Butterflies Symbolize Hope for Paralyzed Veterans

Image of a Monarch butterfly on a flower

Flowers and Sunshine help revive dozens of cold, grounded butterflies during a special ceremony
at the Milwaukee VA’s Spinal Cord Injury building in early May.

On a cold but sunny morning in early May, about 30 patients and staff gathered on the front patio of the Milwaukee VA’s Spinal Cord Injury building. Many of the patients were in wheelchairs.

“We were there to release some butterflies,” explained Army Veteran Scott Griffith. “It was Ependymoma Awareness Day, and we wanted to give our Ependymoma patients an emotional boost. For us the butterfly symbolizes change, and hope.”

“I’m still alive because of the VA.”

The event was put on by the Paralyzed Veterans of America, the organization Griffith works for.

“I was diagnosed with Ependymoma 18 years ago, and I’m still alive because of the VA,” he said. “A lot of Veterans with this disease and other spinal cord injuries are still alive because of the VA. I know they’ve been getting a lot of bad press lately. But I have to say, when you’re looking for something the VA does right, this is one of them. They offer superb care for Veterans with spinal cord injuries. No one does it any better.”

Ependymoma is a cancerous tumor that forms on the brain or spinal cord. Its cause is unknown. Nearly 700,000 Americans had been diagnosed with it as of 2010.

Image of Veterans and Butterflies in the sun during a special ceremony

They were holding hope in their hands

“The box that I opened had about 150 Painted Lady butterflies in it,” Griffith said. “They were shipped in from Texas. The idea was for them to all flutter into the air at once, but they were a little slow to wake up. They didn’t want to come out of the box.

“Apparently the Texas butterflies did not have a fondness for our Wisconsin weather,” he concluded. “The ideal temperature for releasing them is 70 to 75 degrees. It was about 58 here that morning.”

Not only did the sleepy little guys not fly; most of them ended up on the turf.

“They don’t move when they’re cold, so when we opened the box they just kind of flopped to the ground” said Dr. Kenneth Lee, an Army Veteran who heads up the Milwaukee VA’s Spinal Cord Injury unit. “They were just sitting on the grass not doing anything. It was sort of funny.”

But Lee, who was badly injured while serving in Iraq, knows how to find the silver lining in any situation.

“I think it was a blessing in disguise that they didn’t just fly away, because everyone started picking them up and putting them in the Veterans’ hands,” he said. “The symbolism was awesome… all these Veterans in wheelchairs, holding butterflies in their hands, watching them try to move their wings. It was like they were holding hope in their hands.”

Scott Griffith agreed. “You’ve got all these injury-hardened Veterans sitting in their wheelchairs, but then someone puts a fragile little butterfly in their hands and you can see these guys soften right up. They start grinning from ear to ear, like they were playing softball with their granddaughter or something.”

One of those smiling Veterans was Mike O’Leary, an Air Force Veteran and a patient at the Milwaukee VA.

“Some of the butterflies came individually packaged,” he said. “They were inside these little origami things, these little paper pouches. You held it by the corners and pulled it open, and there was your butterfly.”

Shock and Awe

But O’Leary’s little yellow friend was apparently just as sleepy as the rest of his winged associates.

“That poor butterfly,” he said. “It was so cold. I think he was in shock. When I first opened up the pouch and saw my butterfly I was elated. Then when he dropped to the ground I wasn’t so elated. I was worried about him. So I picked him up off the cold ground and held him for a while to get him warm.”

It seemed everyone was busy scooping up comatose butterflies from the ground as fast as they could. Suddenly, out of nowhere, a VA staffer appeared with a flowerpot full of bright red flowers. (Butterflies like flowers.)

“Everyone started putting their butterflies on the flowers,” said O’Leary. “So I put my little guy on the flowers where he could be with his friends. That gave me a good feeling.”

Julie Kronenburg, who works at the Spinal Cord Injury unit, said she thinks all the butterflies survived the morning’s festivities.

“The flowers helped, and the sunshine certainly helped,” she said. “They started to wake up once they were in the sun.”

About an hour after the ceremony ended, Kronenburg decided to return outside and check on the butterfly herd.

“I went back out there and they were all gone,” she said. “They all flew away. They’re Texas butterflies, so I hope they like Wisconsin.”

To learn more about what the VA is doing for Veterans with spinal cord injuries, visit http://www.sci.va.gov/

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/June/Butterflies.asp

PTSD Help with Cognitive Processing Therapy

Male Veteran walking down a rural road surrounded by trees

Taking the Blinders Off:
Veteran Christopher Tyler’s experience with CPT

In observance of PTSD Awareness Month, June 2016, VA’s National Center for PTSD presents the following profile of a Veteran who is living with PTSD and has turned his life around with treatment.

Chris Tyler joined the Army in 1996, right after he graduated from high school. During his nine years of service he was deployed to Kosovo for six months and to Iraq for 17 months.

In Iraq he was part of the 168th Military Police Battalion. He did guard-tower duty. He transported fuel and ammunition. He worked the front gate of his base. But the most dangerous part of his job was prisoner transport.

“My main job was to pick up prisoners from Baghdad police stations and take them to be interrogated by Special Forces at the Baghdad airport,” Tyler said.

To get to the airport, Tyler drove “Route Irish” known at the time as the most dangerous road in the world.

“It was a little nerve-racking to work that road…constant watching of all directions,” he recalled. “Debris on the road could be a roadside bomb. There was a lot of heavy traffic…and then, holding prisoners…in the back of your truck, you don’t really stop for anybody.”

Tyler’s vehicle frequently came under attack. One incident in particular would haunt him for years to come.

When he got back home to Michigan, Tyler knew he had changed. He had a hard time making sense of civilian life. His marriage became strained. His friendships suffered. Work was difficult. He was depressed and angry. He thought about suicide.

“I was just a shell. I was kind of drifting through life,” Tyler said.

Identifying Negative Thoughts Called “Stuck Points”

Finally, eight years after leaving the military, Tyler sought help from the VA. He was diagnosed with PTSD and decided to enter a residential treatment program where he began Cognitive Processing Therapy (CPT). In CPT, patients are taught how the way they think can negatively affect the way they live, and how to recognize the thoughts that are making life difficult. Tyler would spend the course of his therapy learning how to reframe those thoughts. Though it sounds simple enough, to Tyler, it was fraught with risk.

Tyler carefully read through his Impact Statement, both on his own and with his therapist. The goal was to identify negative thoughts called “stuck points.”

“The stuff actually works. It’s very real.”

A stuck point is a thought or belief that people with PTSD just can’t get past and keeps them from living the way they want. It could be a thought like, “I shouldn’t have survived that attack.” Or “danger lurks around every corner,” Or “no one can be trusted.”

With the help of his therapist, Tyler would learn to recognize his own stuck points, and then learn the tools to understand and eventually defuse them.

Over the course of his therapy, Tyler used a variety of written worksheets to understand how his thoughts were causing him distress. Not only did they cloud over his days, but they cast a dark shadow over his past as well. Much like his cache of military treasures, Tyler had kept his most difficult memories tucked away.

Unpacking the Memory of a Traumatic Event

Under the guidance of his therapist, he would unpack and inspect the one thing he’d kept locked up tight: the memory of the traumatic event.

For Tyler, this moment would be pivotal.

The tools Tyler learned in CPT gave him a new perspective on how ingrained and rigid his thoughts had become. He became more flexible in his thinking. From this new vantage point, Tyler could see his traumatic event in a more realistic light. The dark clouds started to lift, and relief, at one time unimaginable, was in sight.

His life began to change for the better.

When Tyler began treatment, he worried that therapy would push him over the edge—that he’d come out worse than when he went in. Instead, Cognitive Processing Therapy helped him break the cycle of his negative thinking, and reframe his perspective on the past…and the present.

He became less suspicious of the world. He was able to engage with people, to make and keep friends. And he was able to see his military experience, even the darkest moments, in a new, more insightful way. It wasn’t easy, but Tyler came through CPT with his PTSD under control and ready to re-engage.

“I thought it’d be all smoke and mirrors and, you know, a dog and pony show like they call it in the military,” he said. “But, no, it’s definitely not a dog and pony show. The stuff actually works; it’s very real.”

You can see the entire AboutFace video “Therapy Story” about Christopher Tyler at http://www.ptsd.va.gov/apps/AboutFace/therapies/cpt.html

For more information on PTSD and ways to raise awareness throughout the year, visit the National Center for PTSD website, www.ptsd.va.gov/about/PTSD-awareness/. This site offers resources such as:

PTSD Coach Online and the award-winning PTSD Coach mobile app, which provide symptom-management strategies. The app is always with you when you need it.
Continuing Education (CE) and continuing medical education (CME) opportunities for providers on the best practices in PTSD treatment (CEs/CMEs offered), including the PTSD 101 curriculum.
AboutFace: An online video collection of Veterans talking about PTSD and how treatment turned their lives around.
Whiteboards: Short animated videos to learn about PTSD and effective treatments.
Subscribe to the PTSD Monthly Update: Stay up to date on new information about PTSD and trauma year round.

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/June/PTSD_Awareness_Month.asp

Veteran has Tongue Cancer Surgery – Home in 3 Days

Two VA Doctors with their VA Patient after surgery

Dr. Babak Givi, Army Veteran Warren Katz and Speech Therapist Latimer Kells

Warren Katz, an Army Veteran and actor, recently came in feeling well and fit for a 10 day post-op appointment with Dr. Babak Givi. He had been treated by the surgical team for a cancerous base of tongue tumor. Dr. Givi says the treatment involved transoral laser micro surgery and a neck dissection. Katz spent only three days in the hospital.

A few years ago, the treatment likely would have been surgery involving cutting open the jaw and splitting the mandible to go to the base of the tongue. Katz is already back to full activity, auditioning for new parts in upcoming projects.

“I hope our new techniques make a positive difference for our heroes.”

Dr. Babak Givi has headed the Head and Neck Clinic at VA’s Manhattan Campus for three years and in that time has made a big difference in how complex problems can be solved with minimally invasive procedures.

His expertise in the newer less invasive techniques is having a direct, positive affect on patient outcomes, both by reducing the probability of complications and making recovery quicker.

Ultrasound Guided Biopsies – Saves Veteran Visits

 

Among the new diagnostic and surgical approaches Dr. Givi has introduced are ultrasound guided biopsies where targeted tissue samples are removed for analysis in clinic during the patient visit.

Dr. Rosemary Wieczurek in Pathology will then analyze the sample the next day and determine the diagnosis. This method saves the patient at least two visits and provides an answer in an expeditious manner, reducing the anxiety of not knowing if they have cancer or not. Before this new routine, it required at least two or three visits and two to three weeks to make a diagnosis.

Dr. Givi has also integrated the speech and language pathology therapy in the clinic. Latimer Kells, a dedicated speech therapist with a vast amount of expertise in treating head and neck cancer patients, evaluates patients before procedures to ensure that there is a clear concept in place about how surgery intersects with post-operative care. She then follows patients after treatment to provide valuable care in improving their speech and swallowing function.

As a surgeon, Dr. Givi introduced minimally invasive approaches to the removal of malignant tumors. This surgical procedure has now replaced the traditional more invasive and disfiguring facial incisions. Dr. Givi says, for example, “One of my patients was recently told by Memorial Sloan Kettering physicians that he needed a craniotomy for his skull base tumor. But, understandably the patient was very happy that with the help of Dr. Seth Lieberman, our rhinologist, and Dr. Dimitris Placantonakis, our neurosurgeon, we were able to successfully remove the tumor through the nose endoscopically. This meant a significant reduction in the chance of complications and the patient has recovered very well. .The patient was discharged from the hospital in three days with no tumor and no incision.”

Salivary Gland Treatment without Surgery

Dr. Givi is also expert in sialoendoscopy, a minimally invasive way of treating salivary gland problems. Guided by a scope measuring only 1.7 millimeters, Dr. Givi removes stones and opens narrowed passages, using the natural openings of the salivary glands. With this procedure, many salivary glands that used to be removed by surgery can be saved.

The Head and Neck Surgery Clinic treats all diseases of the skin, mouth, larynx, oropharynx, salivary, thyroid and parathyroid glands. Some are benign like vocal cord polyps, and thyroid goiters and others are cancerous, often related to smoking.

Dr. Givi: “I am very proud of the service we provide to our Veterans. They put their lives on the line for our country. The least we can do is to help them the best we can. I hope our new techniques and our attitudes make a positive difference for our heroes.”

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/June/Veteran-has-Tongue-Cancer-Surgery-Home-in-3-Days.asp

I was addicted and homeless. The VA took me in.

Image of a male volunteer handing out clothes to a male Veteran.

Vietnam Veteran Mike Doherty, once a patient at the Pittsburgh VA, now runs the clothing program there.


Photo by Bill George, Pittsburgh VA Healthcare System.

Mike Doherty had a good job driving a truck for a vending machine company. He had a wife and two beautiful daughters; a nice house in a pleasant neighborhood.

“I had it all,” he said. “Then it all went away.”

Downhill

Doherty, a Navy Veteran who served in Vietnam, said things started going downhill after he injured his back at work.

“It seemed like I was constantly on pain medication,” he said. “All the medication led to my addiction to painkillers, and to alcohol. I was killing myself, and I was destroying my family. I ended up losing everything: my wife and kids, my job, my house.”

The Vietnam vet, then in his mid-50s, found himself sleeping on a friend’s couch.

“My friend was a Vietnam vet, like me, and he wanted to help me out,” Doherty said. “I slept on his couch for a year. But even your best friend’s hospitality wears out eventually. Finally one day he said to me, ‘You need help. I’m driving you to the VA.’ And that’s what he did. He drove me to the VA hospital in Pittsburgh.”
He added: “My friend’s gone now; he died of throat cancer a few years ago, but he’s the one who gave me the kick in the ass I needed. He was a good friend.”

Getting it Right

Doherty said he was pleasantly surprised by how he was treated by staff at the Pittsburgh VA’s Highland Drive Campus.

“I was apprehensive going in there, but they didn’t judge me,” he said. “They told me they were going to help me. They said, ‘We’ll get it right. We’ll get it right.’ I remember them telling me that over and over.”

The Navy Veteran said one VA nurse in particular stands out in his mind.

“She was one of the first people I met there,” he said. “She’s a saint. Her name is Mary Francis Pilarski, and she always had a smile. I don’t know how she was able to smile all the time. I remember her because she was just so helpful. She was always there for me.”

Green Acres

Doherty said it wasn’t long before he was transferred to the Pittsburgh VA’s transitional housing unit in Cowansville, Pa.

“It seemed like it was in the middle of nowhere,” he said. “It’s way out in the country, surrounded by farms and cows. It used to be a women’s prison. I guess that’s why my room had a steel door and no windows. But you know what? It was a step up for me. I had been sleeping on someone’s couch and now I had my own room.”

Doherty said not all of his fellow patients at Cowansville appreciated the rural aspects of their new environment.

“I was raised on a farm, so this felt like I had come home,” he said. “But some of the Veterans couldn’t get out of there fast enough. It’s not for everyone. But I liked it. That’s why I stayed there for two years.”

Doherty said volunteers from the Disabled American Veterans (DAV) would drive him and his fellow patients from Cowansville to the Pittsburgh VA’s Center for the Treatment of Addictive Diseases.

“We were there every day from 9 to 3,” he explained. “I think I liked group therapy the best. You got to see how other people ended up being in the position they’re in. It gave you some perspective. It made you feel like you weren’t so alone.”

Troy Polamalu

All that was 10 years ago. Today Doherty has his own apartment, a black cat named Troy Polamalu (after the former Pittsburgh Steelers’ strong safety), and a classic 1985 Crown Victoria he uses to get around in. Most importantly, he has his two daughters back in his life.

“I just tried to progress a little bit at a time, as best I could.”

“They turned out great,” he beamed. “I missed out on some of their birthdays and dance recitals when they were growing up, and I have no one to blame for that but me. But they turned out good. One just turned 19 and the other just turned 22.”

He added: “I feel lucky I was given a chance. That’s why the VA is so important to me. They gave me a chance, and I’m grateful to them. So now I’m trying to give back. That’s why I’ve spent the last 10 years volunteering here at the VA.”

Doherty said that 10 years ago the Pittsburgh VA had no formal clothing program, so he decided to start one.

“I know what it’s like to show up here with nothing,” he said. “I look at some of these Vets and I say to myself, ‘That was me.’ They don’t have decent clothes or shoes or a winter coat. Now, whatever item of clothing you need –socks, underwear, anything—we can get it for you. I can’t hold your hand once you leave here, but I can make sure you have proper clothes on your back. I reach out to the VFW, the Purple Heart organization, the American Legion, places like that. They give us all the clothes we need. ”

He continued: “Some of the homeless Vets I’ve given clothes to work here now. They’re VA employees. That gives me a good feeling.”

The Vietnam Vet, who will soon turn 65, said helping his fellow Veterans is what keeps him going.

“It’s what gets me up at 3 o’clock every morning,” he smiled. “I’m here every day handing out clothes. I’m here on holidays. I’m here on Christmas Eve.”

To learn more about VA’s effort to end Veteran homelessness, visit www.va.gov/homeless

Are you a Veteran battling substance abuse? Know a Veteran who is? Find out how the VA can help by visiting www.mentalhealth.va.gov/res-vatreatmentprograms.asp

 

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/May/I-was-addicted-and-homeless-The-VA-took-me-in.asp

You get to choose how you will handle MS.

World MS Day, 25 May 2016 - Logo

I Have MS but MS Does Not Have Me

Every day I wake up, just like everyone else, and see the sun shining and the birds chirping and have the promise of the entire day set before me – 24 hours, 1,440 minutes – just like everyone else. The only thing that makes my waking up a little different than your waking up is that “I have multiple sclerosis (MS), but MS does not have ME.” I believe in the poem “It Couldn’t Be Done” by Edgar Albert Guest…

Somebody said that it couldn’t be done
But he with a chuckle replied
That “maybe it couldn’t,” but he would be one
Who wouldn’t say so till he’d tried.

Capt. Philip White

Capt. Philip White

MS is just on the journey with me to do what is part of my DNA – teach, mentor, and lead. These three things have been part of my life career as a Retired Captain in the US Air Force and a community volunteer. You can do anything you set your mind to do and like any challenge, you get to decide every day how you will overcome the obstacle.

I have a “use it or lose it” philosophy about the cognitive and physical aspects of my disease. We all have a bank of mental and physical energy with which to get it done – and every day we get a new deposit to spend anew. Life with MS is a choice to be healthy and to choose how to spend my energy account. I have learned to listen to my body and know how to space out my activities to maximize my output for the results I seek to achieve, whether it is celebrating the centennial of my fraternity, Omega Psi Phi Fraternity, Inc., serving as the Gateway MS Ambassador, or giving out over 15,000 school bags to students in the St. Louis Public Schools, I choose how to maximize my energy resources.

I continue on and so can you

When I wake up and my body or my mind act like they want to hold me back, I remind them that I am directing this destiny and I do not say, “I can’t” because “can’t” only means “constant act of not trying.” I refuse to let that be a part of my life story. It may mean that I choose to do one or two things instead of the three or four that I might normally do, but I continue on and so can you. MS means “MOST STUFF” to me, that on most days I can do most things.

I refuse to let “can’t” be a part of my life story.

You have a choice, remember that, you did not choose MS, but you do get to choose how you will handle MS. Living with a chronic illness is only limiting if you believe “I can’t” instead of “I can.” You must monitor your energy level, think of your longevity, and keep your mind sharp. Read a book, go to museums, challenge yourself with a new task, eat a healthy diet, and exercise daily. I choose every day to put one foot in front of the other and use my 24 hours for the greatest good instead of allowing MS to stop me.

MS also challenges our cognitive abilities and I choose every day how to keep my mind sharp. I keep busy through volunteering with the Oasis Intergenerational Tutoring Reading Program, along with my work with the VA, and serving as the Upsilon Omega Foundation Vice President and the Omega Center Manager (community service center). As an active member of my fraternity, I was challenged in 2011 to plan a huge centennial conference in St. Louis, some thought it couldn’t be done, but “I DID IT!”

What can life with MS look like? It looks like a man who was Area Captain for four states and who traveled to make history. It looks like a man, for the second time, who donned a tuxedo to attend the inaugural balls for the nation’s re-elected first black president. It looks like a man sitting proudly in the blue section of the inaugural ceremony. It looks like a man who mentors through the Boys and Girls Club, who reads at Lexington Elementary School, and who recruits through Team 100. It looks like 1,440 minutes of “I CAN.”

Every new day is a new opportunity to be greater than your limitations. Remember, “I have MS, MS does not have me.”

About Captain White

Captain (Ret). Philip White is a native of St. Louis, MO. For 26 years he served proudly with the United States Air Force, stationed in several U.S. posts and countries including Korea, Japan, Philippines, and Germany. Following his retirement from military service, he returned to his teaching roots at Whitman Air Force Base, accepting a position as Director of Air Force Junior Reserve Officer Training Corps (AFJROTC). After retiring from his position as Director, he accepted a volunteer position as a member of Team 100, with Oasis Intergenerational Tutoring.

May 25 is World Multiple Sclerosis Awareness Day.

A day to celebrate global solidarity and hope for the future.

It brings the global MS community together to share stories, raise awareness and campaign for everyone affected by multiple sclerosis.

In 2016, the theme for World MS Day is ‘Independence’. It’s all about how people with MS can be independent.

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/May/You-get-to-choose-how-you-will-handle-MS.asp

A Smart Home for Veterans with Brain Injuries

Fictional image of neurons of light firing in the brain

A Smart Home for Veterans with Brain Injuries

VA researchers are doing amazing things to improve the lives of Veterans.

Here’s just one example: the Smart Home. This unique project uses advanced technology to help patients with traumatic brain injury (TBI) independently plan, organize and complete everyday activities.

Some Veterans with TBI have lost the ability to manage basic tasks like doing the laundry or taking out the trash.

Smart Home has been described as a “cognitive prosthetic.”

VA’s Smart Home helps them relearn those skills by tracking their movements around their house and then sending them text or video prompts when they get off track. The remarkable indoor tracking technology can pinpoint the Veterans’ location to within six inches.

 Ben “Ty” Edwards and wife Anna Edwards

Ben “Ty” Edwards and wife Anna Edwards

The Tampa VA Medical Center has installed the high tech equipment in five apartments housing 10 Veterans. It has a system that not only tracks their locations but has sensors that monitor the use of appliances. For example, the washing machine sensors determine when the Veteran puts soap in the machine and also shows when he or she empties the machine after the load is completed. If the user forgets to do either, a nearby screen prompts them to complete those steps. The Smart Home can also notify a caregiver if an activity is not completed.

Other sensors in the bathroom determine how long a patient has been shaving and if they are taking too long, they are prompted to finish that task and move on.

The technology promotes Veterans’ independence by providing reminders for the management of other daily activities such as medication, meal planning, and other necessary tasks.

Smart Home has been described as a “cognitive prosthetic” with the goal of rehabilitating Veterans with TBI so they can function normally in society.

A powerful feature of the Tampa Smart Home is the precision of the customized therapeutic information that can be provided to the recovering Veteran. Data for every interaction with clinical and medical staff are recorded continuously and analyzed, helping the staff visualize subtle but therapeutically significant behavioral changes. Reports are sent back to the clinical team on a weekly basis

This helps to better inform treatment plans and potentially prevent problematic medication effects on Veterans’ memory, as well as gait and balance.

 Joseph “Pepper” Coulter and wife Jill Coulter

Joseph “Pepper” Coulter and wife Jill Coulter

A little more technical information? The Veteran patients and VA staff wear wrist tags linked to a real-time location system that tracks the tags using wall sensors. It’s ultra-wideband technology. The wrist tags broadcast their ID on a 6-to-8 gigahertz channel and uses time-delay-of-arrival and angle-of-arrival methods to determine position in three dimensions.

The Smart Home innovation recently received third place in VA’s Brain Trust summit. The national summit brought together the public and private sector, Veterans, caregivers, clinicians and innovators to tackle the issues of brain health.
     
Dr. Steven Scott, co-director of VA's Center of Innovation on Disability and Rehabilitation Research

One of the leaders of the project is Dr. Steven Scott, co-director of VA’s Center of Innovation on Disability and Rehabilitation Research and chief of physical medicine and rehabilitation at the James A. Haley Veterans Hospital in Tampa. Scott is a nationally known expert in the fields of physical medicine and rehabilitation with research expertise in polytrauma and traumatic brain injury. Much of his work focuses on the rehabilitation and reintegration of Veterans who have experienced blast-related injuries.

Advances like this are being celebrated this week, Research Week, at VA medical centers around the country.

Join us as we celebrate 91 years of research excellence and attend one of the many activities being conducted nationwide.

For more than 90 years, the VA’s Research and Development program has been improving the lives of Veterans and all Americans through health care discovery and innovation.

VA research is unique because of its focus on health issues that affect Veterans. The groundbreaking achievements of VA investigators—more than 60 percent of whom also provide direct patient care—have resulted in three Nobel prizes, seven Lasker awards, and numerous other national and international honors.

 

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/May/A-Smart-Home-for-Veterans-with-Brain-Injuries.asp

GeriPACTs – Specialized Care for Older Veterans

Two male Veterans sitting with female VA Employee looking at a paper flyer

GeriPACTs – Specialized Care for Older Veterans

America is Getting Older – How is VA Responding?

The VA “has your six” – a military term that means I’ve got your back*.  Indeed, the VA has got the back of every Veteran who receives care at VA. Each one has a primary care provider, and that provider has a whole team working with them.

This team model of care is called PACT (Patient Aligned Care Team) and it provides continuous and coordinated care throughout a patient’s lifetime. Veterans receive primary care in PACT clinics, so you may know them by color names, like silver, or military alphabet names, like Bravo.

The fastest growing age group of Veterans VA serves is those age 65 and older. By 2017 almost 10 million of our 21.7 million Veterans (46%) will be over 65. VA is responding with PACT teams customized for older Veterans.

GeriPACTS – Customized Care for Older Veterans
 
A GeriPACT (Geriatric Patient Aligned Care Team) is a PACT team designed for our older and chronically ill Veterans – those who have complicated health problems made even more challenging by social factors and mental health issues. Watch this GeriPACT video to learn more.

The Veteran is at the center of his or her GeriPACT, which includes an “army” of health care providers from many disciplines.

The Veteran’s GeriPACT includes an “army” of health care providers.

Shared Decision Making for Long Term Services and Supports

Experts in the care of older adults – like the GeriPACT team – work together with Veterans to identify challenges that may be barriers to health, independence and quality of life. They ensure that Veterans and their families/caregivers are aware of and connected to the services and supports they need to maintain the Veteran’s independence and quality of life. This shared decision making process helps Veterans decide about the kinds of services and supports, such as Home and Community Based Services, that would best meet their needs and preferences, now and in the future. 

Visit www.va.gov/Geriatrics for more information on Shared Decision Making and Long Term Services and Supports. 

 
Veterans Benefit from Shared Decisions and a Team Approach

Mr. Hastings, an Army Vietnam Veteran in Kentucky, explains, “Lori Paris, a social worker, visited me in the community hospital and talked with me about the full range of programs the VA had to offer and told me about what was available in my community.  One of the options she told me about was the Medical Foster Homes, so I drove out here to check it out and decided to stay!  This is my home now where I am happy and feel safe.”

Another Kentucky Veteran (Navy, WW II) and GeriPACT patient, Mr. Weyrauch, used the www.va.gov/Geriatrics website and the Shared Decision Making Worksheet for Veterans and says, “This information has been helpful in helping me to talk with my Home Based Primary Care Team about my needs and to be aware of other programs that can help me.”  
Both Veterans are receiving care through GeriPACT.

GeriPACT – Moving Forward

VA’s Office of Geriatrics and Extended Care convened a three-day summit on GeriPACT in Albany New York March 15-17.  Over 120 VA physicians, nurses, nurse practitioners, social workers, pharmacists, and psychologists from all networks of VA shared their experiences, insights, challenges, and best practices to grow and improve GeriPACT. 

Summit attendee, LeAnn Bruce, LCSW, MVF-CSW Summit attendee, LeAnn Bruce, LCSW, MVF-CSW said, “Several sessions emphasized the value of shared decision making in support of the patient-aligned care model and illustrated what a good fit it is for GeriPACT and the Veterans it serves.  We use shared decision making across VISN 9 where I work, and hopefully it will be provided by your GeriPACT soon!”

* Basically means “I’ve got your back.” Comes from the old pilot system in which directions correspond to hours on the clock, where 12 o’clock is forward and 6 o’clock is behind. Thus anyone behind you is “at your six.”

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/May/GeriPACTs-Specialized-Care-for-Older-Veterans.asp

Women Vets and Violence

Image of an older woman and a younger woman sitting together at a table.

Paula Boothe (r) and Megan Brown, social work student at West Virginia University, part of the Intimate Partner Violence Assistance Team at the Beckley VA.

Every nine seconds a woman is battered in the United States, according to the American Medical Association.

“That’s a staggering number,” said Paula Boothe, a social worker at the VA Medical Center in Beckley, W.Va. “Most people aren’t aware of how big a problem this really is.”

Particularly Bad

Boothe runs the Intimate Partner Violence Assistance Program at Beckley — a program that sprang into existence less than a year ago.

“We felt there was a real need for something like this,” Boothe said. “Intimate partner violence is a serious problem throughout the country, but here in West Virginia it’s particularly bad. We rank 13th in the Nation for domestic homicide and suicide events. That’s depressing. It’s also unnecessary, because there’s something we can do about it.”

Boothe said emergency room personnel at the Beckley VA are now attempting to screen all their female patients for signs of domestic violence.

“Here at the VA we want to treat the whole person,” she said. “So if you come into our emergency room with a broken nose or a black eye, we’re going to treat you. But we’re also going to bring up the subject of domestic violence with you. If you’re in a bad situation at home, we want you to know we’re here to help, that you don’t have to keep on enduring what you’re enduring.”

“You have to believe that you’re strong enough to leave.”

Troubled Waters

Boothe noted that an abusive relationship can be the root cause of numerous other health issues for a woman, not just broken bones or a swollen lip.

“A woman who’s being routinely abused, physically or verbally, is in a state of constant anxiety and stress,” she explained. “She might develop high blood pressure, or a stomach ulcer. She might develop mental health problems. She’s a candidate for all kinds of trouble.”

So, if you tell someone at the Beckley VA that you’re in a physically abusive relationship, what happens next?

“We’ll hook you up with a social worker here,” Boothe explained. “Someone you can talk to, someone you can trust, someone who can explain your options to you. And there are always options.”

She added: “If you tell us you feel like you’re in imminent danger, that you don’t want to go home again, we’ll find a place for you to stay. There are several local and state organizations we partner with in the area, including the Women’s Resource Center here in Beckley and the Family Refuge Center over in Lewisburg. These folks provide food, shelter, clothing, employment assistance and a bunch of other services for abused women who are trying to start their lives over.”

She continued: “Women need to know there’s all kinds of help just a phone call away. Just pick up the phone, or walk into a VA hospital, clinic or Vet Center and ask for help. Because you’re not alone. You may feel like you’re alone, but you’re not.”

Over 40 percent of victims of severe physical violence are men. – CDC

Sticking Around

Boothe, a victim of domestic violence herself, said a lot of people can’t comprehend how an abused woman can opt to stay trapped in a relationship with a violent partner.

“People will ask you, ‘How do you put up with that? Why don’t you just leave?’” she observed. “Sadly, there are lots of reasons a woman sticks around, even though she’s being beaten. One big reason is fear. You’re afraid that if you leave, he’ll get even angrier than he already is; that he’ll find you and kill you. I sort of felt like that when I was in this situation. I said to myself, ‘He’s going to kill me if I leave.’ Then one day I realized he was going to kill me if I stayed.”

Women will also remain in an abusive relationship because they feel they have no place else to go, according to Boothe.

“They’re isolated,” she explained. “Their self-esteem has been battered into the ground. They have no job, no money of their own. They’re afraid that if they leave they’ll be homeless. A lot of them don’t leave because they feel like they’ll lose their kids. There are a ton of reasons a woman will stay in a very bad situation and just try to ride things out, day by day. Fear, hopelessness and despair can immobilize you.”

Saving Yourself

Boothe said it’s her job to assure a woman that she is stronger than she realizes, that somewhere inside her she has the courage to start over.

“We can’t make you leave someone who’s abusing you,” she said. “You have to want to leave. You have to want to save yourself. We can give you support and encouragement, but you’re the one who has to make the decision to take back your life.”

Boothe said that, on average, a woman will leave an abusive relationship and then return to it about seven times before finally leaving for good.

“A big life change like this often doesn’t happen overnight,” she said. “Sometimes it does, but usually it’s more of a process. We just want you to know that when you’re ready to make that change, we’ll be here for you. We want you to know you deserve a better life.”

To learn more about Intimate Partner Violence and where to turn for help, visit www.womenshealth.va.gov/WOMENSHEALTH/outreachmaterials/abuseandviolence/intimatepartnerviolence.asp or VA’s National Center for PTSD at www.ptsd.va.gov/public/types/violence/domestic-violence.asp

 

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/May/Women-Vets-and-Violence.asp

Sharing Advantages of VA Home Based Care

A doctor visits a patient in his home and takes his hand.

Dr. Milton Havron treats a Veteran patient in his home.

“How inconvenient and needlessly expensive it is for a chronically ill patient who cannot walk to be brought to a clinic by an ambulance crew.

“How much more sense it makes for medical people to go to them. In the patient’s home I am in their milieu, and can better understand how they cope with their illness day to day.“

Dr. Milton Havron is describing VA’s Home Based Primary Care program. He is the director of the program at the Martinsburg, WV, VA Medical Center. And one of VA’s proudest proponents of the program.

“In the patient’s home I can better understand how they cope.”

In a recent letter to the Washington Post, Dr. Havron agreed with a doctor who says “In today’s corporatized, professionally fragmented medical landscape, it is almost impossible for a primary-care doctor to take the time to truly connect with patients and their families.” Dr. Havron’s friendly rejoinder was, “I am blessed, however, to work in a setting that allows just that: the Veterans Health Administration.”

Home based primary care (HBPC), pioneered in the VA system in the mid-1970s, started with a few major centers. Today it has expanded to about 150 programs at VA centers around the country.

It is designed to take care of patients with serious chronic illnesses for whom routine clinic-based care is difficult to get due to geographic barriers or severe physical disability.

HBPC Allows Time for Comprehensive Assessment

As Dr. Havron describes HBPC, “I can spend time getting to know their principal caretakers. I can spot things going on in their homes which may impede their progress. The design of VA’s HBPC program allows me and my staff time to do a comprehensive assessment which is very difficult in the private sector due to time pressure.

“HBPC also serves as an alternative to institutionalized assisted living, allowing the infirm Veteran to stay home. Without regular easily accessible medical care, many of these frail patients will get sick and get admitted to the hospital for prolonged stays.

“While HBPC cannot prevent all such hospitalizations, the statistics tell the story that patients admitted to VA HBPC programs have fewer and shorter hospitalizations, saving on inpatient expenses and sparing the patient much suffering and inconvenience.”

Dr. Havron says that there are many HBPC medical directors around the country doing the same thing he does. “HBPC is a team concept with multiple players, from our head of geriatrics Dr. Elisabeth Sethi, to the midlevels, the RNs, the allied professionals, and our staff.”

Dr. Sethi points out that, “Under Dr. Havron’s leadership, our HBPC program has been one of the fastest growing nationally, supported by VHA rural health grants, by our facility and the VISN (Veterans Integrated Service Network).”

Services Provided to Veterans in Their Homes

HBPC programs generally offer these core services to patients in their homes:

  • A medical provider (physician, nurse-practitioner, or physician assistant) to take a history, examine the patient and prescribe a course of treatment
  • a registered nurse to act as the provider’s eyes and ears in between provider visits
  • a psychologist if counseling is required
  • a social worker to untie many a bureaucratic knot
  • a pharmacist to help providers prescribe medications in the safest and most effective way
  • a physical or occupational therapist to check the home for safety and prescribe exercises for musculoskeletal ailments.

Dr. Thomas Edes, Executive Director of VA’s Geriatrics & Extended Care Clinical Operations, adds, “HBPC is an important part of the future of health care, demonstrating that for those who have the greatest need for frequent care yet face the greatest challenges in access to care, we can increase access, improve quality, and lower total costs of care. The success of VA HBPC contributed to the successful implementation of the Medicare demonstration of HBPC called “Independence at Home.”

“Proud that VA has been a leader”

HBPC also works alongside home hospice services for terminal patients and with specialized home care nurses providing wound care or short-term intravenous drug therapy in the home.

In recent years VA has also been developing telemedicine as a way to bring at-home patients and specialist doctors together.

Home-based primary-care programs can be a refuge where doctors, and their nurse-practitioner and physician-assistant colleagues, can practice traditional personalized medicine while enjoying the benefits of modern communications technology.

“I am proud that the VA has been a leader in this concept,” he said.

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/April/Sharing-Advantages-of-VA-Home-Based-Care.asp

Surgical Implant Prosthesis for Veteran Amputees

Black and white image of Veteran Patient standing with a implanted prosthetic, a close up of the legs and wheel chair.

The muscle grows stronger as the rod fuses with the bone

A giant step in the next generation of prostheses for Veteran amputees

Researchers and physicians hold their collective breath as Veteran Ed Salau clicks his new prosthetic leg into place and stands on it for the first time.
“Oh my gosh, I can’t believe this day is here, it’s so surreal, I have goosebumps,” says Dr. Sarina Sinclair, a key researcher on the team.

And then fist pumps all around as Ed jokes about the Hokey Pokey dance being a whole lot easier now.

In 2004, Salau’s platoon was ambushed by the enemy while out on patrol in Iraq. Two rocket propelled grenades penetrated his patrol vehicle and his left leg was so badly damaged it later had to be amputated just above the knee.

“It’s so weird. I can feel the ground again. I haven’t had that sensation in eleven years,” said Salau.

“It’s perfect. I’m stoked”

Male Veteran with prothesis implant

What started as scribbled ideas on posted notes all over the wall of a research lab is now a reality that could impact the lives of these two Veterans and countless others in the future.

Leg is attached without a socket

The device is called a percutaneous osseointegrated prosthesis or POP. It features a titanium rod surgically implanted into the bottom of the thigh bone. The rod allows a prosthetic leg to be securely attached without the need for a socket.

This team has worked years to get to this day. Peter Beck, an attending orthopedic surgeon for VA and an adjunct professor for the University of Utah, has been invested for over a decade. He says the big barrier for years was preventing infection and perfecting the surgical procedures for inserting the rod into the femur bone.

“Bryant, you’re up.” Says Bart Gillespie, VA Salt Lake City physical therapist.

Veteran Bryant Jacobs was also injured in Iraq in 2004.

He sees himself as a trailblazer willing to take this risk for other Veterans that may follow. He wife is right by his side as he stands on the POP for the first time.

“It’s perfect. That’s what we want. I’m stoked”

Bryant wants to be able to use the rowing machine without a prosthetic sleeve jabbing him in the groin. He also wants to snowboard again in the Utah mountains. After voluntarily having his leg amputated two years ago, Bryant begged to be a part of the clinical study.

“I’m really excited. This is going to be a game changer for him,” said Gillespie.

Ed hopes to be able to climb Kilimanjaro one day, but in the near future, a long walk on the beach with his wife is a good start.

 

A Male Veteran patient wearing a hat and standing with a prosthetic implant

The pair is the first ever in the United States to receive the POP implant. Their first surgery was on December 7, 2015, to insert the metal rod. In a follow-up procedure on Feb. 8, 2016, doctors attached a docking mechanism, extending from the implanted rod and through the skin, to which the leg is attached.

Veterans enjoying fit and comfort

Both Veterans are already raving about the comfort and fit of the new device. Initial first steps have now become longer stretches of walking and stair climbing. Each day the muscle grows stronger as the rod fuses with the bone, and each day the Veterans feel a little more confident and comfortable with their new legs.

But researchers and physicians warn this is just the beginning of a long process and there may be more barriers to overcome along the way. “As researchers we are anxious to gather our results and allow for future improvements. The thing about research is we don’t have all of the answers when we start,” says Dr. Larry Meyer, Director of Research, VA Salt Lake City Health Care System.

This is a VA-funded clinical trial, approved by the Food and Drug Administration. It will assess the feasibility and safety of the new implant in ten VA patients over the course of several years. It could be five years or more before the technology is widely available.

Source Article from http://www.va.gov/HEALTH/NewsFeatures/2016/April/Surgically-Implanted-Prosthesis-for-Veteran-Ampute.asp


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