Monday, December 26, 2011

Needs of amputees disabled by military service will continue long after wars

The beginning of a series in the San Diego Union-Tribune:

The current generation of young war-wounded amputees like Sgt. Collin Raaz (pictured), a 25-year-old Marine scout sniper, will likely live 50 to 60 more years.

Vietnam War veterans demonstrated that, absent other medical complications, the life expectancy of amputees can be as long as their peers if they take care of their health.

But much remains unknown about the physical recovery of troops severely wounded in Iraq and Afghanistan, says Jennifer Town, director of C5, the combat casualty care program at San Diego Naval Medical Center in Balboa Park.

“Forward deployed medical assets are giving massive transfusions to these kids, and they are surviving. The lance corporal is putting tourniquets on his buddy,” Town says. Before modern products and measures to control blood loss, “the Raazes of the world would not have made it out of theater in wars past.”

Environmental contaminants are another wild card in their long-term health. “They’ve had exposures to many things. Afghanistan is a very dirty country. Infections and all those things that were taken care of initially with their acute care, is there a long term in any of that?” she wonders.

Federal finances are another unknown. There is little interest, so far, in slashing military health care funding to balance the budget, but “we have to be willing to go to bat and say there is an ongoing requirement for this population,” Town says. “We’ve got to keep the public aware.”
Improved care

Ryan Pavlu, an executive vice president of Wounded Warrior Project, an advocacy and support organization for post 9/11 combat veterans, said “early on when we started receiving heavy casualties, let’s be honest, we weren’t ready. (The Defense Department) wasn’t ready for the amount of casualties they were seeing and the seriousness of the casualties.”

Since then military medical care for the war wounded has improved significantly, Pavlu said, with increased staffing and better treatments.

Wounded service members continue to report shortcomings with care at some smaller regional health care facilities, an over reliance on medication instead of rehabilitative care, bureaucratic red tape, and the effectiveness of cognitive treatments for so-called invisible wounds such as traumatic brain injury and post traumatic stress.

But when it comes to health care for catastrophic physical injuries such as amputations, “especially at the major military facilities,” Pavlu says, “warriors are really getting top-notch care.”

The draw down of troops from the war zone, however, is going to produce another surge in demand for military health services. “They’re going to have physical injuries, mental health injuries,” Pavlu says. “We’ve got to have the health care system in place to take care of those needs. For a time, the health care system is going to be flooded.”