thedrifter
09-05-05, 08:22 AM
The long, hard road to recovery
September 05,2005
CHRIS MAZZOLINI View stories by reporter
DAILY NEWS STAFF
While Marines and sailors from Camp Lejeune battle in the Iraqi sand, there's another battle going on back home - one that's just as important.
It's the battle to reclaim lives and limbs, as medical personnel at Camp Lejeune Naval Hospital fight to get those wounded in battle rehabilitated and back to their units.
In reality, it's a war the Naval Hospital is always fighting, said Capt. Richard C. Welton, the hospital's commanding officer. With II Marine Expeditionary Force taking over as the predominant force in Iraq in January, the numbers of casualties coming into the Lejeune hospital has remained relatively steady but not as high as feared.
"Before January, we were receiving probably in the neighborhood of 20 to 25 cases per month," Welton said. "Since January, we're getting in the neighborhood of 30 to 35 cases per month, which is considerably less than we thought we were going to be getting."
Welton said Camp Pendleton was receiving around 90 casualties per month during its large deployment.
"That's what we were anticipating, so we've been pleased to find there have been considerably fewer casualties back through the system and so forth then we had previously anticipated," he said.
More experience in the Iraqi theater and evolving combat tactics are some of the reasons Welton cited for the decrease.
"I think it's fair to say that probably the reason we are seeing fewer casualties is the armed forces have a better idea of how to wage the war," he said. "The urban tactics, training and lessons learned have certainly made a difference."
The casualties that are making the long trek home to Camp Lejeune are suffering primarily from muscular and skeletal problems, primarily arm and leg wounds, said Welton, who attributes it to improvements in protective gear.
A convoy of Marines hits a roadside bomb in Iraq. One is wounded, triggering a response system that will move an injured Marine from that bloody street back to Camp Lejeune.
The first responder is the Navy corpsman, whose job is to stabilize the wounded and prepare them to be evacuated on a medical helicopter. Every Marine squad that goes into the field has a corpsman attached to it who is equipped with emergency supplies such as quick clot, IV fluids and pain medications.
Once evacuated on a chopper, the key is to get the wounded into surgery as fast as possible.
"If you can get someone to stabilizing surgical intervention within 30 to 60 minutes, you can pretty much save anybody," Welton said. "So we talk about the golden hour."
The golden hour is becoming easier to reach with new battlefield medical technologies such as the Forward Resuscitation Surgical System, a mobile operating room that can perform about a dozen surgeries in a 24-hour period without resupplying.
The next step is to get them to an in-theater casualty receiving hospital. From there, they hop a flight to Landstuhl, Germany, where they receive any surgery needed before crossing the Atlantic. After landing at Andrews Air Force Base in Washington, D.C., the wounded Marine will go to the appropriate medical facility.
"It depends upon the injury and the extent of specialty medical care they are going to need and whether or not I have it here at the hospital," Welton said. "If I have what they need at the hospital, then they come directly from Andrews to here."
Back at Camp Lejeune, the patient is either admitted to the hospital or, like most, receives treatment as an outpatient until ready to rejoin their unit or return to civilian life.
'Unpredictable stress'
According to a Washington Post article published Aug. 10, there have been more than 13,800 Americans wounded in Iraq.
Research shows that warriors are surviving more injuries during this conflict than in any previous war. According to a New England Journal of Medicine study published in December, only 10 percent of Americans injured in combat have died from their wounds, compared with 24 percent in Vietnam and 30 percent in World War II.
But saving more lives means more wounded veterans must face the physical struggle to regain a normal life and the emotional void of being separated from their units.
At the hospital, it has Welton concerned about mental effects of living through combat.
"The one thing we are most concerned about at this point is the mental-health issues," he said. "We are seeing much more (Post-Traumatic Stress Disorder) than we have seen in the past. The whole spectrum of family and active-duty- member stress has significantly increased over the past six to eight months."
It's a type of war - with enemies that blend in with the civilian populous and are willing to blow themselves up - that could make troops more susceptible to stress disorders, Welton said.
"You don't know when your time is up," he said. "You're standing there talking with your buddy one minute, the next minute your buddy is gone. All of that kind of unpredictable stress, day-in and day-out, and the climate they're in certainly places people at increased risk for developing a stress reaction that may mount to the extent of a PTSD."
Health providers are noticing another frightening effect of the war.
"The other thing coming to light is with these explosions we're getting impact injury to the brain," Welton said. "It's blast injury that doesn't break bones or cause bleeding or brain damage, per se. We're recognizing cognitive deficits from impact and blast that we need to be paying more attention to."
These cognitive deficits are not necessarily being caused by physical brain trauma, Welton said.
"What we're seeing is a thinking result, a loss of thinking, a loss of reasoning or a loss of higher brain function from being involved in an impact or blast where there isn't really a bruise to the brain, but somehow or another it affects ones ability to think.
"That's something new, and I think it's new because we haven't seen it as much in the past. Now that we're seeing it, we're recognizing it's something we need to pay attention to."
On the other side, modern technologies and medical treatment are giving the wounded a better shot at living a normal life - and even returning to the battle.
Advances in surgical techniques have allowed doctors to return functionality to shattered limbs and the new wave of prosthetic limbs have allowed more to return to the front.
"It's kind of fun to hear them say, 'I put on my running prosthesis and ran three miles in 26 or 27 minutes,' which is pretty damned impressive for someone even without a prosthesis," Welton said. "That's motivating for us as health care workers. We get excited when we see our patients get excited that way."
Contact staff writer Chris Mazzolini at cmazzolini@freedomenc.com or at 353-1171, Ext. 229.
Ellie
September 05,2005
CHRIS MAZZOLINI View stories by reporter
DAILY NEWS STAFF
While Marines and sailors from Camp Lejeune battle in the Iraqi sand, there's another battle going on back home - one that's just as important.
It's the battle to reclaim lives and limbs, as medical personnel at Camp Lejeune Naval Hospital fight to get those wounded in battle rehabilitated and back to their units.
In reality, it's a war the Naval Hospital is always fighting, said Capt. Richard C. Welton, the hospital's commanding officer. With II Marine Expeditionary Force taking over as the predominant force in Iraq in January, the numbers of casualties coming into the Lejeune hospital has remained relatively steady but not as high as feared.
"Before January, we were receiving probably in the neighborhood of 20 to 25 cases per month," Welton said. "Since January, we're getting in the neighborhood of 30 to 35 cases per month, which is considerably less than we thought we were going to be getting."
Welton said Camp Pendleton was receiving around 90 casualties per month during its large deployment.
"That's what we were anticipating, so we've been pleased to find there have been considerably fewer casualties back through the system and so forth then we had previously anticipated," he said.
More experience in the Iraqi theater and evolving combat tactics are some of the reasons Welton cited for the decrease.
"I think it's fair to say that probably the reason we are seeing fewer casualties is the armed forces have a better idea of how to wage the war," he said. "The urban tactics, training and lessons learned have certainly made a difference."
The casualties that are making the long trek home to Camp Lejeune are suffering primarily from muscular and skeletal problems, primarily arm and leg wounds, said Welton, who attributes it to improvements in protective gear.
A convoy of Marines hits a roadside bomb in Iraq. One is wounded, triggering a response system that will move an injured Marine from that bloody street back to Camp Lejeune.
The first responder is the Navy corpsman, whose job is to stabilize the wounded and prepare them to be evacuated on a medical helicopter. Every Marine squad that goes into the field has a corpsman attached to it who is equipped with emergency supplies such as quick clot, IV fluids and pain medications.
Once evacuated on a chopper, the key is to get the wounded into surgery as fast as possible.
"If you can get someone to stabilizing surgical intervention within 30 to 60 minutes, you can pretty much save anybody," Welton said. "So we talk about the golden hour."
The golden hour is becoming easier to reach with new battlefield medical technologies such as the Forward Resuscitation Surgical System, a mobile operating room that can perform about a dozen surgeries in a 24-hour period without resupplying.
The next step is to get them to an in-theater casualty receiving hospital. From there, they hop a flight to Landstuhl, Germany, where they receive any surgery needed before crossing the Atlantic. After landing at Andrews Air Force Base in Washington, D.C., the wounded Marine will go to the appropriate medical facility.
"It depends upon the injury and the extent of specialty medical care they are going to need and whether or not I have it here at the hospital," Welton said. "If I have what they need at the hospital, then they come directly from Andrews to here."
Back at Camp Lejeune, the patient is either admitted to the hospital or, like most, receives treatment as an outpatient until ready to rejoin their unit or return to civilian life.
'Unpredictable stress'
According to a Washington Post article published Aug. 10, there have been more than 13,800 Americans wounded in Iraq.
Research shows that warriors are surviving more injuries during this conflict than in any previous war. According to a New England Journal of Medicine study published in December, only 10 percent of Americans injured in combat have died from their wounds, compared with 24 percent in Vietnam and 30 percent in World War II.
But saving more lives means more wounded veterans must face the physical struggle to regain a normal life and the emotional void of being separated from their units.
At the hospital, it has Welton concerned about mental effects of living through combat.
"The one thing we are most concerned about at this point is the mental-health issues," he said. "We are seeing much more (Post-Traumatic Stress Disorder) than we have seen in the past. The whole spectrum of family and active-duty- member stress has significantly increased over the past six to eight months."
It's a type of war - with enemies that blend in with the civilian populous and are willing to blow themselves up - that could make troops more susceptible to stress disorders, Welton said.
"You don't know when your time is up," he said. "You're standing there talking with your buddy one minute, the next minute your buddy is gone. All of that kind of unpredictable stress, day-in and day-out, and the climate they're in certainly places people at increased risk for developing a stress reaction that may mount to the extent of a PTSD."
Health providers are noticing another frightening effect of the war.
"The other thing coming to light is with these explosions we're getting impact injury to the brain," Welton said. "It's blast injury that doesn't break bones or cause bleeding or brain damage, per se. We're recognizing cognitive deficits from impact and blast that we need to be paying more attention to."
These cognitive deficits are not necessarily being caused by physical brain trauma, Welton said.
"What we're seeing is a thinking result, a loss of thinking, a loss of reasoning or a loss of higher brain function from being involved in an impact or blast where there isn't really a bruise to the brain, but somehow or another it affects ones ability to think.
"That's something new, and I think it's new because we haven't seen it as much in the past. Now that we're seeing it, we're recognizing it's something we need to pay attention to."
On the other side, modern technologies and medical treatment are giving the wounded a better shot at living a normal life - and even returning to the battle.
Advances in surgical techniques have allowed doctors to return functionality to shattered limbs and the new wave of prosthetic limbs have allowed more to return to the front.
"It's kind of fun to hear them say, 'I put on my running prosthesis and ran three miles in 26 or 27 minutes,' which is pretty damned impressive for someone even without a prosthesis," Welton said. "That's motivating for us as health care workers. We get excited when we see our patients get excited that way."
Contact staff writer Chris Mazzolini at cmazzolini@freedomenc.com or at 353-1171, Ext. 229.
Ellie