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July 22
UMANA conference 2017: “Help Ukrainians help themselves”

​Article originally by The Ukranian Weekly

CHICAGO – The Ukrainian Medical Association of North America (UMANA) held its 44th Scientific Conference and 37th Assembly of Delegates on Wednesday through Saturday, June 14-18, at the Key Bridge Marriott Hotel in Arlington, Va. The theme of the biennial convention was “Rehabilitation and Reintegration – Helping Ukrainians Help Themselves.”

The conference was dedicated to familiarizing participants with Ukraine’s health care challenges in the face of ongoing war, economic instability and political reform. This is a time of great anxiety but also one of great promise and opportunity. Continuing hostilities in eastern Ukraine are inflicting debilitating military and civilian casualties, raising the demand for rehabilitation medicine. Survivors are in need of services to reintegrate them back into society as useful and productive citizens.

Bringing individual injured soldiers to Western medical institutions for therapy is an emotional, expensive and labor-intensive undertaking. Only a tiny group of the most severely injured can be treated in institutions like the Walter Reed Army Medical Center. All experts agree that rehabilitative therapy works best when applied sooner and closer to the areas of need, closer to patients’ families and closer to avenues of long-term support. As a Ukrainian medical society, UMANA is closely tied to colleagues in Ukraine as we seek to understand the nature and scope of the problems they face so that we can offer appropriate assistance, while also learning from their now extensive experience in caring for traumatized populations.

This year’s UMANA conference was unique in many ways.

To ensure wide participation, non-profit foundations responded with generous grant support. Donors included the Ukrainian Catholic Education Foundation (UCEF), Kyiv Mohyla Foundation of America (KMFA), the Heritage Foundation 1st Security Savings Bank, Selfreliance Foundation, UMANA Foundation and Yuri Deychakiwsky, M.D.

Next, the conference was honored to welcome two distinguished guests from Ukraine, acting Minister of Health Ulana Suprun, M.D., and Vadim Sviridenko, commissioner of the president of Ukraine for rehabilitation of ATO (Anti-terrorist Operation) wounded veterans.

Furthermore, the gathering was truly international in scope, encompassing speakers from the United States, Canada and Ukraine. For three days, a distinguished faculty of nearly 20 presenters experienced in rehabilitation and occupational medicine informed an audience of over 70 confreres on war trauma medicine, physical medicine and rehabilitation, post-traumatic stress disorder, effects of limb loss on young lives and their reintegration into their new realities.

Fields represented included physical medicine and rehabilitation (physiatry), neurosurgery, orthopedic trauma surgery, interventional radiology, public health/epidemiology, optometry, psychiatry, psychology, medical anthropology, physical therapy and occupational therapy. Listeners also heard from specialists in humanitarian relief work and researchers in population response to trauma and displacement.

Prior to the opening of the conference, Dr. Deychakiwsky and Andriy Ripecky, M.D., accompanied the visitors from Ukraine to Walter Reed Army Hospital, including the National Intrepid Center of Excellence where new therapies offer “Hope, Healing, Discovery and Learning for Traumatic Brain Injury and Psychological Health.”

The conference began with a welcome reception on Wednesday evening atop the Key Bridge Marriott with a direct view of the Embassy of Ukraine at the opposite end of the bridge.

The conference was opened formally on Thursday morning, with greetings from the president of UMANA, Borys Buniak, M.D., and the course director, Dr. Ripecky.

Befitting the opening of a conference of international scope, the first presenter, Luke Tomycz, M.D., a Ukrainian neurosurgeon from Texas, spoke to the assembly directly from Ukraine via Skype, where he is helping to train young neurosurgeons. The transmission was flawless, and set the tone for the remainder of the conference.

The day included lectures by Chrystyna Rakoczy, O.D., on visual dysfunction in traumatic brain injury, Col. (Ret.) Paul Pasquina, M.D., on rehabilitation of the blast-injured patient, Ukrainian presenter Orest Suvalo, M.D., on the state of mental health care in Ukraine, and Namrita Singh, Ph.D., on global mental health approaches to promoting community recovery and reintegration after conflict, highlighting a randomized controlled trial of a psychotherapy intervention in Ukraine.

On Thursday evening the conference attendees attended a reception graciously hosted by Valeriy Chaly, ambassador of Ukraine to the U.S.A. After crossing the Francis Scott Key Bridge to reach the sovereign territory of Ukraine at the Embassy, confreres were greeted by Ambassador Chaly, Ukrainian Parliament chair Andriy Parubiy, and Dr. Suprun. After the welcome, guests were hosted to a delicious sampling of Ukrainian culinary creations prepared on-site, leading to extended social discussion and networking among Embassy staff, guests and conference attendees.

Friday morning sessions included presentations by Seth Messinger, Ph.D., on the long-term effects of rehabilitative care on social reintegration and life in the community, and two presenters from Ukraine, Viktoria Gorbunova, Ph.D., on the state of clinical psychology in Ukraine and Vitaly Klymchuk, Ph.D., on the Institute of Mental Health at the Ukrainian Catholic University. After lunch, Maj. (Ret.) Stuart Campbell, M.P.T., spoke on EACE global health engagement; Daniel Hryhorczuk, M.D., M.P.H., explored health, work and environment in conflict zones; Natalie Zaraska, B.Sc. (OT) M.Sc. (Rehab), discussed bringing occupational therapy skills to Ukraine; and Steven Yevich, M.D., presented practical interventional radiological solutions to sequelae of traumatic injuries.

After a busy and full day of educational endeavors, confreres were able to spend a quiet evening at the traditional UMANA reunion dinner. Mr. Sviridenko spoke movingly of his personal struggle to recover from grievous injuries suffered in battle at Debaltsevo in the winter and of his work now in leading Ukraine’s efforts to develop a system of care for injured veterans of the ATO.

While enjoying a wonderful dinner, members were able to revive old friendships, discuss the past two days of lectures, and network among young and senior members of the association. The group broke out in spontaneous sessions of Ukrainian songs, and had to be gently urged to leave late in the evening to make room for the next day set-up crew.

Saturday, the final day of scientific sessions, began with George Jaskiw, M.D., reviewing post-traumatic stress disorder, from neurobiology to rehabilitation; followed by Oksana Buniak, P.T., D.P.T., LSVT, on assisting a change in the regulation of physical therapy practice in Ukraine; Vassyl Lonchyna, M.D., on the ripple effect on rehabilitation medicine in Ukraine; and Roman Hayda, M.D., discussing the complex extremity war injury and the lessons shared in the care of US combatants; and concluding with an overview by Laryssa Kyj, Ph.D., of projects supporting health care in Ukraine as executed by the non-profit United Ukrainian American Relief Committee.

Saturday afternoon was dedicated to a bus tour of “Ukrainian” Washington, with stops at the usual landmarks, including the Taras Shevchenko statue and the recently installed Holodomor Memorial.

The conference concluded on Saturday evening with the keynote address and awards banquet. Dr. Suprun spoke with great passion of her commitment to fundamentally transform Ukraine’s health care system, focusing on all aspects, including training, clinical care, research and financing.

Dr. Suprun received a recognition award for her exemplary work in helping Ukraine’s evolving health system, and Dr. Buniak was awarded recognition for his two years of service to UMANA as the president of the association.

During the cocktail hour preceding the awards banquet, numerous U.S.-based humanitarian organizations that target health care in Ukraine were able to showcase their projects for all attendees. Participating were: United Ukrainian American Relief Committee (uuarc.org; 215-728-1630); United Help Ukraine (unitedhelpukraine.org); Revived Soldiers Ukraine (rsukraine.org); Razom, sponsor of the Co-Pilot Project, focusing on neurosurgery practice in Ukraine (razomforukraine.org);  Kyiv-Mohyla Foundation, supporting Kyiv-Mohyla University and its rehabilitation program (kmfoundation.org); Ukrainian Catholic Educational Foundation, supporting the rehabilitation and mental health program at the Ukrainian Catholic University (ucef.org); Fulbright Program in Ukraine; Andrey Sheptytsky Hospital Charities; UMANA Foundation and World Federation of Ukrainian Medical Associations.

All these groups and organizations welcome the active, hands on participation of volunteers and donations. (UMANA advises that groups not listed above are invited to let the association know of their activity so their work also can be highlighted.)

The 37th Assembly of Delegates was held concurrently on Saturday afternoon, conducting the biennial business meeting of UMANA. The association’s financial affairs and budget were reviewed and confirmed, and reports of all committees were presented. Elections of new officers for the upcoming two years were held with the following results: Dr. Ripecky, president; Dr. Leo Wolansky, vice-president; Dr. Peter Lenchur, president-elect; Dr. Buniak, immediate past-president; Ms. Lida Wozny, secretary; Dr. Liza Pilch, treasurer; and Dr. Andrew Dzul, chapter representative.

Despite the range of disciplines and topics, several points and themes emerged across speakers’ presentations during the UMANA conference.

•  While the problems faced are numerous, all conveyed a notable sense of optimism for the future.

•  Assistance is very much valued and appreciated when offered as a collegial, collaborative effort.

•  Training across many disciplines is needed and welcomed.

•  Collaboration among disciplines was repeatedly emphasized as key by presenters, whether speaking of neurosurgery or psychotherapy.

•  Technology is good but less vital than the systematic application of effective but less costly and more available treatments or devices, such as simple, well-designed and locally produced prostheses.

•  For psychological trauma affecting large numbers of people, treatment by trained, low-level providers such as counselors or bachelor’s level staff has shown great promise.

•  In dealing with disability, resetting expectations across society will be vital. Whether referring to physical or psychological disability, an emphasis on recovery and restoration of function will need to be introduced to elevate Ukraine’s health care practice to world standards.

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Original article can be found here.

July 17
Capitol Police Officer Paints to Heal

Article originally by Roll Call​

Sitting in his garage just a few miles from the Capitol, where his job is to protect the building and those in it, Federico A. Ruiz is surrounded by splatters, brushes stiff with dried paint, and the rattling of a fan mounted on the wall.

The Capitol Police officer is an artist when he comes home and his garage is his studio. Painting is a way for him to cope with his memories from the Pentagon on Sept. 11, 2001.

“We were kind of like the first soldiers in a long sprint of peacetime, if you want to say that, that ended up going in and seeing Americans and soldiers dead. Deceased on U.S. soil,” Ruiz, 43, said.

In 2001, he was a team leader for a search and rescue team based at Fort Belvoir, Virginia. He had been in the Army for five years.

On 9/11, his pager went off, “and I knew the number that I needed to call so I called it and it was my boss [who] said, ‘A plane just crashed into one of the towers in New York and we don’t know what’s going on. Can you get your team ready?’” Ruiz recalled. “Before I got to the floor that I needed to, I had the second pager go off and they said another plane had hit the other tower and to scramble the team to get on the tarmac.”

He led them into two Blackhawk helicopters and they traveled up the Potomac River toward Washington. By that time, another airliner had crashed into the Pentagon, and a fourth hijacked plane was still out there, feared to be headed toward the White House or the Capitol. Ruiz’s team landed in Fort McNair in a holding pattern.

“We still didn’t know what was going on,” he said. “We knew something was going on, but we didn’t know it was a mass terrorist strike on U.S. soil.”

After the fourth airliner crashed into a field in Pennsylvania, Ruiz’s team was told to head to the Pentagon.

“I think it’s probably a couple hours after the plane had blown up that we were allowed to go in and at that point, unfortunately, we were going in hoping to rescue people, but we kind of knew that it was more of a, you know …” he hesitated, “… a mission to just search for survivors and prevent the building from collapsing.”​

“A lot of people forget that people that were in the Pentagon were military and civilian and they were killed by a foreign entity for the first time in a long time on American soil,” Ruiz said. “So, dealing with that was hard for a lot of people.

“It was hard for me,” he said.

The military encouraged first responders to go to group sessions to deal with the trauma and to seek whatever other kind of help they needed.

Ruiz had painted as a child. “I looked into therapy on my own and saw that there was a technique of art therapy out there,” he said.

He started to paint frequently at home to learn to relax. 

In this, he was not alone. Painting, sculpting, crafting and other arts have been used to treat veterans since the 1940s, said Melissa Walker, an art therapist at Walter Reed’s National Intrepid Center of Excellence.

She said service members who have sustained physical and psychological trauma to the brain have difficulty verbalizing what has occurred because of a shutdown in the speech-language area of the brain.

“Traditional talk therapy, on its own, may not be as effective without a therapist-led practice that is visual, sensory, and tactile, resulting in a product (the artwork) which the service member can then describe and process through, reintegrating the hemispheres of the brain,” she said in an email.

At first, Ruiz’s paintings reflected the emotions he was feeling.

“I don’t have any of the paintings because I … destroyed all those paintings,” he said. “It’s not the stuff that I wanted to do because it had to do a lot with just the ugliness. War.”

A 'visual voice'

Walker said painting negative emotions is common.

“Many service members share they feel the art therapy gives them an opportunity to visually express what they often verbally cannot — it provides them with a ‘visual voice,’” she said.

Ruiz recalled some of his artworks including one crafted out of real gas masks, and a painting of the atomic bombings of Hiroshima and Nagasaki.

“It looked more like somebody’s nightmare than anything,” he said. “It got some emotions out, but it’s not what I wanted to paint so I started exploring different types of styles of painting and digging into who I am and what made me happy.”

Ruiz’s parents are from the Dominican Republic and they sent him there frequently as a child to learn about the culture.​

Finding happiness

Those memories were the inspiration behind his art show
"Land, Sea & Sky: A Minimalist’s Caribbean,” hanging through July in Glen Echo Park, Maryland.

“Some of my happiest moments were being on the shoulders of my uncle and he would take me as a toddler into the beaches and I still have these vivid memories of the beaches, these beautiful beaches of the Dominican Republican, just strolling. How happy it made me,” he said.

“The landscapes, the minimalist landscapes, are what make me the happiest,” he said.

He added, “If people enjoy it, then great. But I don’t rely on my paintings to make a living, so I’m blessed that way. I can paint whatever I want and if you don’t like it, I’m sorry,” he said, laughing. “It’s what makes me happy.”

He paints after taking off his Capitol Police uniform, which he has worn for 15 years after leaving the Army after serving for seven years.

“Best job I ever had. I’m very happy to be a Capitol Police officer and it was a great transition from being in the military,” he said. “I still paint to keep my happiness and relaxation after work because you need that.”​

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Original article can be found here.

July 06
Kobelja Takes the Helm of WRNMMC

Article originally by The Journal​


Navy Capt. (Dr.) Mark A. Kobelja assumed authority of Walter Reed National Military Medical Center during a ceremony June 30 in WRNMMC’s Memorial Auditorium.

Kobelja replaces Army Col. Michael S. Heimall, who retired from the military after more than 30 years of service, serving the last 13 months as the WRNMMC director.

Navy Rear Adm. (Dr.) David A. Lane, director of the National Capital Region Medical Directorate, officiated the change of authority ceremony, stating, “This is truly an important event in the life cycle of Walter Reed National Military Medical Center, one of the most storied and recognizable institutions in the U. S. military and in American medicine.

“If you say, ‘Walter Reed National Military Medical Center,’ [people] naturally think of the greatness of military medicine,” Lane said. He added WRNMMC is where “America’s heroes, wounded warriors, come to heal.” WRNMMC offers “unquestionably world leading comprehensive ballistic rehabilitative care” [within its Military Advanced Training Center], diagnosis and treatment of traumatic brain injury [in the National Intrepid Center of Excellence], the only Department of Defense medical center with an enhanced bio-containment unit and special pathogen lab for viruses like Ebola and other infectious diseases, the only DOD medical center performing solid organ transplants, and the John P. Murtha Cancer Center [the only designated cancer center of excellence in DOD], which is also spearheading the White House’s Cancer Moonshot military efforts.

“[In addition], nearly 40 percent of DOD’s graduate health education and over a third of its clinical research gets done [at WRNMMC],” Lane added.

“It takes a special breed of leader to lead an iconic organization like Walter Reed National Military Medical Center, [and] Col. Michael Heimall has been just that kind of special leader,” Lane continued. “This is essentially his fifth command tour,” the admiral added, explaining Heimall has commanded an Army dental activity, medical activity, Army hospital, Army medical center and WRNMMC.

Lane said while Heimall “will be greatly missed and is leaving big shoes to fill,” Kobelja “is the right leader to fill those shoes.” He added Kobelja is among that “special breed of leader” poised “to direct America’s medical center [WRNMMC]. I have complete trust and confidence that he’ll pick up right where Colonel Heimall left off.”

Kobelja is no stranger to WRNMMC or the Naval Support Activity Bethesda campus. He completed his medical degree at the University Services University on NSAB, as well as clinical training in anesthesiology at the former National Naval Medical Center and pain medicine training at the former Walter Reed Army Medical Center, predecessors of WRNMMC. He also served on the NNMC staff as an anesthesiologist, as well as department head of Anesthesiology and Pain Medicine, and chair of the Executive Committee of the Medical Staff and director for Surgical Services, overseeing the integration and transition of surgical staffs of WRAMC and NNMC into WRNMMC. His other previous assignments included deputy commander of the Naval Medical Center San Diego, and commanding officer of Naval Hospital Camp Pendleton, Marine Corps Base Camp Pendleton, California. Prior to coming to WRNMMC as director, Kobelja served as Fleet Surgeon for U.S. Naval Forces Europe/Africa and U.S. Sixth Fleet.

At the change of authority, Kobelja saluted “the unwavering service” of Heimall and the Heimall family. “Congratulations on a distinguished career. Well done. You have built a brilliant leadership team and your work with our external partners has set the stage for generations of success.”

The new WRNMMC director said to the medical center staff, “It’s an honor to work with you again in this noble endeavor. This facility is the descendant of two great institutions, and you have been faithful to the legacies of selfless service, excellence, and compassionate care to our nation’s heroes and their families, [and] champions of expert research and education that has transformed medical and surgical care throughout the world, all while many of you have gone into harm’s way alongside our brothers and sisters in arms. You are leading the way for a grateful nation. Our patients and their families need us, and we have the watch.”

Guest speaker for Heimall’s retirement, Dr. Richard W. Thomas, USU president, also commended the service of the Heimall family, stating the colonel “is another link in a family that has dedicated themselves to service to our nation and their communities….Over 30 years of service, [Heimall] has dedicated himself to ensuring our service members and their families are taken care of every day and receive world-class care.”

Heimall explained one of the things that has made his career rewarding are his “teammates — battle buddies, shipmates and wingmen, pulling each other along, pushing to reach a goal that at times you feel there is just no way you’re ever going to get to, but you do.

“The Army and Navy have blessed me with incredible teams to help me do my mission,” Heimall added. He called WRNMMC “a very, very special place with a great mission – the opportunity to care for America’s most severely injured service members and their families.”

The colonel said the men and women who serve in uniform, along with their families, “have written a blank check to the United States of America with their lives. When they go into harm’s way, they deserve to know that there is a health-care system behind them that is going to spare no expense or sacrifice to bring them home safe and return them to their families as productive Americans.

“Our patients and our staff are really the best America has to offer. They deserve the absolute best medical system we can give them. We need to stop talking about protecting our service-specific equities, resources and control. We need to spend our time talking about how we are going to best care for America’s sons and daughters,” Heimall added.

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Original article can be found here.

May 12
New center at CU Anschutz could create national model for veterans’ care

Article originally by The Denver Post​


AURORA — A new treatment center at the University of Colorado’s Anschutz Medical Campus announced Friday will provide a national model of how to care for the psychological and physical damage of war, campus officials and veterans advocates said.

The facility, which could begin offering some services as early as this summer, will provide a place for veterans to receive comprehensive treatment in one place — whether they need treatment for a traumatic brain injury, counseling for post-traumatic stress, physical therapy or other care. The center plans also to offer alternative therapies such as acupuncture and yoga, and its location on the Anschutz Medical Campus means that more complicated treatment — such as for prosthetics — is all within a few blocks.

That kind of centralized, big-picture care is critical for veterans, who often bounce between doctors and have to try to navigate the medical system on their own, said Pete Scobell, a retired Navy SEAL who served six combat deployments to Iraq, Afghanistan and other countries and suffered from post-deployment stress and brain injury as a result.

“What I learned is that our current health care system is not set up to solve problems,” Scobell said Friday at the center’s unveiling. “It’s set up to treat symptoms.”

“This,” he said referring to the new center, “is not the short game. This is the long game.”

The center will be called the Marcus Institute for Brain Health. It is being paid for by a $38 million gift from Bernard Marcus, a co-founder of The Home Depot who devotes much of his philanthropic efforts to helping veterans. On Friday, he called the current level of care for veterans, “the shame of the country.”

The institute will be housed, at least to start, in the Anschutz Campus’ Health and Wellness Center. Marcus said he hopes the CU institute will be the first of many private-sector facilities across the country to provide veterans with whole-person care in a single place.

“That’s the goal, and that’s what we’re starting with today,” he said. “This is only the first step.”

That first step, though, has been years in the making — and builds on progress the military has made in caring for active-duty service members.

In 2011, a suicide bomber’s blast just 10 feet away tossed Army Staff Sgt. Spencer Milo off his feet and into the group of more than 600,000 service members and veterans suffering from what Milo, who also suffered head injuries in Iraq, calls the “invisible wounds” of war: traumatic brain injury, post-traumatic stress and depression.

When Milo returned from his deployment in Afghanistan, though, there was new hope for treatment in the form of a freshly opened comprehensive treatment center at the Walter Reed National Military Medical Center. At the hospital’s National Intrepid Center of Excellence, service members had their needs addressed individually, at the same time and in the same place.

“The program at NICoE truly saved my life,” Milo said in an interview this week. “Saved my life, saved my marriage, everything.”

Currently, though, that kind of care is not available to veterans. The Veterans Affairs hospitals across the country are able to provide care to honorably discharged veterans, and the Marcus Institute hopes to work with the local veterans hospital to connect veterans to specialty care at the center.

But veterans who were dishonorably or other-than honorobly discharged are not eligible for benefits — even if the circumstances of their discharge were related to their post-traumatic stress or brain injury. It’s those veterans who Milo, now working as an outreach specialist at the Marcus Institute, hopes to focus on at first.

He will be joined in the work by a familiar face, Dr. Jim Kelly, who was the founding director of NICoE and ran it while Milo was a patient there. Kelly, a longtime CU professor, helped conceive the idea for the Marcus Institute and will serve as its executive director.

“This is the one that I think is really going to tip the scales,” he said.

The institute will run on Marcus’ donation for the first five years, and Kelly said he hopes to work with retired athletes or veterans organizations after that to keep it going and possibly expand its reach. The institute will accept payment from insurance when it’s available, but Kelly said veterans receiving services at the center won’t have to pay anything.

Milo hopes what they receive at the institute will be invaluable.

“Basically,” he said, “when they leave, they’re going to see a path forward.”​

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Original article can be found here.

May 11
Afghan veteran ‘didn’t think I was capable of graduating. Period.”

​Article originally by SunHerald

BILOXI - Melissa Estes signed up for college courses in the spring of 2016, not to graduate but just to see if she could do the work.

She had been through so much since 2012, when she was deployed with the Seabees in Afghanistan. A roadside bomb wounded her while she was in a convoy. She wound up in a hospital in Germany and was later shipped back to the States.

She suffered from frequent migraines and slurred speech. Her personality and interests changed. The woman who had loved creative outlets, such as painting and writing, no longer existed. Doctors treated her symptoms but never got to the root of her problems. She walked around in a fog of pain medication.

This same woman, clear-headed today, graduated Thursday night from Mississippi Gulf Coast Community College with an associate degree in criminal justice. Estes was one of about 1,100 graduates who participated, including at least one service member whose service dog joined him for the processional.

Estes has plans and goals.

What made the difference for her were a few people who stopped long enough to care — a new corpsman in her Seabee battalion, a psychiatrist and the professors at the Jefferson Davis campus of MGCCC who have taken an interest in seeing her succeed.

“I have that sense of purpose again,” said Estes, who is 38 years old. “It’s unfortunate that not a lot of people I was on deployment with could find that, the people that are lost. It’s a sad state of affairs.”

She can count eight military friends who have committed suicide since returning from Iraq or Afghanistan.

“They all have served on a combat deployment,” she said. “In my personal opinion, I think that’s a high number for a small area.”

Estes hopes to help veterans one day, as she has been helped. She is transferring from MGCCC to the University of Southern Mississippi Gulf Coast, where she plans to earn a psychology degree and eventually work with veterans who suffer from PTSD and traumatic brain injuries.

She was finally diagnosed with TBI when a new psychiatrist got her into the National Intrepid Center of Excellence at Walter Reed National Military Medical Center in Bethesda, Maryland, in summer 2014. They found three lesions in the front of her brain.

The four-week program at NICoE teaches injured veterans they are not the same person and helps them accept who they are now, she said.

The Seabees medically retired her in April 2015. She was unable to find even a part-time job. She said she wanted to do better for herself and her son.

As it happened, MGCCC’s Jeff Davis campus was just the place she needed.

“Everything I’ve done there at the JD campus,” she said, “is a direct reflection on the amazing professors I’ve had.”

One of those professors was James Farmer, who taught her Biology II and Microbiology. He had returned to school much later in life than Estes did — at age 49. He earned a Master of Science in environmental toxicology at age 51 and his doctorate in biological sciences, with an emphasis in microbiology, when he was 59 years old.

“I think me pointing that out to her gave her a lot of encouragement that she could move on to something better in her life,” he said. “Overcoming her injuries and being a little older wasn’t the worst thing in the world.”

Estes’ mother and stepfather, who live in Maryland, attended her graduation, as did her son, 8-year-old Hunter Wymore.

“I really didn’t think that I would be graduating with honors,” she said. “ I didn’t think I was capable of graduating, period.”​


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Original article can be found here.

May 11
Intrepid Fallen Heroes Fund Breaks Ground on New Intrepid Spirit Center at Camp Pendleton, CA that will Treat US Service Members Who Suffer from TBI

Article originally by benzinga


Intrepid Fallen Heroes Fund to Provide $12.5 Million to Build the New Facility

Camp Pendleton, CA (PRWEB) May 11, 2017

The Intrepid Fallen Heroes Fund (IFHF), representatives from Camp Pendleton, and the Naval Hospital at Camp Pendleton today broke ground on a new Intrepid Spirit center that will diagnose and treat Traumatic Brain Injury (TBI) and psychological health conditions in service members at Camp Pendleton, California. The facility will be the seventh in a series of nine centers located at military bases around the country built by the IFHF, a not-for-profit organization and national leader supporting the men and women of the United States Armed Forces and their families. Intrepid Spirit centers currently are operational at Fort Belvoir, Virginia, Camp Lejeune, North Carolina, Fort Campbell, Kentucky, Fort Hood, TX, and Fort Bragg, NC, and another currently is being constructed at Joint Base Lewis-McChord, WA.

Camp Pendleton's new Intrepid Spirit center will cost approximately $12.5 million to construct and equip with the latest in brain technology and treatment facilities and will span 25,000 square feet. Funding for the project is being raised privately through the IFHF.

"When our brave men and women in uniform who put their lives on the line for us each day are injured while protecting us and our freedoms, it is our duty as Americans to ensure they receive the very best care available," said Arnold Fisher, Honorary Chairman of the Intrepid Fallen Heroes Fund. "Treatment of TBI and psychological health conditions is much more effective when patients can be treated closer to home where they can be surrounded by family and friends. We are proud to break ground our next Intrepid Spirit center at Camp Pendleton, our second on the West Coast, so thousands of service members can receive the care they deserve without having to travel across the country to get it."

As home to the I Marine Expeditionary Force, composed of the 1st Marine Division, 3rd Marine Aircraft Wing, 1st Marine Logistics Group, 11th, 13th, and 15th Marine Expeditionary Units and the MEF Headquarters Group, Camp Pendleton supports more than 42,000 active duty personnel, 23,500 reserve personnel who work and train at Camp Pendleton each year, as well as more than 77,000 retired military personnel who reside within 50 miles of the base.

"We are humbled and grateful to accept this donation to the American People from the Intrepid Fallen Heroes Fund," said Commander Paul Sargent the new center's Medical Director. "Most patients who suffer head injuries improve on their own, however, for those with persistent symptoms, numerous studies show the benefit of an interdisciplinary approach to care. This cutting-edge facility will house 2 full interdisciplinary teams focused on the recovery and rehabilitation of service members with a history of brain injury as well as its physical and psychological consequences."

All Intrepid Spirit centers are being funded and built by the IFHF through a $100 million fundraising campaign. Though the centers are being built exclusively through private donations, each center is gifted to the Department of Defense for operation and management upon completion. All of the centers are located at military bases around the country.

The design and mission of the Intrepid Spirit centers are based on the original National Intrepid Center of Excellence (NICoE) which opened in 2010 at the Walter Reed National Military Medical Center in Bethesda, MD. Operated by the Department of Defense, NICoE is the most advanced facility of its kind in the country, and is the center of the Armed Forces' efforts in researching, diagnosing and treating TBI, psychological health conditions and related injuries sustained by military personnel.

About the Intrepid Fallen Heroes Fund

The Intrepid Fallen Heroes Fund, a national leader in supporting the men and women of the United States Armed Forces and their families, has provided close to $200 million in support for the families of military personnel lost in service to our nation, and for severely wounded military personnel and veterans. In 2010 the Fund opened the National Intrepid Center of Excellence (NICoE) to support the research, diagnosis, and treatment of military personnel and veterans suffering from traumatic brain injury (TBI) and psychological health (PH) conditions. In 2013 the Fund launched a new $100 million campaign to build nine "Intrepid Spirit" centers at major military bases around the country. These centers serve as satellites to the central NICoE facility and extend that care to more service members suffering TBI, PH conditions and related afflictions. Five centers are operational and two others are under construction.

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Original article can be found here.

April 20
WRNMMC, VCE Staffs Discuss Care, Rehab With Blind Veterans

Article originally by The Journal


Walter Reed National Military Medical Center and Vision Center of Excellence staff briefed members of the Blind Veterans Association and Blind Veterans UK about care and rehabilitation capabilities at the nation’s flagship health care facility April 5.

The briefings at Walter Reed Bethesda were part of a week-long visit to the National Capital Region by the BVA and BVUK. The blinded veterans from the war in Iraq and Afghanistan met with key federal agency officials and senior leaders, as well as with vision rehabilitation experts to learn and share best practices which will be disseminated when participants return to their home communities and countries to promote deeper knowledge about the 100-year evolution of blind rehabilitation, war eye injury management, current vision research as well as fostering mutual respect and understanding between allied nations, according to BVA officials.

The blinded veterans spent the week recognizing the 100th anniversary of U.S. entry into World War I April 6, 2017.

WRNMMC Director Army Col. Michael S. Heimall welcomed the veterans to the medical center, and VCE Executive Director Navy Capt. Penny E. Walter briefed the group about efforts in the center to improve vision health, optimizing readiness and enhancing quality of life for service members and veterans.

Retired Army Col. (Dr.) Robert A. Mazzoli, and ophthalmologist at the VCE, discussed 100 years of military ocular and combat casualty care, comparing lessons learned in World War I to today.

Quoting renowned physician Dr. William Mayo, Mazzoli stated, “The only victor in war is medicine,” explaining the ongoing progress in medicine and surgery that is accelerated by wartime discoveries. He added lessons learned by the military often migrate to civilian practice, and civilian practice propagates those lessons. He explained eye care has become “exceptionally specialized,” and “war injuries are invariably ocular polytrauma.”

Mazzoli stressed the importance of wearing protective eyewear, explaining “prevention is always better than treatment.” He added understanding the impact of combat ocular trauma on visual quality of life can help advance treatment, improve eye protection and assist in developing better visual rehabilitation care.

Army Lt. Col. (Dr.) Scott McClellan, chief of ophthalmology service at WRNMMC, discussed its ophthalmology clinic and the care its staff provides, and retired Army Col. (Dr.) Paul Pasquina, chief of the rehabilitation department, briefed the group about the Military Advanced Training Center. Dr. Louis French, deputy director for operations at the National Intrepid Center of Excellence at WRNMMC, briefed the veterans about facility, which specializes in traumatic brain injury care and psychological health conditions.

BVA Director of District 6 Dr. Tom Zampieri explained the relationship between the BVA and BVUK “allows us to share information about the 100-year evolution of veteran blind services, vision trauma care, research, and the long-standing close cooperation with our nations.”

The BVUK traces its founding back to 1915 during World War I, and BVA’s earliest beginnings occurred March 28, 1945 when a group of World War II blinded servicemen formally met in Connecticut.​

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 Original article can be found here.

December 20
Music therapy impacts recovering service members

Article originally by Defense Video Imagery Distribution System (DVIDS​)

BETHESDA, Md., -- Isolation and avoidance were the behaviors Marine Staff Sgt. Anthony Mannino used to cope with adjusting to life when he came back from deployment in Iraq. 


Mannino deployed for eight months total to Iraq in 2007 and 2008. 

“Things are not the same as they used to be,” Mannino, National Intrepid Center of Excellence at Walter Reed National Military Medical Center patient, said. “I’m slower and it’s harder for me to focus. Sifting through all the noise is difficult. Sometimes all I can smell is death, burnt skin and blood.”

His post-traumatic stress enveloped his life and held him captive in a mental prison. 

“The walls [I built] between me and everyone else kept me safe, but also forced me to change who I am,” Mannino said. “They became my life.”

The trauma Mannino experienced during his deployment resulted from concussions from roadside bomb explosions in Iraq and being hit by a truck while stationed in Hawaii. 

Six months after receiving treatment at WRNMMC, Mannino began music and art therapy with NICoE. 

Rebecca Vaudreuil, NICoE music therapist contractor, explained that the music therapy program is part of a four-week intensive outpatient program where active-duty military members participate in extensive treatment including diagnostic testing, rehabilitation and clinical work in approximately 26 different disciplines and over 100 appointments. 

Manninno said he was initially resistant to treatment when he began the program almost a year ago because he disliked art and music, but he got tired of nothing working and kept trying. 

“I started with guitar,” said Mannino. “It made me focus on something else even though I was at the hospital getting treatment.” 

With continued practice, Mannino improved his guitar playing and performed Dec. 13 at the NICoE Creative Arts Café, a performance platform for patients and staff to share creativity through music, art, writing, dance, photography and drama once a month in front of an audience.

“The NCAC began as a collaboration between the U.S. Air Force Band and the NICoE Music Therapy program November 2015 and the inaugural event was Oct. 11, 2016,” said Vaudreuil. 

For this NCAC event, U.S. Air Force Band Max Impact performed alongside several of the patients performances. 

Mannino performed a spoken word piece describing his journey through the NICoE treatment program and his thoughts during each phase while Max Impact played “Walls” by Kings of Leon in the background. 

“This was one of the most rewarding experiences I’ve had in the Air Force,” said Nalani Quintell, Max Impact vocalist. “I wish we had more opportunities to give back to heroes like this. After all, it’s not about us, it’s about what we bring to the fight, which is with the soft power of music.” 

Mannino, along with fellow patients, found music and art to be a way to communicate his frustration about the physical and mental pain he was experiencing. 

Mannino’s wife, Diane, recounted that when he initially began therapy he didn’t believe anything was wrong with him because he didn’t have any physical injuries but after going through therapy, he is able to process and talk about things differently. 

Mannino continued with music and art therapy after the end of the four-week program to work on his continued recovery. 

“I’m not there anymore, even though some days I feel like I am,” Mannino said. “When the walls come down and things get hairy, I’m overcome with emotions, both good and bad; but I’ve been in treatment long enough to know that feelings mean I’m alive.”


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​Original article can be found here.
December 01
Brain Scars From Combat Injuries Linked to Depression In War Veterans

Article originally found on Motherboard​

Family members and friends of veterans have long known that not all the wounds of war are visible. But doctors have never fully understood how, exactly, returning combat veterans experience severe depression and mood imbalance.

While the emotional trauma of seeing death and destruction has been widely discussed, there’s more evidence that many soldiers’ mental health issues have a strong physical component as well. Researchers at Walter Reed National Military Medical Center found that Traumatic Brain Injury (TBI)—physical damage done to the brain from violent outside forces—disrupts the circuitry of the brain’s cognitive-emotional pathways.

This might be the root cause of depression symptoms, and provide more insight into possible treatment. The researchers presented their ffindings yesterday at the annual meeting of the Radiological Society of North America (RSNA). 

While Post Traumatic Stress Disorder (PTSD)—the severe psychological shock that persists in a veteran’s brain after violent experiences—is well known amongst the larger public, TBI—equally as damaging and perhaps more insidious—is not so much. So far, 352,619 soldiers worldwide have been diagnosed with TBI since 2000, according to the Defense and Veterans Brain Injury Center, and many struggle with chronic anxiety, mood problems and depression.

The symptoms of each are similar, but TBI is a physical injury that’s caused by violent shockwaves to the brain, whereas PTSD is a psychological affliction. It happens to soldiers near explosions or who get hit in the head by debris—it also is prevalent in retired NFL players from constant blows to the head.

Yet all the unknown variables have made it difficult to treat TBI. “Sometimes you find yourself saying, ‘I wish...I would have lost a body part,’ so people will see—so they’ll get it.” Army First Sgt. David Griego told National Geographic. Griego is a veteran of tours in both Iraq and Afghanistan.

Researchers at the National Intrepid Center of Excellence at Walter Reed used two different MRI (brain imaging) techniques on 130 active service members diagnosed with mild TBI, and on a control group of 52 men without TBI. What they found was that the circuitry connecting important regions of the brain for cognitive and emotional control—known as white matter tracts—was disrupted in soldiers with mild to severe depression symptoms.

"We can link these connectivity changes in the brain to poor top-down emotional processing and greater maladaptive rumination, or worrying, in symptomatic depressed soldiers after mTBI," physicist Ping-Hong Yeh of Walter Reed said in a public statement.

Yeh thinks that these new findings might lend themselves to personalized medical treatments in the future. We’re going to need it. “This is an ongoing problem facing a large number of warriors in current areas of conflict, and it is likely to be a persistent problem for the foreseeable future," he said.


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Original article can be found here.

November 30
These soldiers at Walter Reed are making masks to reveal the hidden wounds of war. And to heal.

Article originally by The Washington Post​

Chris Stowe worked on a bomb squad during six deployments in Iraq and Afghanistan. Between tours he sought help for the headaches, anxiety, memory loss and other symptoms of trauma and brain injuries he suffered while being exposed to hundreds of blasts.

He tried talk therapy, medication and a self-prescribed regimen of yoga and meditation, before finding some relief in an unexpected form: a white papier-mache mask.

During an art therapy session at Walter Reed National Military Medical Center, he picked up a brush and painted something he had never been able to satisfactorily describe: how he felt.

His mask showed two sides of himself: the calm exterior side-by-side with a monster beneath, filled with rage, his eyes and mouth brimming with bees.

“If you imagine what a bees’ nest sounds like, the buzzing, almost surround sound,” he said. “This is how my head feels.”

Nearly 350,000 U.S. service members have been diagnosed with traumatic brain injuries since 2001, according to the Defense Department. Thanks to modern body armor and military vehicles, many service members survive roadside bombs and improvised explosive devices, only to come home struggling to function.

The invisible wounds of war can be difficult to diagnose and treat. But the military is finding that art, and mask-making in particular, can spur the healing process.

Art therapy, along with music and creative writing, are integral parts of treatment at the National Intrepid Center of Excellence at Walter Reed in Bethesda which opened in 2010 to study and treat traumatic brain injury and the psychological conditions that often accompany it. The therapeutic arts program has shown promising results and is expected to expand to 12  military sites around the country by 2017, through a partnership with the National Endowment for the Arts. Congress appropriated $1.9 million this year to fund this military “healing arts” network.

Two dozen active service members come through each month for an intensive, four-week outpatient treatment program. During the first week, art therapist Melissa Walker gives each service member a blank mask. She invites them to explore their identities or emotions surrounding their injuries or treatment as they decorate it.

“There is something powerful in the mask,” Walker said. “It literally and figuratively encompasses the areas we are focused on here, both the physical and psychological.”​

Creating a ‘safe space’

What starts as a two-hour activity often extends beyond the first session, as service members return to the studio to keep working on their masks.

Brain injuries and trauma can actually impair verbal communication, research shows, but making art can help, particularly when it comes to processing traumatic memories.

Brain scans show that when someone attempts to recall a traumatic event, the left frontal cortex of the brain — the area responsible for speech and language — stays dark, while the parts of the brain that control emotion and the senses light up.

Art-making activates these same emotional and sensory areas of the brain. The job of the art therapist is to create a safe space for service member to tap into those difficult memories, and then to help them describe what they have created, opening a neural pathway that had previously been shut off.ul in the mask,” Walker said. “It literally and figuratively encompasses the areas we are focused on here, both the physical and psychological.”

Walker was inspired to work with veterans because her grandfather, a Korean War veteran, spent his life struggling with trauma. Shrapnel pierced his neck during one of the final battles of the war, and he fell facedown in the mud. Unable to call out, he was initially left for dead. But he was eventually discovered and sent to a military hospital in Japan.

He recovered physically, but the trauma followed him. Walker remembers her grandfather as short-fused and easily startled. He never spoke about his war experiences, even to his wife whom he met in the hospital during his initial recovery. But sometimes he had nightmares. Walker recalls a summer visit to her grandparents’ house when she was a little girl, waking to hear him shouting obscenities in the middle of the night.

Her grandfather died while she was in graduate school. Since then, she has built a career trying to help other soldiers process their experiences so they aren’t trapped by them.

The masks’ many messages

In the six years since the center opened, Walker has indexed more than 1,000 masks that soldiers have created and she has begun analyzing their themes.

Many masks depict physical pain (bloodshot eyes or a knife stabbing the forehead); some show literal injuries (shards of shrapnel in the face and a piece of skull surgically removed to relieve pressure in the brain). Others are metaphorical — one mask depicts a soldier’s confused thoughts as a swarm of flies coupled with a pair of chopsticks trying to capture them.

Some explore their military and national identities. Patriotism is a point of pride and an instrument of suffering, as seen in a mask that shows two small flags propped up next to the eyes as blinders.

Some show hope and healing: A Navy nurse decorated half of her mask with sand and a large eye, representing an injury that impaired her vision, while the other side is a globe that represents a future career path in international health.

One of Walker’s patients was a senior-level service member who had been haunted by the image of a bloody face for seven years after a particularly difficult deployment, in which he suffered a concussion in mortar fire and he lost a close friend in a convoy to an improvised explosive device. He was supposed to be on the convoy; his friend had gone in his place.

For years he tried to avoid the feelings of guilt and hopelessness, but the image of the bloody face continued to haunt him. In Walker’s studio, instead of ignoring it, he made a likeness of the face. His mask was blood red with bulging eyes. In the process of making it, he began talking about it. When he was done with the mask, he put it in a box and put a lid on it. He left it for Walker to take care of.

Walker keeps it on a shelf in her studio. A year later, the soldier reported that the ghoulish visits had almost completely stopped.

Many soldiers leave their masks and memories behind. Walker’s studio is now filled with them. They adorn the entrance to her studio, and the front lobby of the center.

Using the art to help navigate life after war

Some patients leave and take their masks home, a new outlet for their stress or pain.

Rusty Noesner, a former Navy SEAL, came to the center four years ago after he suffered brain injuries after falling out of a helicopter and during a blast in Kandahar.

He immediately gravitated to the art studio, he said. He created a mask that showed two sides of his personality, with a combat scene and a nature scene.

“No one wants to accept you have these emotions, this vulnerable side. . . . You don’t want to have those things in combat,” he said. “But when you get home you have to reconnect so you can move on with your life.”

Noesner, 32, is out of the military and running a nonprofit group called War Paints, based in Harrisonburg, Va., that encourages veterans and service members to pursue art and tap into the part of the brain they abandoned while at war. They can sell their artwork on his website.

For the 41-year-old Stowe, years of talk therapy had not been very helpful. It was hard to sit down again and again. But with art, he did not worry about judgment, he said, and felt more in control of his emotions. Retired from the Marines after 23 years, Stowe lives in Tampa and has a civilian job at U.S. Central Command. He has good days and bad days, he said. Some days he still hears the bees buzzing in his head.

“Those are the days that I paint,” he said. He makes oil paintings at an in-home studio or goes out to the porch with his ukulele. Sometimes he escapes to a glass blowing studio for a few hours.

“It’s really cathartic,” he said. “Whatever I was battling, it slowly fades away.”

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 Original article can be found here.

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