Category Archives: healthcare

The Enduring Crisis: Suicides in Veterans Spiking

126642_600The Veterans Administration released a disturbing report that male veterans under 30 years old saw a 44% increase in the rate of suicide. The rate for women veterans increased by 11%. About 22 veterans a day committed suicide in 2013. That did not count those still on active duty numbers which are still high but have dropped somewhat since 2012 and previous years.

The VA National Mental Health Director for Suicide Prevention, Jan Kemp said “Their rates are astronomically high and climbing…” Kemp postulated that reasons for the spike might include “the pressures of leaving military careers, readjusting to civilian life and combat injuries like post-traumatic stress disorder…”

I believe that the stigma that many felt about getting psychological help while they were in the military continues on when they enter civilian life. Unlike the military where there is still some sense of camaraderie and a chance that the chain of command might force a service member to get help, no corresponding structure or community exists in the civilian world. Young veterans are often isolated and face new stresses while they are already on edge. Many find that the military occupation specialities that they trained for have no direct civilian counterpart, leaving them struggling in the civilian job market. Combat injuries as well as injuries sustained in training often continue on, limiting what they can do and the unseen injuries of PTSD, Traumatic Brain Injury and Moral Injury, often undiagnosed and untreated lurk in the background.

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This is a national tragedy and crisis. Many of these young men and women are among the best and brightest. They volunteered to serve in time of war and now as the military, especially the Army and Marine Corps begin to shed large numbers of troops, many more will be thrust into a world that they may be ill equipped to survive.

They will attempt to go to work or attend school, quite often alone. There they will be surrounded by people who have no idea of the issues that they face or understanding of the military world that they left, or the places that they served. I think this social isolation will be a killer for many.

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My recommendation is that people who work or go to school with these young veterans, or for that matter any veteran get to know them. Help them adjust to the world and keep an eye on them. Ask them how they are doing and just show that you care. You do not have to be a veteran to do that. Likewise get to know about the resources that are available for veterans and help direct them to them. Have the courage to care.

Resources include the Veterans Crisis Hotline which is staffed 24 hours a day, 7 days a week. They can be reached at (800)-273-8255, press 1, or here to chat online. They also allow veterans to send a text message to 838255 to receive confidential support 24 hours a day.

Another resource is the Real Warriors Live Chat. The a trained health resource consultant is ready to talk, listen and provide guidance and resources. They can be reached by calling 866-966-1020 or going to their live chat service here http://www.realwarriors.net/livechat.

Afterdeployment.org http://afterdeployment.t2.health.mil offers wellness resources for the Military Community. Service members in transition to civilian life can contact inTransition by calling 800-424-7877 or at their website http://www.health.mil/InTransition/default.aspx

To me this is personal. I still suffer from the effects of PTSD and I have known far too many veterans who have taken their own lives, or struggle with mental health issues, physical injuries and illness, or social isolation. This week a brilliant and heroic senior officer I knew, who helped me when I was collapsing due to the effects of PTSD took his own life. This is something that all of us have a stake in. Please help look out for our veterans.

Peace

Padre Steve+

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Filed under healthcare, Military, News and current events, PTSD

Trayvon Martin and the Pro-Life Movement: Do the Post-Born Matter at All?

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I am perplexed tonight. I see people, many of whom are friends fight stridently against all abortion. I am not for abortion, but I do not think that it should be banned. That aside what I think the pro-life movement as a whole in the United States has become is simply an anti-abortion movement. Sometimes one where demented individuals in it feel justified in killing people who work in abortion clinics, even murdering them in church.

I am perplexed because I seldom see any of the high level culture warriors that fight the abortion battles ever raise a cry about issues of justice concerning people that are already born.

The Trayvon Martin murder and acquittal of the man that killed him should send a chill down anyones spine. In some places like Florida all someone has to claim is that they “felt threatened” to justify the use of deadly force against unarmed people. That is the law, and if there are no videos of the incident or eyewitnesses willing to lay it all on the line then there is a strong chance that the killer will go free. That is a fact and I will not go deep into the racial component of this but it doesn’t seem to me that we have advanced that much since young Emmett Till was murdered and his murderers also acquitted.

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But going back to my main point I don’t think that we really have a true “pro-life” movement in this country. We have an anti-abortion movement which to some degree say that they are fighting for the lives of unborn babies. One does not have to agree with the theology, philosophy or science that they use, but that certainly has to be considered a part of a comprehensive pro-life ethic, abortion for the sake of eugenics including the selection of the sex of an unborn child or solely as a means of birth control are ethically problematic. That being said there are many times, more so than we would want to admit that abortions are tragically necessitated for the life and health of the mother. Sorry, the woman carrying the child should also have the right to her life.

You see I don’t think that simply being anti-abortion is being pro-life, unless you are willing to apply that right to life to already living people.

I have a hard time with people that claim to be pro-life not fighting against the death penalty, against unjust wars of aggression, against targeted assassinations, against the use of drones to kill supposed militants in the remote parts of Pakistan notwithstanding the fact that many infants and pregnant women carrying unborn babies are killed as well. But then I guess that they are just collateral damage and don’t count. After all they are all Moslems and not Americans.

I have a hard time with those that are anti-abortion who would fight against government programs designed to care for pregnant women such as good pre-natal care for the child and primary care for the medical needs of the mother.  I wonder why they are not fighting for the medical and nutritional needs of babies born to poor people and assist young families from impoverished areas get decent jobs and ensure that affordable child care is available. I wonder why supposedly “pro-life” people are not out marching against gun violence, why many will not lift a finger to help the poor, care for the needy, care for the sick and dying, including the elderly who our society seems to be throwing under the bus in every imaginable way unless they are fabulously well off.

Why does it seem that many pro-life leaders are not concerned about issues that effect the lives of pro-life people who happen to be poor, or members of racial or ethnic minorities? But what seems to be the case is that the most vocal and prominent leaders that call themselves “pro-life” or “family values” conservatives both the preachers and the politicians are more concerned about low taxes for the wealthiest people and corporations than they are about people.

Some conservatives and libertarians will say that these are not government responsibilities but the responsibility of churches and charities. I understand the philosophy and in fact I would love to see more churches doing more to alleviate the need for the government to step in. But by and large churches in general and especially conservative evangelical Christian churches have abdicated this responsibility which is mandated in the Gospels and exemplified in the lives of people like Saint Francis of Assisi and so many others. But now even churches that run hospitals frequently subordinate care to the insurance industry and while considered “not for profit” are as for profit as any non-religious hospital.  If evangelicals put half the money that they did into Sunday morning entertainment sessions masquerading as worship and building massive mega-church, media and television empires dominated by the families and friends of their pastors maybe I would have some faith that they were indeed “pro-life.”

I know that some of my conservative friends will see this as some sort of liberal screed. I get that but please, I ask that if people only want to be anti-abortion and not rest of the pro-life ethic then be honest and say that.

The fact of the matter is we are not a pro-life society now in any way shape or form and from our history including slavery, the genocide committed against native Americans, the exploitation of poor countries for the sake of our economy I have a hard time believing the myth that we ever were such a society.

Trayvon Martin is dead. The Florida law was followed, but justice was not done. A young black man was denied his right to life and it doesn’t seem to matter to the “pro-life” movement as a whole. I can’t wait to hear some of the political preachers and politicians that claim to be pro-life defend this verdict.

I guess that is why I am perplexed. It just doesn’t seem to me that the post-born matter to supposedly pro-life people.

Peace

Padre Steve+

 

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Filed under christian life, civil rights, healthcare, News and current events, philosophy, Political Commentary, pro-life anti-abortion

Happy 105th Birthday to the United States Navy Nurse Corps

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Last week was National Nurses Week. Today was the 105th Anniversary of the Navy Nurse Corps. Nurses are the lynchpin of medicine. Physicians are incredibly important and as a society we usually ascribe more value to them. However in many case, if not most it is a nurse who is the person that does the heavy lifting in the care of the sick. Before the modern era of nursing was often done by Nuns or by women that volunteered to assist military physicians.

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The First 20 Navy Nurses “the Sacred 20″ 1908

It was in the quagmire of the Crimean War that Florence Nightingale brought about the modern era of nursing, even though physicians and hospitals often saw the women who served as nurses as inexpensive help to care for the sick. Despite this nursing became more and more professional and technical over the years without ever losing that particular calling of ministering to the afflicted that is the essence of their history. In the later 1800s the first nursing schools were established and in 1901 New Zealand was the first country to have Registered Nurses. In 1903 North Carolina became the first US State to require the licensure of nurses.

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Chief Nurse Lena Higbee, Second Superintendent of the Nurse Corps, and first woman awarded the Navy Cross (above) and the ship named after her the USS Higbee DD 806 (below)

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The US Navy Nurse Corps was established n 1908 with nurses being commissioned as officers and assigned to Naval Hospitals. However it was the needs of war that brought nursing into the modern age where it is formally recognized as a key component of Health Care. In the World Wars nursing came into its own as a profession. Nurses were among the US personnel that endured the initial onslaught of the war in the Pacific. The Army and Navy Nurses that served and cared for the wounded, starving and emaciated Soldiers, Marines and Sailors on Bataan and Corregidor were heroes in their own right.

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Navy Nurses released from Japanese Captivity (above) and a Nurse aboard USS Benevolence with a POW released from Japanese Captivity in 1945

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The profession of nursing continues to grow and the women and men who serve as nurses at various levels, from the most highly trained Clinical Nurse Specialists and Nurse Practitioners, or other highly specialized Registered Nurses many of whom have advanced degrees including doctorates down to the most humble Licensed Vocational (or Practical) Nurse and even Certified Nursing Aides. These women and men are the backbone of medicine and despite the long hours, the years of training and certification required of them, many people don’t fully appreciate them until they become sick and are cared for by these wonderful people.

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Ensign Jane “Candy” Kendeigh, the First flight nurse to serve in Iwo Jima and Okinawa Campaigns

Today US Navy Nurses serve in every place one can find a Sailor or Marine. They serve in Hospitals, Medical Centers and other Medical Facilities in the United States and overseas. They serve aboard surface ships, combatants as well as Hospital Ships, with the Fleet Marine Force, in Joint and Multi-National Medical activities deployed in combat zones and in humanitarian operations.

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I have been blessed to have known and worked with many amazing nurses in the course of my career as a Medical Service Corps Officer in the Army and as a Chaplain in the military and civilian settings. Today I was present and offered a prayer at the cutting of the Navy Nurse Corps Birthday Cake at Naval Hospital Camp LeJeune. It was my 5th year serving in Navy Medicine and offering this prayer and blessing was an honor that I will always remember. Since I will be transferring out of Navy Medicine in the August-September time frame to assume new duties at the Joint Forces Staff College this will be the last one of these events that I get to officiate at for a few years.

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LCDR Eric Gryn in Afghanistan tending a wounded Afghan Soldier on a Medivac flight in 2011, he serves at Naval Hospital Camp LeJeune

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As such I just want to thank all of my friends that serve as Navy Nurses with whom I have shared joys and sorrows the past several years. Blessings on all of you!

God Bless all Nurses tonight, especially those tending the sick, ill and injured and those in harm’s way.

Peace,

Padre Steve+

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Filed under healthcare, History, iraq,afghanistan, Military, shipmates and veterans, US Navy

Thoughts after Springing Forward: A Symposia, Time with Family and Miscellaneous Thoughts

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Sprung forward

Last night most of us that observe Daylight Savings Time “sprang forward” losing an our of sleep but gaining added daylight with which to enjoy life. As usual I was “one of us” and though it was my last night home following a week at a Navy Medicine Chaplain Training Symposia, which happened to be where my wife is, I did get some sleep.

The week was interesting because for the past two and a half years I have been stationed in Camp LeJeune North Carolina while my wife has been in Virginia Beach Virginia. So the week was kind of like one of those weird make up baseball games where the visiting team, which I was got to be the home time, or more fitting the home team playing as the visiting team.

A Symposia

The training was well worth it and featured speakers from both the Pastoral Care and Psychological disciplines who spoke on how Chaplains work as part of the interdisciplinary team in health care, mental health and other aspects of caring for wounded warriors. One thing that was nice to see that the Navy Hospital that I serve at is on the cutting edge of much of what was discussed and that what the speakers discussed was not really news to me. Most of that is because I work with a wonderful team of Physicians, Chaplains, Mental Health Professionals and Pastoral Counselors who are not threatened by each other and who work together for the good of those that we serve. We are not perfect, we are all still learning; I guess that is why they call it “practicing” medicine but we are constantly moving forward. For me it was nice to see just how far along we are compared to other military, VA and civilian health care and mental health care services.

Family

The week also allowed me to spend time with Judy and both of our dogs. For those that have not experienced military life, it is not only deployments where you are apart but quite often due to health, family or professional concerns military personnel are forced to serve in locations away from their families, sometimes after deployments and injury that affect their family relationships.

Like many, if not most returning veterans, especially those suffering from PTSD or TBI injuries our relationship suffered and there were times that we wondered if our marriage would survive. I can say now that despite the fact that we are still apart that we are enjoying our life together again. Our times together, mostly limited to long weekend or unusual situations like the past week are becoming sweet again, times that we both look forward to whenever they are possible. It will be about two and a half weeks before we are together again when I take a bit of leave in conjunction with the Easter Holiday to celebrate my birthday with her.

While we were together we were able to spend a lot of time together and saw the new film The Great and Powerful Oz and take Judy to her first hockey game watching the Norfolk Admirals defeat the Hershey Bears by a score of 4-1 in an American Hockey League game at Norfolk’s Scope Arena. The sad thing was there were no fights in the hockey game and I missed the bench cleaning brawl between Canada and Mexico in the World Baseball Classic.

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Miscellaneous Thoughts on Krazy Karzai, North Korea Nukes, Sequester, a Papal Conclave, NASCAR and the World Baseball Classic

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I have been watching with mixed feelings as I have caught bits and pieces of the news. First in my mind has been the continued nutty rantings of Hamid Karzai, President and First Buffoon of Afghanistan. I wonder how long before someone in his own government does away with him.

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Then there was Kim Jun Number One and his new nuclear threats against the US and South Korea mixed in with a You-Tube video combining nuclear explosions going off to the tune of We are the World. http://www.youtube.com/watch?v=hK8zQIsMmnk But who can blame him for wanting to destroy us after spend a weekend with Dennis Rodman?

Seaquest-ration 

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Amid this the continued Sequester nonsense continues to amaze me. First of all because I thought the series Seaquest DSV was positive stupid but especially when I realize that if it happens that I won’t be getting much time off. This is because my civilian Pastoral Counselors will not be able to keep their place in our on call chaplain duty rotation. The limitations on hours that they can work, overtime and comp time will keep them from doing this, not to  mention that we will have to do what we can to make up for the 32 hours per pay period that they cannot work. If it happens as planned it looks like I will have the after hours and weekend duty pager 15-16 days a month and still work 5 days a week. The same will be true for my other Navy Chaplain. Yes sequester will be a pain in the ass. I challenge anyone in the civilian world to work 50 plus hours a week and be on call 24 hours a day 15-16 days a month dealing with life and death issues on a base heavily impacted by the war with suicides, murders, drug and alcohol abuse and mental illness. So if you are one of those “I hate the government types” please don’t tell me how overpaid I am, or for that matter anyone else dealing with this working for the Federal Government. If you think that then you can blow it out your ass. With all due respect.

Papal Conclave

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The Cardinals arrive

Of course I have written about the upcoming Conclave to elect the next Pope in Rome so I won’t say much more about it now except to say that if elected I will turn down the job, I have such a hard time keeping white uniforms clean. My money is on one the the old European guys dressed in red to be elected as the next Pope.

NASCAR

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Then there are sports. Living in North Carolina is starting to wear me down. I am getting interested in NASCAR and am now doing strange things like read about the technical specs of the cars and the types of tracks. I think that part of this is because I think that Danica Patrick is hot, something that I can’t say about any of the men racing the other cars.

Baseball

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I have also gotten a chance to follow more baseball this week with Spring Training and the World Baseball Classic going on. What is nice is finally to have baseball on TV again. Tonight I am watching Puerto Rico play the Dominican Republic following the victory of the United States over Canada in their elimination game. The really cool thing about the game I am watching now is to see how much energy the fans of the Puerto Ricans and Dominicans bring to the game. It makes it a joy to watch.

Site Notes 

I have done some updates to a number of the pages on this site and added pages titled Baseball and Life, Shipmates Veterans and Friends and TLC Book Tour Reviews as well as the addition of several new links. 

Coming this Week

This week, Lord willing and the creek don’t rise I expect to do some baseball writing, and write about the Conclave and the new Pope. whoever he may be. Tomorrow I will publish a book review for TLC Book Tours on Cecil Williams and Janice Mirikitani’s memoir Beyond the Possible about Glide Memorial United Methodist Church in San Francisco. Of course I will also write about other events as they break or others as I inspired.

Have a great week.

Peace

Padre Steve+

 

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Filed under Baseball, healthcare, laws and legislation, Military, News and current events

A Cavity and a Visit to the Dentist: The Miracles of Modern Technology

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Happiness is your dentist telling you it won’t hurt and then having him catch his hand in the drill. —Johnny Carson, Yes that is Padre Steve in this Picture

Today was my first visit to the dentist to repair a new cavity in well over a decade. When I found out last week that I had a cavity I was taken by surprise. I was less surprised that a couple of old fillings were deteriorating and needed to be replaced. So I set up an appointment with my colleague and occasional drinking buddy George at our hospital dental clinic.

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Open Wide

Now those people that know me know the trepidation that I approach visits to the dentist. My first dentist in Oak Harbor Washington was a bit of a sadist, something like an old, balding and bespectacled version of Steve Martin’s dentist in Little Shop of Horrors. It was decades before I began to go to the dentist without the feeling of absolute dread and terror, despite the fact that I never had to suffer a dentist like him ever again.

steve-martin-dentist Because I am Your Dentist

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 Today I went to get my new cavity fixed and one of the two old fillings replaced. George and his crew were good. It was not an unpleasant experience, despite the fact I would rather be almost anywhere than in the dentist chair. This was really an important event for me because I used to be an Anti-Dentite.

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http://www.youtube.com/watch?v=mV7m6IIN_tI

 I used to be an Anti-Dentite

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http://www.youtube.com/watch?v=lW6R9kSGV2Q

They worked so well that I didn’t have time to play with the chair controls as is my custom. I tend to want to play with the chair and other equipment if they are not attentive. However I was able to take out my I-Phone, play a few games of Angry Birds as they worked and even take some pictures of the work in progress.

I think that the young technicians figured that something must be seriously wrong with me, and they are right. In a sense I am not right, but one of the ways that I cope with going to the dentist, or any other unpleasant experience is to use humor and absurdity to make light of the experience and to keep my mind off of the pain. Thankfully, George who knows me made no complaint. Thank God for modern technology.

Such was the case today. When I showed the picture to friends at my local hang out, Rucker John’s on Emerald Isle, I was told that “you are just not right, and that is why we like you.”

So anyway may your night be good and your teeth free of pain.

Peace

Padre Steve+

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Filed under healthcare, Just for fun

349: Active Duty Military Suicides Hit New High in 2012

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The 2000 Yard Stare by Thomas Lea

The Defense Department released the numbers for what Secretary of Defense Leon Panetta has described as “epidemic” of military suicides. The total of 349 active duty personnel includes 182 Soldiers, 48 Marines, 59 Airmen and 60 Sailors. It does not include Coast Guard personnel. The last statistics for that service showed 5 active duty suicides for 2012 as of mid-August, the service had only seen 6 in 2011.

As of November there were 124 Army Reserve and National Guard suicides not on active duty, 6 Naval Reservists. I have not been able to find the data for Air Force Reserve and National Guard or the Marine Corps Reserve.  The reserve figures are of drilling reservists not of those in the Individual Ready Reserve (inactive reserve) who do not attend drill but have served their obligated active time and can be recalled to active duty until the end of their service obligation.

The Veterans Administration estimates that nearly 6,500 veterans take their lives yearly. The numbers include veterans of all wars not just those of Iraq and Afghanistan nor are they complete because sometimes death certificates do not record a veteran’s service.

It is growing problem that unfortunately will not get any better anytime soon. Part of the issue is that despite service attempts to change the culture there is still a stigma attached to those that seek mental health care. There are other reasons that factor into the equation, deployments, high operational tempo, lack of enough mental health care providers to meet the demands as well as the effects of combat stress injuries, PTSD,

Traumatic Brain Injury as well as what is now called “moral injury. One definition of Moral Injury “the lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” 

Marine Corps Major General Smedley Butler who was awarded the Congressional Medal of Honor twice wrote a moving of those afflicted with what we now call Moral Injury after World War One:  “Boys with a normal viewpoint were taken out of the fields and offices and factories and classrooms and put into the ranks. They were remolded; they were made over; they were made to “about face”; to regard murder as the order of the day. They were put shoulder to shoulder and through mass psychology, they were entirely changed. We used them for a couple of years and trained them to think of nothing but killing and being killed.

The effects are as chilling now as they were in Butler’s day when he wrote:

“These have already been mentally destroyed. These boys don’t even look like human beings. Oh, the looks on their faces! Physically they are in good shape but mentally they are gone….There are thousands and thousands of these cases and more and more are coming in all the time…”

I know. I see it every day but I see it in a number of ways. I see it in the faces of the Marines and Sailors going back and forth between Afghanistan, Iraq and now North Africa and also among those in the medical, mental health and chaplain services that care for these men and women.

Provider burnout, including suicide is a problem. Just recently a former Army Psychologist who had served in Iraq during the surge and had been treating veterans in the VA committed suicide. Less than two years ago, this man was the lead author of a article that dealt with burnout and suicide of caregivers. Peter Linnerooth who was awarded the Bronze Star in Iraq committed suicide on January 2nd 2013. His widow, also a mental health professional commented:

“He was really, really suffering…And it didn’t matter that he was a mental health professional, and it didn’t matter that I was a mental health professional. I couldn’t help him, and he couldn’t help himself.”

Linnerooth’s faculty advisor commented: “When he went in and when he came out, it was shockingly different…”

That was a problem then and it is a problem now. The thing is that these active duty 349 men and women, as well as the others I have mentioned where the numbers are not well defined are not just numbers. They are people. Real men and women, sons and daughters, husbands and wives, fathers and mothers. Their deaths at their own hand are more than the combat deaths in Afghanistan this year.

Dr Larry Shellito the Commissioner for Veterans Affairs in Minnesota said something that is dead on:

“Oftentimes, you have to look at the people that surround the people with (PTSD) to make sure they are also OK, because it’s got a multiple impact…It’s not just the individual who suffers, it’s the people who care for him.”

I see it all the time. Butler’s description of the men who served in the trenches that were in veterans hospitals and facilities nearly 20 years after the war ended are as true today as they were then. Ask any caregiver in the service or in the VA system and they will tell you how overwhelming this epidemic is.

It cannot be wished away and assuaged by people simply doing the bumper sticker “I support the troops” thing without looking deeply at what is causing this and investing in the lives of these men and women before their lives are completely destroyed. It also means that politicians and their think tank and media advisors who constantly beat the drums of war, without fully funding it and without caring for those that are sent to fight them must be held accountable by voters.

I know how this is on a real live up close personal basis as a chaplain. I went to Iraq and came back changed. The PTSD, depression, anxiety and hopelessness that I felt were overwhelming. Thankfully I am doing a lot better and I did get the therapy and assistance needed, but it took a while to get it and thankfully at my present command I had people that I worked with help me get the help that I needed. But I have been back almost five years. A lot of that time was spent in the wilderness wondering if there was hope, if I would ever get better and sometimes wondering if God even existed and if he did, did he care. During the whole time I continued to work with and care for others like me. Their injury also impacted me in ways that I could not imagine before I was afflicted.

I care about this issue, because it affects those that I serve as well as their families, communities and those that serve with them. 349 active duty suicides. Think about it. One is too many. 349 is inexcusable and that does not count all those that we cannot count because we don’t know the numbers or the full story.

349: Keep that number in your mind and do something about it.

Peace

Padre Steve+

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Filed under healthcare, Military, Pastoral Care, PTSD

HD Dreams and Stranger Things Part Two: Sleep Medications and Dreams, the PTSD Conundrum

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Ever since Iraq I have had terrible times with insomnia as well as very vivid dreams and nightmares. I have written about it in a previous article HD Dreams and Stranger Things: PTSD and Sleep.

Over the past four years or so I have been on various sleep medications, none of which has done much of anything to help my sleep. Most have left me drowsy on awakening the next day as if I was hung over, without the fulfillment of getting shit-faced the night before surrounded by friends. Believe me a good craft beer, or a lot of good craft beer does me a lot more good than various sleeping pills.

At the same time they have done strange things with my dreams. At times they are most vivid and terrifying and at other times for whatever reason they have been practically suppressed depending on the medication.

I found that because of the amount of the anxiety and insomnia that I had that my doctors prescribed high doses of the various medications used. Most had little effect, sleep was still at a premium and in the morning I would wake up groggy. That was my life the past for the past five years if you count the time before I started taking sleep medications.

In the past week that has changed. I mentioned in that previous article that I was beginning a course of therapy that would involve some different techniques to help me deal with the symptoms of my PTSD. That therapy was incredibly helpful and helped me to put my experiences into a perspective that before was not possible. Likewise my therapist dealt with my frequent sleep disruptions and made recommendations concerning how to manage my sleep.

We experimented. Since I was on a fairly heavy dose of Lunesta and still had to maintain a duty pager adjustments had to be made. On the nights when I had no duty I took no medication with the effect of getting no sleep at all and feeling like crap the next day. On days I took my medicine I would get some sleep, frequently interrupted and always with the consequence of a drug induced hang-over in the morning. Finally we tried a couple of more things. First was the use of a over the counter sleep aid used by many physicians that have to work odd on call hours called Insomitrol. It is a mix of Melatonin and Gaba extract. On the plus side I did not feel hung over in the morning. One the minus side my HD dreams went to 3D Luscasfilm HD and were the most memorable, surreal and occasionally frightening dreams I have ever experienced. We ended that experiment and went to over the counter Melatonin. It has worked well. My sleep is no worse, my dreams are quite fascinating and I do not feel hung over in the morning. I have discontinued the use of the Lunesta.

I still take an anti-anxiety medication to help bring me down at night and I will be obtaining either on my own or through the military a bio-feedback program to use on my computer before I go to sleep.

Since starting the Melatonin my sleep has gotten better. The HD dreams are still there and memorable enough that I can remember them and hope to find some meaning and interpretation in them, even the nightmares.

Those of us that deal with the aftereffects of PTSD and trauma have much to deal with. Sleep or the lack of it, dreams and nightmares, medications and the use of other drugs or alcohol are rampant among veterans with PTSD. There is no “silver bullet” or “cookie cutter” that works for all of us. But for me this seems to be a means of freedom and healing. I hope that my experience helps others and encourages them to work with their physicians, therapists and spiritual advisors on their journey to healing.

I don’t understand all the scientific aspects of sleep. I am beginning to learn about them though and as I learn it takes away some of the fear of closing my eyes, which for me opens a world more vivid, surreal and sometimes terrifying than keeping them open. But it is an unexplored world for me, one that I hope and pray helps me continue to integrate my life, faith and spirituality in ways that I never could have imagined before.

To me that is absolutely fascinating and something that I look forward to experiencing.

Peace

Padre Steve+

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Memorial Day 2012: The Perpetual Cost in Human Lives, PTSD, Suicide and Other Issues

Al Waleed Border Crossing 2007

On Memorial Day there will be many official observances at various Military and Veterans cemeteries to honor the members of the United States Military that have died in the service of our country throughout our history. Many died directly in battle while many more died to combat related injuries, illness, suicide as well as substance abuse and addiction.

In addition to the more than 6000 US Soldiers, Sailors, Marines and Airmen killed in battle there have been tens of thousands more who have died of causes related to their service in combat.  That is nothing new, the same was true in Vietnam, Korea, the World Wars and before.  War changes people and the wounds incurred, physical, psychological, spiritual and moral impact those that served as well as their loved ones for years, sometimes for the rest of their life. The problem is exacerbated when the society in which the soldiers return is itself not invested in the war being fought.

The fact is that no matter how well individual soldiers train and prepare for combat and combat conditions there is nothing that truly prepares that one can never fully expect what will happen to them in theater or after they return.  I can speak personally to this as well as testify about the things that I learn from others that have served. Likewise I know what others have written or shared.

Audie Murphy 

One of the most prominent soldiers ever to share his experiences of what was then called “battle-fatigue” was America’s most decorated soldier, Audie Murphy. Murphy served in North Africa and Europe in the Second World War and was awarded the Congressional Medal of Honor, Two Silver Stars and Two Bronze Stars in addition to 28 other US and foreign awards for service and for valor. When he returned from the war he suffered from depression, chronic insomnia slept with a loaded pistol under his pillow and became addicted to prescription sleeping pills. In the immediate aftermath of the war following his discharge from active duty he struggled to find employment and slept in a gym before finally finding work as an actor. He starred in 44 films including the biographical film about his life To Hell and Back. He spoke up for Vietnam vets returning from war with similar problems before he was killed in a plane crash on May 28th 1971.

I have also found that Chaplains and others that provide care to those in combat become particularly isolated when they return with PTSD or other combat stress related issues. One of the biggest reasons for this is that in many churches and religious bodies a chaplain that suffers from these issues has nowhere to turn and is isolated in his or her denomination. In the past few years a number of chaplains, Army and Navy have committed suicide following tours in Iraq. I knew a couple of them, one who had also served as an Marine infantryman in Vietnam. I have know others including medical personnel that have suffered from PTSD, depression, substance abuse and known a couple that have attempted suicide following their return from combat. I know others that have lost their faith or suffered a spiritual crisis brought about by their time in combat. I read today about Army Chaplain Darren Turner who left the Army following his time in Iraq suffering from combat stress issues, faith and readjustment to life back at home and for a time was separated from his wife. He has since returned to the Army but his path was not easy and I am sure based on my knowledge of others that more are out there afraid to tell their story.  (See the article on CNN http://religion.blogs.cnn.com/2012/05/26/battlefield-chaplains-war-unfolded-on-many-fronts/?hpt=hp_c2

Former Army Vice Chief Of Staff General Peter Chiarelli has fought the American Psychological Association to have the diagnostic term PTSD changed to PTSI, Post Traumatic Stress Injury to reduce the stigma that often prevents servicemen and women from seeking help. His request was recently rejected but it has merit. Other countries such as Canada treat it as such for their veterans.

I wrote about my experience of this on a number of occasions one of which I wrote in 2010 I asked if there were other chaplains like me. That article Raw Edges: Are there other Chaplains out there Like Me? attracted the interested of the local newspaper in Jacksonville North Carolina which did an article on me. (See http://www.jdnews.com/articles/cmdr-89433-stephen-military.html ) That article in turn led to my involvement with the DOD Real Warriors Campaign http://www.realwarriors.net/  They did a video on my story and interviewed me last week as part of a DOD Military Bloggers live forum.

I don’t feel alone anymore. I still have my struggles and I have talked about them a lot in other articles and plan to continue to do my best to help others who are struggling with the effects of war and return from it, especially chaplains, medical personnel and those that now struggle with faith and belief after their time at war. My encouragement is to just say that in spite of everything you are not alone.

Peace

Padre Steve+

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Filed under film, healthcare, iraq,afghanistan, PTSD, vietnam

In Praise of Nurses

Last week, May 5th-12th was National Nurses Week as well as the 104th Anniversary of the Navy Nurse Corps. Nurses are the lynchpin of medicine. Physicians are incredibly important and as a society we usually ascribe more value to them. However in many case, if not most it is a nurse who is the person that does the heavy lifting in the care of the sick. Before the modern era of nursing was often done by Nuns or by women that volunteered to assist military physicians.

It was in the quagmire of the Crimean War that Florence Nightingale brought about the modern era of nursing, even though physicians and hospitals often saw the women who served as nurses as inexpensive help to care for the sick. Despite this nursing became more and more professional and technical over the years without ever losing that particular calling of ministering to the afflicted that is the essence of their history. In the later 1800s the first nursing schools were established and in 1901 New Zealand was the first country to have Registered Nurses. In 1903 North Carolina became the first US State to require the licensure of nurses.  The US Navy Nurse Corps was established n 1908 with nurses being commissioned as officers and assigned to Naval Hospitals.

However it was the needs of war that brought nursing into the modern age where it is formally recognized as a key component of Health Care. In the World Wars nursing came into its own as a profession. Nurses were among the US personnel that endured the initial onslaught of the war in the Pacific. The Army and Navy Nurses that served and cared for the wounded, starving and emaciated Soldiers, Martines and Sailors on Bataan and Corregidor were heroes in their own right.

The profession of nursing continues to grow and the women and men who serve as nurses at various levels, from the most highly trained Clinical Nurse Specialists and Nurse Practitioners, or other highly specialized Register Nurses many of whom have advanced degrees including doctorates down to the most humble Licensed Vocational (or Practical) Nurse and even Certified Nursing Aides. These women and men are the backbone of medicine and despite the long hours, the years of training and certification required of them, many people don’t fully appreciate them until they become sick and are cared for by these wonderful people.

I have been blessed to have known and worked with many amazing nurses in the course of my career as a Medical Service Corps Officer in the Army and as a Chaplain in the military and civilian settings. As I wrote yesterday I lost a dear friend and co-worker, Commander Marsha Hanly a Navy Nurse who died unexpectedly yesterday. Marsha exemplified the best of nursing and thank God there are so many more like her who serve so well, and care so well for those committed to their. Likewise many a physician and chaplain for that matter owe a great deal to nurses.

God Bless all Nurses tonight.

Peace

Padre Steve+

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Filed under healthcare, History

Juiced and Loving It

Former Major League Baseball slugger Jose Canseco wrote a book in which he described his use of performance enhancing drugs, or steroids. The book not only detailed his use but made accusations that many players were using such substances helped to reveal a culture in MLB that saw many players using while owners and management turned a blind eye. My version of being “juiced” to borrow Canseco’s book title is far different. I prefer citrus and other fruits run trough a blender to anything that I might have to inject with a needle. I don’t like needles or shots. 10 years of allergy shots  given 1-2 times a week as a kid cured me of that.

For 30 years in the military I have struggled with being in my weight standards. My problem is that I am undertall. just a bit about 5 and a half feet tall with a barrel chest and thick body build.  But in the military which is ruled by tall skinny people with the exception of Army Chief of Staff Ray Odinero defines undertall as overweight, even if you are in otherwise excellent physical condition and can kick ass on the Physical Fitness Test. The older you are the harder it gets, especially when the services are downsizing, no pun intended.

Since I entered the Army in 1981 until now the standards for physical readiness have increased. In fact to score an equivalent score to what I needed to get a maximum score in the Army in the 1980s I have to do as much or more. My weight limit is basically what I had to meet when I was in my 20s. Now I don’t know about you but not many people in their 50s are anywhere close to their physical condition when they were in their 20s and most civilian employers don’t care so long as you can do the job.  As a 52 year old in the Navy I have to meet weight, body fat and physical standards that are little different from when I first entered the Army over 30 years ago. I am not complaining but that is the way life is, as some say in the Navy “choose your rate choose your fate.” I chose to continue to serve as an old person in an organization which is designed for young people. The men and women that I entered the military back in 1981 are almost all retired or have otherwise left the military. I am now a dinosaur. When I entered the Army if you were over 50 you were exempt from the standards. the same in the Navy. It is not that way now. Fat people are easy targets when ranks need to be thinned, no pun intended.

My body type is a prime target. I am for all practical matters a fireplug. Depending on my height on a given day I can be 66” or 67” tall, which in the Navy is a difference f 5 pounds. Thus if I go beyond the maximum weight on the weigh for my height in I am subjected to a Body Fat Composition determined by a highly subjective measurement of my abdomen and neck.  In the year following my tour in Iraq when I was physically, emotionally and spiritually a wreck I tipped the scales a bit too heavy and was taped. I passed the physical fitness test with aplomb both times but because I was over my body fat I failed both times. In the Navy if you fail 3 times (weight/body fat/PT test) in 4 years you are out.

Thus I ended up on what I call the “BCA (Body Composition Analysis) Death Watch. This means that if I fail the weight standards again before 2014 I am out. As I mentioned I am have a fireplug body build. Even way under my official weight limit I am not skinny and since my neck is not thick if I fail the weight limit I am probably going to be near, at or over my body fat limit no matter how hard I try. Thus I need to be under the weight limit.

I didn’t have a real problem with this until I came back from Iraq in 2008  Then everything went to hell. I gained a lot of weight, suffered from PTSD, severe depression, loss of faith and had a number of nagging physical injuries that I kept re-injuring. I self medicated with beer and donuts. Tasted great, made me feel better but made me fat. Nothing like 4-6 hot and fresh Krispy Kreme Glazed donuts with a couple of good amber lagers to wash them down just before bed. However as good tasting and satisfying as the combination is it is not healthy and I don’t recommend it, unless done in severe moderation which was not my habit back then.

Now it has been a couple of years since I failed a BCA. I have worked hard, but not without struggle. I gained more weight than I wanted to after I broke my leg last summer and was really afraid to do much on it. However as it healed I began to test my physical endurance and helped by a switch of running shoes, enabled me to really get back in shape. For the first time since before I deployed to Iraq in 2007 I ran over 7 miles last weekend. I have developed a really good conditioning regimen that exercises all of my body and supplement it with running on the beach near my apartment. But exercise is only part of the equation. The other part is diet.

Since I gained more weight than I wanted over the winter I had to find a way to shred it without resorting to starvation type diets. What I found was my blender. Yes most parts are edible. Actually no, it was what I put in the blender and what I am now loving. My mix which produces about a liter of juice follows:

2 medium Ruby Red Grapefruit, 1 Banana, 1 Medium Navel Orange, 2 cups Strawberries (Halved)  8 ounces water

I lover this. I drink this during the day rather than eating donuts and high fat/sodium junk foods and then follow up with a healthy dinner, low in fat but rich and balanced with appropriate amounts of proteins, carbohydrates etc…. Once in a while I will splurge and have a big burger or pizza and an occasional dessert but generally I have switched over to healthy items taken in moderation. I also did not have to stop drinking beer which I have with dinner every night. The result was that I lost weight and feel better. In fact after I passed my weigh in today I had more of my juice before going out for a big burger reward.  When I came home from dinner I made another batch of juice. I like it and plan to continue it because like I said I like it. I figure now why not? If I keep up my physical conditioning while watching my diet I will be better off and in the fall during the next Physical Readiness cycle I will not have to change habits.

For physical conditioning I alternate running on the beach with doing a type of circuit training that I designed to fit me. I have a course that is about 4/10th of a mile. I run it and at a predetermined point stop and do 25 sit-ups, 15-20 oblique sit-ups on each side, 70-100 flutter kicks and 15-25 push ups. I then stand up, start running and repeat. I try to do this for at least an hour pausing only to tie my shoes if they come undone. In an hour this means I run about 4 miles, do 150-250 push ups, 250 regular sit ups, 300-400 oblique sit-ups and 700-1000 flutter kicks during the work out. As I get in better  shape each week my number of repetitions has increased on each exercise and my running distance has increased. It is a good thing. I have to think my old assistant who was my body guard in Iraq, RP1 Nelson Lebron for helping me figure out something that would work for me. Nelson is a beast and has been on Team USA and the All Navy Team in Mixed Martial Arts and was a Gold Gloves Boxer.

My blood pressure and cholesterol always surprise my doctors because they are better than most people younger than me. Part of this has to be genetics but part is conditioning, diet and hard work.

As far as overall physical condition I am happy and pleasantly amused that at age 52 I can outdo many younger people who should by all accounts leave me in the dirt.

Reward (But in Moderation): The American Burger at Rucker John’s Emerald Isle

I am blessed that I have recovered from injury and am back in shape. It has taken a lot of work but it is worth it. I feel better and it is a good thing. Tonight I celebrated with a big burger and a couple of beers at a local restaurant. Tomorrow I will do my juice, get in a strong workout and eat a healthy dinner. However I may continue my celebration with a dinner at the local Mexican restaurant before going back to salads, soups or small pasta dishes with an occasional steak or burger.

Here’s to health.

Peace

Padre Steve+

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Filed under healthcare, Military, PTSD, sports and life