March 19, 2008 marks the fifth year of the OIF invasion
Since 2003 our country has been at war, but for many of us the impact is minimal. Not so for our veterans who have seen combat on the front lines, some who have even repeated their combat tours two and three times. For them life is different.
This war and its injuries differs from previous conflicts. There is an incidence of polytrauma from Improvised Explosive Devices (IEDs). Additionally thanks to improvements in medical care on the battlefield or shortly thereafter, these service members are surviving wounds they might not have a couple of decades ago. But these improvements can pose challenges for the VA Health Care System, which takes care of these veterans over the long term.
Today, there are nearly 9,600 Persian Gulf, Operation Enduring Freedom (OEF-Afghanistan service) and Operation Iraqi Freedom veterans who receive their care from the Phoenix VA Health Care System. Of these 8650 are men, 950 are women and 3200 have had multiple deployments. As these "Returning Warriors" seek VA for their health care needs, we are responding with a variety of venues including:
Five Years of FREE VA Health Care: Military veterans who served in combat since Nov. 11, 1998, including veterans of Iraq and Afghanistan, are now eligible for five years of free medical care for most conditions from the Department of Veterans Affairs (VA).
This measure increases a two-year limit that has been in effect nearly a decade. Combat veterans who were discharged between Nov. 11, 1998 and Jan. 16, 2003, and who never took advantage of VA's health care system, have until Jan. 27, 2011 to qualify for free VA health care.
The five-year window is also open to activated Reservists and members of the National Guard, if they served in a theater of combat operations after Nov. 11, 1998 and were discharged under other than dishonorable conditions. VA has several doctors who can talk to you about our nationally recognized health care.
Mental Health Therapy specifically designed for Post Traumatic Stress Disorder (PTSD) including Cognitive Processing Therapy a type of Cognitive Behavioral Therapy which helps patients work through their memories and maintain their accuracy. In time, people can change their memories. When they are traumatic, it is often easier to have the memories reflected in a more negative tone which isn't often accurate. To avoid depression VA tries to get the patients to keep their memories balanced. This therapy is often 13 weeks long.
VA also offers Exposure Therapy for PTSD. Exposure methods work by helping anxious patients confront their fears with the aim of reducing the fear or anxiety that can be managed. This therapy also incorporates relaxation therapy. The CTHVAMC has several PTSD experts who can help describe the processes used to help these veterans.
Operation Enduring Freedom and Operation Iraqi Freedom Program Coordination: Returning veterans are triaged by the OEF/OIF program manager who determines the level of case management care required. These OEF/OIF veterans are then case managed by a Nurse Case Manager, Social Work Case Manager or both. The CTHVAMC case managers are here to assist the OEF/OIF veterans with their post deployment needs. This case management consists of oversight of medical and mental health care to ensure the veteran is getting comprehensive services that are coordinated for better outcomes. The program is also responsible for community outreach to the military and the community at large. The goal is to educate returning service members. Sometimes they may be overwhelmed with information and efforts to "get back to normal" when they are discharged. So VA steps in to remind them and their families about VA benefits and health care options. Our VA also screens all veterans for symptoms of brain trauma, which may not manifest itself right away. Earlier identification and treatment of veterans with more subtle forms of brain injury means a better chance of recovery. In fact, the Carl T. Hayden VA Medical Center was on the forefront of developing a screening tool early in the war. We have also recently established the "Brain Boosters" group that has begun to help veterans. The CTHVAMC case managers can share heart warming stories of how we are responding to the unique needs of these veterans.
Audiology and Speech Pathology Services (ASPS): This area provides comprehensive diagnostic and treatment services on an expedited priority basis (less than 30 days) for OEF/OIF veterans concerned about communication or cognitive problems. This includes hearing loss following military noise exposure or memory loss following traumatic brain injury. When indicated, they provide hearing aid services and other options for amplification, and memory devices that may assist the veteran in their daily routines. ASPS tries to assist the combat veteran so that the veteran can pursue his or her goals in life. For example, custom hearing protection is provided if routine noise exposure continues in the veteran's post-service occupation or recreational activity. ASPS makes every effort to accommodate the OEF/OIF veterans' schedule which may be limited due to their work or college schedules.
Sleep Research for Operation Enduring Freedom (OEF-Afghanistan Service) and Operation Iraqi Freedom (OIF) Veterans with Traumatic Brain Injury (TBI). Insomnia is very common among persons with traumatic brain injury (TBI). TBI is the signature injury of the war and sleep disturbance is frequently reported by Iraq war veterans. VA is determining OEF/OIF needs and preferences for insomnia treatments, and ways to deliver treatments to them.
This study was funded by the VA Office of Research and Development, Health Services R&D Service, QUERI Program. The preliminary findings suggest that veterans prefer a combination of non-pharmacological and pharmacological insomnia treatments. Veterans also prefer electronic methods of receiving non-medication treatment such as the Internet and MP3 files. These preferences may reflect the technology savvy of this new era of veterans. An Internet-based, non-medication intervention option could supplement the medication treatment available in routine care. The CTHVAMC has an Insomnia Research expert on our staff that can show you more about this study.
These programs are just a glimpse of what we are providing. We can also offer interviews with veterans who are utilizing VA services to share the effects of the care they are receiving.
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