Veterans Dealing With Chronic Pain

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They called it a hard, hard 

landing…

A helicopter crash left John with chronic back pain and a traumatic brain injury. Swamped with painful memories, at first he turned to drinking to manage his depression. His commitment to taking care of his children gave him a reason to stop drinking and to reach out for help from VA.

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ShaunneU.S. ARMYARMY RESERVE / NATIONAL GUARDDESERT ERA

Shaunne found light at the end of the tunnel

SeanU.S. ARMYARMY RESERVE / NATIONAL GUARDOEF / OIF / ONDCOMBAT VETERAN

Successful ways to deal with pain and stress

TerriU.S. NAVYDESERT ERA

A Veteran's treatment helps the whole family

DerekU.S. ARMYOEF / OIF / ONDCOMBAT VETERAN

The first thing you have to do is take that step

What is chronic pain?

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• If I’m experiencing chronic pain, what can I do about it right away?
• Take the next step – Make the connection.
• Explore these resources for more information about chronic pain in Veterans.

Do you have an injury that doesn’t seem to get better? Are you often irritable because of constant physical discomfort or pain? Does agony make it difficult to stand, walk, sit, or do everyday tasks? These can all be signs of chronic pain.

When a person experiences pain in one or more areas of the body, such as his or her neck, head, arm, or leg, for at least three to six months, it is considered chronic pain. The pain may be nagging or severe and often seems worse than short-term pain because of its prolonged duration. General wear and tear from aging as well as different types of illnesses and injuries can cause chronic pain. Some Veterans have chronic pain due to injuries that occurred in the military, such as having a phantom limb after an amputation or severe back or spinal cord damage after an accident. Other times, it can be hard to figure out the source of long-term pain.

Many times, injuries suffered in training or during deployment may seem to have healed, but as you age, they can reemerge and become a source of chronic pain.

Many people experience chronic pain at some point in their lives. Chronic pain can hinder or even prevent common, day-to-day activities like sitting, standing, and waiting in line. Many people who deal with chronic pain find the constant experience of pain and the restrictions it places on their daily activities makes them feel down, irritable, or hopeless. Some people become depressed if they think the pain will never end and there is nothing they can do about it.

“In combat, I had no other option than to ‘suck up’ the pain and ‘drive on.’ But now that I’m back, it’s a relief to know there are ways for me to cope with it.”

When it comes to chronic pain, you don’t have to just live with it. Depending on what’s causing the pain, there are various options for chronic pain treatment, such as:

• Physical therapy to increase your level of pain-free activity
• Therapy or counseling to change the way you relate to or cope with your pain
• Relaxation techniques to manage the stress of chronic pain
• In some cases, advanced medications to reduce the level of severe pain

If I’m experiencing chronic pain, what can I do about it right away?BACK TO TOP

“Dealing with pain is something I’m used to. I did it for years. What I wasn’t used to is the way it affected my mood and overall energy level. My wife was tired of watching me suffer and you know what? So was I.”

If you are experiencing chronic pain, there are a few things you can do to deal with your symptoms and improve your well-being:

• Tell your doctor about it. He or she can help develop a treatment plan for you
• Educate yourself on your condition so you can decide on the best options for managing your pain
• Keep a “pain diary,” where you can record your progress with pain and how it affects your life
• Find ways to stay physically active, according to the recommendations of your doctor

Your friends and family members have likely noticed that your chronic pain is affecting your life. Talking to them can be especially helpful as you look for the type of chronic pain treatment that is right for you.

Take the next step – Make the connection.BACK TO TOP

Every day, Veterans who served in the Army, Marine Corps, Navy, Air Force, and Coast Guard connect with effective treatments for chronic pain management and chronic pain support resources. If chronic pain is affecting your well-being or getting in the way of your relationships, work, or daily activities, you may want to reach out for support. Consider connecting with:

• Your family doctor: Ask if your doctor has experience treating Veterans or can refer you to someone who does
• A mental health professional, such as a therapist, who can provide you with effective ways to cope with your pain
• Your local VA Medical Center or Vet Center: VA specializes in the care and treatment of Veterans and has clinics and programs dedicated to pain management and treatment
• A spiritual or religious advisor

Explore these resources for more information about chronic pain in Veterans.BACK TO TOP

Learn more about the possible associations between chronic pain and other issues such asdepression, posttraumatic stress, and alcohol or drug problems.

VA Medical Center Facility Locator
Chronic pain may be a sign of health conditions that need attention. This website will allow you to search for VA programs located near you. If you are eligible to receive care through the Veterans Health Administration, you can enroll in one of VA’s treatment programs.
http://www2.va.gov/directory/guide/home.asp?isflash=1

Vet Center
If you are a combat Veteran or experienced any sexual trauma during your military service, bring your DD214 to your local Vet Center and speak with a counselor or therapist—many of whom are Veterans 

Vietnam veterans in Cambodia

Vietnam veterans make good life for themselves in Cambodia

By Matthew M. Burke

Stars and Stripes

Published: December 20, 2015

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Andy Richards is a member of a small but thriving community of Vietnam veteran expats in Phnom Penh, Cambodia. The 65-year-old from Madison, Wis., served in the Army's storied 82nd and 101st Airborne divisions. He came back to Southeast Asia in 1999, hoping to release the ghosts that haunted him from the war, and never left.

MATTHEW M. BURKE/STARS AND STRIPES

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  A friendly chat between Marines and Viet Cong

  On a 92-degree day in late September, Marine veterans joined two Viet Cong veterans at the Red Beach Resort on the outskirts of Da Nang for coffee. The following is a transcript of the conversation, edited for length and clarity.

PHNOM PENH, Cambodia — The scent of burning marijuana mixes with the pungent odors from food push carts and garbage piles.

Scantily clad women lure tourists to bars that offer ice-cold beer to stave off the steamy heat.

Cambodia has come a long way since the brutal Khmer Rouge massacred more than 1 million people in the infamous “killing fields” in the 1970s. Yet it also remains a nation rooted in the past, a land of friendly locals and immense cultural beauty with darkness and debauchery lurking beneath the surface.

Phnom Penh, its capital, is a place where the business of survival never sleeps — panhandlers carrying babies meander in a seemingly endless parade, motorized rickshaw drivers offer cheap rides at all hours, fast-talking children peddle homemade wares, and nearly every price is dirt cheap — and negotiable.

In many ways, it’s frozen in time, reminiscent of Saigon at the height of the Vietnam War.

For a handful of American Vietnam veterans who left a little piece of themselves behind during the ferocious jungle war and say they were vilified when they went back to the states, Phnom Penh has become home.

“The war was the worst thing that ever happened to me,” Andy Richards, 65, said as he sat in a bar booth, swirling wine in a glass. “I’ve had three open-heart surgeries.”

Richards, a bar manager with a handlebar mustache and sunbaked skin, generally attributes his heart problems to the war. He is warm, friendly and easygoing.

“I like Cambodia,” said Richards, who arrived in 2002. “I like the lack of rules. There’s more personal freedoms here than anywhere else. It’s inexpensive. The people are very nice.”

The Madison, Wis., native joined the Army in 1968 at 18 because he expected to be drafted. He spent a short time in the storied 82nd Airborne Division but disliked it because it was “too spit-shined.” He transferred to the 101st Airborne and headed for Vietnam’s jungles.

Richards went from a paratrooper to a bandana-wearing grunt, like something out of the 1986 film “Platoon.” He and his fellow soldiers spent time in the most northern part of South Vietnam, the region with the highest concentration of North Vietnamese Army forces. They operated near Khe Sanh, in the highlands, and made forays into the demilitarized zone.

Richards left the Army and Vietnam behind in April 1971 and earned a journalism degree from the University of Wisconsin. He worked at small local newspapers but battled the bottle and his anger for years.

“They considered us whiners,” Richards said of his return stateside. “We were a pariah.”

In 1999, at the prodding of a friend, he went back to Vietnam to “release the ghosts.”

“I was scared,” Richards said. “I was apprehensive. But after my first day in Saigon, I was talking with ex-NVA, telling war stories. I got that monkey off my back. It was the best thing for me.”

In southern Vietnam, Richards got the thanks he never received at home. They were kind to him; they shook his hand and thanked him for trying to help them. He then traveled to Thailand and Laos.

After briefly returning to the U.S., Richards went back to Southeast Asia for good in November 1999, living first in Thailand, then Vietnam and Cambodia, where he decided to put down roots. After years of searching, he had found a home.

John Muller, 66, from Seattle, told a similar tale. He joined the Army in 1969 and spent the next year in Vietnam.

“I wish I’d never gone,” he said. “It was a real waste of lives and a huge expense.”

After the war, he returned to the States and, like Richards, went to school, earning a political science degree. He, too, felt that he and his fellow veterans were treated like criminals, and, after several jobs, he decided to leave for good as well.

Muller had visited Southeast Asia several times beginning in 1976 and returned there to live 10 years later.

“I wanted to come back and do something good,” he said. “That’s my whole motive for why I’m out here.”

Muller, who runs a private security company, said his legacy has been working with the Cambodian government to regulate the industry, taking guns off the streets and providing jobs to ex-troops.

“It’s easy to work here,” Muller said. “There is a lot of opportunity. It’s easy for me to get around and do business.”

For legendary and eccentric photographer Al Rockoff — portrayed by John Malkovich in the Academy Award-winning film “The Killing Fields,” which he derides — his continued work in Cambodia is the next chapter in a love affair that began when he was an Army combat photographer in Vietnam.

Rockoff was known to go to extreme lengths to get his iconic images that today adorn the walls of the U.S. Embassy and the Foreign Correspondents’ Club in Phnom Penh. He said he once died on the table after a piece of shrapnel pierced his heart while taking pictures at the front as the Khmer Rouge advanced through the countryside. A Swedish surgeon saved him.

He splits his time between Florida and his adopted country, and can still be seen riding around Phnom Penh on the back of a moped, camera in hand, snapping pictures of the colorful people he encounters.

“This country has opportunity like Thailand did 20 to 30 years after World War II,” he said. “It has a good nightlife … The police deal with people all right. I’m getting back to where I left off in the Army. I want to show people what’s going on.”

Richards, Muller and Rockoff belong to a small club. While Thailand has many Air Force and Army veterans living there, and Vietnam has a growing number, Cambodia still has few.

Richards said Phnom Penh draws him partially because it is a big city with a small-city feel, and has become almost “cosmopolitan” in recent years. Rockoff likened its charm to Monaco.

Yet, despite all the growth and development, which was inevitable as Cambodia came out of the dark Khmer Rouge period in the early ‘90s, the men say their adopted country will never lose its luster.

“I will stay here,” Richards said. “I wouldn’t live anywhere else. This is the end of the road, dude.”

WHY IS VA HEPATITIS-C TREATMENT SLOWING DOWN?

December 09, 2015, 12:30 pm

Sudden drop-off in VA hepatitis C treatments alarms veterans community

By Diane Zumatto

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The Veteran Service Organization (VSO) community has been pleased and even relieved to see several new drugs come onto the market over the past two years that can now cure most veterans who were unknowingly infected with hepatitis C virus (HCV) during the course of their military service. Congress responded quickly and generously to the Department of Veterans Affairs’) (VA) requests for emergency supplemental appropriations to allow the department to offer these new life-saving and long-term cost-saving treatments to veterans infected with HCV. 

In fact, the Senate Appropriations Committee’s subcommittee on Military Construction and Veterans Affairs (MilConVA) provided $200 million above and beyond the VA’s initial request for FY2015 supplemental funding for veterans’ HCV treatments, and we remain highly optimistic that the final VA appropriation, whether as a stand-alone bill or as part of an omnibus, will now reflect an even greater level of investment in treating and curing veterans with HCV in light of the recent budget deal. 

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Throughout the course of 2015, the veteran community has been pleased to see VA patient data reflect an increasingly aggressive approach to treating HCV within the veteran population. In fact, as we neared the end of the fiscal year in September, the VA was treating up to 1,700 new veterans each week for HCV infection. 

However, as encouraged as we were by this trend, we are equally dismayed and alarmed now by the trend we saw reflected in VA treatment data immediately following the start of the new fiscal year. 

Despite the fact that Congress appropriates VA’s medical services account a full year in advance precisely to avoid a slowdown in VA services and treatment should there be any fiscal uncertainty with the rest of the government at the start of a new fiscal year, VA’s treatment of veterans with HCV dropped astoundingly to less than 400 for the first week of October, and has remained alarmingly low since then. 

Congress has provided and continues to provide every dollar that VA has asked for to offer veterans infected with HCV with the latest breakthrough medical treatments and to generously and fully fund all medical services provided by the VA. Furthermore, until the new MilConVA appropriations bill with supplemental HCV funding for FY16 is passed into law, VA knows that it can borrow from within its medical services account to continue its previously aggressive pattern of treatment of veterans with HCV infections. 

There is, therefore, no fiscal, logical, administrative, or other reason for VA medical providers to be halting or slowing treatment of veterans with HCV following the start of the new fiscal year. The VA should be continuing to treat as many veterans as it is able to with the money that it has currently available in line with established clinical guidelines. 

Good stewardship of the money that Congress appropriates to the VA is of paramount concern to the VSO community and to the veteran community writ large, and we intend to closely monitor this trend over the next few weeks and months in order to observe and publicize, if necessary, whether the Veterans Health Administration returns to acting good faith in aggressively treating cases of HCV. 

In the meantime, the VA should review its own prescription and treatment data for HCV patients and be proactive in ensuring that as many veterans as possible with HCV continue to receive the care and treatment that Congress intended for VA to expeditiously provide. 

Zumatto, a U.S. Army veteran, is the national legislative director of American Veterans (AmVets)