatment while reviewing the events of Afghanistan War veteran Marco Grosso who took his own life in November.

The following community sites -- plus Antiwar.com, Ms. magazine and Tavis Smiley -- updated last night and today: