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Mr. Laz
04-30-2006, 10:39 PM
Post-combat stress hits harder

Numbers don’t include troops yet to return from combat

By DAVID GOLDSTEIN
The Star’s Washington correspondent

KEITH MYERS/The Kansas City Star
Iraqi war veteran Josh Lansdale of Kansas City, North, has been dealing with post tramatic stress disorder.

WASHINGTON –– The number of troops back this year from Iraq and Afghanistan with post-traumatic stress disorder could be five times higher than the Department of Veterans Affairs predicted.

Instead of 2,900 new cases that it reported in February to a veterans advocate in Congress, the increase could be 15,000 or more, according to the VA.

At the Kansas City VA Medical Center, only nine vets from current combat were diagnosed with PTSD in 2004.

Last year, it was 58. In just the first three months of fiscal 2006, the hospital saw 72.

“It’s absolutely incredible,” said Kathy Lee, at the Missouri Veterans of Foreign Wars.

A former Army nurse in Vietnam who works at the hospital, Lee said, “Every single Iraq vet who comes in, I give them a list and say, ‘How many of these (PTSD) symptoms do you have?’ It’s almost nine out of 10.”

A top VA mental health official said it was difficult to predict the number of new PTSD cases because of unknown factors like the troop discharge rate and how many veterans will use the VA.

But Laurent Lehmann, associate chief consultant for mental health, disaster, post-deployment and post-traumatic stress disorder, acknowledged that 2,900 new cases “would be an underestimate.” He said the VA hoped recent increases in funds and new programs “would catch” unanticipated cases.

“Are we ahead of the curve?” Lehmann said. “That’s the question I don’t think I can answer except to say we’re going to be monitoring our heads off on this.”

John Baugh, who attends a PTSD support group at the Kansas City VA Medical Center, said many soldiers still in combat zones are suffering from the disorder.

“They think that the numbers are high right now,” said Baugh, 31, a former driver for an Army construction battalion in Iraq. “Wait until those guys get out and try to start functioning in the civilian world. There’s going to be hell to pay.”

The miscalculation on PTSD echoes last year’s underestimation by the Bush administration of how many Iraq and Afghanistan veterans would need medical treatment. It had underfunded VA health care by $1 billion, despite assurances to Congress that the department had enough money.

Congress subsequently added $1.5 billion to the VA’s budget, but money problems still loom.

“They’re going to be short and they’re going to be playing catch-up,” Cathy Wiblemo, deputy director for health care at the American Legion, said of the VA’s PTSD treatment. “They’re not going to have the money, and the waiting list will grow.”

PTSD is an anxiety disorder that can follow combat or other traumatic experiences. Symptoms include survivor’s guilt, flashbacks, nightmares, depression and irritability. It can lead to drug abuse and even suicide.

The war in Iraq presents a higher PTSD risk than other wars, said Robert Ursano of the Department of Psychiatry at the Uniformed Services University of the Health Sciences.

“Since it’s a terrorist war, one could be under attack in any spot,” he said. “There is an enduring sense of a lack of safety.”

Among the half million veterans who have served in Iraq or Afghanistan, more than 144,000 have gone to the VA for health care. Nearly a third have been diagnosed with mental disorders, with nearly half of those PTSD, according to the VA.

The White House asked for $80.6 billion in 2007 for the VA, including $3.2 billion for mental health programs. But Rep. Michael Michaud, a Maine Democrat on the House Committee on Veterans Affairs, said the VA would need more, sooner.

“What’s going to happen is unless we give added resources, they’re going to have to start rationing care,” Michaud said. “It’s going to have to start pitting veterans against veterans.”

Jeff Schrade, a spokesman for Sen. Larry Craig, an Idaho Republican and chairman of the Senate Veterans Affairs Committee, said Craig was unhappy over the VA’s botched estimates on health care last year.

Congress now requires quarterly budget reports, which Schrade said show that VA’s budgeting appears to be on track.

“What concerns us is they’re seeing a lot more patients than they anticipated,” he said.

The VA’s contradictory estimates on PTSD surfaced in February. Prior to a Capitol Hill budget hearing, the agency replied to written questions from Rep. Lane Evans of Illinois, ranking Democrat on the House VA panel.

Asked about the need for mental health services, the VA told Evans that it expected to see 2,900 new cases in fiscal 2006, which began Oct. 1 and ends Sept. 30.

A week later, the agency issued its latest quarterly report on use of the VA by Iraq and Afghanistan veterans.

The numbers indicated it had diagnosed 4,711 possible cases just from October through December — more in the first three months than it told Evans to expect over the entire fiscal year.

VA spokesman Jim Benson said the estimate of 2,900 cases was based on earlier data. The latest quarterly numbers were still in the draft stage at the time of the hearing, he said, and VA officials stuck with the earlier data because trying to explain “would be more challenging and perhaps more confusing.”

“The reason they felt it was OK to do that was that, although the numbers are increasing” due to more troops being discharged and seeking help, Benson said, “the rate of PTSD is staying relatively constant.”

But critics said that even if the annual PTSD rate was constant, the number of cases was rising nonetheless.

“They continue to downplay the severity and the real size of the problem,” said Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America and a platoon leader during the war.

VA officials also had at the time of the February budget hearing a report from the department’s Special Committee on Post-Traumatic Stress Disorder. It warned that the VA was unable handle services to new combat veterans as well as survivors of past wars, saying: “We can’t do both jobs at once within current resources.”

Most of the PTSD cases the VA sees involve veterans from earlier conflicts, primarily Vietnam.

Baugh of Kansas City won’t talk much about his Iraq deployment because it triggers bad memories. But when he returned home in 2004, he couldn’t escape them.

“I was jumpy, angry, irritated, sleeping one-two hours a night,” Baugh said. “I was totally worn out. I’d drink and drink and drink just to shut the memories down and the nightmares.”

His wife pushed him to get help. Baugh said he’ll “jump through the ceiling” if she drops a frying pan. The clattering of kids skateboarding down his street sounds just like “gunfire in the distance: kack-kack-kack-kack.”

Joshua Lansdale knows about nightmares and noises, too. A 23-year-old veteran from Kansas City, North, he spent 11 months in the Sunni Triangle as a firefighter and emergency medical technician with the Army Reserve’s 487th Engineer Detachment.

“It was a pretty hot zone,” he said. “We took a lot of mortar fire, IEDs, car bombs, saw a lot of helicopter crashes and worked the UN embassy bombing. I dragged a lot of people out of burning buildings, cars, motorcycle wrecks and explosions.”

Back home, Lansdale was diagnosed with PTSD and joined a support group at the VA hospital. He predicted that returning troops would overrun the VA.

“A third of all soldiers are seeking help,” he said. “Do we have the capability of treating all those soldiers? I don’t think we do.”


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To reach David Goldstein, Washington correspondent, call 1-(202) 383-6105 or send e-mail to dgoldstein@krwashington.com.

go bowe
05-02-2006, 12:27 AM
the way we treat our wounded veterans is a travesty...

always has been, probably always will be...

trndobrd
05-02-2006, 01:52 PM
This is a good and bad news story. The VA has been much more agressive in reaching out to veterans immediately upon their return and conducting screenings and interviews. Every returning veteran has a screening immediately when they return, and again after 4 months after they return.

All most all veterans have some symptoms of combat stress upon their return. Identifying problems early is the key to preventing full blown cases of PTSD (a term that gets thrown around more than it should) and the long term problems associated with it.

The symptoms the kid in the story talks about are pretty common and may or may not be PTSD. Left on his own, they could get worse, although they tend to subside after several months. The important thing is that they are identified, treated and monitored.