Friday, May 09, 2008

Center Creates 'Little Miracles' in Treating Combat Stress

By Donna Miles
American Forces Press Service

May 9, 2008 - A revolutionary treatment program here is demonstrating "little miracles" as it gives new hope to soldiers afflicted with
post-traumatic stress disorder who want to stay in the Army , its director reports. The new program is the brainchild of clinical psychologist John E. Fortunato, who uses a holistic approach to treating PTSD at the new Fort Bliss Restoration and Resilience Center.

Fortunato conceded that his proposal "wasn't an easy sell" initially, particularly because it wove yoga, massage therapy and other nontraditional approaches into its treatment program. But driven by the frustration of seeing soldiers with
PTSD forced to leave the Army against their wishes, Fortunato pressed forward and won approval for his prototype program.

With $2.2 million in initial funding and a 1940s barracks building to rehab, he set out to launch the Restoration and Resilience Center in June 2006. The center opened last summer.

Fortunato was convinced traditional
PTSD treatments weren't long enough, intense enough or comprehensive enough. "So we set out to create a program to address all aspects of PTSD and treat the whole soldier," he said.

The participants, all volunteers, take about one-half the doses of medications they'd typically get through community mental-health programs. "That's because we're doing a bunch of other things," Fortunato said.

PTSD-afflicted soldiers experience "hyper-arousal," which the center staff treats with techniques like medical massage and "Reiki," a Japanese stress-reduction technique. Acupuncture has proven to be "extremely effective" in treating the anxiety, panic, and tension-induced physical pain many experience, Fortunato said.

There's a big physical component to the program, too. The soldiers must walk at least 10,000 steps a day, including a daily 45-minute "power walk." They play water polo three times a week, forcing interaction that Fortunato said many would rather avoid.

"That's another piece of
PTSD. They want to socially isolate. They don't like to interact with other people," he said. "So we have them interact with the people they feel most comfortable with: other soldiers with PTSD."

Field trips during the program take the soldiers to the local mall and Wal-mart, "two hells" to many of them because they're too big, too crowded and too noisy, Fortunato said. "We teach them ways to regulate their stress level so they can handle those kinds of environments."

Many afflicted soldiers have trouble with concentration and memory, Fortunato said. For them, the program's mix of physical activity and calming techniques appears to help. They do yoga; tai chi, a Chinese martial art; "Quigong," a centuries-old Chinese self-healing method; and biofeedback, which uses the mind to heal the body. "We have a meditation room that looks like it came out of a Zen monastery," Fortunato said.

The program aims to repair the physical damage to the "learning center" in many
PTSD sufferers' brains. That's caused, Fortunato explained, when the body's stress hormone is elevated too high and for too long -- as it commonly is among combat troops.

"The good news is, [the learning center] is one of only two parts of the brain that can grow new cells," he said. So his program requires participants to sit at a
computer several times a day, doing mental exercises to help them regain their cognitive functioning.

While confronting the physical aspects of
PTSD, the program addresses the emotional and spiritual aspects, too.

"Few soldiers come back from war without terrible images and events in their head," Fortunato said. Many "suck it up and soldier on" in the combat theater because they have no choice. But when they return home, these issues can percolate to the surface as nightmares, flashbacks and other problems.

Fortunato's program uses "rehearsal therapy" to help participants confront their most painful memories and experiences. "The soldier tells the story, as painful as it is, over and over until you've emptied it of its emotional punch," he said. "They are never going to forget the story, but it doesn't have to have the grip on their guts that it did before."

Meanwhile, many soldiers with
PTSD find that their combat experience has shaken their core beliefs and values, Fortunato said. A chaplain helps them review "the big organizing things in their life" as they address the spiritual piece of their PTSD struggle. "We weren't doing much to address this before," but it's critical to a soldier's healing, he said.

Fortunato said there's nothing monumental about the Recovery and Resilience Center's approach to treating PTSD. "If you put all of that together, it isn't magic," he said. "None of it is magic. And do you know what? None of it is new. All we did is, we looked at the whole soldier and tried to treat all of him."

The "whole soldier" approach appears to be paying off. Twelve of the 37 soldiers who volunteered for the program have graduated and returned to their units. Among the recent graduates is a soldier who was in a catatonic state in August, but now is free of all signs of

"Little miracles are what we are watching happen," Fortunato said.

So far, only two participants have washed out of the program, both taking medical discharges from the

Fortunato is the first to say his program isn't for everyone. "This is a hard program," he said. "[Participants are] in treatment 35 hours a week [with] daily psychotherapy, daily group therapy [and] integrative medicine. They go from 8:30 in the morning until 4:30 every afternoon. You have to be highly motivated to put up with that much treatment."

There's no set timetable for completing the program, but Fortunato said he's finding six months to be optimal for most soldiers. "As long as they are working hard, we are going to hang in with them," he said.

The soldiers formed their own platoon, which they dubbed, "the Wolf Pack." It's a testament, Fortunato said, to the way they take care of each other and the strength they've shown in admitting they have
PTSD and seeking treatment.

As the soldiers work to overcome their combat stress and return to their units, Fortunato said he's convinced the program is in the
Army's best interest as well.

The cost alone of treating a soldier -- somewhere between $14,000 and $20,000 -- is a bargain to the force, he said. By comparison, he said it would cost about $400,000 to recruit and train a new soldier and provide lifetime disability payments and medical care to the discharged soldier.

"So why wouldn't you do this?" Fortunato said. "I think the numbers are all in our favor."

Defense Secretary Robert M. Gates appears to agree. He toured the Restoration and Resilience Center on May 1, calling the visit an "extraordinary experience."

"They are doing some amazing things here in terms of helping soldiers who want to remain soldiers but who have been wounded with
post-traumatic stress disorder," he said. "It is a multi-month effort by a lot of caring people, and they are showing some real success in restoring these soldiers."

Gates called the center an example of new approaches the military is taking to care for these troops. "This center here is illustrative of what can be done," he said.

Gates said he'll consider the idea of possibly replicating Fort Bliss' prototype program to other posts.

Fortunato said he's all for duplicating his effort, but emphasized that his program's small size is a key to its success. The soldiers and staff all know each other, have nicknames for each other, and feel a personal commitment to each other. "We all love these guys," he said.

America Supports You: Group's Quilts Get Cameo on 'Army Wives'

By Samantha L. Quigley
American Forces Press Service

May 9, 2008 - They didn't have any lines, and if it weren't for their bright colors against the spartan background of a C-17 Globemaster's cargo bay, quilts produced by the
South Carolina Quilts of Valor troop-support organization might have gone unnoticed. But their cameo appearance in a scene of Lifetime Network's military drama "Army Wives," however, reflects the importance the quilts have in the lives of real servicemembers.

Susan Thomas, president of the quilt-making group, said
Air Force Reserve Capt. Wayne Capps, public affairs officer for the 315th Airlift Wing here, suggested to the show's staff that they use her organization's quilts in a scene while coordinating details of the May 5 filming here of parts of the upcoming season's fourth episode.

"It's just so inspiring, just to know that somebody cares enough to say, 'We want to show this,'" she said.

When their 15 minutes of fame ended, the quilts were boxed up and sent overseas with a note letting recipients know about their quilts' star status.

South Carolina Quilts of Valor is part of the national Quilts of Valor Foundation that started four years ago. The mission of the foundation, and all its chapters, is to cover every wounded servicemember with a quilt to let them know how much they're appreciated.

In the three and a half years since it began, the
South Carolina chapter has completed 660 of the quilts, ranging from 50 by 60 inches to 62 by 72 inches in size, just right for use on the litters used to transport wounded warriors on aeromedical airlift flights.

The nearly 30 group members spend about three weeks and a little over $100 to create each heirloom-quality quilt, using only quilt store fabric and a particular kind of batting that ensures they're soft and will hold up to the rigors of a hospital stay.

Despite the seemingly small number of quilters in the chapter, their quilts are anything but cookie-cutter.

"We send a variety," Thomas said. "In fact, [an
Army chaplain] sent me an e-mail after he received his box and ... said, 'I love to turn your boxes upside-down and watch the colors fall out.'"

The differing patterns do more than keep one quilt from looking like the next, Thomas said. The pattern name often is included on the label, which raises some curiosity in the recipients.

Two quilt recipients have told the group that they go online to look at the organization's Web site and to research the history of the pattern. "It gives them something to do in the hospital," Thomas explained.

While she never knows where her group's quilts will end up when they're shipped overseas, Thomas said she knows for a fact that they have a huge impact on the recipients.

The half dozen quilts used in the "
Army Wives" episode theoretically will end up at the fictional Fort Marshall, where the show is set. But their real impact will be much broader. They not only will bring comfort to real servicemembers, but also will shine a spotlight on Quilts of Valor Foundation's less-recognized chapters, Thomas said.

Army Wives" second season begins June 8 at 10 p.m. on Lifetime Network.

Editor's Note: To find out about more individuals, groups and organizations that are helping to support the nation's servicemembers, visit America Supports You directly connects
military members to the support of the America people and offers a tool to the general public in their quest to find meaningful ways to support the military community.

Armed Forces Make Progress in Regenerative Medicine

By Jamie Findlater
Special to American Forces Press Service

May 8, 2008 - Thanks to great strides in medical care, today's U.S. warriors have a 50 percent greater chance of survival if they're wounded on the battlefield than their
Vietnam War counterparts did. State-of-the-art prosthetics help troops who have lost a limb resume many, and in some cases all, of their pre-injury activities. The Defense Department is hoping to find new and even better ways to help the nation's warriors as it researches a field called regenerative medicine that would enable people to generate new skin and even grow new limbs, Army Col. (Dr.) Robert Vandre told online journalists and "bloggers" in a conference call yesterday.

Vandre, research area director for combat casualty care research at the U.S.
Army Medical Research and Materiel Command, has fielded the Armed Forces Institute of Regenerative Medicine, a consortium that has the top scientists in the field working with the Army to drastically improve the quality of life of wounded servicemembers.

Statistics show that 82 percent of returning wounded servicemembers have extremity injuries, 33 percent have wounds to the face or head, and 5 to 6 percent have burns, Vandre said. He noted that thanks to the Defense Advanced Research Projects Agency, prosthetics for wounded warriors have come a long way in recent years.

"DARPA has great programs in place for prosthetics," he noted, "but we are hoping that eventually there will be no need for prosthetics."

Vandre said doctors often are forced to remove limbs because they know that if they don't, the injured servicemember would always be in excruciating pain, and unable to function normally. The Armed Forces Institute of Regenerative Medicine is working to find ways to improve chances of recovery and regeneration that would encourage doctors to keep damaged limbs in place.

"The idea is to use stem cells to put people back together and re-grow the cells that are damaged," Vandre said. The scientists use adult stem cells from the actual patients in their research to minimize the likelihood of rejection.

"Aside from guaranteeing that the body will likely accept the new stem cells, adult stem cells are also less likely than fetal stem cells to cause cancer," he said.

Vandre explained a process called extracellular matrix, in which scientists are working to re-grow damaged muscles.

"Currently, if someone has a wound right in the middle of the muscle and is missing the middle third part, there is not much you can do," he explained. "But with regenerative growth, you can tie the ends back together."

Vandre said the ability to produce new skin should be available in the next few years. "We will easily be able to do things like replace ears and the tip of the nose," he said.

Seven of the 10 top regenerative scientists in the United States are part of the institute, Vandre said, calling that a great indication of its potential for success. "It's really a dream team of people," he said.

The team is funded by $85 million in Department of Defense and National Institute of Health research funding and an additional $80 million generated through state and university grants.

"Since many of these scientists are already pretty big-name people, they already have grants from NIH and the National Science Foundation that adds about another 100 million worth of research to the total equation," he said.

Funding is key, he said, because it determines how many ideas can go forward as projects. "Out of 100 things you work on in the lab, only one becomes a project," he said. "We are bringing the gap by providing the funding to bring some of these projects to fruition, translating basic research to affect actual people."

America Supports You: Group Provides Reading Program at Military Hospitals

By Air Force Maj. (Dr.) Renee Cevey
Special to American Forces Press Service

May 8, 2008 - Wilford Hall Medical Center here has launched a new program emphasizing the importance of literacy to parents and children alike. Reach Out and Read, a national nonprofit organization, uses several methods to promote early literacy as part of routine pediatric care, including having volunteers reading aloud in pediatric waiting rooms.

Its main approach, though, is to promote literacy during well-baby or well-child visits for children from ages 6 months through 4 years. Pediatric providers trained in the Reach Out and Read model offer age-appropriate tips to emphasize to parents and caretakers the importance of reading aloud to children. The parents also are encouraged to invent stories to go with pictures in the books.

During each of these visits, the child receives a new developmentally appropriate book to keep.

Reach Out and Read's programs are located in more than 3,700 hospitals and health centers in 50 states, the District of Columbia, Puerto Rico, Guam, and the United States Virgin Islands. Through these programs, more than 5.4 million new books are distributed each year to more than 3.4 million children and their families.

In 2007, Reach Out and Read teamed up with the Defense Department and its Office of Family Policy, Children and Youth to implement the institution of the organization's programs in up to 20
military health care facilities across the nation.

Research demonstrates that parents who are encouraged by their pediatric providers to read aloud to their children are more likely to do so, and consequently report reading aloud as a favorite activity to share with their children. Furthermore, children who are read to during the first years of life are much more likely to learn to read on schedule, contributing to later school success.

Reach Out and Read helps parents understand developmental stages, builds routines that reassure children, and develops skills and knowledge essential for families being tested by separation and deployment.

The organization is a supporter of America Supports You, a Defense Department program connecting citizens and companies with servicemembers and their families serving at home and abroad.

Air Force Maj. (Dr.) Renee Cevey serves at Wilford Hall Medical Center.)