The Invisible Wounds of War

They are called the invisible wounds of war, PTSD and TBI.  Today such conditions are becoming increasingly more common among returning soldiers. 

They are two illnesses, which in the past few years have become a growing concern for both soldiers and caretakers. Joseph Wilson, Veterans Affairs and Rehabilitation Commissioner for the National Headquarters of the American Legion, says there has been an influx of soldiers returning home from combat with Traumatic Brain Injuries (TBI) and Post-Traumatic Stress Disorder (PTSD). Modern technology is helping keep more soldiers alive than during past wars and Wilson has determined that “it’s only going to increase further.” Now with more soldiers returning home from war than ever before, caretakers and soldiers are left to deal with not only the physical but mental affects of war. But recognizing and treating these conditions is not always an easy task.

Linda Scwhartz, Commissioner of Veterans Affairs for the State of Connecticut, says after Vietnam there was no such thing as PTSD and only in the past two years has the VA begun screening for PTSD and TBI. In Connecticut, Scwhartz says, 19 percent of those who responded to a survey conducted by the VA, said they had been in circumstances where an explosion took place, and reported experiencing blackouts afterward. Additionally 30% of those who took the survey had symptoms of PTSD.

 Returning home from combat is a culture shock, says Cpl. Kostantinos Vathianakis, a Marine Corps Reserve who served in Iraq. “Most don’t realize that military life is a subculture; a very different and life changing one to be exact. Everything is run differently and called differently from the ‘real world.’ ” Vathianakis explains the hardest part about being back home is being a person again and not a Marine.

 A soldier suffering from PTSD may feel irritable, have difficulty concentrating, or feel as though they have no future, says Wilson. A traumatic brain injury can often transition into PTSD, therefore it is critical, explains Wilson that PTSD and TBI be caught early, so they can be treated properly.

 Lance Cpl. Peter J Mangin, a Marine who served in Iraq, echoes a similar sentiment to Vathianakis. Upon his return home from combat, Mangin says he realized a lot had changed since he’d been away. Between his father being gravely ill and the death of one his fellow Marines, who was accidentally shot while cleaning his hunting rifle, it all really began to sink in for Mangin when he returned home. “Here I was thinking the war was over for me because I was home. Meanwhile all too often there is a war awaiting you upon your return home,” says Mangin. Making that switch from Marine to civilian is mentally a difficult adjustment, and simply being around people can be a feat in itself, says Vathianakis.

Wilson says the VA is taking an active stance in treating these illnesses, however due to the similarities in symptoms of both, caretakers have trouble identifying whether a soldier has one or the other. Specifically, there are clinical challenges to treating TBI because symptoms like insomnia, irritability, and change in behavior, which are common for TBI sufferers, are often written off as PTSD. Wilson stresses PTSD and TBI are two very separate issues. TBI is a neurological issue resulting from actual damage to the brain as a result of a blast, whether a human being, automobile-main catalyst, or manhole set it off. PTSD, on the other hand, is a psychological one, caused by experiencing traumatizing situations while in combat. PTSD sufferers are often prone to outbursts, have difficulty concentrating, become anti-social, or worst of all, see no positive future in sight.

Wilson says it is often hard to diagnose TBI, especially mild TBI, which is commonly referred to as a concussion. Wilson explains many soldiers experience mild TBI’s and do not even know it. It is only after they return home that they being experiencing the symptoms discussed above. There is no objective test like an MRI, which would reveal a mild TBI. Simply judging based on common indicators can be difficult, because as Wilson explains, PTSD and TBI have similar warning signs. In order to separate TBI and PTSD sufferers, the VA has begun using screening tools and asks the soldier a series of questions.  Based on the feedback received from the test, caretakers can determine whether or not the veteran has experienced a TBI.

However, Wilson says, many soldiers fear the stigma that will be placed upon them if they admit to having symptoms of PTSD or TBI. If either ailment is affecting them to the point where they cannot perform their duties, they can be put on medical retirement or can’t re-enlist. But if not treated properly, as stated above, TBI can transition into PTSD and thus depression, or long-term brain damage.  Wilson stresses it is critical a TBI be recognized early, because with time and the right treatment, this injury can be overcome. There is not much that can be done to reverse the affects of a TBI, therefore the focus is placed on rehabilitation and preventing any further injury. Otherwise a TBI can cause life-long damage to ones sensory, motor and cognitive learning skills. 

For PTSD sufferers, Wilson says there is no definitive resolve, however there are plenty of treatment options available. The VA works to place soldiers in one on one counseling sessions as well as in group therapy, in order to help them mentally adjust back to civilian life. Mangin says it all has to do with whether the individual is serious or not about seeking help. Mangin believes programs like, “the VA can only do so much for a veteran who can’t admit that they have a problem."

 Luckily, says Wilson, The National Guard, Reserve and the VA are now working in conjunction to help identify those soldiers suffering from either TBI or PTSD. Also the VA and American legion have recently put in place many programs to help ease the worries of PTSD and TBI sufferers. Job Placement programs, suicide prevention and family counseling are just some of the areas of patient care the VA and American legion are working aggressively to improve, says Craig Roberts, head of Media Relations for the American Legion. 

 Vathianakis explains, there are plenty of warrior transition briefs and pamphlets being handed out to help veterans deal with the shock of returning home from war. But he says one of the hardest parts about coming home was being around people who didn’t care or couldn’t understand what he had been through while in Iraq. Mentally, this can become a hard burden for soldiers to bear and Mangin says, it’s important for them to take advantage of the support offered by the armed forces that will help them transfer their minds and bodies from a war zone to a civilian zone. Doing so can help caretakers determine whether a soldier may be suffering from TBI or PTSD.

“With all the stressors building up when I returned home, I was about to have a breakdown,” says Mangin, and that’s when he sought help from the VA. Overall, he says, he is proud to say he has successfully grown from all he had to deal with while overseas, “and upon returning home it has made me the stronger person I am today.”

photo courtesy of APimages.com

 

The Weapon that is our Cellphone

Many of us have been there..texting late night only to regret out actions the next morning. Now there's a website that compiles some of the most hilarious "texts from last." 

Without the context of the conversation included, many of them are ones we can all relate to. Definitely worth checking out. 

A Two Front War

For many soldiers there is a battle awaiting them upon their return home.

Each month 10 thousand young men and women return home from Iraq, Afghanistan and other areas of conflict only to be faced with more hardship. One challenge soldiers face is receiving adequate healthcare upon their return. Many Americans and veterans criticize the government and armed forces for not sufficiently caring for soldiers when they return to the U.S. In March, President Obama considered instituting a law that would bill soldiers private medical insurance to cover medical costs for injuries they sustained in combat. This new piece of legislation would require private medical insurance companies to reimburse the Department of Veterans affairs for the treatment of soldiers injured in combat. The plan was thought up of as a way to generate money for the Department of Veterans Affairs, and was said to save $530 million a year for the Veterans Affairs federal budget. But Veterans Organizations were not in favor of the plan and voiced their concerns that it may affect a veteran’s ability to access healthcare. If this plan was followed through, veterans affairs advocates feared it would drastically higher premiums for veterans and make healthcare very unaffordable for soldiers and their families. Currently the Government covers any medical costs for a soldier related to an injury they received due to military service.

Cpl. Kostantinos Vathianakis, a United States Marine Corps reserve, who served in Iraq calls the plan, “ridiculous.” Vathianakis says, “any injuries occurring on duty are obviously directly related to the mission being followed. Missions are passed down the Chain of Command in direct support of an Operation from the Department of Defense.” Vathianakis believes making the individual soldier cover their own medical costs, “is basically abandoning troops to defend for themselves.”

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Lance Cpl. Peter J Mangin served in Iraq and was outraged upon hearing of this plan. He realizes cut backs need to be made in order to reduce government spending, but servicemen and women should not be the ones paying the price. Mangin says it’s the government’s sole responsibility to take care of returning soldiers. Although the bill has been rescinded, Marines like Mangin took the proposal of the bill as an insult. “Knowing that we are making ultimate sacrifices to greater this country and this is what we get in return?,” says Mangin.

Linda Schwartz (pictured at right), Commissioner of Veterans Affairs for the State of Connecticut, believes once the Obama Administration listened to these concerns, they realized they made a mistake and withdrew the proposed plan. There is some even better news for veterans, assures Schwartz. Obama wants adequate funding for the VA healthcare budget and has a plan to increase the Veterans Affairs healthcare budget by $25 billion. But Schwartz says despite such efforts, the VA has been underfunded for years and many soldiers “fall through the cracks because they don’t know what’s available to them.”

She believes today it’s “a whole new ball game for soldiers coming home from war.” A former military nurse, Schwartz says years ago all of the soldiers returned to the same base, where there was one central hospital, and everything they needed was right there for them. Today, however, things are much different. Schwartz explains the military is now relying so heavily on the National Guard and Reserve that these men and women are returning back into the community where making that transition into civilian life can be difficult and help is needed.


“Civilians can’t fathom what we’ve been through,” says Vathianakis. He agrees overall the help is there for a soldier if needed but far too often tragic cases arise and it’s too late. Vathianakis explains there are standard rehabilitation steps that are taken when leaving Iraq and returning home. Soldiers go through post-deployment checkups, counseling, and are constantly reminded from their chain of command what is out there for them and awaiting them when they return home from combat.

Schwartz says there is plenty available but that doesn’t mean there aren’t flaws in the system. Schwartz says the process of filing a disability claim at the VA can become so stressful that some people joke, “if you didn’t have Post Traumatic Stress Syndrome at the start of it, you will by the end.” Schwartz explains the VA can take anywhere from three to six months to process a disability claim. More alarming is the fact that three to six months is considered good for the VA. But for someone who is sitting at home, injured, unable to work and without any income, it’s not, explains Schwartz.

The far distance from a soldier’s home to a facility, and the possibility of a very long wait to see a doctor easily turns soldiers off from seeking help. "Boy was it a maze to figure out," says Mangin, who sought help from a Veterans Affairs Hospital. "But with help from my command and other Veteran’s going through the same process, I made it out alive so to speak."

While Mangin agrees in some cases the military and the government has failed returning soldiers in rehabilitating them, what it comes down to is “there has to be a valid effort from the veteran as well as the provider.” Some facilities like the VA and outpatient clinics can be large and confusing, says Mangin, and a three-hour wait is standard at many of them. Schwartz says there are plenty of people out there that want to help these brave young men and women, but changes need to continue to be made. Mangin says while there was some confusion and long waits are typical, a little patience can go a long way.

Programs are evolving and now there are many options available to soldiers of which they are not even aware. While a disability claim may take months to process, the VA is more than willing to help a soldier file the paperwork and get them set on the right foot. Some, Schwartz say, think they solely have to do all of the work themselves, but that’s not the case. The VA's job is to make sure they reach out to soldiers who may not even know where to begin.


Vathianakis put it simply, “the bottom line comes down to the individual; first to realize they need the help then go out and get it.” While the process can be long and strenuous, Craig Roberts, head of Media Relations for the American Legion says he believes the current administration is doing a respectable job as far as facilitating returning soldiers from combat. Roberts, like Schwartz, admits there certainly are weaknesses. Suicide prevention and family counseling are two aspects of post rehabilitation care that have been failing, says Roberts, but he assures soldiers they are working aggressively to fill those gaps. In fact, the American Legion and The Department of Veterans Affairs have teamed up to advocate on soldiers’ behalf. Both organizations are working to strengthen job placement programs, business seminars and encourage entrepreneurship. 

Overall Schwartz and Roberts are optimistic about Obama’s new federal funding plan for veterans. They believe he has fulfilled the U.S.’s promise to them, which is to take full responsibility for the care of soldiers who risked their lives for this country. For the most part the same sentiment resonates with veterans like Mangin and Vathianakis. Despite the outrage and insult they felt after hearing of Obama's proposed medical insurance plan they believe a respectable job has been done in helping them both mentally and physically upon their return to the United States. "The Government needs to take full responsibility in covering the costs. It’s not anyone else’s responsibility but their own. They sent us to war therefore they are obligated to have to deal with the repercussions of it," says Mangin. Veterans organizations and soldiers alike can only hope Obama’s new budget plan will do just that.

Learn more of the details of Obama's federal budget plan for the Department of Veterans Affairs