thedrifter
06-16-03, 06:08 AM
Intensified medical screening due for vets after Iraq war
By DALE EISMAN, The Virginian-Pilot
© June 14, 2003
WASHINGTON -- Frustrated by the continuing mystery of why thousands of veterans of the first Persian Gulf war came home sick, or became ill after they returned, the U.S. military is screening hundreds of thousands of its members for health concerns in the wake of Operation Iraqi Freedom.
A ``post-deployment health assessment'' already administered to every service member on a prolonged stay overseas, was revised and expanded just before this spring's conflict in Iraq. It asks questions about symptoms ranging from runny noses to chest pains, as well as possible battlefield exposure to chemical and biological agents.
In addition to completing the four-page questionnaire, each returning service member must supply a blood sample, which is stored permanently in a repository of more than 30 million such specimens near Baltimore. Every sample is tested for the AIDS virus, then filed away for comparison with samples the donor may provide in the future.
Though the new questionnaire was put in place with the Iraqi war in mind, soldiers, sailors, airmen and Marines deployed worldwide will have to complete it, officials said. Many sailors and Marines are getting the screening as they cruised home; others must visit a military health care provider and complete the questionnaire within 60 days of returning.
``This is one example of the military's concern about taking care of our deployers,'' said Navy Cmdr. Margaret Ryan, director of the Defense Department Center for Deployment Health Research in San Diego.
The screenings should help doctors spot immediate problems that some service members might otherwise shrug off, Ryan said. The findings, loaded into a computer database, should give doctors and researchers a detailed picture of the health of returning troops that could help them find common threads should a new round of war-related illnesses appear, she added.
Ryan said blood samples from any members who already appear ill or report symptoms will be given appropriate tests immediately. Preserved samples will allow researchers to compare blood taken from a service member who becomes ill in the future with blood that member provided just after the war.
Researchers studying illnesses from the first Gulf War have had to rely on less comprehensive information, often not gathered until months or years after deployment, when the service member involved first reported a problem.
In those cases, a doctor's notes made during a routine physical or office visit may be the only information available about the member's health during and just after the war.
Notes can be helpful in individual cases, but anyone who has tried to decipher a prescription form knows that ``trying to make sense of a doctor's notes is not a very good way to do research,'' observed Lt. Col. Charles Engel, a veteran of the first Gulf War and deployment health specialist at Walter Reed Army Medical Center, who helped develop the questionnaire.
Engel, a physician who also teaches at the Uniformed Services University of the Health Sciences, said he knows from his personal experience in the Gulf War that the battlefield is a complex and uniquely hazardous workplace.
And he acknowledged that the new survey asks a number of questions some service members may find discomfiting. One question, for example, asks whether the returning service member ever entertains thoughts that ``you would be better off dead or hurting yourself in some way?''
Other inquiries focus on whether the member came under direct fire or saw comrades or enemy troops killed in battle, and whether the member has had nightmares or ``felt numb or detached'' after being in the war zone.
Engel acknowledged that the ``wrong'' answers to such questions could cost a service member his or her career. Commanders are properly reluctant to go into battle with subordinates who may be paralyzed emotionally by previous experiences on the battlefield, he said.
But ``if we expect people to come to us (with health concerns) there has to be an element of confidence and we have to protect it in every way possible,'' Engel added. The military health care providers administering the questionnaire must make case-by-case judgments balancing their obligation to protect patient confidentiality against the need to protect other service members in future battles, he said.
He said it's too early to tell if significant numbers of those taking the new questionnaire will be less than fully forthcoming in answering tough questions. Similarly, it's too soon to say whether significant illnesses will show up among veterans of Operation Iraqi Freedom as they did among those who took part in Desert Storm.
Reach Dale Eisman at icemandc@msn.com or (703) 913-9872.
http://home.hamptonroads.com/stories/story.cfm?story=55503&ran=66916
Sempers,
Roger
:marine:
By DALE EISMAN, The Virginian-Pilot
© June 14, 2003
WASHINGTON -- Frustrated by the continuing mystery of why thousands of veterans of the first Persian Gulf war came home sick, or became ill after they returned, the U.S. military is screening hundreds of thousands of its members for health concerns in the wake of Operation Iraqi Freedom.
A ``post-deployment health assessment'' already administered to every service member on a prolonged stay overseas, was revised and expanded just before this spring's conflict in Iraq. It asks questions about symptoms ranging from runny noses to chest pains, as well as possible battlefield exposure to chemical and biological agents.
In addition to completing the four-page questionnaire, each returning service member must supply a blood sample, which is stored permanently in a repository of more than 30 million such specimens near Baltimore. Every sample is tested for the AIDS virus, then filed away for comparison with samples the donor may provide in the future.
Though the new questionnaire was put in place with the Iraqi war in mind, soldiers, sailors, airmen and Marines deployed worldwide will have to complete it, officials said. Many sailors and Marines are getting the screening as they cruised home; others must visit a military health care provider and complete the questionnaire within 60 days of returning.
``This is one example of the military's concern about taking care of our deployers,'' said Navy Cmdr. Margaret Ryan, director of the Defense Department Center for Deployment Health Research in San Diego.
The screenings should help doctors spot immediate problems that some service members might otherwise shrug off, Ryan said. The findings, loaded into a computer database, should give doctors and researchers a detailed picture of the health of returning troops that could help them find common threads should a new round of war-related illnesses appear, she added.
Ryan said blood samples from any members who already appear ill or report symptoms will be given appropriate tests immediately. Preserved samples will allow researchers to compare blood taken from a service member who becomes ill in the future with blood that member provided just after the war.
Researchers studying illnesses from the first Gulf War have had to rely on less comprehensive information, often not gathered until months or years after deployment, when the service member involved first reported a problem.
In those cases, a doctor's notes made during a routine physical or office visit may be the only information available about the member's health during and just after the war.
Notes can be helpful in individual cases, but anyone who has tried to decipher a prescription form knows that ``trying to make sense of a doctor's notes is not a very good way to do research,'' observed Lt. Col. Charles Engel, a veteran of the first Gulf War and deployment health specialist at Walter Reed Army Medical Center, who helped develop the questionnaire.
Engel, a physician who also teaches at the Uniformed Services University of the Health Sciences, said he knows from his personal experience in the Gulf War that the battlefield is a complex and uniquely hazardous workplace.
And he acknowledged that the new survey asks a number of questions some service members may find discomfiting. One question, for example, asks whether the returning service member ever entertains thoughts that ``you would be better off dead or hurting yourself in some way?''
Other inquiries focus on whether the member came under direct fire or saw comrades or enemy troops killed in battle, and whether the member has had nightmares or ``felt numb or detached'' after being in the war zone.
Engel acknowledged that the ``wrong'' answers to such questions could cost a service member his or her career. Commanders are properly reluctant to go into battle with subordinates who may be paralyzed emotionally by previous experiences on the battlefield, he said.
But ``if we expect people to come to us (with health concerns) there has to be an element of confidence and we have to protect it in every way possible,'' Engel added. The military health care providers administering the questionnaire must make case-by-case judgments balancing their obligation to protect patient confidentiality against the need to protect other service members in future battles, he said.
He said it's too early to tell if significant numbers of those taking the new questionnaire will be less than fully forthcoming in answering tough questions. Similarly, it's too soon to say whether significant illnesses will show up among veterans of Operation Iraqi Freedom as they did among those who took part in Desert Storm.
Reach Dale Eisman at icemandc@msn.com or (703) 913-9872.
http://home.hamptonroads.com/stories/story.cfm?story=55503&ran=66916
Sempers,
Roger
:marine: