Nimitz Medical Department Performs Emergency Procedure At Sea

By Mass Communication Specialist 3rd Class Jacquelyn Childs, USS Nimitz Public Affairs

USS NIMITZ, At Sea (NNS) -- USS Nimitz (CVN 68) Health Services Department performed an emergency procedure at sea March 6, less than 24 hours after getting underway for the first time in more than a year.

Hospital Corpsman 1st Class (SW) James Ruane, an independent duty corpsman (IDC), alerted the ship's surgeon, Lt. Karen Woo, when a patient arrived showing typical symptoms of appendicitis including nausea, abdominal pain, tenderness, and loss of appetite.

"The patient checked in at the front desk for sick call," said Ruane. "We were getting a lot of nausea and vomiting complaints because of the sea sickness, but he didn't start getting sick until that morning and was having abdominal pain that started late the night before and progressively got worse."

After a thorough examination in which Ruane checked the abdominal muscles for muscle rebound pain and asked the patient to stand and jump in the air which he was unable to do, Ruane sent the patient to the laboratory for a blood test. After the results showed his white blood cell count was somewhat low Ruane notified Woo of the appendicitis.

Woo checked the patient out and made the clinical decision of an immediate appendectomy. At that point, the only decision was whether to do the surgery on board or have the patient medically evacuated. After assessing the challenges and risks of both a helicopter evacuation and operating on the ship, the command decided to perform the surgery in the operating room on the ship.

"Lt. Woo talked to our senior medical officer and told him we were ready to do the job on the ship here and had all the proper equipment and manpower," said Hospital Corpsman 3rd Class (SW/AW) Jason Ast.

According to the corpsmen, performing the operation at sea is the best thing for everyone.

"We'd rather have procedures like that done here on the ship when they can, instead of medevac when there's no need for it," said Hospital Corpsman 2nd Class Marcos Guevara.

One concern was the preparation of the department just coming out of the yards, and whether they would have all the appropriate equipment and training to complete the task. According to Woo, her team was perfectly ready to perform this type of procedure.

"It's always nerve-racking when you come out of the yards and then you find out you have all this stuff you need," said Woo. "But with good supply and good team efforts we performed the surgery like you would at a hospital."

Medical personnel took time in the yards to train and prepare for these types of situations.

"I think we did a very good job on preparing ourselves for a situation like this," said Ast. "We went through a couple mock scenarios for situations like this."

Sailors were able to come together to make all the necessary preparations for the procedure.

"We basically just sterilized all the instruments and set up the room to do the procedure," said Guevara. "It was kind of incredible because it was the first time we've done this type of surgery in more than two years. Overall I feel the procedure went well."

The team and their success was led by Woo, who performed the surgery.

"She was very calm and under control," said Ast. "She was professional, like she'd done this a hundred times."

Woo gives credit to the success of the operation to her team, including the hospital corpsmen and other doctors.

"The surgery went well," said Woo. "Surgery in itself has complications and risks and when we're out to sea it even adds a little more risk to it. I'm just glad I had a good team."

According to Woo, the medical team on board Nimitz is very supportive of one another and they were able to come together to assist in this procedure and make it a success.

"It's like 'teamwork is a tradition', it's no joke," said Woo. "It's serious on Nimitz, you have to have teamwork."

The patient is currently recovering in the Intensive Care Unit and doing well.

Nimitz is currently underway for the first time in more than a year since it entered its Docked Planned Incremental Availability. After completing sea trials, the ship will arrive at its new homeport of Everett, Wash.

Experts Testify on DOD Missile Defense System

By Cheryl Pellerin

American Forces Press Service

WASHINGTON, March 8, 2012 – Technical challenges remain for the complex ballistic missile defense system designed to protect the United States and its allies, but the capability is crucial to the nation’s defense posture, experts told a congressional panel this week.

Bradley H. Roberts, deputy assistant secretary of defense for nuclear and missile defense policy, Army Lt. Gen. Patrick O'Reilly, director of the Defense Department’s Missile Defense Agency, and other experts testified March 6 before the House Armed Services Committee’s subcommittee on strategic forces.

Since 1999, the United States has invested more than $90 billion in missile defense. The fiscal 2013 budget request for missile defense is $7.75 billion.

Roberts said the missile defense strategy balances the need to defend the homeland with the need to address regional threats overseas to U.S. forces, allies and partners, and he described the plan to bolster both.

“We live in an era of missile proliferation, we project power forward globally, [and] we have security commitments in regions where missiles are proliferating,” he told the panel. “We must protect our forces, we must protect our allies, [and] they must participate in protecting themselves. To not do that calls into question the very foundation of our security role in the international environment today.”

New capabilities have emerged over the past 10 to 15 years that now are available to bolster regional missile defense, Roberts said. “So we’ve put in place a program to ramp up these regional defense capabilities over the years ahead … in partnership with allies,” he added. “They are not along for a free ride. We’ve given them many opportunities to strengthen their own self-defense, and many are rising to this challenge.”

The United States has missile defense cooperative programs with the United Kingdom, Japan, Australia, Israel, Denmark, Germany, the Netherlands, the Czech Republic, Poland, Italy and many other nations.

Roberts said the two-stage plan for bolstering homeland defense includes strengthening the ground-based midcourse defense system, or GDM, and in the next decade, shifting to a land-based standard missile called SM-3 Block 2B as a complementary second layer of the system. GDM is an element of the ballistic missile defense system made up of ground-based interceptors and ground systems components.

Defense strategy calls for ground-based interceptors to be enhanced over the next 10 years, Roberts said. When SM-3 2B missiles become available around 2020, he told the panel, those will be added to the system to provide a second layer of protection on the ground in the United States.

“For regional defense, we now have two layers of protection,” he added. “The homeland deserves the same. Depth and redundancy are better than reliance on a single system.”

Such ground- and sea-based interceptor missiles destroy an incoming missile using a direct collision, called “hit-to-kill” technology, or an explosive-blast-fragmentation warhead.

O'Reilly told the panel that the Missile Defense Agency’s top priority is to protect the homeland from the growing threat of intercontinental ballistic missile attacks from Iran, North Korea, Syria and other nations.

“We have made significant progress in enhancing our current homeland defense over the past year,” he added. Progress includes activating a forward-based transportable radar in Turkey and an upgraded early warning radar at Thule, Greenland, to track intercontinental ballistic missiles from the Middle East.

The agency has also upgraded three ground-based interceptors, or GBIs, activated a second command-and-control node -- part of the command, control, battle management and communications network that links the warfighter to sensors and interceptor missiles -- and completed the newest missile field at Fort Greely, Alaska.

“Further enhancement of our homeland defense is paced by the resolution of a technical issue identified in the last GBI flight test and the need for a successful intercept with the newest version of the GBI exo-atmospheric kill vehicle by the end of this year,” O’Reilly said.

A successful nonintercept GBI flight test this summer, he added, will confirm that the problem is resolved.

This year, O’Reilly told the panel, ballistic missile defense capability will be built into five more Aegis ships, three SM-3 Block 1B flight tests will demonstrate resolution of the previous test-flight failure, and materiel release is planned for a second terminal high-altitude area defense, or THAAD, battery for area defense, space-based sensors and sea-based capabilities.

The agency’s 2013 budget will deliver a third THAAD battery and three more Aegis ballistic missile defense upgrades, for a total of 32 BMD-capable ships, he said.

“This year and in 2013,” the general said, “we will conduct the largest, most complex, integrated layered regional missile defense tests in history by simultaneously engaging up to five crews and ballistic missile targets with Aegis, THAAD and Patriot interceptor systems, a forward-based [transportable] radar, and a command-and-control system operated by soldiers, sailors and airmen from multiple combatant commands.”

An important part of the ballistic missile defense system that’s under development is the Precision Tracking Space System, or PTSS, a space-based constellation of satellites that will for the first time be able to track a missile over its entire flight.

“There is no sensor that can fill the function of tracking a missile over its entire flight from space and the broad field of views that we need to cover an entire theater, where we could see missiles simultaneously launched,” O’Reilly said.

“The combination of [ground-based midcourse defense], SM-3 2B, PTSS and other programs,” the general said, “will provide effective and adaptable missile defense for our homeland to counter the uncertainty of ICBM capability from today’s regional threats for decades into the future.”

Active-duty Downsizing Should Benefit Reserve Forces, Board Says

By Lisa Daniel

American Forces Press Service

WASHINGTON, March 8, 2012 – A policy board plans to ask Defense Secretary Leon E. Panetta to highlight service in the reserve forces as a good option for outgoing active-duty members during downsizing.

In its first official action with broader membership and a direct line to the secretary, the Reserve Forces Policy Board yesterday agreed to send eight recommendations to Panetta to encourage National Guard and reserve service for people leaving active duty. The fiscal 2013 defense budget request calls for the military to reduce its end strength by 5.5 percent in the next five years.

Retired Marine Corps Maj. Gen. Arnold L. Punaro, who chairs the board, said a force reduction letter the secretary sent to the services last month included 12 objectives in the drawdown, but did not mention the National Guard and reserves.

Air Force Maj. Gen. Anita Gallentine, a reserve mobilization augmentee who heads the board’s continuum of service subcommittee, said the Defense Department should learn from past drawdown mistakes that discouraged active duty members from joining the reserve components. In the post-Cold War drawdown, she said, programs helped service members become civilian teachers and police officers and offered bonuses for troops to leave active duty, but they had to pay the bonuses back if they entered the Guard and reserves.

Gallentine noted that the reserve forces now are more of an operational force than their traditional status as a strategic reserve, and other members of the 20-member board spoke of the need to preserve those operational capabilities and training investments.

Gallentine said the military pay and personnel system does not allow for an easy transition into the reserve forces, and noted that many benefits are not portable. Past efforts in the Defense Department to improve continuum of service, she added, have “buckled under their own weight.”

“We believe that there is a lot of work that needs to be done in those over-arching areas,” she said, adding that reserve centers should offer more widespread support for reservists, modeled after active-duty deployment centers.

The board also agreed to send these recommendations to the secretary regarding homeland defense:

-- Policy changes to accelerate the use of Guard and reserve forces to respond to disasters;

-- Guidance that training exercises can be used to support disaster relief and other missions, such as when the National Guard pre-positioned forces leading up to Hurricane Irene in 2010;

-- Guidance that will allow state leaders better predictability for calling up forces under Title 32, which has been used 13 times in the past nine years;

-- Increase from 75 to 90 percent the amount the Federal Emergency Management Agency would reimburse states for National Guard disaster relief operations;

-- Give consistency to protections and benefits states give National Guard members.

Also, the board requested that Congress change the law on the Defense Department’s disaster reimbursement fund for states to stipulate it is for domestic use only. “If we don’t limit it to domestic use, it becomes a State Department get-well fund,” he said.

West Virginia National Guard members rescue stranded citizen after tornado

By Army National Guard Staff Sgt. Debra Richardson

West Virginia National Guard

KIAHSVILLE, W.Va. (3/8/12) - On the evening of March 2, Janet Lynn Porterfield – a resident from here - was doing something most of the state was doing: watching the development of a tornado on TV.

But unlike most of the state, as she watched the hook of the tornado begin to develop on the television screen, she began heard the roar of the tornado as it approached her house.

“I told my nephew to grab the kids and I ran into the bedroom, pulled a mattress off the bed, and pulled it over top us as we crouched underneath the stairs,” Porterfield said.

The tornado hovered over Porterfield’s house for a mere minute and -- in the first few seconds of the aftermath -- it appeared that nothing had been damaged.

“I walked to front door and my mouth dropped open,” Porterfield said. “All the beautiful, strong trees were gone. Even in the dark, I knew the tornado had wiped out the entire valley.”

The tin roof was stripped from the house and one of the bedroom walls was carried away like feathers on the wind. After the wind subsided, the rain began and as the night drew on, the rain turned into snow.

“It was the worst minute of my life,” Porterfield said. “I wondered

 whether March was going to come in as a lamb or a lion and on the second day, it came in roaring.”

The following morning, Porterfield’s nephew began the long hike out of the devastated valley with his wife and two children to seek help. Porterfield, suffering from arthritis, was unable to make the trek. She remained in her home without food, water or power.

“A few department of highway guys told us that an elderly woman was stranded in her house,” said Army Spc. Shaun Olds, a heavy equipment operator with the 821st Engineer Company, West Virginia National Guard.

After two days of clearing trees out of the road, Olds was able to drive humvee all the way down to the house to pick up Porterfield and bring her to safety.

“She was very excited when she saw the humvee,” Olds said. “She thanked us repeatedly but we were just glad to see she was okay and in good spirits.”

Porterfield and her nephew are currently in the process of acquiring materials to rebuild the roof. While the task of cleaning up the downed trees and strewn materials is overwhelming, Porterfield keeps a smile on her face as she cleans up the yard, one artifact after another.

“There’s nothing left to do but smile and get on with the work,” she said.