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Veterans return with more than memories

Diagnoses, treatments have changed for some health problems

Diagnoses, treatments have changed for some health problems

July 09, 2007|By JULIE E. GREENE

Brad Runkles was sitting in the passenger seat of a 5-ton gun truck leading a convoy back to its home base in Tikrit, Iraq, during the late afternoon of June 28, 2004, when an improvised explosive device, aka a roadside bomb, exploded under the passenger side of the truck.

Runkles doesn't remember what happened next, but three years later he considers himself one of the lucky ones. Thousands of Operation Iraqi Freedom and Operation Enduring Freedom veterans have died, and many of the thousands of injured veterans still deal with their injuries and/or mental health issues.

Although some scars remain, the second-degree burns on the right side of his face and on his right hand healed within four months, and the range of motion and strength are back in his right hand.

"I got right back into my old lifestyle," said Runkles of returning home in July 2004 after his tour with the 167th Airlift Wing of the West Virginia Air National Guard, based in Martinsburg, W.Va.

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"I didn't have a very hard time adjusting back into the civilian world," said Runkles, 26.

Runkles, who stayed with the West Virginia Air National Guard as a technician, moved from Hedgesville to Martinsburg and got married Sept. 30, 2006.

Military members serving in Iraq and Afghanistan have more exposure to improvised explosive devices, or IEDs, than veterans of past wars, so doctors are seeing more blast and blunt trauma injuries, according to officials at the Martinsburg Veterans Affairs Medical Center.

Other medical conditions these veterans are dealing with upon returning home include traumatic brain injuries and post-traumatic stress disorder.

Of approximately 686,000 troops who had returned from Iraq and Afghanistan and left the military, about 229,000 had gone to Veterans Affairs facilities as of April for health care, whether it was a veteran getting a flu shot or a quadriplegic receiving perpetual care, said VA spokesman Phil Budahn in Washington, D.C.

Budahn said he didn't have specific statistics for injuries caused by IEDs, but the VA was treating about 400 people for traumatic brain injuries. Such injuries could range from subtle symptoms such as loss of concentration all the way up to extreme personality changes and short-term memory loss.

In the past, everyone thought they understood the risks of traumatic brain injury to be obvious physical injury such as shrapnel, so traumatic brain injury wasn't always properly diagnosed, Budahn said.

But in 2003, a study out of the Tampa, Fla., VA hospital pointed out that people could experience a closed head trauma, or concussion, with no visible wounds, just from being close to a bomb going off, said Dr. John Sentell, chief of Mental Health Service at the Martinsburg VA Medical Center.

The brain can get injured from an IED blast without visible blood; even from the brain being jostled in the skull from the blast, Sentell said. These less obvious traumatic brain injuries are more common in today's wars and often make diagnosis difficult.

Common maladies

Dr. James Mark Battin, a staff primary care physician with the VA Medical Center in Martinsburg, said the No. 1 category of complaint he has heard from veterans relates to musculoskeletal problems such as shoulder, back and knee pain.

"They tell me it is from 'heavy body armor and combat loads' they carry daily, as well as 'taking a knee' and 'jumping in and out of Humvees,'" wrote Battin in an e-mail to The Herald-Mail. Then there is the strenuous physical training and frequent marches in full gear, he said.

Referencing a report from Dr. Ron Teichman with the War-Related Illness and Injury Study Center in New Jersey, Battin said the top five concerns of veterans from Iraq and Afghanistan are: exposure to sand, noise, smoke from trash, vehicle exhaust and jet fuel, Battin wrote.

Battin wrote that one of the biggest problems he's seen in returning veterans of Operation Iraqi Freedom and Operation Enduring Freedom is alcohol abuse and the effects of that on their bodies, minds, jobs and families.

Post-traumatic stress disorder

After musculoskeletal problems, mental health problems made up the second-most-common category of ailments for which veterans of Operation Iraqi Freedom and Operation Enduring Freedom had sought treatment from the VA, Budahn said.

Many of the 840,000 such cases are post-traumatic stress disorder, an anxiety disorder that can occur after a traumatic event. According to the National Center for Posttraumatic Stress Disorder's Web site, symptoms are avoiding situations that remind the person of the event, reliving the event, feeling numb and feeling hyper.

Signs a veteran might be experiencing post-traumatic stress disorder are a loss of trust with employers, getting angry with family and co-workers, or - seeing others having a good time - feeling there are years they've lost that they'll never recover, said Marsha Mills, clinical psychologist with the VA Medical Center in Martinsburg.

"A lot of them have lost their ability to have fun," Mills said.

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