Military slow to treat mild traumatic brain injury
Filed under: Government, Health journalism, Hot Health Headline
ProPublica’s T. Christian Miller and NPR’s Daniel Zwerdling have found unpublished military documents which indicate that tens of thousands of soliders who suffer from mild traumatic brain injury have gone undiagnosed.
Photo by isafmedia via FlickrThese are in addition to the 115,000 soldiers known to suffer from such injuries, many of which are inflicted by shock waves caused by roadside bombs. They write that the lack of concern shown by top brass for mild traumatic brain injuries was “a reflection of ambivalence about these wounds at the highest levels.”
“It’s obvious that we are significantly underestimating and underreporting the true burden of traumatic brain injury,” said Maj. Remington Nevin, an Army epidemiologist who served in Afghanistan and has worked to improve documentation of TBIs and other brain injuries. “This is an issue which is causing real harm. And the senior levels of leadership that should be responsible for this issue either don’t care, can’t understand the problem due to lack of experience, or are so disengaged that they haven’t fixed it.”
After a thorough review, one not helped by a top medical official’s early attempts to prevent local medical commanders from responding to the reporters, the duo distilled their findings into three bullet points:
- From the battlefield to the home front, the military’s doctors and screening systems routinely miss brain trauma in soldiers. One of its tests fails to catch as many as 40 percent of concussions, a recent unpublished study concluded. A second exam, on which the Pentagon has spent millions, yields results that top medical officials call about as reliable as a coin flip.
- Even when military doctors diagnose head injuries, that information often doesn’t make it into soldiers’ permanent medical files. Handheld medical devices designed to transmit data have failed in the austere terrain of the war zones. Paper records from Iraq and Afghanistan have been lost, burned or abandoned in warehouses, officials say, when no one knew where to ship them.
- Without diagnosis and official documentation, soldiers with head wounds have had to battle for appropriate treatment. Some received psychotropic drugs instead of rehabilitative therapy that could help retrain their brains. Others say they have received no treatment at all, or have been branded as malingerers.
Read the full investigation at ProPublica or NPR. It’s some of the deepest work on the subject we’ve seen thus far, and includes incredible quotes such as “What’s the harm in missing the diagnosis of mTBI?” as well as graphics and an explanation of why the numbers are so fuzzy.
MSNBC tells of earthquake amputees, soldiers
In the aftermath of the Haiti earthquake, an MSNBC team has set out to cover, through a variety of media, an American prosthetic group working at a rural hospital to fit limbs to hundreds of earthquake amputees. At the same time, the team is sharing personal essays written by American soldiers who lost limbs in Iraq and Afghanistan. It’s an unusual post-disaster focus that has yielded some impressive stories.
Here are a few of the most notable dispatches:
- The natural ease with which young children adapt to prosthetics (And share with each other | While their families struggle to cope)
- An American helicopter pilot adapts after losing limbs in Afghanistan.
A housing community set up for prosthetics patients after the Haiti quake - Fitting prosthetics to Haitian patients whose limb loss dates back to long before the earthquake.
- Making and fitting a new limb
- The life of one of the doctors fitting all those prosthetics in Haiti
VA works toward improving care for female vets
Acknowledging that female veterans have gotten short shrift at VA hospitals, some are now working to improve the services and experience women receive, according to NPR’s Erin Toner.
For example, the Clement J. Zablocki VA Medical Center in Milwaukee now has a women’s clinic and one manager there says the hospital is working to change the culture.
Toner also reports that a bill pending in Congress would “authorize a study of women who’ve served in Iraq and Afghanistan to find out how the wars have affected their physical, mental and reproductive health.
“The bill also would require a review of the barriers women face in accessing VA health care.”
NPR also includes a map of how many female veterans are in each state.
Related
During a 2008 panel on veterans’ health presented by the San Francisco Bay Area Chapter of AHCJ, Tia Christopher described her difficulties getting the help she needed as a Navy veteran who survived military sexual trauma and has PTSD. She expressed concern for female vets, whose experiences and health issues are significantly different from those of male soldiers and are largely underreported.
Listen to Christopher and the other panelists talk about the health care challenges facing vetereans.
Resources to cover mental health and the military
AHCJ offers resources to help journalists cover the wide range of health topics, including those surrounding the military, veterans and post-traumatic stress disorder. Members and other journalists write articles and tip sheets specifically for AHCJ about how they have reported a story, issues that our members are likely to cover and other important topics.
We have compiled a selection of tip sheets, articles, Web sites and reports that we feel could be helpful as journalists cover the aftermath of the Fort Hood shootings.
Some of these resources are normally available only to AHCJ members but we are opening them up to nonmembers for one week to help journalists cover this important topic.
War injuries advance treatment of brain injuries
In a three-part package published this month, the Los Angeles Times‘ Melissa Healy explains recent advances in the diagnosis and treatment of traumatic brain injury, with special focus on the United States armed forces.
- Treating traumatic brain injuries: Anecdotes from an Army National Guard medic and an equipment officer show how much lives can be changed by traumatic brain injury, an ailment that doesn’t even show up on CT scans or MRIs, and how a simple accurate diagnosis can provide patients with hope and understanding.
- War injury leads to advances at home: Healy writes that while combat veterans with traumatic brain injury are receiving the lion’s share of the attention, they’re just the tip of the iceberg. The “silent epidemic” has hit about 2 percent of the civilian population as well, which totals up to about 11 million since the wars in Iraq and Afghanistan began.
- Treating brain injuries on the sports field and battlefield: Finally, after tackling diagnosis and prevalence, Healy moves on to treatment. She walks through every step, from prevention to diagnosis to treatment, examining the latest in medical science along the way. It’s the longest piece in the package, and the best to start with if you’re looking for a better technical understanding of traumatic brain injury.
CNN looks into link between Lejuene water, cancer
CNN’s Abbie Boudreau and Scott Bronstein investigated a possible link between male breast cancer and contaminated drinking water provided at the Marine training base at Camp Lejeune between the ’60s and the mid-’80s. Twenty male Marines with breast cancer have found that the only thing they have in common is drinking the water at Lejeune, but, Boudreau and Bronstein report, “two independent studies have found no link between water contamination and later illnesses, according to the Marine Corps.”
The reports talked to seven of the cancer-afflicted men, finding that neither the VA nor the Marine Corps will pay for their cancer treatments, citing in at least one case that the cancer “neither occurred in nor was caused by service.”
The men with breast cancer are among about 1,600 retired Marines and Camp Lejeune residents who have filed claims against the federal government. According to congressional investigators, they are seeking nearly $34 billion in compensation for health problems they say stemmed from drinking water at the base that was contaminated with several toxic chemicals, including some the federal government has classified as known or potential cancer-causing agents.
In a blog post about the piece, Boudreau discusses questions raised by her research on unproven links between Lejuene water and cancer, openly wondering if the connection will ever be conclusively proven to be either true or false.
DoD campaigns against stigma of depression, PTSD
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury’s new Real Warriors campaign is designed to aid soldiers with what they seem to see as the three r’s of military mental health: resilience, recovery and re-integration.
The RealWarriors.net site not only directs soldiers to additional resources, but also shares anecdotes from their peers and provides them with guidelines for good mental health, both in combat and out of it.
The effort, launched in May, even has a Twitter account.
(Hat tip to Arline Kaplan of the Psychiatric Times)
Related:
Bay Area panel on veterans’ health highlights untold stories
Pentagon: War takes toll on soldiers’ children too
USA Today’s Gregg Zoroya reports the results of a Pentagon survey of more than 13,000 active-duty soldiers and their spouses intended to gauge the effect of the ongoing wars in Iraq and Afghanistan upon their children.
Among the survey’s findings:
- Six in 10 say children’s fear and anxiety increase when a parent goes to war
- A majority say their children have coped well, but a quarter say they have coped poorly or very poorly
- A third say their child’s grades and behavior in school have suffered
Zoroya also reports on all the measures the military has taken to help parents cope, including family counselors, Sesame Street kits and graphic novels.
Lack of oversight contributes to Army suicides
Filed under: Government, Hot Health Headline, Studies
The Army reported that 143 active duty soldiers killed themselves in the last year, the highest number since the statistics started being kept in 1980. This year’s numbers are on track to break that unfortunate record. Gregg Zoroya of USA Today reports that an Army investigator blames at least part of this rise to a lack of day-to-day oversight by commanders accustomed to leading amidst the intensity of the battlefield rather than the less-obvious perils of the barracks.
The investigator’s solution is simple: commanders need to interact with their troops more, to keep in touch and keep their eyes out for risk factors.
Zoroya also noted another contributing factor to the climbing suicide rate:
Along with soldiers who engage in risky behaviors, McGuire says, the Army has a greater number of troops who entered the service with pre-existing anxiety or depression or who have stopped taking their behavioral medication in order to meet entrance requirements.
Soldiers concerned they may be at risk can try this online mental health self-assessment designed specifically for members of the armed services.
Report exposes failures of Army mental health care
This week on Salon.com, Mark Benjamin and Michael de Yoanna are posting the results of their investigation into climbing “preventable death” rates among American soldiers. The reporters focused on the cases of soldiers in Ft. Collins, Colo., but also included the national implications of their findings. In January, they report, the army suspects more soldiers killed themselves than died in combat in Iraq and Afghanistan combined.
Their findings are being published in a series called Coming Home:
“Salon put together a sample of 25 suicides, prescription overdoses and murders among soldiers at Colorado’s Fort Carson since 2004. Intensive study of 10 of those cases exposed a pattern of preventable deaths, meaning a suicide or murder might have been avoided if the Army had better handled the predictable, well-known symptoms of a malady rampant among combat veterans: combat-related stress and brain injuries.”
According to Benjamin and de Yoanna, many, if not all, of the deaths were preventable. They point to systemic problems with the military culture and the military standard of medical and psychological care as the root cause. The reporters said the Army’s mental health system had failed the soldiers, many of whom had returned from Iraq and suffered classic symptoms of chronic PTSD.
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The AHCJ-NLM Fellowships will give four journalists the chance to spend a week on the campus of the National Institutes of Health learning about research and data from NIH and NLM, biomedical statistics, programs and resources and get hands-on training. Applications due Aug. 2.
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
