Two UC-San Diego Researchers Aim to Help Gulf War Veterans with Gulf War Illness

"This is just as much about future combat operations as it is about the past"

Healthy and Ill 1991 Gulf War Veteran Research Study Participants Needed

Written by Anthony Hardie, 91outcomes.com

(91outcomes.com) -  Two medical research researchers at the University of California-San Diego are aiming to help veterans of the 1991 Gulf War suffering from Gulf War Illness by working to improve the scientific understanding of precisely what is going on in GWI patients' bodies.

One of the unrelated UCSD medical research projects is led by Dr. Beatrice Golomb, whose groundbreaking study found CoQ10 to be the first treatment proven successful in reducing some of GWI's symptoms, including post-exertional fatigue.  She is also the author of a 1990s RAND Institute study on Pyridostigmine Bromide (PB) anti-nerve agent protective pills, which found PB to be associated with Gulf War Illness patients' adverse health outcomes.  

The second is led by Dr. Bruce Zuraw, a widely published Professor of Medicine at the UCSD Medical School and Program Director of the UCSD Allergy and Immunology Fellowship Program.  His research interests include allergic inflammation in humans.  

Both medical research projects studies received their funding separately from the peer reviewed Gulf War Illness (GWI) Congressionally Directed Medical Research Program (CDMRP), an activity of the U.S. Department of Defense that receives its specific direction, peer review requirements, and funding on an annual basis from Congress.  

Dr. Beatrice Golomb: Developing a Biomarker for Oxidative Damage in GWI

The first UCSD study is led by Dr. Beatrice Golomb and is a follow-on to her landmark CoQ10 GWI treatment study.  CoQ10 is believed to be effective because it helps alleviate ongoing oxidative damage at the cellular level, called "oxidative stress".  

Dr. Golomb's new study is seeking 40 participants -- all ill -- and this time involves measuring the oxidative damage resulting in Gulf War veterans with GWI.  

Entitled simply "Oxidative Stress"(GW093063), this study will look at potential oxidative damage biomarkers for GWI taken from samples of a blood draw and excreted in the urine.  

The study is narrowly focused.  Study participants must:

• Be a Veteran of the U.S. Armed Forces; and
• Have U.S. military service service in the Persian Gulf Region at any time during the one-year period commencing August 2, 1990 and ending July 31, 1991; and
• Be between the ages of 35 and 73; and
• Meet recognized diagnostic criteria for Gulf War Illness (to be determined by the study team).

Participation involves a short telephone interview and in-person testing during a visit of about 3 hours to the UCSD campus.  

Dr. Bruce Zuraw: Developing a Biomarker for GWI with Respiratory Symptoms

The second UCSD GWI study, focused on respiratory issues inherent in many GWI patients' disease, is slightly larger and is seeking 60 veterans of the 1991 Gulf War, including 30 "healthy" and 30 "ill" veterans.  

The study is being led by Bruce Zuraw, M.D. of the Veterans Medical Research Foundation of San Diego, and is entitled "Epithelial Cell TRPV1-Mediated Airway Sensitivity as a Mechanism for Respiratory Symptoms Associated with Gulf War Illness (GW080156).”

Dr. Zuraw is hoping the project will help determine a possible test for diagnosing GWI with respiratory symptoms (a distinction he terms, "GWI-R").  No such test currently exists, making it difficult to distinguish between GWI or GWI-R and other chronic multisymptom illness conditions for which causes -- and perhaps more importantly, treatments -- may be wildly different.  

According to a San Diego Union-Times article about his study:

Zuraw and his research team are focusing on Gulf War illnesses featuring respiratory problems, drawing on his work as director of the Allergy and Immunology Section at both the VA San Diego Healthcare System and the University of California San Diego.  Researchers have noticed that Gulf War veterans often have symptoms of inflammatory lung diseases such as asthma or chronic bronchitis, but they test negative for them.  The paradox led the San Diego team to an examination of transient receptor potential channels, or TRPs, in the lining of the lungs and nerves, and their role in increased airway sensitivity. They hypothesize that in patients with Gulf War illness, the receptors are locked in a harmful cycle: receptors in the epithelial cells of the lungs alert the nerves, the resulting nerve response irritates the lining of the lung, and the process repeats indefinitely, resulting in respiratory distress.  By isolating and documenting the interplay, they hope to create a means of diagnosing a distinct illness, and perhaps a means of stopping the cycle and its irritating effect on the lungs.  .... “It’s a gift when veterans offer their time to clinical research,” said Kerstin Lynam, the CEO of Veterans Medical Research Foundation. “Only through their participation can we learn more about this evasive disease.

Congress Directs the Funding

The result of an odd twist of events, most Gulf War Illness research is now being conducted outside the U.S. Department of Veterans Affairs (VA), the agency that purports to be veterans' "chief advocate".
Gulf War veteran activists recently discovered an unannounced, two-thirds budget cut in the VA's current budget proposal, which would reduced already limited GWI medical research at VA to less than $5 million annually.  By contrast, peer reviewed treatment-focused GWI research was funded by Congress in the Department of Defense at $10 million last year.

As the name would suggest, Congress specifically directs the funding for the Congressionally Directed Medical Research Program, which is administered by the U.S. Army Medical Research and Materiel Command at Ft. Detrick, Maryland.  

Programs within the CDMRP portfolio are generally created by Congress at the request of patients suffering from a disease or disorder, and the GWI programs are no different.  Created under the Fiscal Year 2006 Defense Appropriations Act, the GWI program has existed -- and grown -- ever since.  Gulf War veterans sought the creation of the GWI CDMRP, and Gulf War Illness patients and their advocates are active in the program's annual funding decisions by Congress. 

Funding decisions about individually submitted medical research proposals are determined through a multi-tiered process that includes Congressionally-mandated peer review -- review of each proposal's merits by other members of the scientific community.  CDMRP programs also include consumer reviewers -- individuals affected by the specific disease or condition -- at every step of the process.  

Congressional language authorizing the GWI CDMRP program has remained unchanged over the years.  It is perhaps most notable for what kinds of medical research studies are allowed -- "studies of treatments" and "identification of objective markers for [GWI]" -- and what are not -- "no studies based on psychiatric illness and psychological stress as the central cause of Gulf War Illness". 

The committee directs the Secretary of the Army to utilize the authorized funding for this program to undertake research on Gulf War illnesses. The committee directs that activities under the program should include studies of treatments for the complex of symptoms commonly referred to as Gulf War Illness, and identification of objective markers for Gulf War Illness. The committee recommends that no studies based on psychiatric illness and psychological stress as the central cause of Gulf War Illness be funded under the program. The committee directs that the program be conducted using competitive selection and peer review for the identification of research with the highest technical merit and military value. Further, the committee directs that this program be coordinated with similar activities in the Department of Veterans Affairs and the National Institutes of Health.

In April 2010, the highly reputable Institute of Medicine issue a report that found Gulf War Illness to be a unique diagnostic condition that affects about 250,000 veterans of the 1991 Gulf War as well as other U.S. Forces.

John, a former military police Gulf War veteran from Washington State in his early 40s who asked that his last name be withheld to protect his medical privacy, agreed to be interviewed by the San Diego newspaper staff and supported the study, seemed to agree with those last six words, "as well as other U.S. forces."  

"This is just as much about future combat operations as it is about the past," John told the reporters.

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TO PARTICIPATE

If you are a U.S. military veteran of the 1991 Gulf War (Aug. 2, 1990 - Jul. 31, 1991), you appear to meet the basic study criteria information, and you’re willing and able to participate:

For the new Golomb study at UCSD:

• Call:  (858) 558-4950 extension 203 (Janis) or 210 (Kate)
• Email:  jbritchie@ucsd.edu or cbloom@ucsd.edu
• A small compensation stipend is provided; travel is not covered.

For the Zuraw study at UCSD:

• Call (858) 822-6599
• Gulf War veterans who are both ill (with Gulf War Illness and GWI-related respiratory symptoms) and healthy are needed.
• A small compensation stipend is provided; travel is not covered.

Memorial Day Remarks on Vietnam War 50th Ring Hollow for Gulf War Illness Veterans

Below is the President's speech on Memorial Day 2012, at the Vietnam Wall, commemorating the 50th anniversary of the Vietnam War.   


The White House would do well to recognize that veterans of the 1991 Gulf War have largely been forgotten, their all too real Gulf War Illness still dismissed by far too many within the VA.


There is much left to do for Gulf War veterans, yet rather than moving forward, it now looks like Gulf War veterans are being left to slide back down the hill into the dark valley where for years they were ignored and ridiculed by successive Administrations' VA bureaucrats.  


Evidence for this retranchement is an unannounced two-thirds budget cuts by for Gulf Illness research in the current VA budget proposal, outright ignoring the Congressionally chartered research body entrusted with oversight of GWI and Gulf War health research, and extended foot-dragging on what might eventually -- more than 21 years later -- be the first of its kind GWI medical research strategic plan.  Add to that precious little GWI research from VA, an apparent refusal by VA to formally cooperate with the one successful GWI medical research program ever created in the federal government -- the treatment-focused, peer reviewed GWI Congressionally Directed Medical Research Program -- and complicity in a recent Institute of Medicine presentation on GWI in which five of the eight presenters were focused on stress and psychosomatic "causes" of GWI, a case long closed as acknowledged by an earlier, definitive 2010 IOM report that found GWI was not only a unique diagnosis that affected 250,000 of the 697,000 Gulf War veterans but could not be ascribed to any psychiatric cause.  


For countless thousands of Gulf War veterans, their enduring -- and in many cases substantially worsening -- Gulf War Illness issues began while still in the Gulf more than 21 years ago.  They've been up front about their issue since the get go, and Congress has gotten tougher and tougher on VA and DoD over the years at it became apparent that a cabal of unaccountable bureaucrats have been and remain dead set against assisting them in any kind of meaningful way beyond counting them or the number of their symptoms and the growing numbers of their resultant diagnosed conditions.


The White House would do well to recognize that actions speak louder than words, and Gulf War veterans, hearing these flowery words regarding Vietnam Veterans this weekend, are all ears.


Gulf War veterans don't need apologies -- they need competent administrators willing to make whatever choices are necessary to remedy their debilitating health conditions and the growing number of wounds inflicted by VA officials -- past and present.  

-A.H., 91outcomes.com


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The White House

Office of the Press Secretary

For Immediate Release

May 28, 2012

Remarks by the President at the Commemoration Ceremony of the 50th Anniversary of the Vietnam War

The Vietnam War Memorial
National Mall
Washington, D.C.

2:27 P.M. EDT

THE PRESIDENT:  Good afternoon, everybody.  Chuck, thank you for your words and your friendship and your life of service.  Veterans of the Vietnam War, families, friends, distinguished guests.  I know it is hot.  (Laughter.)  But you are here -- to honor your loved ones.  And Michelle and I could not be more honored to be here with you. 

It speaks to the complexity of America’s time in Vietnam that, even now, historians cannot agree on precisely when the war began.  American advisors had served there, and died there, as early as the mid-'50s.  Major combat operations would not begin until the mid-'60s.  But if any year in between illustrated the changing nature of our involvement, it was 1962.

It was January, in Saigon.  Our Army pilots strapped on their helmets and boarded their helicopters.  They lifted off, raced over treetops carrying South Vietnamese troops.  It was a single raid against an enemy stronghold just a few miles into the jungle -- but it was one of America’s first major operations in that faraway land.

Fifty years later, we come to this wall -- to this sacred place -- to remember.  We can step towards its granite wall and reach out, touch a name.  Today is Memorial Day, when we recall all those who gave everything in the darkness of war so we could stand here in the glory of spring.  And today begins the 50th commemoration of our war in Vietnam.  We honor each of those names etched in stone -- 58,282 American patriots.  We salute all who served with them.  And we stand with the families who love them still.  

For years you've come here, to be with them once more.  And in the simple things you’ve left behind -- your offerings, your mementos, your gifts -- we get a glimpse of the lives they led.  The blanket that covered him as a baby.  The baseball bat he swung as a boy.  A wedding ring.  The photo of the grandchild he never met.  The boots he wore, still caked in mud.  The medals she earned, still shining.  And, of course, some of the things left here have special meaning, known only to the veterans -- a can of beer; a packet of M&Ms; a container of Spam; an old field ration -- still good, still awful.  (Laughter.)          

It's here we feel the depth of your sacrifice.  And here we see a piece of our larger American story.  Our Founders -- in their genius -- gave us a task.  They set out to make a more perfect union.  And so it falls to every generation to carry on that work.  To keep moving forward.  To overcome a sometimes painful past.  To keep striving for our ideals. 

And one of the most painful chapters in our history was Vietnam -- most particularly, how we treated our troops who served there.  You were often blamed for a war you didn’t start, when you should have been commended for serving your country with valor.  (Applause.)  You were sometimes blamed for misdeeds of a few, when the honorable service of the many should have been praised.  You came home and sometimes were denigrated, when you should have been celebrated.  It was a national shame, a disgrace that should have never happened.  And that's why here today we resolve that it will not happen again.  (Applause.)    

And so a central part of this 50th anniversary will be to tell your story as it should have been told all along.  It’s another chance to set the record straight.  That's one more way we keep perfecting our Union -- setting the record straight.  And it starts today.  Because history will honor your service, and your names will join a story of service that stretches back two centuries.

Let us tell the story of a generation of servicemembers -- every color, every creed, rich, poor, officer and enlisted -- who served with just as much patriotism and honor as any before you. Let’s never forget that most of those who served in Vietnam did so by choice.  So many of you volunteered.  Your country was at war, and you said, "send me."  That includes our women in Vietnam -- every one of you a volunteer.  (Applause.)  Those who were drafted, they, too, went and carried their burden -- you served; you did your duty.

You persevered though some of the most brutal conditions ever faced by Americans in war.  The suffocating heat.  The drenching monsoon rains.  An enemy that could come out of nowhere and vanish just as quickly.  Some of the most intense urban combat in history, and battles for a single hill that could rage for weeks.  Let it be said -- in those hellholes like Briarpatch, and the Zoo and the Hanoi Hilton -- our Vietnam POWs didn’t simply endure; you wrote one of the most extraordinary stories of bravery and integrity in the annals of military history.  (Applause.)  

As a nation, we've long celebrated the courage of our forces at Normandy and Iwo Jima, the Pusan Perimeter and Heartbreak Ridge.  So let us also speak of your courage -- at Hue and Khe Sanh, at Tan Son Nhut and Saigon, from Hamburger Hill to Rolling Thunder.  All too often it's forgotten that you, our troops in Vietnam, won every major battle you fought in.  (Applause.)

When you came home, I know many of you put your medals away -- tucked them in a drawer, or in a box in the closet.  You went on with your lives -- started families and pursued careers.  A lot of you didn’t talk too much about your service.  As a consequence, this nation has not always fully appreciated the chapter of your lives that came next. 

So let us also tell a story of a generation that came home, and how -- even though some Americans turned their back on you -- you never turned your back on America.  (Applause.)  Like generations before you, you took off the uniform, but you never stopped serving.  You became teachers and police officers and nurses -- the folks we count on every single day.  You became entrepreneurs, running companies and pioneering industries that changed the world.  You became leaders and public servants, from town halls to Capitol Hill -- lifting up our communities, our states, our nation. 

You reminded us what it was like to serve, what it meant to serve.  Those of you who stayed in uniform, you rose through the ranks, became leaders in every service, learned from your experience in Vietnam and rebuilt our military into the finest force that the world has ever known.  (Applause.)  And let’s remember all those Vietnam veterans who came back and served again -- in the wars in Iraq and Afghanistan.  You did not stop serving.  (Applause.) 

Even as you succeeded in all these endeavors, you did something more -- maybe the most important thing you did -- you looked after each other.  When your government didn’t live up to its responsibilities, you spoke out -- fighting for the care and benefits you had earned, and, over time, transforming the VA.  And, of course, one of these Vietnam veterans is now our outstanding Secretary of Veterans Affairs, Ric Shinseki.  (Applause.)

You looked after one another.  You cared for one another.  People weren’t always talking about PTSD at the time -- you understood it, and you were there for each other.  Just as importantly, you didn’t just take care of your own, you cared for those that followed.  You’ve made it your mission to make sure today’s troops get the respect and support that all too often you did not receive.  (Applause.)  

Because of you, because our Vietnam veterans led the charge, the Post-9/11 GI Bill is helping hundreds of thousands of today’s veterans go to college and pursue their dreams.  (Applause.)  Because of you, because you didn’t let us forget, at our airports, our returning troops get off the airplane and you are there to shake their hands.  (Applause.)  Because of you, across America, communities have welcomed home our forces from Iraq.  And when our troops return from Afghanistan, America will give this entire 9/11 Generation the welcome home they deserve.  That happened in part because of you.  (Applause.)

This is the story of our Vietnam servicemembers -- the story that needs to be told.  This is what this 50th anniversary is all about.  It’s another opportunity to say to our Vietnam veterans what we should have been saying from the beginning:  You did your job.  You served with honor.  You made us proud.  You came home and you helped build the America that we love and that we cherish.

So here today, it must be said -- you have earned your place among the greatest generations.  At this time, I would ask all our Vietnam veterans, those of you who can stand, to please stand, all those already standing, raise your hands -- as we say those simple words which always greet our troops when they come home from here on out:  Welcome home.  (Applause.)  Welcome home. Welcome home.  Welcome home.  Thank you.  We appreciate you.  Welcome home.  (Applause.) 

Today, we’re calling on all Americans, and every segment of our society, to join this effort.  Everybody can do something.  Five decades removed from a time of division among Americans, this anniversary can remind us of what we share as Americans.  That includes honoring our Vietnam veterans by never forgetting the lessons of that war. 

So let us resolve that when America sends our sons and daughters into harm’s way, we will always give them a clear mission; we will always give them a sound strategy; we will give them the equipment they need to get the job done.  We will have their backs.  (Applause.)  We will resolve that leaders will be candid about the risks and about progress -- and have a plan to bring our troops home, with honor.

Let us resolve to never forget the costs of war, including the terrible loss of innocent civilians -- not just in Vietnam, but in all wars.  For we know that while your sacrifice and service is the very definition of glory, war itself is not glorious.  We hate war.  When we fight, we do so to protect ourselves because it's necessary.

Let’s resolve that in our democracy we can debate and disagree -- even in a time of war.  But let us never use patriotism as a political sword.  Patriots can support a war; patriots can oppose a war.  And whatever our view, let us always stand united in support of our troops, who we placed in harm's way.  (Applause.)  That is our solemn obligation.  (Applause.)   

Let’s resolve to take care of our veterans as well as they’ve taken care of us -- not just talk, but actions.  Not just in the first five years after a war, but the first five decades. For our Vietnam veterans, this means the disability benefits for diseases connected to Agent Orange.  It means job opportunities and mental health care to help you stand tall again.  It means ending the tragedy of veterans' homelessness, so that every veteran who has fought for America has a home in America.  You shouldn’t have to fight for a roof over your heads when you fought on behalf of the country that you love.  (Applause.) 

And when an American does not come back -- including the 1,666 Americans still missing from the Vietnam War -- let us resolve to do everything in our power to bring them home.  This is our solemn promise to mothers like Sarah Shay who joins us today, 93 years old, who has honored her son, Major Donald Shay, Jr., missing in action for 42 years.  There she is.  Sarah, thank you for your courage.  God bless you.  (Applause.)

This is the promise we’re fulfilling today to the Meroney family of Fayetteville, Arkansas.  Forty-three years after he went missing, we can announce that Army Captain Virgil Meroney, III, is coming home, and he will finally rest in peace.  (Applause.)

Some have called this war era a scar on our country, but here’s what I say.  As any wound heals, the tissue around it becomes tougher, becomes stronger than before.  And in this sense, finally, we might begin to see the true legacy of Vietnam. Because of Vietnam and our veterans, we now use American power smarter, we honor our military more, we take care of our veterans better.  Because of the hard lessons of Vietnam, because of you, America is even stronger than before.  (Applause.)     

And finally, on this anniversary and all the years to come, let us remember what binds us, as one people.  This is important for all of us, whether you fought in the Vietnam War or fought against it, whether you were too young to be shaped by it.  It is important that our children understand the sacrifices that were made by your troops in Vietnam; that for them, this is more than just a name in history books.  It’s important that we know the lesson of a gift once left at this Memorial. 

It was towards the end of the day, and most of the tourists and visitors had departed.  And there it was -- a football helmet, black with white stripes, and a wristband.  And with them was a handwritten note.  And it was from a young man, still in high school.  And mind you, this was more than two decades after Vietnam.  That high school student was born years after the war had already ended.  But in that short, handwritten note he captured the reverence -- the bonds between generations -- that bring us here today.  

The letter began, "Dear Vietnam Veterans, here are two things from me to you that I think you should have."   He explained that it was his helmet from midget football and his wristband from his senior year.  So today I want to close with the words he wrote:

In these two pieces of equipment, I was allowed to make mistakes, correct them, grow and mature as a person.  However, that was on my battlefield.  You didn’t get the chance to do that on your battlefield.  Some of you were forced to grow up too fast; all of you died too soon.  We do have many things in common, though.  We both have pride, heart and determination.  I'm just sorry you guys had to learn those qualities too fast.  That is why I'm giving you what I grew up with.  You are true heroes and you will never be forgotten.

That's from a high school kid, born decades after the end of the war.  And that captures the spirit that this entire country should embrace.

Veterans, families of the Vietnam War, I know the wounds of war are slow to heal.  You know that better than most.  But today we take another step.  The task of telling your story continues. The work of perfecting our Union goes on.  And decades from now, I hope another young American will visit this place and reach out and touch a name.  And she’ll learn the story of servicemembers  -- people she never met, who fought a war she never knew -- and in that moment of understanding and of gratitude and of grace, your legacy will endure.  For you are all true heroes and you will all be remembered. 

May God bless you.  May God bless your families.  May God bless our men and women in uniform.  And may God bless these United States of America.  (Applause.)

 END                   2:50 P.M. EDT 

Upcoming RAC Meetings to Include GWI Research Findings, VA Accountable

On the agenda are Important new medical research findings related to GWI, Accountability for VA-proposed two-thirds budget cut to GWI research, Foot-Dragging on GWI strategic plan, and Ignoring key RAC recommendations in national survey of Gulf War veterans

**Agenda and Teleconference Call-In Information at bottom of article**




Written by Anthony Hardie, 91outcomes.com


(91outcomes.com) - During an upcoming meeting of the Congressionally chartered Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI) in Boston, medical researchers will present new research findings related to Gulf War Illness (GWI) and chronic pain, brain and nervous system dysfunction and abnormalities, the role of chemical exposures, and a few of the many promising potential treatments for the disorder estimated by the Institute of Medicine to affect more than one in three veterans of the 1991 Gulf War, as well as other U.S. forces.

At the same time, the public Committee has agenda items that set the stage for publicly holding VA accountable for a massive, unannounced, two-thirds cut to GWI medical research proposed by VA in its recent budget proposal, and VA foot dragging on a long overdue, first ever GWI medical research strategic plan.  An announcement last week that VA's Office of Public Health (OPH) has moved forward with issuing a follow-up survey of Gulf War veterans that failed to include any of an extensive list of recommendations by the Committee is likely to be another sore spot as top OPH officials are on the agenda to make presentations to the Committee.

The RAC meetings will be held on the Boston University Medical Center campus on June 18-19, 2012.

Notable GWI medical researchers Dr. Dane Cook of the University of Wisconsin-Madison and Dr. Robert Haley of the University of Texas-Southwestern are scheduled to kick of the two days of public meetings, discussing their research findings related to chronic pain in Gulf War Illness (GWI).  Dr. Cook will present his most recent findings in a presentation entitled, "Diffusion Tensor Imaging (DTI) in Gulf War Veterans with Chronic Pain," while Dr. Haley will present, "fMRI reveals abnormal central processing of sensory and pain stimuli in ill Gulf War Veterans."

Next on the schedule are presentations related to brain and nervous system abnormalities by Dr. Apostolos Georgopoulos of the Minneapolis VA Medical Center, presenting, "Magnetoencephalography (MEG) imaging Patterns in Gulf War Illness," and Dr. Alvin Terry of the Georgia Health Sciences University, presenting "Functional consequences of repeated organophosphate exposure: potential non-cholinergic mechanisms."  Dr. Terry was awarded CDMRP funding in FY11 for an organophosphate-related study and its effects on the myelin sheathing of nerves and transport of nerve signals between the axonal endings of nerve cells.

Beginning the first afternoon of the RAC's meetings, Dr. Diane Rohlman of the Oregon Health Sciences University will kick of a series of medical researchers presenting their findings related to chemical exposures in the 1991 Gulf War and their connection to GWI.  Dr. Rohlman will present, "Meta-analysis of cognitive effects from Organophosphate exposures."

Then, during the RAC's second day of Boston meetings, Dr. Rodney Johnson of the University of Illinois at Urbana-Champaign, presenting, "From inflammation to sickness and Cognitive dysfunction: when the Immune system subjugates the brain."  Rounding out the discussion on organophosphate chemicals and their effects on Gulf War veterans later in the day will be Dr. Kimberly Sullivan, presenting her findings from a CDMRP-funded study (FY06), "Structural MRI and Cognitive Correlates in Military Pesticide Personnel from the Gulf War."

In between Johnson's and Sullivan's presentations will be three presentations on alternative and complementary medicine as potential treatments to lessen or make more manageable some of GWI's symptoms.   Dr. Lisa Conboy of The New England School of Acupuncture, will present her team's initial findings from an FY08 CDMRP-funded study, with, "The effectiveness of acupuncture in the Treatment of Gulf War Illness."  Dr. Britta Holzel of the Massachusetts General Hospital and Harvard Medical School will presente, "The effects of mindfulness practice on the neurobiology of pain processing and emotion regulation," and Dr. Chenchen Wang of the Tufts University School of Medicine will present, "A randomized trial of Tai-Chi for fibromyalgia treatment."

In addition to the research findings, VA officials will present an update on the Gulf War brain bank, an important effort initially heralded by Gulf War veterans and the RAC that has been inexplicably derailed for several years, as well as an overview of the activities of the VA Office of Public Health (OPH).  The OPH has come under substantial criticism for ignoring the RAC's critical research recommendations, choosing in a newly publicized national survey of Gulf War veterans to focus on stress issues and failing to incorporate key RAC recommendations.

The Committee will also hear from VA officials regarding, and discuss the overall VA Gulf War Research Program, including new requests for proposals, the status of the still pending draft GWI strategic plan, and the unexpected and an unannounced two-thirds cut to GWI research funding contained in the VA's FY2013 budget proposal. *(1)*

The public will have the last word each day, with open public comment periods scheduled at the end of each day.  Including veterans and the public has been a hallmark of the Congressionally chartered RAC since its creation through legislation passed by Congress in 1998 at the urging of Gulf War veterans.  Unlike some entities that have received sharp criticism from Gulf War veterans, all portions of the RAC's proceedings are always fully open to the public.

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(1)  FY 2013 Budget Submission, U.S. Department of Veterans Affairs, Volume II:  Medical Programs and Information Technology, p. 3A-5.





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IF YOU'RE GOING

What:

Agenda

When:

Monday, June 18, 2012, 8 a.m. - 5:30 p.m. (approximate)

and 

Tuesday, June 19, 2012, 8 a.m. - 1:30 p.m. (approximate) 

Where:  

Boston University Medical Campus
Room 109
80 East Concord Street
Boston, MA 02118 

Map      Directions

Call-In Information:

1-800-767-1750

Access Code:  44644 

 

Ft. Wayne Journal-Gazette: U.S. falls short on debt to military vets

SOURCE: This article is from the Ft. Wayne, Ind. Journal-Gazette, http://www.journalgazette.net/article/20120527/EDIT05/305279968/1147/EDIT07

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Published: May 27, 2012 3:00 a.m.

U.S. falls short on debt to military vets

Jonathan D. Walker

Here is something worth remembering as we celebrate Memorial Day: The Department of Veterans Affairs estimates that every 80 minutes a veteran takes his or her own life. The problem is so serious that although only 1 percent of Americans have served in the military, former service members represent 20 percent of suicides in the United States. And the news is filled with stories about how the VA is struggling to get the funding it needs to address the problem.

But that is only the tip of the iceberg. A 2007 study in the American Journal of Public Health indicated that almost 2 million veterans are uninsured, along with almost 4 million of their family members, and a Harvard study estimated that more than 2,200 veterans died in 2008 due to lack of insurance. You may have thought that veterans can automatically be treated at a veterans’ hospital, but this is not the case. Veterans who have a service-connected injury can get care, but uninsured veterans face a “means test” based on their income. The test determines their priority level for care and how much they have to pay. And if the system doesn’t have enough money, it can stop enrolling veterans if they fail the means test – as happened from 2003 to 2009.

But even if the VA were able to fully cover every veteran, it would still leave a lot of veterans without care because they do not live near a VA hospital. And even if they live near a hospital, they still may need to drive far away to get services that aren’t available locally; for instance, there are veterans in Fort Wayne who have to go to Indianapolis for treatment. There are laws that make it illegal for an insurance company to force patients to drive an excessive distance to stay in their network, yet we think nothing of making veterans drive long distances simply to get the care to which they are entitled.

Rick Unger, a writer at Forbes Magazine, points out that we make a deal with our veterans: They put their lives on the line when we send them off to fight our wars, and in return we promise to take care of them when they come back.

Although the men and women in uniform deliver on their promise on a daily basis, we very much do not. When pollsters try to identify the issues that are important to us, veterans’ health care doesn’t even make the list. Non-profit organizations, such as the Iraq and Afghanistan Veterans of America, try to fill the gap created by our national lack of concern, but their resources are also limited. Unger says it best: “You and I are, at the end of the day, a bunch of deal-breaking, contract-breaching welchers who don’t care enough about our promises to those who would die for us to view this as a concern worthy of making a pollster’s list.” And now one of our veterans chooses suicide every 80 minutes.

It is totally understandable that people want smaller government and lower taxes, but we should still be willing to do whatever it takes to provide these men and women with the resources they need to stay physically and mentally healthy. Sen. John McCain, R-Ariz., has advocated providing veterans a card that would allow them treatment at any health care facility so they would never have to worry about access to care. Only 1 percent of us serve in the military. Why can’t the rest of us take care of them properly?

Dr. Jonathan D. Walker is an assistant clinical professor at Indiana University School of Medicine in Fort Wayne. He wrote this for The Journal Gazette.

NY TIMES: The V.A.’s Shameful Betrayal

SOURCE:  THis article is from the new york times, http://www.nytimes.com/2012/05/28/opinion/the-vas-shameful-betrayal.html?_r=1

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OP-ED CONTRIBUTOR

The V.A.’s Shameful Betrayal

By MIKE SCOTTI

Published: May 27, 2012

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THE Department of Veterans Affairs, already under enormous strain from the aging of the Vietnam generation, the end of the Iraq war and the continuing return of combat troops from Afghanistan, announced in April that it would increase its mental health staff by about 10 percent. But too many veterans waging a lonely and emotional struggle to resume a normal life continue to find the agency a source of disappointment rather than healing.

The new hiring is intended to address the infuriating delay veterans face in getting appointments. The V.A. says it tries to complete full mental health evaluations within 14 days of an initial screening. But a review by the department’s inspector general found that schedulers were entering misleading information into their computer system. They were recording the next available appointment date as the patient’s desired appointment date. As a result, a veteran who might have had to wait weeks for an appointment would appear in the computer system as having been seen “without a wait.” That allowed the agency to claim that the two-week target was being reached in 95 percent of cases, when the real rate was 49 percent. The rest waited an average of 50 days.

As a veteran of both Iraq and Afghanistan, I found that news maddening. While the schedulers played games with the numbers, veterans were dealing with mental wounds so serious that getting proper attention at the right time might have made the difference between life and death. Even worse was that the V.A. had failed twice before to change; the inspector general found similar problems in 2005 and in 2007. This suggests a systematic misrepresentation of data and an unwillingness to stop it.

Unfortunately, the problem goes even deeper. There are potentially hundreds of thousands of veterans who are struggling with post-combat mental health issues who never ask the V.A. for help. Some, hamstrung by fear of stigma, are too proud or too ashamed to ask for help. Others don’t ask because they’ve heard too many stories from peers who have received poor care or been ignored.

I have close friends who could no longer drive because of their lingering fears of roadside bombs. Others had gone to the V.A. because they had suicidal thoughts, only to receive a preliminary screening, a pat on the back, a prescription for antidepressants — and a follow-up appointment for several months later.

I’ve had my own struggle: in 2001 I was part of the initial force of Marines who landed in Afghanistan, and in 2003 took part in the heavy fighting of the first wave of the invasion of Iraq. Since coming home, I’ve had my mind hijacked by visions of the corpses of children, their eyes blackened, at the side of the road. I recall carrying the coffins of fallen brothers. I remember losing friends who probably knew exactly what was happening to them, as they bled out on the side of a dusty road in Iraq.

And I’ve felt the shame of having suicidal feelings. Like many others, I chose to hide them. Yet, even in the darkest days of my own post-traumatic stress, when I was considering choosing between making my suicide look like an accident or taking a swan dive off some beautiful bridge, I never considered going to the V.A. for help.

My image of the V.A., formed while I was on active duty, was of an ineffective, uncaring institution. Tales circulated among my fellow Marines of its institutional indifference, and those impressions were confirmed when I left Iraq for home. At Camp Pendleton, Calif., a woman with a cold, unfeeling manner assembled us for a PowerPoint presentation and pointed us to brochures — nothing more, no welcoming sign of warmth or empathy for the jumble of emotions we were feeling. Her remoteness spoke volumes to me of what I might expect at home.

To regain veterans’ trust, the V.A. must change its organization and culture, not just hire more people. First, its leadership must be held accountable for employees’ behavior, and anyone caught entering misleading data should be fired. The agency must reach out, with public awareness campaigns and with warmth, to veterans who may be suffering in silence. It must help reduce the social stigma that attaches to the mental health issues the veterans face.

Dedicated V.A. personnel run a suicide-prevention hot line, but it is only a temporary salve for emergencies. One impressive and highly effective alternative to the V.A.’s traditional treatment process is the Wounded Warrior Project’s Combat Stress Recovery Program, which emphasizes the importance of interpersonal relationships, goal-setting and outdoor, rehabilitative retreats and seeks to avoid the stigma associated with traditional treatment.

What this generation of veterans needs from the V.A. is a recognition that when the color of life has faded to gray, you need to talk to someone about it today, not weeks or months from now. We need America to acknowledge what war does to the young men and women who fight it and to share the message that dragged me out of the darkness: It’s O.K. if you’re not O.K.

Mike Scotti, a former Marine, is the author of “The Blue Cascade: A Memoir of Life After War.”

A version of this op-ed appeared in print on May 28, 2012, on page A17 of the New York edition with the headline: The V.A.’s Shameful Betrayal.

Memorial Day Remembrance

Congressional Committee Rejects Requested Increase for GWI Treatment Research Funding

Written by Anthony Hardie, 91outcomes.com


(91outcomes.com) - In a turn highly disappointing to Gulf War veterans, the Congressional committee responsible for recommending funding today rejected a much needed increase in the treatment focused Gulf War Illness (GWI) Congressionally Directed Medical Research Program (CDMRP).

Earlier this year, veterans suffering from Gulf War Illness and their advocates worked hard to secure a record-breaking 65 cosigners to a joint "Dear Colleague" request letter to Rep. C.W. Bill Young (R-Fla.) and Rep. Norm Dicks (D-Wash.), Chairman and Ranking Minority Member of the Defense Appropriations Subcommittee.

Led by outgoing Rep. Dennis Kucinich (D-Oh.) and Rep. Phil Roe, M.D. (R-Tenn.), the 60 Democratic minority party members cosigning the "Dear Colleague" letter separately requested an increase in funding of the program from last year's $10 million level to $25 million.  The five majority party Republican cosigners requested general support for the program.

However, the bill passed today by the full House Appropriations Committee today rejected that requested funding increase, which according to advocates for the program would go primarily towards funding critically important inter-institutional consortia funded for development with earlier program funding.

The three consortia currently in development focus on comprehensive interdisciplinary approaches to identifying effective treatments for the disease that, according to a far reaching report issued two years ago by the National Academy of Sciences' Institute of Medicine, affects more than one in three veterans of the 1991 Gulf War as well as other U.S. forces.  Without the requested increase in funding, these new and important efforts are unlikely to be able to proceed.

Other CDMRP programs fared differently.

Eight of the medical research programs were recommended for increases over FY12 funding, ranging from a three percent ($0.3 million) increase for lung cancer research, recommended for funding at $10.5 million, to a 56 percent ($5.4 million) for spinal cord research, recommended for funding at $15 million.  Other programs recommended for increased funding were:  tuberous sclerosis ($0.9 increase to $6 million); autism ($0.9 million increase to $6 million); ALS ($1.1 million increase to $7.5 million); multiple sclerosis ($1.2 million increase to $5 million); cancer ($2.2 million increase to $15 million); and ovarian cancer ($4 million increase to $20 million).

Nine medical research programs in the CDMRP portfolio, including the GWI program, were recommended for  the same level of funding as last year.  They are:  Bone Marrow Failure Disease ($3.2 million); Duchenne Muscular Dystrophy ($3.2 million); Global HIV/AIDS prevention ($8 million); Alzheimers ($12 million); Orthopedic research ($30 million); Joint Warfighter medical research ($50 million); prostate cancer ($80 million).

Faring worse among the CDMRPs were two programs recommended for funding decreases and three recommended for elimination.  A $10.5 million cut was recommended for the Peer-Reviewed Traumatic Brain Injury and Psychological Health Research program, along with an 11 percent cut recommended for the Alcohol and Substance Abuse Disorders Research Program.  Recommended for elimination were peer reviewed research programs for hemorrhage control, restorative transplantation, and a $50 million catch-all known as the Peer Reviewed Medical Research Program (PRMRP).

The Fiscal Year 2013 Defense Appropriations bill, which was adopted by the Committee on a voice vote, now awaits consideration by the full U.S. House of Representatives.  Amendments made from the floor by House Members are possible.

A parallel defense appropriations bill is expected in the Senate as early as this month.  A Senate "Dear Colleague" effort, led by Sen. Bernie Sanders (I-Vt.) garnered ten cosigners, all members of the Democratic majority.

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MORE INFORMATION

For text of the bill and report, please visit:

http://appropriations.house.gov/UploadedFiles/BILLS-112HR-FC-AP-FY13-Defense.pdf and

http://appropriations.house.gov/UploadedFiles/DEFENSE-FY13-FULLCOMMITTEEREPORT.pdf

For a summary of the legislation, please visit:

http://appropriations.house.gov/News/DocumentSingle.aspx?DocumentID=294116

Message from Rep. Dennis Kucinich, GWI CDMRP Funding Champion

Wed, May 16, 2012 2:40:50 PM

Message from Congressman Dennis Kucinich (D-Oh.), perennial champion of 

funding for the treatment focused Gulf War Illness Congressionally Directed Medical 

Research Program

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Dear Anthony, I would like to thank you for your support, and thank the tens of thousands of concerned Citizens for Kucinich who in the past few months have written, emailed and called to discuss my running for Congress in Washington State. At the end of this term I will have served sixteen years in the House of Representatives, leading the way for peace, to bring an end to the wars, for workers' rights, for health care for all, for monetary policy reform and to end the corrupting influence which money has on our political decision-making process. My staff and I have worked to deliver a level of constituent service to the people of Cleveland, which most agree is unmatched for results. As testimony to our efforts in the Cleveland area I received about 75% of the vote from my present constituents who were included in the newly redistricted area in which I ran in March. Because of my love of public service, I have given a great deal of time and much thought to the advice and encouragement I have received from so many people of good will in Washington State. I certainly want to continue to be of service to our country and to the working men and women who have built it. After careful consideration and discussions with Elizabeth and my closest friends, I have decided that, at this time, I can best serve from outside the Congress. My commitments to peace, to workers' rights and to social and economic justice are constant and are not dependent upon holding an office. They are dependent upon my continuing to stand up, to speak out, to organize, to motivate and to inspire our nation as to its deeper potential. This I promise I will do with great energy and heart. I will complete my service in the U.S. House on January 2, 2013, with the same passion and devotion to duty with which I began it on January 3, 1997. And when I do, I shall think of you and all those who have given me encouragement to continue to be of service, and I will smile, knowing that we shall meet again in our celebration of the potential of citizen activists to change the world. Please continue to encourage your friends and family to sign up at www.Kucinich.usbecause we will need to continue to work together for change outside Congress, as we have worked for it from within. This is just the beginning! Sincerely, Dennis PO Box 110475 | Cleveland | OH | 44111 | 216-252-9000

Options to Supplement Health Care Coverage for US Military Veterans

91outcomes.com Guest Post by Sara Mackey

(91outcomes.com) - There is a general and often erroneous assumption that acting military personnel and veterans receive health insurance and medical care from the government in a "no questions asked, whatever you need" fashion. The situation is actually much more complicated, and just as many veterans are searching for affordable supplemental health premiums online as any other class of insurance consumer.

The Basics of the TRICARE Program

All veterans and active duty military personnel can receive health insurance through the United States Department of Defense via the TRICARE program established in 1966. TRICARE is not actually an insurance agency, but rather a managed health care system using both the medical resources of the armed forces and medical networks outside the military structure.

The coverage is offered at three levels: prime, extra, and standard. In response to the passage of the 2010 Patient Protection and Affordable Care Act, there is also a Young Adult program, which extends coverage to children of qualified participants up to age 26, as per the requirements of the health care law.

Tiered TRICARE Structure Offers Varied Benefits

At the prime TRICARE level treatment occurs mainly at military facilities and is overseen by a primary care manager. The costs are the lowest in this model, but veterans must be enrolled and pay a fee to participate. TRICARE Extra does not involve a fee, but does carry an annual deductible.

Standard, the most flexible of the three options, operates on the fee-for-service model and allows policyholders to select from a range of authorized providers. There are no annual fees or enrollment requirement and TRICARE Standard can be used in tandem with TRICARE Extra and with other health insurance. Deductibles and co-payments do apply.

Veterans and Supplemental Insurance

Often veterans can draw on other sources of insurance, for instance, coverage that is available to them as a job benefit either from their own employment or that of their spouse. It's also a good idea for veterans to carry auto insurance policies that include medical benefits in the aftermath of an accident as it may be easier and faster to access those payments than it would be working through the TRICARE system.

In this regard, veterans do not really differ from any other kind of insurance consumer except that TRICARE provide a foundation on which they can create a comprehensive and affordable overall coverage umbrella. The goal is always to address potential gaps in coverage, especially if the vet has a disability as a consequence of service and will require lifetime care and therapy.

TRICARE has also protected veterans from the tendency of private insurers to exclude for pre-existing conditions by existing exclusively to care for men and women injured in the service of their country. Even if the Supreme Court strikes down the Affordable Care Act, veterans will continue to enjoy this safety net.

Every veteran faces a unique situation in regard to supplemental insurance with all manner of factors effecting the decision. For instance, if a veteran lives at a considerable distance from a military care facility, supplemental insurance might be necessary to cover care at a civilian facility until transfer could be arranged. These are the kinds of things that must be considered in conjunction with affordability and need when considering supplemental policies.