VA Finds New Ways to Treat This Generation of Injured U.S. Veterans

VA finds new ways to treat this generation of injured U.S. veterans
by Jill Armentrout,

Left, Physical Therapist Kim Daniels, 35, of Bay City checks the mobility of Staff Sgt. Maurice A. Sears, 28, of Midland at the Aleda E. Lutz Veterans Affairs Medical Center. Sears injured his back during combat operations in Iraq. Photo by David A Sommers

SAGINAW – Marine Cpl. Andrew E. Love of Kochville Township was in Iraq for two weeks when a bomb blast blew up his vehicle.

The explosion crushed his pelvis, damaged his right leg and arm and bruised his brain.

Marine Lance Cpl. Ricardo Gutierrez Jr. of Bridgeport Township suffered two gunshot wounds as he tried to save a fellow Marine during a sniper attack in Fallujah, Iraq, in March 2007.

Staff Sgt. Maurice A. Sears of Midland has served two tours of duty in Iraq with the Army and Army National Guard. When he returned home in August, he was using painkillers to help with a back injury that kept him from bending at the waist…

The men are among the more than 500 veterans of conflicts in Afghanistan and Iraq whom doctors at Lutz Veterans Affairs Medical Center in Saginaw have treated so far in the fiscal year that began Oct. 1, 2007, through the end of January. That number could reach 1,000 by Sept. 30, said Gabriel Perez, medical center director.

"I had heard bad things from older veterans about the VA, but they’ve come a long way," said Gutierrez, 25, who has a Purple Heart and Bronze Star. "They have more to help us. They’ve put us from this war as their first priority."

The Saginaw center and the entire Veterans Affairs system have spent the past five years meeting the needs of veterans — especially in finding those with brain injury from blast waves and those needing mental health care for post-traumatic stress from combat experiences.  

Officials say they are reaching out to this generation of veterans in ways they haven’t in the past.

"The Vietnam veterans didn’t have this level of treatment," said Carrie Seward, public affairs officer at Lutz. "That’s why the military and VA together are doing this. We don’t want a repeat of what they went through."

Getting help

The Saginaw Veterans Affairs Vets Center opened in January at 4048 Bay in Saginaw Township to provide counseling and other readjustment services to combat veterans and their families, with staffing from fellow service members. It is one of five in the state.

"We are a storefront operation," said team leader Ronald Hamden. "We like to be out in the community, as opposed to in the larger hospital, as a first stop. We can help families understand there are changes on both sides when a soldier returns home. If a veteran walks in here, they will be seen, and we can refer them to whatever service they need."

Gutierrez and Sears have received counseling for combat stress.

Gutierrez attended group sessions with veterans young and old dealing with post-traumatic stress.

"They’ve helped calm me down," he said. "I’ve taken some medication for it. I didn’t want to take anything, but it did the job. Being in the group helped. I knew I needed something."

For Gutierrez, the stress reveals itself in nightmares about what he saw and did during battles and in ongoing sleeping problems.

His body became used to sleeping three hours at a time in Iraq.

"They told us about what could affect us when we got back," Gutierrez said. "They do screenings. But no one thinks they’ve got (stress). They think they come back perfectly fine. But they can’t tell they have it, and it can happen six or seven months after you get home."

Post-traumatic stress from the war changes veterans when they come home, he said.

"I’ve heard stories of Marines coming back and getting into fights," Gutierrez said. "When I first got home, I drank every day for three months."

Sears, 28, said his symptoms of combat stress — nightmares and daydreams — surfaced several months after he came home from his first tour of duty in 2003. In treatment with a private counselor, he learned methods to help protect himself from the worst of it, he said.

"I use CDs with sounds of wildlife and lakes and streams and listen to them before bed to meditate. I write my thoughts in a notebook. I would tell any soldier who has a lot on their mind, these are things you can do. Most veterans don’t talk about it," he said.

More support

Anne Milko-Delpier, a social worker at Lutz, coordinates community oversight for those who served in Operation Iraqi Freedom/Operation Enduring Freedom.

Veterans Affairs and the Department of Defense began the Seamless Transition project in 2003 to help soldiers returning home find care and support.

"If the military hospital calls to set up a liaison for a veteran with a severe injury, we assign a caseworker and ask what they need," Milko-Delpier said. "Then the veteran doesn’t have to come home and figure it out. We get appointments set. They have enough to do when they get home."

Seamless Transition offers employment services, financial and family support, transportation and some skilled home care, Milko-Delpier said.

"A lot of them need all of it," she said. "Some are reservists who have lost jobs. If they have injuries, they might not be able to work. Spouses may have to care for them and can’t work. This sacrifice is a whole family event. If they are injured, their fight continues."

Lutz staffers go to deployment briefings to explain benefits and attend homecoming and reunions at service centers. They hand out cards with key phone numbers for veterans seeking help.

Sears said he can see the difference. The care has improved greatly since his first tour of duty in Iraq in 2003, he said.

"There is more support, more accolades," he said. "The first time I came home, I had no support, no counseling. I had to seek it out on my own and paid for it on my own. They didn’t know what was going on with the soldiers. As the war continues, they are learning."

This time, he completed screenings at Lutz and met with social workers, who offered monthly sessions, but he chose to return to his church counselor instead of buying gas for the drive from Midland.

"I’ve had soldiers in my unit who don’t want to come here," Sears said. "They say they’re fine. But in two months, who’s to say? I recommend they all come and get their care provided."

Persuading veterans to use the center is a familiar battle for Lutz’s director.
Extended military benefits provide five years of free health care for veterans who served in combat since 1998. There is no time limit for service-related health problems. Free care also is there for low-income veterans, and more are claiming benefits as the unemployment rate rises, Perez said.

"Some don’t come here because they are fearful of the VA," he said. "Some are very independent and go to private doctors. We see this from any era, and it’s a challenge for us."

More physical therapy

Since fighting began in Afghanistan in late 2001 and in Iraq in 2003, more than 31,200 U.S. soldiers have suffered injury in action — 14,000 of them seriously wounded and no longer able to serve, the Department of Defense’s official tally as of March 17 reports.

Wounded soldiers don’t come directly to Saginaw from the Middle East. They enroll for care at Lutz after their discharge or after leaving other military and veterans hospitals.

Lutz serves veterans from 35 counties stretching from mid-Michigan to the Mackinaw Bridge. Offering mostly outpatient care, it staffs clinics in Gaylord, Oscoda and Traverse City. Clinics in Alpena and Clare will open this year. Funding for mental health care has tripled, and mental health staff has increased to 40 workers from 10, officials said.

Gutierrez had seven surgeries and recuperated for a month and a half in military hospitals abroad and stateside. He arrived home April 29 and started physical therapy at Lutz.

His leg has improved. When he arrived, he couldn’t straighten it and used crutches to walk. Gutierrez walks on his own now but still has a hard time moving around in the mornings or after sitting for long periods, he said.

"The pain will be with me for the rest of my life," he said.

He is working at odd painting jobs and getting ready to enroll at Delta College. He may study to become a parole or corrections officer. He once wanted to become a police officer, but his leg injuries led him to reconsider.

Treatment

A newly expanded physical therapy department opened two months ago at Lutz, with more space and new equipment, Seward said.

"We have more demand, and a new (physical therapy) supervisor who has new ideas about research and modalities of care. We work with newly injured veterans and older veterans with strokes and after surgery. Our population continues to shift. We also have in-home therapy."

In treating veterans of all wars, the center’s staff sees about 500 outpatients a day in Saginaw and at clinics in Gaylord, Oscoda and Traverse City. The center opened in 1950 was named in 1990 to honor Lt. Aleda E. Lutz, a U.S. Army flight nurse from Freeland who died in 1944 when a hospital plane evacuating wounded soldiers from Italy crashed. She earned six battle stars and was the first military woman to die in a combat zone in World War II. The center is the first VA facility named for a military woman.

In addition to mental health care, physical therapy and rehabilitation, the center offers speech therapy, oncology, outpatient substance abuse treatment, home health services, cardiology, hospice care, a diabetes clinic, urology and women’s health care, as well as general outpatient care. Veterans also have dental benefits.

Saginaw’s center has about 800 employees and an annual budget of more than $100 million, Perez said.

Signature injuries

Advances in battlefield medicine are saving many more of the injured than in previous wars, but leaving survivors with traumatic brain injury, amputations, burns, blindness and spinal injuries.

Thousands come home with more subtle signs of brain damage not included in casualty figures, while thousands more are seeking mental health treatment. Military and hospital officials use screening tools for both — experts call them the signature injuries of this war, "silent epidemics."

The Defense and Veterans Brain Injury Center, a research and treatment agency run by the Pentagon and the veterans department, found that 31 percent of the soldiers who required medical evacuation for battle-related wounds had traumatic brain injuries. This covers a broad spectrum, from concussions to severe injuries such as those suffered by Love.

Veterans Affairs funds some care at private rehabilitation facilities, including Love’s residential treatment facility in Bay City.  

"The VA is waking up to what is needed for rehabilitation," said the Kochville Township man’s mother, Diane G. Love. "Our center in Saginaw has been working very hard. They are very supportive."

The total number of servicemen and women deployed in these ongoing conflicts has topped 1.7 million, many of whom have taken on second or third deployments. More than 4,460 have died as of March 17.

Beyond those hurt in combat, another 31,000 have been hurt in other ways — such as truck, construction or training accidents or non-hostile fire — or succumbed to illness that required treatment while serving in the two conflicts.

President Bush is seeking a budget of $93.7 billion in fiscal year 2009 for the Department of Veterans Affairs — more than $3.4 billion more than present spending, with health care and disability compensation receiving most of the funding.

The budget includes $1.3 billion to meet the health care needs of an estimated 330,000 veterans returned from service in Iraq and Afghanistan, $3.9 billion for mental health services systemwide and $1.5 billion for prosthetics and sensory aids.

"We encourage everyone to get mental health support," Perez said. "VA services are holistic, from the mind to the physical."

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