Thursday, August 23, 2012

Tony Horton Visits California Sailors, Helps Navy Promote Culture of Fitness

By Kimberly Gearhart, Naval Base Ventura County Public Affairs

POINT MUGU, Calif. (NNS) -- A celebrity fitness guru visited Naval Base Ventura County (NBVC) Aug. 21, exercising and talking nutrition with Sailors and Marines and helping the Navy promote a culture of fitness.

Tony Horton, best known for his P90X series of workouts, is visiting several military installations in California this month, talking to Sailors, Marines, Airmen, Soldiers and Sailors about getting fit and staying healthy through smart choices about food and exercise.

"It's about creating a different mindset," Horton said. "If you work out today, you're a better man today."

Horton started the day with a workout at NBVC Point Mugu in the hangar that is home to reserve unit Fleet Logistics Support Squadron (VR) 55. In addition to the VR-55 crew, members of NBVC command, Airborne Early Warning Squadron (VAW) 113 and several chief petty officer selectees from around base gathered to workout with Horton.

After an hour-plus workout that included cardio, yoga and martial arts elements, the 75 sailors in VR-55's hangar were sweaty, but still excited.

"I feel motivated and ready to do more," said Chief Aviation Ordnanceman (select) Justin Darnell, of Navy Munitions Command Det. Point Mugu. "The Navy of today is definitely more fit than the Navy of yesterday. The standard has been raised."

Ready for the next step in his Navy career, Darnell said he sees fitness as a way of maintaining readiness and leading the way as a chief petty officer.

For others, getting fit was a life-changer. After the workout, Electronics Technician 3rd Class Elliott Turnbull of VAW-113 talked about how getting fit and flexible has improved his life and made him a better Sailor. Smiling while Horton signed a T-shirt, Turnbull talked about how he was skeptical of adding yoga moves to his routine, but now he is a believer.

"Listen to that. Grown men talking yoga. I love it." Horton, whose routines incorporate several yoga moves, said.

After touring C-130s with the California Air National Guard, which shares a runway with NBVC, and VR-55, Horton moved to NBVC Port Hueneme to tour USS San Diego (LPD 22) and workout with the crew.

Two workouts a day is common for these tours, said Susan Lucy, Horton's liaison and member of his team. At 54, Horton said he is in better shape than he was at 24, thanks to good nutrition and fitness choices.

"You don't need all that fancy equipment. Just your body and a space about as big as a table. You just have to move, so there aren't any excuses for not doing it," Horton said.

Aboard USS San Diego, Horton's second workout was just as intense as the morning routine. After the regular routine, Horton challenged the crew to more exercises, including doing push-ups while balanced on two exercise balls.

Ship's rescue swimmer Yeoman 3rd Class Thomas Meriwether was up to the challenge; after a wobbly start, he successfully completed two push-ups with his feet and hands gripping large exercise balls.

"For me, it's very important to be physically fit," Meriwether said. "I have to be ready to jump in the water and save someone all hours of the day."

Also taking Horton's challenges was ship's dentist Lt. Shannon Kelso. She did a series of push-ups and side planks with her hands gripping small medicine balls. Kelso, who is also the health services department head for USS San Diego, sees being fit as the first step in being a good leader.

"Leading form the front is one of the most important things you can do as an officer and the best place to start is taking care of yourself. That means eating right and exercising and allowing your people the time to do the same," Kelso said.

‘Hurricane Hunters’ Track Isaac as Southcom, Northcom Prepare

By Donna Miles
American Forces Press Service

WASHINGTON, Aug. 23, 2012 – With Tropical Storm Isaac bearing down on the Dominican Republic and Haiti and threatening to strengthen over the eastern Caribbean, the “Hurricane Hunters” from the Air Force Reserve’s 53rd Weather Reconnaissance Squadron are in the air, relaying critical data to National Weather Service forecasters in Miami.

Meanwhile, staffs at both the U.S. Southern and Northern Commands are monitoring the storm closely and ensuring they are ready to provide support to civilian authorities, including the U.S. Agency for International Development and Federal Emergency Management Agency.

Three six-person crews from the 53rd WRS and their maintainers and support staff deployed to St. Croix from Keesler Air Force Base, Miss., last weekend, Air Force Lt. Col. Jon Talbot, the squadron’s chief meteorologist, told American Forces Press Service. Operating out of the international airport there, they began flying their specially equipped C-130J Hercules aircraft through the storm Aug. 21.

On a typical mission that can run up to 12 hours, the aircrews crisscross the storm in what the teams call an “alpha pattern,” he explained. Sophisticated onboard instruments and small canisters dropped by parachute to the ocean’s surface collect accurate measurements of the storm’s location and intensity.

That information is fed continuously to the National Hurricane Center via an onboard satellite link. In addition, the aircraft sends automated messages every 10 minutes, relaying barometric pressure, wind speed and direction, and other measurements.

“The reason this data is critical is because, with satellites, you can track where storms are and get a general picture, but you can’t peer into the storm and physically measure what is happening at the ocean’s surface,” Talbot said. “That is the important piece of information you need to know when it comes to providing warnings to the public. The emergency management community needs to know what is going on near the surface of the ocean, because those are the winds that are going to come ashore.”

With about six missions already under their belts during the past three days, Talbot said, the pace will pick up considerably as Isaac moves west toward the United States. “Currently, we are doing about three missions a day, but that will go up to four or five when the storm comes within 300 miles of the U.S. coastline,” he said.

The Hurricane Hunters expect to move west along with the storm, redeploying to Keesler Air Force Base to resume those missions beginning this weekend. In the event that the crews have to evacuate Keesler, Talbot said, they already have alternate operating sites lined up. “We track these things pretty closely, because if we end up having to jump from here, we still have to continue flying and providing that data while we are evacuating our own resources,” he said. “It becomes a big, tangled web, but it always works out pretty well.”

As a precaution, aircraft and ships are being moved out of the storm’s possible path and other assets are being secured, according to Southcom spokesman Army Lt. Col. Darryl Wright. Planning teams are busy running rehearsal meetings and preparing to verify personnel and resource requests, if USAID issues them, he said.

Wright emphasized that military support, if provided, would be part of a coordinated U.S. response led by civilian authorities. “We conduct close coordination and planning and provide DOD support to relief efforts upon request,” he said. “Through this close coordination, we ensure that we respond with the most efficient means available to the U.S. government.”

In terms of disaster response, Wright said efficiency is typically more important than speed in reducing suffering and saving lives.

Northcom, too, is in a monitoring mode. But with the storm expected to intensify late this weekend when it hits the Atlantic and the Florida Straits, the command deployed a defense coordinating officer and element to Puerto Rico on Aug. 20 to support FEMA, John Cornelio, Northcom’s media operations chief, told American Forces Press Service.

The element of about 20 people is assessing the situation and standing ready to provide assistance, if requested. “We have learned the value of being forward enough to cut down on the response time, if required,” Cornelio said.

With Isaac’s path still anyone’s guess, officials say it’s too soon to know whether it will hit Tampa, site of next week’s Republican National Convention. Northcom has a team deployed there to support the Secret Service during the convention, Cornelio reported.

Dempsey, Japanese Counterpart Bolster Partnership Across Domains

By Amaani Lyle
American Forces Press Service

WASHINGTON, Aug. 23, 2012 – The chairman of the Joint Chiefs of Staff welcomed his Japanese counterpart to the Pentagon today as part of ongoing efforts to strengthen military ties between both countries.

Army Gen. Martin E. Dempsey met with Gen. Shigeru Iwasaki, chief of joint staff for Japan Self Defense Forces, to discuss ways to further enhance the nations’ strategic and personal partnership in the Asia-Pacific region and beyond.

“Our partnership with Japan is historic, … very long and very enduring,” Dempsey said. “We’ve committed to each other that we will continue to improve and build on that partnership and make it even stronger.”

Dempsey said he first met Iwasaki, then chief of the air forces, during a visit to Tokyo in October, and the two men have since become “counterparts, peers and friends.”

“We came to an agreement to further cooperation with U.S. forces to deepen our understanding as we did in the past,” Iwasaki said after the meeting.

Dempsey said he and Iwasaki compared notes on topics from family to joint operations, including the significance of the U.S. deployment of tilt-rotor Osprey aircraft to Japan and associated safety measures.

“The Osprey is our next generation of tactical airlift, and so very important to our modernization efforts in our future,” Dempsey said. “We … want very much to assure the people of Okinawa, and Japanese people in general, that it will be safe to operate. We will continue to work hard to build confidence in the system -- confidence that we have here.”

As aviation and maritime systems continue to evolve, Dempsey and Iwasaki said, they will seek avenues to expand an already solid military-to-military relationship in other domains, including cyberspace, land, intelligence, surveillance and reconnaissance.

“We’re not limiting ourselves to discussion about the maritime domain,” Dempsey said. “I think our relationship expands far beyond that, and, in fact, we’ve served together all across the world.”

Trauma Chief Cites Sweeping Changes in Critical Care

By Elaine Sanchez
Brooke Army Medical Center

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas, Aug. 23, 2012 – From battlefield innovations to revamped health care systems, the military has radically transformed its trauma care over the past decade, a trauma expert here said.

These advances have led not only to the nation’s highest combat survivability rate in history, but also to countless saved civilian lives, said Air Force Lt. Col. (Dr.) Jeremy Cannon, the chief of trauma and acute care surgery at San Antonio Military Medical Center, which houses the Defense Department’s only stateside Level 1 trauma center.

Cannon summed up many of these sweeping improvements to military and civilian critical care in the August edition of the “Surgical Clinics of North America.” Serving as guest editor, the doctor called on a number of his military and civilian health care colleagues to contribute articles on recent advances, while offering insights from his experiences during three deployments in the past six years.

One of the most significant trauma care advances, he noted in the journal, was the introduction of regionalized trauma care, which involves a network of trauma centers in the same region working in coordination to save lives.

South Texas offers a perfect example of a smooth-running regional system, he noted. A network of area hospitals, including SAMMC, accepts trauma cases from smaller hospitals that may not be equipped to handle severe injuries. All work together to ensure patients receive optimal care, Cannon wrote.

The military adopted this civilian-based concept in combat, he added, implementing care that ranges from point-of-injury treatment to extensive surgery. By doing so, he explained, the military was able to take this concept downrange, “tweak it,” and feed it back to the nation with improvements.

Cannon also noted the introduction and growing popularity of “damage-control” surgery. This approach involves surgeons focusing on the most life-threatening wounds first, followed by other surgeries as time and the patient’s strength allow. Prior to this concept, he said, surgeons typically would “fix everything and close,” then adopt a “wait and see” approach. While this may be fine for some patients, the doctor said, it became evident, particularly with catastrophic combat casualties, that a multi-phased approach would better benefit some patients.

Wound management also has seen significant changes, Cannon said, noting the impact of vacuum-assisted dressings, a temporary closure that protects the organs while monitoring fluid output. These dressings, which allow stabilization of the wound, have eliminated the need to change gauze dressings several times a day, increasing patient comfort and enabling nurses to focus on other, more pressing aspects of care.

“It’s had an invaluable benefit to a tremendous number of patients,” he said.

Cannon also noted the major advances in en-route critical care, or taking a soldier from the point of wounding to definitive care. He attributes successes to a combination of long-range transport by critical care teams and advanced critical care therapies for “early acute organ failure.”

Additionally, cutting-edge technology has transformed the care provided in intensive care units, Cannon said, citing ultrasound equipment as an example. Bedside ultrasound imaging has “greatly enhanced the ICU toolkit for diagnosis, monitoring and interventional procedural guidance,” he said. These monitors, he explained, have become less invasive and better at pinpointing vital information.

Cannon points out these examples and many more in the journal, while also looking to even broader changes in the years ahead. The Joint Theater Trauma System, for example, will provide the framework for identifying future potential critical care needs. Through this system, doctors enter combat casualty data rapidly into the JTT Registry, which they can later mine for information regarding diagnoses and survival rates. Put simply, this information can be used to make better decisions regarding future care.

Cannon said he set out to chronicle lessons learned and to create a reference point for future generations to explain “why we do what we do.”

“It was an honor to be asked to do an update of such an important topic,” he said. “I hope it can serve as a benchmark for today’s trauma care.”

Frontline Psych with Doc Bender: Neuroendocrine Dysfunction May be Tough to Say, Diagnose

By Dr. James Bender, DCoE psychologist

Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division 4th Brigade Combat Team out of Fort Hood, Texas. During his deployment, he traveled through Southern Iraq, from Basra to Baghdad. He writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.

I spent a few days this month in Orlando, Fla., attending the 127th annual American Psychological Association (APA) Convention, which is the largest gathering of psychologists and psychology students in the world. The convention allows health care providers from all areas of specialization in psychology and from research, practice, education and policy to get together for four days to learn about the latest advances in psychology. For the third year, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) subject matter experts presented at this convention to increase psychologists’ knowledge of the unique needs of the military population, including treatment options for psychological health conditions and traumatic brain injury (TBI).

A group of us trained about 25 civilian psychologists as part of a workshop on proven ways to diagnose and treat combat veterans with psychological health and TBI concerns. I focused specifically on TBI, addressing the topics of specialty interventions and classifying and assessing TBI. In my discussion, I highlighted neuroendocrine dysfunction (NED) caused by TBI.

Providers who treat a military population have seen their share of TBI, but they may not be as aware of NED resulting from TBI and may not consider it when assessing and treating a patient with mild TBI. NED can be defined as any condition that is caused by an imbalance of hormones that are produced in the brain. The hypothalamus and pituitary gland are the parts of the brain that produce hormones, and damage to either of these areas can cause NED.

An estimated 15 percent of patients with mild TBI experience persistent symptoms and 15 to 30 percent of that group develop NED. If any of these cases are misdiagnosed, which is easy to do, then some patients have spent a significant amount of time in treatment not getting better and providers have spent a lot of time giving ineffective treatments. Many providers who first learn about NED are surprised to learn about some of the symptoms associated with it including:

■Poor memory
■Lack of concentration
■Frequent mood changes
■Increased abdominal fat mass
■Decreased muscle mass and strength
■Cold intolerance
■Hair loss

Since NED has many symptoms in common with both TBI and other co-occurring conditions like posttraumatic stress disorder, NED can be tricky for providers to diagnose and manage. But if a patient has symptoms that suggest NED that don’t resolve after three months, the provider should consider referring the patient to an endocrinologist. To learn more, DCoE just recently developed clinical support tools that provide medical guidance to evaluate and treat NED. You can download the NED Screening Post Mild TBI Clinical Recommendation and Reference Card or contact DCoE at to request hard copies.

It’s important for providers to stay abreast of the latest developments in diagnosis and treatments. Organizations like DCoE and APA make this task easier. Visit the Health Professionals section of the DCoE website often for new psychological health and TBI clinical resources.

Thanks for reading.