War-zone nurses put their skills on the front line

Sunday, May 25, 2008
Angels of the battlefield

War-zone nurses put their skills on the front line

By Andi Esposito TELEGRAM & GAZETTE STAFF
aesposito@telegram.com


Severely injured with a tunneling wound through his liver, the Marine lay sedated, clinging to life, in the intensive care unit at the 399th Combat Support Hospital in Al Asad, Iraq, under the care of U.S. Army Reserve Lt. Melinda A. Nekervis of Sterling.

“He ended up getting well over 100 different blood products,” said Lt. Nekervis, a soft-spoken Army ICU and flight nurse who returned in October from Mosul and Al Asad, Iraq. When everything but whole blood was exhausted, Lt. Nekervis asked if the Marines keeping vigil would donate their own.

“They were more than willing to do that,” she said. “We transfused the buddies’ blood into the patient. It was quite a moving experience. We were very lucky not to lose him. He was pretty sick. They had to do surgery right at the bedside, and he survived.”


Stabilized, the Marine was later sent to Germany aboard an Air Force medical evacuation flight.

“I know that the doctors, from the extent of his injuries, didn’t know if he would make it and what his deficits would be,” said Lt. Nekervis, 32, who in civilian life is a registered nurse working in intensive care at UMass Memorial Medical Center — University Campus.

“I had him for four long days,” she said. “I will never forget him, but he will never remember me.”

Military nurses in Iraq and Afghanistan are a critical link in a chain of medical care that has enabled more soldiers to survive injury than ever before in the nation’s history of warfare. In World War II, about 30 percent of soldiers died from wounds, a rate that fell to 24 percent in the Vietnam War. Since the start of combat seven years ago in Afghanistan, and since 2003 in Iraq, more than 32,000 service members have been wounded in action. Statistics recently released by the Department of Defense show that 4,579 have been killed in action or died under non-hostile conditions during Operation Iraqi Freedom and Operation Enduring Freedom.

But the survivability rate — the portion of people dying from wounds on these fronts — has fallen to about 10 percent.

“We are doing such a good job saving soldiers that there is a much higher rate of survival,” said Col. Andrea J. Wallen, chairperson of the Department of Nursing at Worcester State College and chief nurse with the 804th Medical Brigade at Devens, which oversees the 399th and 12 other medical units.

Nurses and military medical experts say the survival rate is higher because soldiers wear more and better equipment, and because medical help has been pushed closer to the battlefront and dispersed into smaller teams reaching more locations. More people are being trained in lifesaving procedures, specifically in response to trauma; surgery is done earlier; and better communication has allowed medical equipment and supplies to be quickly sent where needed.

But most important is the speed at which the wounded are attended.

People are moved in record time by helicopters, aircraft and specially fitted flying hospitals — in C-17s and KC-135s — to higher-level or more specialized care in Germany and the United States, including Brooke Army Medical Center in San Antonio, known for its burn center.

“The goal was to get the critically injured to Landstuhl (Regional Medical Center) in Germany within 72 hours,” said Lt. Nekervis, who also logged 50 hours of retrieving and nursing the wounded aboard a Blackhawk helicopter medevac air ambulance and earned a Bronze Star Medal for her service.

Much as Civil War soldiers called Oxford’s Clara Barton, founder of the American Red Cross, “angel of the battlefield” for care she gave the injured in makeshift hospitals close to the battlefront, military nurses, often working under fire, help make the difference between life and death. Most are in the National Guard or Reserve on deployment from hospital and health care jobs. These weapons-carrying nurses, wearing Kevlar body armor, helmets and dressed in desert fatigues, are combat-ready professionals who, faced with the terrible consequences to flesh and bone of roadside bombs, guns and rockets, save lives under challenging conditions and at risk to their own safety.

Many have been deployed several times; most would go again in a moment.

“Battlefield nursing is about service, and if you can serve your country, make a difference and be a powerful force on the battlefield helping people, that is life-changing,” said Col. Bruce A. Schoneboom, a nurse anesthetist and acting dean of the Graduate School of Nursing of the Uniformed Services University of the Health Sciences, Bethesda, Md. The school specializes in military and public health medicine and trains people for battlefield medicine in Iraq and Afghanistan.
go here for more
http://www.telegram.com/article/20080525/NEWS/805250617/1116

500,000 PTSD cases? Not even close but half way there.

Report: More Army Troops, Vets Committing Suicide


The following is a transcript of a report by medical editor Marilyn Brooks that first aired May 29, 2008, on WTAE Channel 4 Action News at 5 p.m.


Disturbing details released by the Pentagon show the number of U.S. Army troops committing suicide is at a 20-year high.


Pentagon reports said 108 soldiers took their own lives in 2007, which was six more than 2006. About a quarter of those deaths occurred in Iraq, too.

But its not just active duty soldiers that are taking their own lives. National Guard and reserve troops are as well.

The need for help in the emerging mental health crisis is high, but the military is short on therapists and must rely on outside help

"We've deployed a million and a half men and women to the global conflicts around the world," said Dr. Mary Davis of the American Psychiatric Society. "Maybe up to 500,000 individuals are going to have mental health issues when they return."

Thousands of private counselors are offering free services to returning troops. They said America's armed forces and veterans need help coping with depression, family, marital and job problems and suicide on a scale not seen since Vietnam.

"We must expand mental health services for both military and dependants for their spouses, for the families," said Dr. Richard Harding of the American Psychiatric Foundation. "It's something we just have to do."

go here for more
http://www.thepittsburghchannel.com/health/16427400/detail.html
500,000? Nope, not even close. Try double it. They need to use the data from Vietnam and then increase it to cover the redeployments and then they may come up with the right number. By 1978 a DAV study had already reached 500,000. The numbers went up after the study was published, as they predicted it would. Last year alone, a report came out that there were 148,000 Vietnam veterans seeking help for PTSD in an 18 month window from 2006-2007. In 1986 a report came out that 117,000 Vietnam veterans had committed suicide. Other studies put the number between 150,000 and 200,000. The experts need to start using what we already know so history will not be repeated.

Sgt. First Class Jason Dene "was in no shape to return to the war."

Family Mourns Loss Of Soldier From Vermont

The Department of Defense said Thursday Army Sgt. First Class Jason Dene died in his sleep Saturday while serving his third tour of duty in Iraq.

His aunt and uncle told Newschannel Five the soldier was in no shape to return to the war. They say Dene was depressed after being injured by a roadside bomb last summer.

His uncle, Patrick Farrow, published a letter in the Rutland Herald expressing his anger with the Bush administration.

Dene is also the nephew of actress Mia Farrow, who wrote on her web site about Dene and her disatisfaction with the war.

go here for more
http://www.wptz.com/news/16429955/detail.html

PTSD:Fix Tri-Care or hire more VA doctors

Military Insurance Falls Short on Mental Health Care

Halimah Abdullah


McClatchy Newspapers

May 29, 2008
May 28, 2008, Washington, DC - Across America, soldiers, veterans and their families are running into red tape and roadblocks when they try to use their military insurance to get treatment for ailments such as post traumatic stress disorder.

Since 2003, some 40,000 troops have been diagnosed with PTSD. The number of cases rose by roughly 50 percent in 2007, according to Pentagon statistics released Tuesday.

The deployment of hundreds of doctors and therapists to Iraq and Afghanistan and the shortage of military health care providers has forced patients at U.S. installations to wait for months for appointments — and longer if they need to see a specialist, according to advocacy groups for members of the military and their families.

Meanwhile, civilian doctors and psychiatrists say they're often faced with tough decisions about whether to turn away patients on Tricare, the Defense Department program that insures 9.2 million current and former service members and their dependents, because its reimbursement rates are low and its claims process is cumbersome.

Others volunteer their time and services rather than navigate Tricare's red tape for what may ultimately prove to be a small reimbursement for services.

"We do have a lot of doctors who are seeing Tricare patients almost on a pro bono basis because they care and for the love of their country. But it's easier to do that if it's a dozen patients than if there are 100 patients," said Steve Strobridge, the director of government relations at Military Officers Association of America.

Tricare's reimbursement rate are linked to Medicare levels. Health care providers who treat patients on both programs will take a 10 percent pay cut on July 1 and a second, 5 percent, pay cut on Jan. 1, 2009.
go here for more
http://www.veteransforcommonsense.org/ArticleID/10238

Clinton not first woman to run, that happened in 1870

“There is no escaping the fact that the principle by which the male citizens of these United States assume to rule the female citizens is not that of self-government, but that of despotism…

King George III and his Parliament denied our forefathers the right to make their own laws; they rebelled, and being successful, inaugurated this government. But men do not seem to comprehend that they are now pursuing toward women the same despotic course that King George pursued toward the American colonies”

Victoria Claflin Woodhull, from her speech And the Truth Shall Make You Free: A Speech on the Principles of Social Freedom, 1871

The first woman to declare herself as a candidate for president, Woodhull announced her run on April 2, 1870, by sending a notice to the New York Herald. This was an absolutely astounding thing to do: women only recently received the right to vote in the two relatively obscure territories of Wyoming and Utah, and it would be another fifty years before the ratification of the 19th Amendment that assured the ballot to all American women. Moreover, she took this step without contacting any leading suffragists, who by then had been well organized for more than two decades. Susan B. Anthony and others were stunned by the action of this controversial woman, whose “open marriage” was the talk of New York City.

The next presidential election was two years away, and Woodhull used this time to bring attention to women’s issues, including the right to vote. Undaunted by the fact that women could not vote and that she was not yet old enough to legally become president, Woodhull traveled the country campaigning. Her speeches not only advocated the vote, but also birth control, “free love,” and other positions that were a century ahead of her time. Many listeners were surprised to find themselves more sympathetic than they had expected: her beauty, soft voice, and reasoned arguments took the edge off of such shocking statements as her belief that marriage was “legalized prostitution.”

Woodhull and her sister, Tennie C., were in jail, however, when the 1872 presidential election occurred. Because they wanted to draw attention to the era’s hypocrisy on sexual matters, their newspaper published the facts about an adulterous affair between the nationally popular Rev. Henry Ward Beecher and a leader of the women’s movement, Elizabeth Tilton. It was true, but not politically correct, and the sisters were indicted for both libel and obscenity. The charges eventually were dropped, but the scandal was enough to end Woodhull's presidential aspirations, as she spent election day in jail.

Click here to read more interesting information on Victoria Woodhull
http://www.nmwh.org/president.html

The only reason I know this is playday is today and we went to the Hall of Fame President's Museum in Clermont today. The tour guide pointed to her picture. This makes me wonder why all of the historians in the media have not mentioned her name in all of this. There were a lot of women who ran for president. Click above for more of them.

Russian army: nearly a battalion a year commit suicide

Every nation, every generation, faces traumas that cause suicide. The world needs to deal with this and it is one thing that the world can come together on.

Russian army: nearly a battalion a year commit suicide


May 29, 2008, 15:41 GMT


Moscow - The Russian army lost near a battalion, 341 servicemen, last year to suicide, the chief military prosecutor said Thursday.

'Almost a battalion of servicemen was lost last year,' chief military prosecutor Sergei Fridinsky was quoted by Interfax as saying at a news conference in Moscow.

Fridinsky called for 'urgent reforms,' saying that though the total number of suicides had fallen 14 per cent from 2006 it had risen as a proportion of non-combat losses.

'We cannot but worry that suicides make more than half of all non- combat losses,' he stressed.

Violent hazing of conscripts by older soldiers, experts say, is the main cause of high the suicide rate.

The army began addressing bullying in 2005 when the media gave wide coverage to the case of Private Andrei Sychyov, who had his genitals and legs amputated after being beaten and tortured by older soldiers on New Year's Eve.

Top military brass have repeatedly vowed to fight high suicide numbers that have caused embarrassment to the army, which flush with state money is working on reforms after being stripped of resources at the end Soviet Union.

The Committee of Soldiers' Mothers, which campaigns for the rights of Russian servicemen and their families, however, said hazing was difficult to abolish because it is tolerated by army superiors as part of the same experience they lived through as recruits.

'Since Stalin's times nothing has changed: a single soldier does not count for anything,' committee head Valentina Melnikova told Deutsche Presse-Agentur dpa.

http://www.monstersandcritics.com/news/europe/news/
article_1408274.php/Russian_army_nearly_a_battalion_a_year_
commit_suicide

Capt. Luis Montalvan PTSD for 17 years of service

After returning from two tours of duty in Iraq, Capt. Luis Montalvan is the highest ranking member of Iraq Veterans Against the War. Despite post-traumatic stress disorder, he is campaigning to expose the Iraq War's grim realities. He has been branded a coward and traitor, but this recipient of the Purple Heart is on a mission to expose what he calls "incompetent" leadership in the highest ranks of the military.
Watch the video below on the side bar of this blog.


Capt. Luis Montalvan's site

This site is created to chronicle my experiences, both in Iraq and in the United States, ever since the Iraq War began. It's also part of an ongoing effort, including recent articles in The New York Times and The Washington Post, to distinguish the truths about the War in Iraq from the demoralizing and damaging illusions that obscure its realities. Those realities include a significant number of American leaders who have compromised our national security to further their own self-serving agendas. The resources here are dedicated to the memories of Iraqi and American patriots who sacrificed all for duty, honor and country and for the many civilians who have suffered.

May we never forget that for virtue and humanism to prevail, deeds must follow thoughts and words. Citizens must stand and speak their minds to hold those leaders accountable for their actions. Indeed, that is the only way we will ever hope to have a society that reflects our principles and ideals.
http://luiscarlosmontalvan.com/


17 Years of service, medals and now he's called traitor.

VA retaliated against employees who did not comply with denials

CREW and VoteVets to VA Inspector General: Investigate PTSD Misdiagnoses; "This practice is widespread and systemic."
Submitted by crew on 28 May 2008 - 11:42am. PTSD Veterans Affairs
CREW and VoteVets.org requested that the Inspector General for the Department of Veterans Affairs (VA) open an investigation into the process and manner by which the VA makes a diagnosis of post traumatic stress disorder (PTSD) in veterans. The letter to the VA, which we sent today, can be found here.

In the wake of the disclosure by CREW and VoteVets.org of an internal VA e-mail advising VA mental health staff in Texas to consider a diagnosis of adjustment disorder in place of a PTSD diagnosis as a cost-cutting measure, both organizations have received new information from VA employees and veterans attesting to the fact that this practice is widespread and systemic. VA Secretary James Peake has repudiated the email as not reflecting VA policy.

The VA has adopted incentive programs that, by rewarding those employees and hospitals that distribute lower levels of compensation to veterans, encourage adjustment disorder diagnoses rather than the most appropriate but also more costly diagnosis of PTSD.

In addition, the VA's internal computer system permits medical files to be changed by health professionals who did not conduct the initial examinations, a practice that appears to have resulted in changed diagnoses from PTSD to adjustment disorder, even where there is no additional medical evidence to support the downgraded diagnoses.

CREW and VoteVets.org also heard from VA employees who suffered retaliation for their failure to support these practices.

Melanie Sloan, executive director of CREW, said:

It is unconscionable that the VA would actively encourage its staff, through monetary incentives, to misdiagnose our veterans’ mental health. Add to that the mind-boggling disclosure that medical files can be altered to downgrade service members’ conditions, and we have a VA that is betraying those it is supposed to serve. The VA Inspector General must spearhead an investigation into these abhorrent practices immediately.

Jon Soltz, Iraq War vet and Chair of VoteVets.org, added this statement:

Despite what Secretary Peake said, the misdiagnoses being encouraged at the Temple, TX VA Center were not an isolated incident. The only question now is: How widespread is this, and how high up does the problem go? Those of us who served this nation in war deserve to have full confidence in the programs set up to help transition us back to civilian life. These new revelations personally give me zero confidence in the mental health screening and care system the VA oversees.

On May 14th, CREW also sent a Freedom of Information Act request to the VA asking for all records pertaining to any guidance given regarding the diagnosis of PTSD.
http://www.citizensforethics.org/node/31847

While it sickens me greatly reading this from CREW and Vote Vets, I have to admit it does not shock me. How could it? Given the fact the DOD is still using Battlemind, which has been proven to be of little good if at all, along with everything else going on, it appears to have been lip service in support of the wound and then sharpening the knife to stab them in the back.

According to the BBC report, the new arrivals in Iraq and Afghanistan are shown Battlemind for "11 1/2 minutes to learn about the psychological impact" as if that is supposed to prepare them for anything. Why is this not working? Simply because it is no good. The rate of suicides has gone up since they began to use it, not only while actively deployed, but the suicide rate has gone up back home as well. What they are doing is not working. If it was, then the rates would drop, not go higher.

Now we learn from the investigations like this one from CREW and Vote Vets, the law suit filed by Veterans For Common Sense, this has all be a fraudulent claim of care. How dare they not only deceive the American people, but further damage the troops as well?

Female veterans are told they will not receive the treatment they need because "they cannot afford the money" when the senate said they would have funded even more if they had known there was a problem.

Dominic DiNatale did the report for the BBC from Afghanistan. He interviewed Sgt. Bruce Cantral, a medic on his 4th deployment between Iraq and Afghanistan, at Bagram Air Base. The Sgt. has already been diagnosed with PTSD and is on a mix of medication and therapy.

Back to Battlemind, again, while only in country a few hours, the new arrivals have to spend two days worth of briefings, which include a lousy 11 1/2 minutes of Battlemind, to prepare them for the psychological impact of war. A very lame attempt to prepare them for the fact 1 in 5 will develop PTSD in theater and later half of those deployed will develop it later.

There are now combat stress teams being airlifted in to try to face this crisis. Yet there are not enough of them. A case in point comes from Fort Warrior.

At a chapel in Afghanistan's Fort Warrior, Chaplain Hill recounts a unit that had been through a terrible fight and arrived at the chapel still covered in blood.

While many will have to live with PTSD, there is also combat stress that is immediate and happens under extreme stress. How is 11 1/2 minute going to prepare them for any of this?

Physical and psychological conditions do not seem to matter as long as they can get them back into combat. This again will only harm them further. The "relentless deployments" and stop loss add to the development of PTSD. This the Army knew years ago, yet the warning fell on deaf ears.

DiNatale tried to interviews at FOB Warrior, but the commander told him that he thought it would harm the careers of anyone he interviewed. Imagine that a commander still thinks it will harm the careers of his men if they talked about being human. Yes, this still exists and give the above report from CREW, it is alive and well no matter how much reassurance the public is given that this attitude no longer lives in the minds of those in charge.

One last thing came in the last few minutes of this report. Congressman Filner was interviewed. He stated that 1/3 of the already diagnosed have committed felonies and there have been 200 homicides, mostly committed against family members.

Go here and watch the interview for yourself and see how seriously this all needs to be taken.

http://news.bbc.co.uk/2/hi/programmes/newsnight/7422853.stm

Now you can see that the troops are not getting what they need while deployed and then are greeted with more of the same from the VA afterward. Yet they seem so surprised there is such a huge problem. The right-wing bloggers are attacking the media and Peake is telling them that the problems reported are overblown!

Senior Chaplain Kathie Costos
Namguardianangel@aol.com
www.Namguardianangel.org
www.Woundedtimes.blogspot.com

"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation."

- George Washington

Miracle Drug, Poison or Placebo?

Miracle Drug, Poison or Placebo?
Do antidepressants work?
Effectiveness may vary from person to person
By Maia Szalavitz for MSN Health & Fitness


Modern antidepressants have been blamed for deadly shooting rampages and violent suicides. At the same time, they’ve been hailed as miracle drugs that transform baleful Eeyore-types into bouncing Tiggers.

Now the latest review of the research claims that the effects of the drugs are only marginally different from those of placebos or sugar pills.

It seems impossible that the same substances in the same dosage ranges could simultaneously be poison, miracle drug and placebo. But the diversity of responses is remarkable—and it points to the possibilities and pitfalls of personalized medicine.

For example, Stacy*, a 48-year-old woman who works in public relations in Ohio, describes her experience with Zoloft like this: “It felt like water after being in the desert. It wasn't an experience of elation or anything bi-polar … I'm far happier, more confident, far more relaxed.”

Lisa*, a 33-year-old business consultant from Maryland, had experienced severe suicidal thoughts as early as kindergarten. She says of taking Effexor, “My entire life is different and I finally feel like a normal person with normal emotions. These days I can honestly say I am a happy, well adjusted person.”

But JoAnne*, a 35 year-old educator and dancer living in the Washington, D.C. area, reported that both Zoloft and Prozac produced muscle weakness and excessive sweating—and no benefits.

And Bernice*, a 53-year-old science journalist in California, described her experience with a Prozac-like antidepressant this way: “It made me feel disconnected from myself and my family, so that I no longer felt any empathy and did not really care what happened to them or to me. It was a terrifying sensation of flatness and I definitely felt depressed and hostile in a way that I had never felt before.”

Bizarre experiences abound as well: Bernice had “a vivid nightmare of being shot in the head,” and the sensation she felt of dripping blood did not immediately disappear on awakening. Others report elimination of sexual desire, weight loss, weight gain, heart palpitations and elevated blood pressure.

go here for more

http://health.msn.com/health-topics/depression/articlepage.aspx?cp-documentid=100202836&GT1=31009

Lip service for PTSD From Peake and Stevens

VA: PTSD and TBI "Overblown"; Like "Football" Injuries
by Brandon Friedman
Tue May 27, 2008 at 03:38:47 PM PDT
VA Secretary James Peake continued to show little respect for the service of America’s newest veterans yesterday by dismissing concerns about the effects of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) in troops returning from Iraq and Afghanistan.

Speaking alongside Senator Ted Stevens (R-AK) in a remote Alaskan village, Peake first used the word "overblown" when discussing PTSD and TBI and then made a "football" comparison.
go here for more
http://www.dailykos.com/story/2008/5/27/182653/350/999/523775

Maybe Peake thinks this is a game, like high school football, and maybe he thinks it's overblown but what he fails to see is that THIS IS HIS JOB! It's his job to take care of the men and women who are risking their lives, and I don't mean just in Iraq and Afghanistan, but still risking them when they come home. What the hell is wrong with this administration? How can they take such a callous attitude when they could be saving lives? What about getting ahead of the curve instead of being stuck out waiting behind the opponents goal post? That is what they have been doing. They are supporting the enemy by ignoring PTSD and TBI, attempting to minimize this crisis instead of doing something about it. Sure they can say they take all of this very seriously when they are in front of congress with the cameras rolling, pretending to really give a crap about what's going on, but when you get right down to it, they have a totally different attitude when they are in front of their base. It shows!

It shows when the suicide rate goes up instead of down this long into all the reports of what they have supposedly been doing to address the crisis. It shows when there are still far too many waiting for appointments, for claims to be processed and approved, when workers have not all been hired, when psychologist have to donate their time to address this without pay because the VA is not able to deal with any of this. Given the tone from Peake it's obvious why all the problems are still ongoing. Overblown!!!! He called it overblown and the right wing bloggers have jumped on board this fantasy flight claiming the media is playing it all up instead of looking at the facts. This is a national disgrace but they take it as a slam against their hero Bush when the real heroes are dying for their attention.