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Electrical stimulation treatment helps PTSD patients

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Mark Brown couldn’t sleep and felt like he was in a “fog” constantly. His speech and vision were impaired. Life was miserable for the Marine who had deployed four times.

Brown’s angst stemmed from a conversation about a decade after his 2005 deployment with the 3rd Battalion, 25th Marines, 4th Division.

“We lost 48 Marines,” Brown recalled. “It was later when I just kind of snapped. I didn’t want to get out of bed. I felt tired all the time. And I knew something was wrong. My wife did, too.”

Brown sought help and received a tough assessment from a military doctor — “You are not going to get better overnight. You need a lot of treatment.” The doctor prescribed Zoloft for Brown, setting him on his “so-called path to recovery, as I ate meds for the next two years.”

Things began to change for Brown when he set aside the pills and tried a new treatment called PrTMS (Personalized repetitive Transcranial Magnetic Stimulation). The treatment is an innovative technique that targets specific areas of the brain using brief, painless electrical pulses through an FDA-approved device intended to stimulate and align brain waves. The number of PrTMS treatments will depend on the individual’s diagnosis, severity of symptoms, and response rate. Typically, patients receive one or two 20-minute treatments for six to eight weeks. About one in five return for follow-up treatments.

“The third day I woke up I actually felt like the fog lifted in my brain,” Brown recalls. “I felt like I had motivation to do something. I hadn’t done anything really in two years. I hadn’t fixed anything in my house; I didn’t help with the laundry; I didn’t cook; I didn’t do anything. Since this treatment I have installed a faucet, replaced all the grates in the grill. I’ve done a whole bunch of things around the house that I wasn’t doing. And now I feel like I want to be a part of the world, instead of just sitting in my house.”

Brown is among thousands of veterans, children with autism and others who have sought PrTMS treatment from Dr. Kevin Murphy, a Navy veteran and professor at the University of California, San Diego, who specializes in brain tumors. The patients have suffered from neurocognitive disorders such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), anxiety, depression, insomnia and addiction.

Murphy founded PeakLogic in 2014 after discovering his autistic son and cancer patients showed significant reduction in cognitive impairment following PrTMS treatment. This finding led to his research on patients with concussions, PTSD and TBI.

“If you have a brain, you’re a candidate,” he said. “We treat the brain like an organ so you can manifest your symptoms of anxiety and depression a certain way based upon age or experience or certain other personality traits. The manifestation of how you show your anxiety or stress or deprivation of sleep is interesting to me. But the more important issue is why the brain is doing that. Can we realign the brain waves themselves and re-establish a synchrony and a balance?”

First, patients are evaluated by Murphy’s team and a customized treatment plan is designed. Medical technicians interview the patients and give them an electroencephalogram and a physical evaluation. Technicians evaluate the patient’s brain waves, looking for hills and valleys of activity — irregular and disorganized neuron activity.

The more disruption in frequency, the more likely it is that the patient will be having difficulty sleeping or coping. Technicians also look for how often the brain fires — like a heart beating. At sleep, the brain fires four times a second; during anxious times, it fires 40 times a second.

Murphy’s team tries to identify the patient’s ideal sweet spot — the number of times a neuron fires. When patients undergo the treatment, the machine is programmed to generate a weak electrical current in the brain activating neuronal circuits at the stimulation site, at a prescribed rate, promoting neuronal harmony and optimal brain function. This recalculates the brain activity, allowing it to fire at a speed that allows the patient to sleep.

He explains that the brain needs time each day to go offline — or sleep — in order for the neuron to recharge for the next day.

“Over time, if we don’t give that neuron a repetitive night’s sleep, it starts to take that frequency back from us,” he said. “And it won’t be at the same rate. It tends to slow, as a self-preserving mechanism, for being overworked, overrun. We really want patients to sleep well, as part of our therapy. We drag those neurons back online, and make them behave, and ideally, each night, you give that neuron a chance to sleep and restore.”

Without the restoration, people experience mood shifts and behavior changes. After undergoing the treatment, Murphy says, the changes are extraordinary. Athletes perform better. Autistic kids speak more clearly. Veterans and others with PTSD sleep better and are more relaxed.

Ed Hanson, a Vietnam War veteran, had a similar experience to Brown’s.

Hanson remembers waking up seven to 12 times each night before getting his treatment. The Navy veteran was on alert because his wife, Marilyn, was experiencing a serious health issue.

“I tried to stay awake at night,” he said. “I would go to work and run my business during the day. Months went by and when my wife got better, my brain didn’t know how to shut itself off and so I’d still wake up 7-12 times at night. I didn’t think it could be fixed because here I am almost 70 years old.”

Hanson was frustrated, worried about having dementia and experienced short-term memory loss. But he decided to try the treatment. After only three sessions, he noticed a difference.

“On the third night I went to bed, I woke up and it was 5 in the morning,” he recalled. “It had been 25 to 30 years since I slept through the whole night. I am thinking, this is just a fluke. The next night I went to bed, and I woke up at 5:30 a.m. I am looking forward to going to bed now.”

Hanson, a member of American Legion Post 303 in El Cajon, Calif., feels recovered. He’s more energetic and has restarted an exercise routine with his Bowflex machine.

“I dusted off my Superman cape that I thought was trashed,” he said. “Now, I am a better husband, better father. All because of the treatment. My wife noticed that, well, she got her Ed back. And I always wanted to be her superhero, but I didn’t have the energy anymore. Now, I am less anxious. I am not so jumpy. And it was all because of sleep deprivation.”

Nick Norris is a former Navy SEAL who was experiencing similar symptoms but didn’t want to try opioids, sleep medication and other treatments that his peers have tried.

“I went into treatment and I felt just calm, more approachable,” Norris says, adding that he had to return for a second series of therapies to be “reset,” as Murphy describes it. About 20 percent of patients return at some point to undergo a second series of the therapy to reset their brainwaves.

Two weeks into his second treatment, Norris could tell the difference. He realized he had slipped back into where he was before the initial treatment. He was stressed, argumentative and angry.

“I feel like I have turned a corner in the last week,” he said amid his second round of treatment. “My edginess is gone. I am more engaging. I feel friendlier. Something has changed to make me a better version of myself and optimize who I am and allowed me to be a better father, and a better husband, a better friend, and a better business partner. It has definitely been a remarkable treatment. I really kind of rely on it to keep me as the better version of myself moving forward.”

Those kinds of success stories are what motivates Murphy.

“Of the 300 to 400 veterans, maybe a third of them will tell me, ‘You saved my life,’” said Murphy, a member of The American Legion. “That’s very rewarding. Or their families will say, ‘You saved his life’ or they’ll say, ‘You saved our marriage’ or ‘You saved our kids.’ There are a few things in medicine that do this, that get that kind of result, that make that big of a difference. I am flattered to be involved in it.”

Before Brown underwent the treatment, loud noises made him jittery and he often resisted venturing to public events or places. But that was before he underwent the treatment that he describes as “absolutely life changing.”

Now, he voluntarily goes grocery shopping and looks forward to his son’s basketball games — and doesn’t need to take his medication before doing so.

Later this year, Brown will retire while his wife is committed to serving nine more years in the Navy. He is looking forward to the change — another breakthrough in his recovery.

“I didn’t want change; I didn’t want to accept change,” he said of the time before he tried out PrTRMS. “Now, I look forward to going with her wherever she goes.”


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Navy audiologist contributes to Pacific Partnership

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YAP, Micronesia — Pacific Partnership 2018 marks the 13th iteration of the Navy's humanitarian and civic assistance mission. It brings together a vast array of military personnel from countries including the U.S., United Kingdom, Australia and Japan. In each demographic, you’ll find personnel who are on their first, second, or even third trip to Micronesia.

But only one participant this year can claim to have the most firsthand experience with the Micronesian islands. He is Navy Lt. Matt Thomas, an audiologist stationed at Navy Environmental Preventative Medicine Unit 6 in Pearl Harbor, Hawaii, with 18 years of service on active duty and in the Navy Reserve.

Seeking a Change

Before joining the Navy, Thomas found himself working for a baseball team and being less than impressed with the “grunt work” the job entailed.

“During my breaks, I would read, mostly history. I was a history major, and I wanted to work overseas when I got out of college, but I was not doing that. So I put it all together and figured the Navy would be the way to make that happen,” Thomas explained.

Thomas pursued a career as a surface warfare officer, but it was during a deployment to Djibouti in 2010 that he began not just a transition from the reserve to active duty, but also to a whole new field.

“The medical field was my avenue to go from the reserves to active duty, and audiology offered me the chance to take the prerequisite courses while I was deployed. I took eight classes that one summer in Djibouti, applied to every school that I could, and got accepted,” Thomas recalled, adding he continued to serve in the Navy Reserve while balancing a full-time class schedule.

Navy Environmental Preventative Medicine Unit 6, Thomas’ command, has a significant operational presence in the Oceana area. But, he said, it was force of will that got him to Micronesia.

“I had to piggyback myself to missions that were coming out here. I’d done my research and seen [Micronesia] had, at one time, taken U.S. dollars to start a newborn hearing screening program for audiology, so that was the foot in the door when we had a couple of projects in Chuuk,” he explained. “Two months later, I was in Yap with an entomologist. While he did his work, I did audiology and reviewed their programs. Since then, there’s certain funding that comes up for public health works, and myself and a couple of other team members are the caretakers for that. We go to different states in Micronesia and determine what their needs are, and I’m also doing audiology, so I’m dual-hatted in that sense -- working as a provider but also as an advance planner for public health works there.”

Helping Where Needed

While medical professionals in Micronesia can perform hearing screenings, Thomas explained that in the event of a patient failing the screenings, solutions local to the islands are nonexistent.

“There is no audiologist in [Micronesia], period … if the kids don’t pass, they don’t have the capabilities to do a follow-up diagnostic test to determine if there’s any damage, or determine the extent. It’s nice to come in and reassure parents that the kids are fine medically, or if there’s permanent hearing loss, educate them on what next steps to take. It helps to educate the teachers as well -- students who may have not appeared to be paying attention actually can’t hear,” he said.

The effort to bring screenings to more people appears to be paying off, Thomas said, allowing him to focus on the patients who need him most. “My first day in Chuuk, I saw 40 people, and averaged 35 per day while I was there,” he said. “Now I’ll average 12-20 people, and the last time I was in Pohnpei, I saw six a day -- cases that were earmarked for me to see -- cases with failed hearing screenings or speech difficulty.”

In addition to the lack of a resident expert, Thomas identified two environmental factors for hearing loss in Micronesia.

“I see a lot of the hearing loss is due to ear infections,” he said. “Kids in general are susceptible to ear infections, but when you add in a warm tropical climate and, in Chuuk especially, the kids are always in the water -- it’s a picnic for bacteria. Some treatment, if it’s done, it’s not followed through, or they just don’t stay out of the water. So you see what could be a temporary hearing loss develop into permanent hearing loss, and unfortunately I’ve seen that happen a number of times here.”

Thomas noted that while children can usually be treated, the sands of time are to blame for adult hearing loss.

“The kids I have seen here, I can get them to pass the hearing screening, but a lot of the adults have permanent hearing loss through age. They’re not exposed to a lot of the loud noises we have in the U.S., so that’s typically not an issue we see here,” he said. “The ear infections that lead to permanent hearing loss are definitely prevalent here.”

Specialists

Audiology is far from the only specialty available among the personnel taking part in the Pacific Partnership mission, and for Thomas, it is an incredible reward to see the effect that has on the people they help.

“A big thing for Pacific Partnership is the specialties they don’t have and can’t sustain. It has a long-lasting impact. I was a surface warfare officer for 14 years, and none of those deployments were as enjoyable as this one – you didn’t have the feel of the impact on the local population,” he said. “You don’t have the feeling of, ‘I’m affecting lives on a local basis.’ I became an audiologist in 2015, and I have been begging, kicking and screaming to go on Pacific Partnership ever since. I finally got on this one, and I’ve already thrown my hat in to go on next year’s as well.”

Disclaimer: Re-published content may have been edited for length and clarity. Read original post.



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American Legion invites Fort Wayne area veterans to discuss VA care

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The American Legion invites all Fort Wayne, Ind., area veterans and their family members to a town hall meeting to discuss their VA care.

The meeting will be held on April 23 at 7 p.m., at American Legion Post 241, 7605 Bluffton Rd. Fort Wayne, IN 46809.

The town hall is one of many events that The American Legion will conduct around the United States this year. The American Legion hosts these events to hear feedback from veterans about the quality of health care they receive at their local VA healthcare facility.

Staff from The American Legion National Headquarters in Washington, D.C., American Legion Department of Indiana and representatives from VA and members of the Indiana congressional delegation will be in attendance.


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National commander visits Boston VA with department leadership

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American Legion National Commander Denise H. Rohan received an update on the Million Veteran Program (MVP) during her visit to the West Roxbury Campus of the VA Boston Healthcare System on April 6 with Department of Massachusetts leadership, which included Past National Commanders Jake Comer and Paul Morin, Commander Michael Davis and Adjutant Milton Lashus, as well as American Legion Executive Director Verna Jones.

MVP is an initiative of the Department of Veterans Affairs to collect genetic information from one million veterans who are enrolled in the VA in order to build a database of genetic, military exposure, lifestyle and health information. The purpose of MVP is for VA researchers to better understand how genes affect health and illness so doctors can design future treatments to an individual’s molecular body composition. The program looks at post-traumatic stress disorder, cancers, mental health, diabetes, cardiovascular health and more.

To date, more than 650,000 genetic samples have been collected.

“Our veterans know how important this is … they view it as another way to serve their country,” said Dr. Mike Gaziano, principal investigator of MVP and the scientific director of the Massachusetts Veterans Epidemiology Research and Information Center at Boston VA. “I have to say that there is nothing more satisfying than working in this community. Our job is to find some new cures, figure out how genes work, and it’s really a way I think that we’re leading the world in this kind of research. (VA) will use this information to understand how diseases really work.”

A goal for the program is to have more diversity. “Diversity is key to what we are doing,” said Jennifer Deen, who works on recruitment, engagement and public relations for MVP. Only about 50,000 of the genetic samples collected are from female veterans. And with a study currently underway on predicting breast cancer risks in women veterans, the increase of female enrollees is a goal for the program. “We need to do better.

“And we need to do better with our minority veterans.” Through their studies, Deen said that they are seeing that macular degeneration presents differently in African-Americans than it does in Caucasian men.

MVP will once again be exhibiting at The American Legion’s national convention in Minneapolis this August. They will have a booth in the exhibit hall where they will be enrolling Legionnaires in the program and collecting a blood sample. MVP is taking part in celebrating the Legion’s centennial by having a goal of enrolling 100 veterans a day, for five days, in the program.

During their visit, Rohan and department leadership also learned about Boston VA’s Women’s Integrated Treatment and Recovery Program (WITRP), the only one of its kind. The program provides specialized treatment for women veterans who have both PTSD and substance abuse problems. It opened in 2017, and has served over 350 women veterans from 40 states – a group of eight women veterans every eight weeks live and attend treatment groups together.

Dr. Sharon Baker, a psychologist with WITRP, shared that the average age of the women is 45, they have been out of service about 15 years, 80 percent have experienced military sexual trauma, 84 percent have alcohol dependence and 63 percent have drug dependence.

Iraq Army veteran AJ Thomas went through the program and shared her experience. Once she left the military in 2004, she had difficulty finding her way and “didn’t feel like I fit in,” she said. “I didn’t know how to socialize. I didn’t know who I was. I started self-medicating (alcohol) then trying drugs.”

Through care at another VA, she learned about WITRP and became “excited.” It gave her a new way of thinking and a new life. “I could picture myself being sober … I learned to be mindful, to breathe. I learned to be able to express how I was feeling.”

Rohan’s visit at the Roxbury campus also consisted of visiting with patients at the bedside and in the lobby. Several of the patients she spoke with were Legionnaires, such as 46-year Legion member Bob Winston and Mary Corrigan.

Corrigan, an Army veteran, has been participating in the National Veterans Wheelchair Games ever since she lost both legs to health reasons 11 years ago. When she showed up to her first games in Milwaukee in 2007, to compete in swimming, firing and bowling, seeing 600 other veterans in wheelchairs “was the best medicine for me,” said Corrigan, a member of American Legion Post 440 in Newton, Mass. Corrigan was leaving the VA after swimming in the therapy pool when she was greeted in the lobby by Rohan.


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A first-of-its-kind partnership

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On April 14, Morvay-Miley Post 524 celebrated the second of three grand openings for its brand new – and first-ever – post facility. Local and state government officials joined Post 524 Legion Family members and state and national Legion leaders at the event.

Also attending were Department of Veterans Affairs staff, who were there to tout a unique partnership between the post and VA. In the first such arrangement of its kind in the nation, a Department of Veterans Affairs outreach team will provide virtual care services at the post.

The service will provide a relief for local veterans who normally would have to travel more than 70 minutes each way to get health care at either of the VA facilities in Wilmington, Del., or Philadelphia.

“This is the future,” New Jersey National Executive Committeeman Chuck Robbins said. “It’s important in this area because you’re in South Jersey, and it’s a long way to travel to the Philadelphia or (Wilmington) VA hospitals. It’s real important that the veterans in this area get the proper treatment and get it fast, if needed.”

Vince Kane, director of Wilmington VA Medical Center, from where the virtual care will originate, said the ground-breaking partnership came as a result of Legion-VA conversations about delivery of care. “People like (New Jersey Department Executive Committeeman) Jim Scanlon and others have been meeting with us for some time to talk about what are the needs of veterans: those that call Cape May County home, as well as those that visit,” Kane said. “Together, we came up with some ideas that would allow some of the newer technology in VA – the virtual care – to be utilized in this beautiful brand new building.

“We have outreach teams from (the Wilmington VAMC) stationed here in South Jersey that work with veterans. If they come across a veteran … they’ll be able to call our outreach team, (and) we can show up and connect them to providers inside the VA, whether that’s for health care or mental health care.”

The virtual care equipment is portable and stays with the outreach team. The team will bring the equipment to the post and then talk to the veteran at the post. “We can dial up a provider, send them a link, and the provider will come up on the screen and we will have a session right there,” Kane said.

Jacqueline Hinker, Veterans Community Outreach Specialist for Southern New Jersey, said having the post available for virtual care sessions “makes it so much more convenient. Our outreach teams spend a lot of time embedded in the community. We can get to the veteran a lot quicker in one utilized space. This will make it so much easier: to have a space to sit down that veterans know they can come to on a regular basis.”

Kane said having the service available at Post 524 allows “VA to be more in the community and to have the community know what VA can do for them. So to have those services almost be available on the spot makes all the difference in the world – especially if you have a veteran in crisis. To be able to address their needs right there, in real time, makes all the difference in the world for that veteran and for our mission.

“It shows you the innovation of the leadership team here at the Legion. These types of innovations are imperative. Here you’re going to a Legion post and getting the help you need.”

That’s one of the missions of Post 524. “We always have been about veterans serving veterans,” Post 524 Commander Bob Marzulli said. “I’ve taken that bus ride down to the VA in Wilmington. It’s a long day.

“We’re going to offer that veteran to come here and meet face to face with their doctor in Wilmington and feel comfortable in a post environment. We’re going to provide them a secure place. I think that it’s critical for us to do that.”


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Did you know?

A veteran’s family must request a United States flag.

A flag is provided at no cost to drape the casket or accompany the urn of a deceased veteran. Generally, the flag is given to the next of kin. Only one flag may be provided per veteran. Upon the request of the family, an “Application for United States Flag for Burial Purposes” (VA Form 21-2008) must be submitted along with a copy of the veteran’s discharge papers. Flags may be obtained from VA regional offices and most U.S. Post Offices.