Hidden damage revealed in veterans’ brains from IED blasts (Reuters)
A research team at Johns Hopkins University says they have found a unique honeycomb pattern of broken and swollen nerve fibers in brains of Iraq and Afghanistan combat veterans who survived improvised explosive device (IED) blasts, but later died of other causes. In doing so, the team says they may have found the signature of “shell shock” – a problem that has afflicted many soldiers since World War I warfare. The team of eight researchers, led by Vassilis Koliatsos, professor of pathology, neurology and psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, studied the brains of five U.S. combat veterans and compared them to 24 other brains of people who died from causes such as car accidents, drug overdoses and heart attacks. Koliatsos says the honeycomb pattern is unique to the combat veterans’ brains, and was found in the frontal lobe which controls decision-making, reasoning and other executive functions. “We typically think of traumatic brain injury as something that happens when an external force comes against your skull,” says Koliatsos. But he says they may have found a new type of injury unique to combat veterans exposed to an IED blast. “In this particular case, the force is coming against your chest so the blood gets squeezed. And as the blood gets squeezed, there’s a lot of bad blood into the brain. And because there’s a pulse of over-pressure wave that happens (like this), the brain also swells (like this). And when the brain swells, it pushes against some of the fixed elements inside the skull,” says Koliatsos, explaining the distinctive honeycomb pattern found in critical brain regions. Koliatsos says this hidden brain injury may later play a role in a veteran’s psychological and social problems. “And because of the way vasculature is organized in the brain, most of this damage happens in the front of the brain – what we call the frontal lobes. And that’s very important because this is the site, the center, of the executive functions of the brain. Functions that allow you to put your life together, organize, plan ahead, understand abstract. And you can imagine this can make your life difficult,” says Koliatsos.
McCain wants answers on delays in healthcare for veterans (The Hill)
Sen. John McCain (R-Ariz.) is demanding answers from the Department of Veterans Affairs (VA) in the wake of reports that roughly 35,000 veterans were delayed from enrolling in VA healthcare. McCain, chairman of the Armed Services Committee, sent a letter to VA Secretary Bob McDonald on Thursday suggesting veterans were potentially “delayed or discouraged” from getting VA health benefits. “I continue to be disappointed in the VA’s inability to manage the benefit programs enacted by Congress,” McCain wrote. “The VA has a robust budget and has been given ample additional resources to make the necessary changes to its systems and processes so that these 35,000 veterans could have been properly enrolled and received VA care.” More than 35,000 combat veterans, many of whom are Iraq War veterans, were blocked from enrolling because of a computer error, according to VA documents leaked to The Huffington Post. The veterans were listed as “pending” for not finishing a means test, which measures household income, something combat veterans aren’t required to complete. Pointing to the fact that the documents were leaked by a VA whistleblower, McCain questioned McDonald on the department’s level of transparency with both lawmakers and the public. “Why was this information not provided to Congress and had to be released by a whistleblower and, subsequently, by the media?,” McCain asked, adding, “how can Congress and veterans be assured that this issue will not occur again with future benefit changes?” McCain also wants to know who at the VA can modify the agency’s system to let combat veterans enroll without a means test and whether anyone has been held responsible for the glitch.
Retiring Army chief raises concerns about battle-hardened leaders, Gold Star families (The Washington Post)
Gen. Raymond T. Odierno took questions from reporters for an hour Wednesday at the Pentagon, his hands frequently resting on a podium elevated to complement his imposing 6-foot-6 inch frame. He is just a few weeks short of retiring as chief of staff of the Army, and addressed a wide range of issues. Odierno discussed what he sees as the top security threat to the United States (Russia), what went wrong in Iraq after the U.S. withdrawal there in 2011 (politicization of its military) and even his thoughts on Republican presidential candidate Donald Trump’s stance that U.S. troops should be deployed to seize oilfields from Islamic State militants (he disagrees). Near the end of the briefing, however, Odierno’s tone softened. Asked what concerns he had about caring for U.S. veterans of the Iraq and Afghanistan wars, he said he was encouraged by what has been done already, but sees needs for both veterans and their caregivers that stretch forward for years. He also talked about those still in uniform. “I worry about our senior leaders,” Odierno said. “You know, we were talking yesterday in my office. So in 2003, someone who was a captain is now a colonel or a brigadier general. They have probably had six or seven deployments over that period of time.” “We tend not to talk about our leaders,” he added. “We have [noncommissioned officers] who are probably sergeants or privates back then who are now sergeant first classes, master sergeant, sergeant majors who have had six, seven, eight deployments. They’re doing well, but we have to make sure we have programs in place to take care of them as well as they continue to lead our great soldiers.” Odierno added that the military needs to stay connected to the Gold Star families who have lost loved ones through military service. “They love just staying connected to the Army, to the units that their children or sons or daughters or husbands were in, and for me, that’s incredibly important that we do that,” the general said. “Because we should never forget the sacrifice that they made and the sacrifice that their families that send their children continue to make, because their dad or mom’s no longer here.” The general said he will live with those sacrifices “for the rest of my life.”
VA ‘greatly regrets’ brain exams by unqualified doctors (KARE-Minneapolis)
The Minneapolis VA Medical Center acknowledged that some exams for traumatic brain injuries (TBI’s) were done by unqualified doctors, in violation of Veterans Administration policy. Earlier this week, KARE 11 reported that some local veterans had been denied TBI benefits based on the improper exams. Those veterans are being called back for new examinations by specialists. In a written statement to KARE 11, the VA said: “This was our oversight, and we greatly regret the inconvenience to Veterans who returned for a repeat evaluation.” The statement did not disclose the number of improper exams – or the number of veterans who may have been denied benefits because of them. But Congressman Tim Walz (D-MN) has said he’s been told more than 300 area veterans are involved. KARE 11’s investigation revealed that since at least 2010, the Minneapolis VA has been violating Department of Veterans Affairs rules about the type of specialist required to make an initial diagnosis for a veteran claiming to have a traumatic brain injury. The policy is designed to protect veterans like Butch Hamersma, who lost part of his skull in Vietnam when he drove over a land mine. “Three days later I woke up in Japan,” Hamersma said. Emphasizing the policy with the word “Important!” a VA training manual states that only four types of specialists – physiatrists, psychiatrists, neurosurgeons and neurologists – can make an initial TBI diagnosis. The same rule also is spelled out on the forms used by VA Compensation and Pension examiners. In spite of that, KARE 11’s investigation found the Minneapolis VA ignored the rule time after time, including during Butch Hamersma’s TBI exam in 2012. Who did his exam? “It was a nurse practitioner,” Hamersma recalled. Hamersma’s VA medical records confirm that instead of being evaluated by a specialist, as required, a nurse-practitioner named Brenda Roche made his diagnosis. “There is no diagnosis of TBI/concussion,” she wrote. As a result, Hamersma was denied VA traumatic brain injury benefits.
VA locked in 20-year lease for N.C. clinic, paying $68 million (WNCN-Raleigh)
The VA is locked into a 20-year lease with Summit Smith Healthcare Facilities for its clinic in Wilmington, N.C. With rent set at almost $300,000 a month for the clinic, that means taxpayers will spend more than $68 million to lease a facility that they will not own at the end of the 20-year term. The details of the lease were first requested and the amount the VA was paying in rent after the clinic had been partially unusable for 3 months due to a internal plumbing issue that was contaminating the clinic’s water. Commercial real estate brokers say that the rate the VA is paying for the clinic is about twice the going rate for prime medical office space in Wilmington. Two months after we requested a copy of the lease to see what exactly was included in the lease, we finally got it. The lease says “the Annual Rent does NOT include interior utilities and interior janitorial services, however it does include the Operating Expenses.” Operating expenses appear to involve maintaining all of the building equipment and systems, “including mechanical, electrical, and plumbing.” Although Summit Smith is required to cover operating expenses under the terms of the lease, the VA paid an additional $928,000 in a one-time lump sum payment to help Summit Smith cover operating expenses, too. It does not appear that the lease includes any of the medical equipment or furniture inside the Wilmington Clinic, which we thought may have accounted for rent payments in such excess of the going rate for medical office space. In addition to what the VA is paying to rent the building, they are also paying $217,000 a year ($18,000 a month) to lease the land under the building from the airport authority.
WWII veterans remember war’s end 70 years ago (Philly.com)
World War II fighter pilot Ray Garcia heard the stunning news aboard the Sea Owl while the troop ship waited with scores of others to pass through the Panama Canal on the way to combat in the Pacific. A member of the 57th Fighter Group, he had just left a grueling fight against the Germans in Europe and was preparing to take on the Japanese when he and his comrades learned of fearsome new bombs dropped on Hiroshima and Nagasaki. Then – as the Sea Owl changed course for the United States – more momentous tidings came by way of a small ship newspaper and the shipwide address system. “Now hear this! Now hear this!” a voice said. The Japanese had surrendered. The war was over. Tough combat veterans wept for joy. Some broke out alcohol they had hidden away, and cheered one another in celebration. “It was such a relief,” said Garcia, now 90, a veteran of 82 combat missions, who lives at the Wellington Hall retirement community in West Chester. “I was really happy.” Across the country, the dwindling number of World War II veterans are remembering the day 70 years ago when the guns fell silent and they could think again about rejoining families, finding jobs, and starting over. Aug. 14, 1945 — depending on the time zone, it might have been Aug. 15 — was a euphoric time of parties, patriotic parades, and massive flyovers. “Adults and children spontaneously ran into the streets and started parading and waving flags,” said William M. Detweiler, consultant for military and veterans affairs at the National World War II Museum in New Orleans. “People turned their lights on at night because the blackout restrictions were over,” said Detweiler, a former national commander of the American Legion. “Neon lights illuminated buildings again. It was a big thing to see the lights back on.”