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- From: Neil McGlothin <nbmdude@xxxxxxxxx>
- To: tcb@xxxxxxxxxxxx
- Date: Tue, 26 Jun 2007 20:01:29 -0700 (PDT)
Okay. It ain't bus related. But, please take the
time to read this. To see whats happening to our
sons, brothers, fathers, sisters...to people you know
and don't know.
These sons and daughters of America deserve to be
thought of...remembered...and yes, to be cried for.
Gov't struggles to care for wounded GI's By MARILYNN
MARCHIONE, AP Medical Writer
Sat Jun 23, 6:50 PM ET
More than 800 of them have lost an arm, a leg, fingers
or toes. More than 100 are blind. Dozens need tubes
and machines to keep them alive. Hundreds are
disfigured by burns, and thousands have brain injuries
and mangled minds.
These are America's war wounded, a toll that has
received less attention than the 3,500 troops killed
in Iraq. Depending on how you count them, they number
between 35,000 and 53,000.
More of them are coming home, with injuries of a scope
and magnitude the government did not predict and is
now struggling to treat.
"If we left Iraq tomorrow, we would have the legacy of
all these people for many years to come," said Dr.
Jeffrey Drazen, editor-in-chief of the New England
Journal of Medicine and an adviser to the U.S.
Department of Veterans Affairs. "The military simply
wasn't prepared for its own success" at keeping
severely wounded soldiers alive, he said.
Survival rates today are even higher than the record
levels set early in the war, thanks to body armor and
better care. For every American soldier or Marine
killed in Iraq, 15 others have survived illness or
injury there.
Unlike previous wars, few of them have been shot. The
signature weapon of this war ? the improvised
explosive device, or IED ? has left a signature wound:
traumatic brain injury.
Soldiers hit in the head or knocked out by blasts ?
"getting your bell rung" is the military euphemism ?
sometimes have no visible wounds but a fog of war in
their minds. They can be addled, irritable, depressed
and unaware they are impaired.
Only an estimated 2,000 cases of brain injury have
been treated, but doctors think many less obvious
cases have gone undetected. One small study found that
more than half of one group of wounded troops arriving
at Walter Reed Army Medical Center had brain injuries.
Around the nation, a new effort is under way to check
every returning man and woman for this possibility.
Some of those on active duty may have subtle brain
damage that was missed when they were treated for more
visible wounds. Half of those wounded in action
returned to duty within 72 hours ? before some brain
injuries may have been apparent. The military just
adopted new procedures to spot these cases, too.
Back home, concerns grow about care. The Walter Reed
hospital scandal and problems with some VA nursing
homes have led Republicans and Democrats to call for
better care for this new crop of veterans.
A lucky few get Cadillac care at one of the VA's four
polytrauma centers, where the most complex wounds are
treated with state-of-the-art techniques and whiz-bang
devices like "power knee" or "smart ankle"
prosthetics. Others battle bureaucracy to see doctors
or get basic benefits in less ideal settings.
Mental health problems loom large. More than a third
of troops received psychological counseling shortly
after returning from Iraq, and a third of those were
diagnosed with a problem, a recent Pentagon study
found. The government plans to add 200 psychologists
and social workers to help treat post-traumatic stress
disorder and other issues.
No one knows what the ultimate cost will be. Harvard
University economist Linda Bilmes estimates the
lifetime health-care tab for these troops will be $250
billion to $650 billion ? a wide range but a huge sum
no matter how you slice it.
Who are the wounded?
Lee Jones, 24, of Lumberton, N.C., was severely burned
on the face, hands, feet and legs when his Humvee was
hit with an IED two years ago. A partial amputee with
speech and other problems from a severe brain injury,
he now does work therapy delivering mail at a VA
hospital and tries to re-establish life in a nearby
apartment with a wife and baby daughter.
Marine Cpl. Joshua Pitcher, 22, from upstate New York,
is a Purple Heart recipient who returned to Iraq after
he was shot in 2005. Half of his skull was removed to
allow his brain to swell as he now recovers from a
brain injury and shrapnel wounds from a grenade blast
in February.
Maj. Thomas Deierlein, 39, is a New York City
marketing executive who served five years after
graduating from West Point. Twelve years later, called
up as a reservist, he nearly died of bullet wounds
that shattered his pelvis, leaving him with a
colostomy and learning to walk again.
Joseph "Jay" Briseno, 24, of Manassas Park, Va., was
shot in the back of the neck by an Iraqi in the early
months of the war. One of the most severely wounded,
he is now a quadriplegic, on a breathing machine,
blind and unable to speak, but aware of what has
happened to him.
"The mistake in Vietnam was, we hid the injured away
from folks so they didn't get to tell their stories.
Now it's important that we let them tell their stories
to the public," said Dr. Steven Scott, director of the
Polytrauma Rehabilitation Center at the Tampa VA
Medical Center in Florida.
Counting the wounded can be contentious. Earlier this
year, the Department of Defense changed how it tallies
war-related injuries and illness, dropping those not
needing air transport to a military hospital from the
bottom-line total.
Bilmes, the economist, thinks this is disingenuous.
"An accident that happens while they're there is a
cost of war, particularly when you factor in the
length of deployment" and injury-inducing conditions
like very hot weather, carrying heavy packs, and more
vehicle accidents because it is not safe to walk
anywhere, she said.
As of June 2, 25,830 troops had been wounded in
action. Of these, 7,675 needed airlifts to military
hospitals and the rest were treated and remained in
Iraq.
There were another 27,103 non-battle-related air
transports. Of those, 7,188 had injuries. Most
occurred from vehicle accidents, training or
work-related accidents. Ten percent were sports
injuries, said Dr. Michael Kilpatrick, who tracks this
information for the Defense Department.
Nearly 20,000 of these "non-hostile" airlifts were for
illnesses or medical issues: general symptoms like
fever or pain needing tests or evaluation; back
problems; psychological problems adjusting to being in
a war zone; "affective psychoses" (not able to
function or care for themselves); neuroses;
respiratory or chest symptoms; depression; head and
neck problems (including traumatic brain injury);
epilepsy; infections, and muscle pulls and strains.
"I don't want to try to say these are not war-related.
Being in the military is a very physically demanding
job," Kilpatrick said.
For stress-related problems, the military tries "three
hots and a cot" ? warm meals and a chance to sleep.
Most of the time it works and troops return to their
unit, Kilpatrick said.
Of the troops air evacuated to the military hospital
in Landstuhl, Germany, 20 percent return to Iraq and
80 percent go back to the United States for more care
or disability discharge.
Of the half-million troops who have left active duty
and are eligible for VA health care, about one-third
have sought it. The most complicated cases end up at
one of the four polytrauma centers, in Tampa, Fla.;
Richmond, Va.; Palo Alto, Calif.; and Minneapolis.
These were formed after doctors realized they were
missing problems ? amputees who were confused and
unable to put on their prosthetics because of
undiagnosed brain injuries, and guys who could
remember their therapy dog's name but not their
doctor's, or who could carry on a conversation but not
recall what they had for breakfast.
Troops at these hospitals have an average of six major
impairments and 10 specialists treating them.
"The important thing to realize is you could have all
of them at once" ? trouble speaking, seeing, walking,
hearing, etc., Scott said.
Most of these injuries are caused by IED blasts, which
send a pressurized air wave through delicate tissues
like the brain, sometimes send it smacking against the
inside of the skull and shearing fragile nerve
connections that control speech, vision, reasoning,
memory and other functions. Lungs, eardrums, spinal
cords ? virtually anything ? can be damaged by the
pressure wave. Injuries also come from collapsing
buildings, flying debris, heat, burns or inhaled gases
and vapors.
"Many of these you can't see on an X-ray," such as
glass shards that can cause internal bleeding, Scott
said.
In prior wars, one of every five to seven troops
surviving a war-related wound had a traumatic brain
injury, the military estimates. It's much higher in
this war.
A pilot project at Walter Reed in 2003 to screen 155
patients returning from Iraq found that 62 percent had
a brain injury.
"This is a very rapidly evolving area as a disease,"
with no screening test, agreed-upon set of symptoms
for diagnosis, or even a billing code, said
Kilpatrick, the military doctor.
Much needs to be learned about how to treat these
injuries, he said, but credited the military medical
staff for having the chance.
"It's just amazing to me every day when I look at
these numbers," he said. "The good news is that the
majority of these people who become ill or injured ...
are going to survive and are going to be able to
return either to the military or to civilian life and
be productive."
___
On the Net:
Government casualty data:
http://siadapp.dmdc.osd.mil/personnel/CASUALTY/castop.htm
State breakdowns:
http://siadapp.dmdc.osd.mil/personnel/CASUALTY/STATE_OEF_OIF.pdf
Defense and Veterans Brain Injury Center:
http://www.dvbic.org
Harvard economist report:
http://ksgnotes1.harvard.edu/Research/wpaper.nsf/RWP/RWP07-001
Department of Veterans Affairs: http://www.va.gov/
Department of Defense: http://www.defenselink.mil/
Copyright © 2007 The Associated Press. All rights
reserved. The information contained in the AP News
report may not be published, broadcast, rewritten or
redistributed without the prior written authority of
The Associated Press.
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