Category Archives: military

Dear Imprudence: The Questions You Don’t Get To Ask

A concerned family member writes to Miss Manners:

Dear Miss Manners:

My brother served in Iraq a couple of years ago. He suffers from PTSD and was wounded. The physical wound is not one you can see, but people (family especially) will still ask him what it was like to fight in the war and even go so far as to ask if he killed anyone.

It never ceases to amaze me the way that people feel entitled to information about other people. They love to ask questions about your disability, and when a person happens to be a veteran and has seen combat, one of the first questions that comes up, almost without fail (unless that inquiring person happens to be a veteran or the family member/close friend of a veteran), is whether or not that particular veteran has killed some body.

Have you ever killed anyone?

I just can not fathom having to live with the reality of having lived through that burden, let alone having to deal w/ having to relive any of the emotions attached to that each time a thoughtless person asks “Have you ever killed anyone?”.

The letter writer wants to avoid having to stay away from a family function to keep zir brother safe from such carelessness from other family members, and honestly that breaks my heart. A PWD should not have to completely cut themselves off from friends, family, and other outside contacts to avoid triggering situations, but the reality is, this is overwhelmingly the way that it usually works.

I know for a fact that there are many veterans living in isolation because of PTSD, and yes, several of them are women, because of people who aren’t veterans, who can’t grasp what that must have been like (and not even all of us, as veterans can know what that is like), who can’t abstain from getting too nosy and triggering their PTSD. Why can’t we just have the same conversations as everyone else? Not everything in our lives revolves around our disabilities and our experiences in The Sandbox. Not everything is about the worst thing that has ever happened to us.

I like the way Miss Manners answers this letter:

Can you do this without creating consternation and even more curiosity about his condition?

She cautions the letter writer to caution the family to avoid the topic of war without creating a more awkward situation that might cause the family to avoid zir brother as if he is a ticking time bomb.

[He] will probably tell us about the war eventually, but right now it’s his least favorite topic, and I know he’d appreciate our staying off the subject.

This is the perfect way to describe this.

This is the 60th anniversary of the Korean War, the Forgotten War, many call it. My grandfather is a proud veteran and a Purple Heart recipient. He didn’t like to talk about the war with us, even when I was a shining eyed, curious young girl, who was almost never denied anything she asked of her grandfather. It was painful for him to remember, and the only time I ever saw him reminisce was when we traveled to Des Moines for his unit’s reunion many years ago.

But after I joined the Navy he sent me a letter at my A-School sharing a moment of understanding for what I was doing, and later, when my partner and I PSC-ed to Korea, he sat and talked to us for hours about what he remembered of the country. He told us harsh and sometimes beautiful stories of his memories. He told his of his marching from Pusan all the way to far North, of being picked up by Navy ships, transported back to Pusan and doing it again, after salvaging boots from the dead to cover their own bleeding feet. He tells it better, and I hope to get it recorded the next time I see him. But he told it to us in his own time, when it didn’t hurt him anymore.

I remember when The Kid’s Tae Kwon Do instructor told us of his memory of being a child during the war. A child in her class said that he was too young to do something or another well. The Master told us a story, of being eight, and of being held by his mother in a drainage tunnel and being told to not make a sound while North Korean soldiers ran over head. He was able to barely breathe, soundlessly, and stand against the side, like you see in movies, as they flashed their lights looking for people. He shared that story with us freely, and I remember the look on his face, as if he could still feel the chills of fear, like he was back there for a moment, but stronger now, sixty years later.

We have no right to ask them to regale us with the details of the horrible things they had to do to get by, to make a living for their families, to live, all because they were told it was the right thing to do. Or because they had to survive. They had a moment to think, but they have a lifetime to live with that decision.

People who live through wars will tell their stories when they are ready, because the pain will give them a moment of release, it will subside for a moment, or forget to pound them with the aggressive flashback or terror.

We, as people who have never lived through that, have no right to inflict that upon them.

I Bet It’s Exactly Like That!

[Trigger Warning for descriptions of violent thoughts of self harm]

Oh, by now, faithful readers, you know where we are about to go. We are about to go on a little journey into my mind, the scary place that it is, where I open the floor to discussion about the ways that, once again! Stars and Stripes has managed to get so much so wrong. Because tonight, gentle readers, as I clutch the place that might be close to where my duodendum is and sip my Korean Red Ginsing tea, which the lady at the market told me might help my indigestion, I am reminded once again that I am my mental health are nothing but a metaphor to be co-opted at someone’s convenience!

Let me give you a little background here, because the only online version I can scrape up is this e-version of the print edition, and while WAVE found no accessibility issues with it, I am not going to guarantee that it will be accessible to everyone or accommodating of everyone’s needs. It is, however, a way around their habit of not putting all of their content in their online version (and also allows deployed troops to access the daily paper as well). The front page has the story’s picture, of a white male soldier in Army Green uniform: a light green collared shirt, black tie, green jacket with various awards and pins, a black belt, a black beret, holding a rifle with a bayonet affixed to it. The text on the photo says “Model soldiers [break] Every detail counts when you’re trying to join the storied Old Guard”. The actual article starts on page 4 if you are so inclined to read.

The Old Guard is a ceremonial guard that headquartered out of Fort Meyer, VA, and performs most of its duties in Arlington National Cemetary, similar to the Navy’s Ceremonial Guard, in that they perform many military funerals daily with the cleanest of precision. Their military bearing is expected to be above and beyond that of any other in their branch of service. Their uniforms are expected to be ridiculously perfect, with exquisite attention to the finest aspects of the details, not missing a single loose thread or even a speck of lint. A scuff on your shoe could set you back a week in training. They stand grueling hours at “attention” (The Navy’s Ceremonial Guard does this while holding the business end of the rifle and keeping the butt parallel to the ground for hours, I do not know about the Army’s Old Guard. Full disclosure: I once and briefly dated a guy from the Ceremonial Guard). Everything you know about military bearing is wrong when you arrive for duty, and it is re-taught to “look better”, including the way you turn, march, stand, dress, and press your uniforms (you are even issued special dress white uniforms that are made to withstand the repeated ironing in the Navy Ceremonial Guard).

Do you see what I did there?

I was able to give you some brief background on the very strict regulations of the Old Guard and the Ceremonial Guard without using ableist language. I didn’t once have to compare soldiers or sailors who are required to iron their uniforms exactly right, or who are trained to notice when their medals are one sixteenth of an inch off from the proper dress line to someone who actually obsesses over things like drinking bleach or shoving cork screws in her eyes. Or what it would feel like to jump from a fifth floor balcony.

Because these, my gentle readers, are actual obsessions. They actually intrude on your thoughts and disturb your life, and are really very upsetting, I can assure you. They make you do things, like pull out your hair, burn yourself with a curling iron, wash your hands again and again, and pick at the little imperfections on your skin. Yes sometimes you even iron your uniform again and again and again because you just can’t get it right and double creases are the End of The Universe as We Know It, but it might be because you are certain that if you stop then you are going to iron your hand, not because your Leading Petty Officer is going to chew you out (or your whole division, I mean, does the article expect me to believe that the entire Old Guard has Obsessive Compulsive Disorder? Because that is not on the application!) but maybe because you recently thought that you might do something very harmful to someone you loved if you stopped holding that iron very tightly. Even if your LPO has put the fear of Cthulhu in you.

Being part of an elite military unit who is honored to be charged with memorializing the fallen and handing flags to their loved ones* or escorting the President or guarding the Tomb of the Unknown Soldier is a pretty powerful thing, I am sure. The end result of the intense training, of the weeks and weeks of repeated inspections and physical demands, might very well leave some people with OC tendencies or maybe even OCD outright I suppose — I am not a doctor I don’t know and I don’t pretend to know every experience — but it isn’t the same as living with a condition that sometimes (OK, often) inhibits your day to day ability to live, interact, and (here’s the important one) do your job because you are busy carrying out compulsions to get the damned obsessions out of your head.

Yeah, getting worked up over a uniform inspection? I bet it’s exactly like that!

Only, I’ve been there and done that and bought the cheap t-shirt (hell, I’ve been the OC girl who has had to prepare for uniform inspections!).

It isn’t anything like that at all.

*I want to also point out that the article, for those of you who aren’t able/don’t want to read it via the e-reader the requirements for Old Guard: Must be 5’10 or taller, must have combat experience, blah blabbitty blah. Nothing like another exclusionary Old Boys Club for the military, so they can sit around and pat each other on the backs about how Awesome! they all are. I might note, out of some Branch Pride that the Navy Ceremonial Guard frequently wins the Joint Service competitions and they have *gasp* women in their guard.

Oh, and those people receiving flags? Always widows. Always. Way to erase anyone else who might be a surviving loved one of a fallen troop, there S&S, Army, and anyone else involve. UGH!

New VA Research Could Explain Lasting Effects of PTSD

Gentle readers! I come to you today with a delighted feeling that I do not believe is caused by the half life if a painkiller! Today I read an article in my paper version of Stars and Stripes that had to do with the intersection of disability and veterans and I was not instantly thrown into a bout of contemptuous paper shredding! I mean, really, I could make party favors and possibly go into business selling paper mache animals for children to beat with broom handles in hopes of gathering candy! But I am a slightly morbid person some days, especially when the painkillers aren’t working.

But in all seriousness, this article, about the long term effects of PTSD on the body, has some points which I will now discuss with you in a non-concise manner! Not the least of these details, relegated to two brief paragraphs, is the fact that the people at the VA are doing one study specifically aimed at women who served in the Vietnam War, acknowledging that while women did not serve in combat, that the war affected them in very real ways:

Women did not serve in combat during the Vietnam War but many experienced trauma while serving as nurses and care providers to the wounded returning from battlefield, Magruder said.

“No one has studied the mental health of these women,” she said. “Their experiences were certainly different than the men, but they had other experiences. Some of these women were the last people to hold the hand of an 18-year-old kid who was dying.”

Gee, their experiences were different from men, you say? No kidding? *ahem*

One of the biggest myths that I encounter, being the go-to girl on military matters in some social justice blogging circles is that combat veterans have the patent on PTSD, which is not only incorrect, but also erases the experiences of countless other people whose lives are destroyed by the ways that PTSD is still misunderstood. I’ll take two paragraphs if it means that the VA is finally getting around to accepting the idea that ladies might actually have what it takes to handle the VA being wrong (about ladies having PTSD, that is).

The VA is now trying to weasel out of the fact that they were ordered to look into this PTSD business a long time ago — a decade but who’s counting, amirite? — but decided to throw Congress the bird and a “Ah do what Ah WANT!” Eric Cartman impression. The National Vietnam Veterans Longitudinal Study, expected to help create new policies and effect changes for incoming veterans with PTSD by 2013 might have actually done some good for people who are already having trouble convincing doctors at the VA that their condition is real if the VA could have been arsed to get this show on the road back then. A decade ago they were one less war behind.

It’s nice that they are starting to get around to looking into things like the correlation between living with PTSD for years and developing other conditions. Things like cardiovascular disease, cancer, dementia, asthma and diabetes are common among Vietnam vets who have been living with PTSD for decades, and according to the article there are some who believe even the immune system is affected by years with PTSD. But you can’t help anyone when you aren’t doing the research to find out how.

As the VA is becoming sandwiched between claimants from war era veterans from major wars that have left physical and mental scars on so many, it is important that they get their act together and start doing what they were told to do a long damned time ago. Having the longitudinal data from Vietnam veterans will more than likely prove useful as more and more people come home from two fronts to their old lives and attempt to readjust, and it could lead to better services for more veterans from any war. I can’t say that I have a lot of faith in them to get it together. As Charles Trumpower, a disabled Marine who tours the country speaking to veterans about PTSD notes, not a lot has changed in the last 35 years.

Don’t get me wrong, I’m thrilled to see this research and this effort going underway, but wow, readers, should this have been done a long time ago. I can’t help but think of all the people that this could have helped.

Dear Imprudence: Thank You for (Proving) Your Service!

Slate Magazine’s Dear Prudie got one right this week, with a letter from a woman who’s husband is a U.S. military veteran, who recently lost his leg “due to a medical condition that was unrelated to his time in the military”. According to the letter writer, her husband has adjusted well to his recent amputation, however, it is the passers-by who seem to not be able to just let it go. She writes:

[O]ften strangers will pause to talk to him while we are in public, and these well-meaning individuals will ask whether he is a veteran. When my husband answers yes, it is inevitably assumed that he was injured in Iraq, and he is often thanked for his sacrifice for our country. One elderly gentleman hugged him with tears in his eyes! While my husband is a veteran and technically qualifies for the warm gesture, it seems deceitful to allow these people to believe he suffered a grave injury in Iraq. We don’t want to share my husband’s complicated medical history with strangers, but we don’t want to discourage people from giving thanks to vets in the future. What should we do?

Prudie’s response is pretty solid, in my opinion here. People with disabilities face nosy questions all the time. Everyone from children who can’t help but be unabashedly honest to grown-ups of the well-intentioned and otherwise variety. People with visible disabilities are constantly questioned about the whats, the hows and the whys of their conditions, as if they are under some obligation to share private pieces of their personal medical information. PWDs with invisible conditions are scrutinized by even their close friends when their health varies from day to day.

Veterans also face a barrage of these questions even when they are able-bodied, from people wanting to know about their service, where they’ve been, even if they have killed someone (hint: you should NEVER ask a veteran this question). Sometimes this line of questioning ends in tears and hugs and thank yous because people are grateful and some even want to share common experiences. Sometimes this creates tense situations. One place where I was stationed in California this actually resulted in people throwing their drinks on sailors and calling us “baby killers”, resulting in a lockdown on how and when we were allowed to leave the base or our houses.

The place where this intersects creates a wholly unique situation. Like Prudie says, people see a person of about the right age with a disability and presume that this person must be a combat-wounded veteran. Cue the questions and thank-yous, and demands for, once again, medical information that is none of their business. All based on presumption.

I agree with Prudie here. “Didn’t” and her husband are under no obligation to correct these people, no matter how well intentioned they may be in their demands for information or genuine their appreciation of his service. It is an invasion of his privacy, of their privacy, and it should be enough to appreciate the sacrifice that they made as a family (however much of that time was spent together) and he himself for his time spent in service, because it is a sacrifice of time and life. If these strangers want to assume that his loss of leg is related, then that is on them, but there is no litmus test of injury or illness that is required in order for your service to be appreciated.

Being patient and understanding that some of these people mean well is one thing, and it reflects well on Didn’t and her husband if they are willing to do so, and thank them for their gratitude. But when it goes beyond a thanks and violates their comfort levels they should feel no guilt over drawing a line and letting them know that they would rather not discuss it.

Fighting To Get Back And Other Cute Metaphors

Moderatix note: This post will be United States Military centric, as that is the perspective I offer, and the broken system within which I currently exist and attempt to navigate.  Other voices are welcome and experiences appreciated within the context of the conversation, since I can not pretend to know every thing about every military experience from every branch in every country.

A while back I wrote a little bit about Permanent Limited Duty, or PERMLIMDU as we called it in the Navy. It is the status you are placed in when you are injured or sick enough that you can no longer perform your job to military standards and the military has a board decide how much you can do, how long you can do it for, blah blibbity blah.

I also get a daily subscription to the Stars and Stripes newspaper because I like to read while I am on the toilet. It seems appropriate.

So it stands to reason that I would come across this article from Stars and Stripes (the online and the paper may vary a bit, I haven’t matched them up side by side, but there is usually a slight variation if I can find them in both mediums at all) about servicemembers who are “fighting to get back”. Actually, in the online version the headline uses a cute joke “but results may vary”. I tried hard to laugh. *ahem*

Now, let me be perfectly clear: I applaud the efforts of the military members who worked through their injuries and fought to return to their jobs. I hesitate to applaud this type of story, because these always, always, especially when covered by the military, feel “inspirational” to me, even though the veteran in me applauds the veteran who is them, irrespective of the intersection of race, gender or other marginalization, for getting back to any kind of duty status. Because the military is an animal that will eat the less than perfect alive and shit them out and bury them, forgetting they ever existed.

According to the article, “200 soldiers, 58 Marines, 33 sailors [I would have been 34] and six airmen have petitioned for, and won, the ability to continue to serve even though the military has found them unfit for duty”, which is nothing short of remarkable considering the way the military has about tearing people down. What is interesting is this article and the way it highlights some aspects of this marginalization, and glosses over others altogether.

Most interesting to me is that of all of those people, they could not find one woman to highlight? Hmm… funny that. I can’t imagine that not one of those many people who came back to PERMLIMDU status was a woman.

Most aggravating to me was the story of Spc. Jake Altman, whose story was almost presented as a he-said, he-said, except that they casually dismissed Altman’s feelings of being mistreated. He mentions being put on patrol in a damned war zone without his prosthesis, because his superior said that it looked like it was hard for him to see others doing it better than him. So, what? Was it Sgt. O’Brien’s job to teach Altman a lesson in hard knocks? Because something tells me that Altman had already skipped ahead a few courses in that one and could happily give O’Brien the Cliff’s notes explanation. Not that I think he would listen. Because a good number of TABs tend to not really try to get it when PWDs try to describe their experiences to them.

Altman contacted the Warrior Transition Unit, a wonderful thing the Army has going on, and has eventually sought discharge. I can empathize.

Because at the end of the day, no matter how much you want to stay in and do the job, what others think and how they treat you matters. It matters enough to drive you out. I think that if someone did a study or a survey or wev, they would find that people who transitioned out of the military due to illness or injury might possibly have depression due to a crushing loss of the camaraderie, but that is my lay opinion based on my own experiences.

The dismissive air of the article over Altman’s attempt at returning to deployment, and the following segment, subtitled “Up To The Challenge” as if Altman somehow had a moral failing, as if the treatment of those around him, who judged him outright and convicted him of being less-than due to his injury.

My job in PERMLIMDU would have been much different. I am not even exactly sure what it would have been, to be honest, because… well, in my mind I still gave up. Getting injured in the military, or ill, or anything that makes you less than a perfect TAB specimen, eats you alive. It starts to kill you from the inside, knowing that you are a failure, because you have been conditioned that anything less than the best is unacceptable. The glimmer of hope that is PERMLIMDU gives you back a sliver of that self worth.

Recommended Reading for June 3, 2010

Two totally adorable golden lab puppies with floppy ears, wearing blue cotton bandanas with the tag "Service Dogs."
Two totally adorable golden lab puppies with floppy ears, wearing blue cotton bandanas with the tag "Service Dogs."

Service puppies in training!!

Miami Herald – Embedded therapists protect National Guard members’ mental health

Roger Duke is a Vietnam veteran, a retired Marine lieutenant colonel and a licensed marriage and family therapist. Since 2006, he’s spent at least one weekend a month embedded with a California National Guard unit. Duke, 57, wasn’t deployed with the unit’s soldiers in Iraq and Kosovo, but he’s a trusted face whom the soldiers confide in before and after their deployments. “Some of the best conversations I have with them are at one in the morning in a Humvee during a training exercise,” said Duke, who’s part of a California program designed to help returning Guard and Reserve members by attaching mental health counselors to their units.

Threadbared – Hanky Pancreas: insulin pump accessories and cyborg embodiment [this post was so nuanced and complex and beautifully written that I hesitate to even do a pull quote because I strongly (strongly) encourage you to click through and read the whole thing]

Floeh’s designs permit wearers to make a strategic double-move around camouflage and visibility, simultaneously hiding the pump and drawing attention to its location (i.e., waist, hip, bustline). When I’m in disability-pride mode, I’m troubled by this kind of hiding, following the logic that visibility is good (i.e., wearing the pump on the outside makes us legible, shows the limits of clothes designed for bodies without peripherals, disrupts conventional, hetero feminine gender presentation) and hiding is, well, hiding, with its affective companions: shame, fear, desire for normalcy, willingness to pass.

But visibility is only one tactic among others, and hiding the pump can also be a radical act – especially if it facilitates feeling-good-while-diabetic (for example: the best act in my burlesque repertoire hinges on repurposing a strap-on harness as an under-dress pump-holder; most of the time, my solution to the dress-problem is a jury-rigged system involving a black garter with small cosmetics pouch from Benefit, bra straps, and safety pins to keep things from sliding down my leg – unless I’m already wearing a garter belt). Of course, in the case of hiding or disguising one’s pump, feeling good can also mean feeling closer to a conventional femininity and mythic norm. I don’t want to elide that possibility, but I also return to the reality of living with chronic illness: that we live in a space of contradiction, that we work with what we have & do what we need to do to claim our (sick, cyborg, incurable) bodies as desirable. In my ideal world – one I suspect Floeh wants, too – we’ll recognize that transformation can (and should) mean more than transforming the pump, or the wearer’s relation to it, to align more closely with a dominant, normate feminine ideal. Creating, enabling, accommodating, and celebrating a multitude of diabetic, cyborg embodiments — and advocating for wider access to the pump (with all of its troubling potential) for those who are uninsured and can’t afford the $6000 price tag — these are the kinds of social transformations that need to happen in conjunction with personal ones.

BBC News – Mental health research is ‘incredibly underfunded’

Only 5% of medical research in the UK is into mental health, despite 15% of disability resulting from disease being due to mental illness.  Last week, one of the major research funders, the Medical Research Council, published one of the most up to date reviews of the strengths and challenges of mental health research in the UK. It not only showed that the research that does get funded is world-class but that the UK is well-placed to lead the way in this area. The review concludes that there are several opportunities to fund more research in the UK that would help accelerate progress in developing new treatments, or lead to better ways of preventing mental illness in the first place.

7 News Denver – Is Xcel’s Tiered Rate Program A Surcharge On Disability?

Xcel Energy’s new tiered-rate program [for electricity] began Tuesday. Customers whose lives depend on electricity aren’t given an exception. Xcel users who need electricity 24 hours a day to power oxygen tanks or ventilators have to pay the same usage costs as someone who wastefully keeps on their air conditioning.”That’s what the problem is, it’s basically a surcharge for disability,” said Julie Reiskin, executive director of Colorado Cross Disability Coalition.Reiskin told 7NEWS her organization was never notified by the Public Utilities Commission prior to the tiered-rate system decision. The PUC oversees Xcel.”I was shocked we did not know about it,” said Reiskin. “It’s disturbing that the PUC saw fit to get input from Xcel, but not from the people who are directly affected by this.”

A Happiness That Forgets Nothing – You know what? I take back that shit about not hating people.

SO. My brother—my clinically depressed brother—was met by police today. You know why? Because he mentioned to his friends that he had suicidal feelings. So what did they do?
CALLING THE POLICE, TELLING THEM WHERE HE WORKS, AND HAVING HIM HOUNDED BY THEM ABOUT HIS PERSONAL FEELINGS IN FRONT OF HIS COLLEAGUES.
I am in tears right now. Enraged tears.
My brother has a mental illness. But he is still an autonomous, competent fucking person. He can make his own goddamned decisions without alleged friends having  him hunted down like a fucking criminal.

[and finally, a mystery in which I ask for your assistance! I have seen several blog mentions of this thing – product? service? – called ‘Buddy’ that has a contract with the NHS and is supposed to help people with disabilities and I cannot understand it! Perhaps you can help?]

Buddy is a post-digital social care service that seeks to improve the well-being of people living with long term conditions, and at the same time, reduce the cost of service provision. At the heart of Buddy is a social media radio which lets users broadcast from a physical device, to a range of social media platforms. By using social networks, Buddy extends the community of carers around an individual beyond healthcare professionals, to friends, families and peers. Our idea is to decentralise and socialise care, creating a more people-powered service, where friends and families are working alongside professionals to support individuals, in real time. Co-production is the jargon.

Military Docs Treat Pain in New Ways and Shame in All the Old Ways

Gentle readers! I know! I am going to worsen my hernia by reading this stuff every day! I can’t help myself! It’s like tearing myself away from a Star Wars Marathon and a free case of Guinness and Harp on New Years Eve Back when I was child free and in college! Did you ever hear about that drinking game?

Because what I really need right now is more news pounding home just how EEEEEVIIIIL drugs are and how in danger some of us are of becoming dependent on them!

Especially, WOES! Those poor servicemembers, because they would never ever have a reason to use them. Not with an almost decade of war going on in two countries and the highest rate of PTSD, suicide, TBI, and other things we have ever seen in our troops before.

Now, let me slow down for a moment, because there are some really good things going on here. This nerve blocking thing sounds pretty awesome, but I am not a medical professional of any type unless you were going by the number of dram bottles I have on hand. While I have a lot of not-so-nice things to say about the already “pins and needles” feelings in my hands and feet, I will take that in other parts of my body over what I deal with now thats-for-damned-sure. But the juxtaposition of a new therapy with the whole “drugs are bad, mmmm’kay” meme is wearing on my last pain free nerve. The shaming of opiate use is tired and older than my favorite period underwear.

As more troops return from the battlefield with chronic pain, the military has seen a spike in the number of prescriptions for opiate painkillers. More troubling, abuse of painkillers is on the rise: About 22 percent of soldiers admitted misusing prescribed drugs, mostly painkillers, in a 12-month period, according to the results of a Pentagon survey released this year.

So, how did their magical survey define “misusing”? Taking more than prescribed? One more? Two more? Because you were in MORE pain than that prescribed amount of pain managed and you were having trouble getting an appointment with your PCM to get the dosage adjusted or any other treatment? Anything beyond precisely what is on the label is “misusing” a prescription. The military has an entire month devoted to prescription drug abuse awareness…but what they don’t do much to address is the underlying need that might cause servicemembers to resort to such a thing; the fact that they might be in pain and they might not have doctors paying attention or being able to pay enough attention to them or their pain.

At the VA hospital in Tampa, all patients taking painkillers are incrementally tapered off them, Clark said.

Because chronic pain never completely goes away, the hospital’s staff emphasizes physical rehabilitation to strengthen muscles and joints near the pain source. When the injury involves the brain — as in PTSD and mild TBIs — the focus is on treating symptoms that could exacerbate pain.

“Pain may make it more difficult to treat those issues,” Clark said, because “all these things interact.”

But what about the remaining pain? The article never goes on to address what is done for that remaining chronic pain. You know, the pain that never goes away. Because we know that just sucking it up doesn’t work in patients who have chronic pain, and if all patients on painkillers are taken off of them over time…well then, what the hell is actually being done?

This new treatment sounds great for the people to whom it is available, and for the people for whom it will work, but let’s not jump ahead of ourselves and pat ourselves on the backs pretending that this is some magical solution that has suddenly rid us of the need for those nasty opiates or narcotics that are JUST. SO. BAD. FOR. EVERYONE. (You fucking addicts! I mean, c’mon, you were all thinking it!) (Right?) Dr. White is one of only six doctors who do what he does, and the article doesn’t say that the others offer his fancy treatment, nor does the article make any mention of how many civilian specialists are working on this treatment.

I worry that the VA and other military treatment facilities will look at this as a sign that they should be able to deny more patients painkillers. Progress will mean exactly nothing if it sacrifices patient care or hinders the quality of life of patients in chronic pain and with life-long illness and injury. While this article correctly talks about how chronic pain is processed differently by the brain not every uniformed doctor and military medical professional subscribes to that theory, and what the military doesn’t need right now is more doctors, medical professionals, or hospitals bragging about how all of their patients are off those evil, bad, no good drugs without offering them real help.

How Many Straws?

A blue and white lane-marking buoy in a swimming pool.I know that I am not 18 any more.

One of my doctors kindly pointed that out to me recently.

What I mean is that I can no longer demand of my body what I once did. And I know this, as I embrace the things that come with years gone by. Aging is a complicated issue for me, emotionally charged and not something I am willing to discuss right now, but it is important to note that this post is not about aging. It is, however, about the way my body has worn down due to my disability.

When I was 18 I drilled endlessly on the U.S. style football fields, with the careful precision that four years of training an 8-to-5 step — that being my ability to march exactly eight steps in five yards to whatever beat you set for me — will ingrain into a person. I was able (and expected) to teach others under me to do the same all while playing the horn. To this day I can not hear most music without at least tapping my foot. Emerson, Lake, & Palmer’s “Karn Evil 9” will actually cause me to hum along wistfully. Later I did the same at University. Anyone who participated in University Marching Band at Eastern Michigan University can tell you that marching band was not something you just did, but rather worded at, and I worked hard. Hauling that tuba around during pregame was no easy feat. There was a reason music majors received PE credit for marching band.

Before I was diagnosed I was a runner. When I was 18 I had pounded out miles on the track and on mapped out road routes in order to get into the condition I needed to race for years. I was able to sprint out the eleven or thirteen steps, whichever felt right, to take me to the high jump pit and sail over the bar. I wasn’t amazing, but I had determination to demand it from myself. I ran in high school, and I hated it. I loathed it. I had clever names for the malevolent task-masters whom I called Coaches that I went to voluntarily every day after school and asked for work out schedules and whose hands I shook afterwards.

I ran before, during and after my pregnancy (when I wasn’t throwing up), cussing myself out the whole time. I ran in Navy boot camp, filling myself with the urge and the desire to do well. I hated every moment, but loved the feeling of feet on pavement even as my shins cried out in pain. I filled myself with the desire to go one step further, two, one mile, two, as I shoved tears out of me to replace the pain that filled my body (and I usually peed my pants a little at some point, but that is another story).

Eventually the shin pain became a lot worse. It was massive, and no amount of ice or ibuprofin was going to alleviate it. A bone scan later and some Tolkein-esque blathering you don’t care about and I am told I can never run again. Sure, the Navy loved that. I couldn’t get a chit to back it up w/o getting kicked out earlier than I already did, so I had to go back every 45 days or so to get a new one, and I had to be very sure it was a nice sailor-doctor who signed it, because the Fitness Enhancement people were not going to take anything signed by anyone who was a civilian or any other branch of the military regardless of what degrees they had on the wall. So, running was right out, and they weren’t making it easy for me to, well, take care of me.

I became a swimmer, and I was fantastic at it. I probably knew this deep down, having been a natural swimmer since before I could walk. Had anyone told me that I could swim as an option to running in the Navy sooner I would have. I swam thousands of meters a day, until I was exhausted (trying not to notice that my body was telling me this was sooner and sooner each day). I would do kick turns through migraines that were getting more and more fierce despite the amount of over-the-counter meds I was pounding. Go figure. My Fitness Test scores went from Good/Low to Excellent/High.

Until my abdominal muscles gave out.

I finally pulled something doing sit-ups. I went from doing in the high 60’s to barely being able to do the 35 that was required to pass for my age group pretty much overnight. I would get to 15 and the pain would make me yell out it was so sharp. I could almost clock it, too. Of course sit-ups were always first, and this made push-ups impossible. I couldn’t even do the simple 15 I needed to pass. My doctor felt around, and determined that core exercises were out for fitness tests. I was to do them only at my own pace or with a doctor in physical therapy.

Finally the headaches were bad enough that it was too much and my swimming was scaled back. My exercise was restricted so much that I was barely allowed to do 30 minutes a day. I was still not receiving any pain medication other than anti-depressants, which were not working for me. I started seeing a chiropractor, and doing yoga, which I was told was not a “real” workout, but would count for my weekly number of workouts anyway. Even then I couldn’t do a full class because I was in too much pain.

Still, as I gained weight, cornered in by pain and now stuck in a body that wasn’t allowed to move anymore, my new doctors (because they were always changing) said that I just needed to lose weight, if only I would watch my diet and include more exercise into my daily routine, which by now was only limited to half days of work due to pain and 15 minutes of exercise by my chiropractor and PCM, and Hey! How about seeing a dietician?

After my discharge, when my second career choice was unceremoniously ended with me handing over my ID card, I finally settled into a place where I stopped hating my body so much (OK, you got me, I’m still working on it). I am finally on a pain management regimen, I do light exercise as the pain permits, and my body is stable at a weight that hasn’t fluxed one way or the other for a few years now. I had to give some things up (drinking alcohol any more than a few sips being the one that comes to mind mostly) because of those medications. But all of this aside, I have tried to take care of myself. I have followed what doctors have told me to do, I didn’t smoke, I tried to eat right, I wore sunscreen…I even eat very little meat, having been an on again/off again vegetarian. I know that these are not hard and fast actual things that guarantee health, they are just things that I have always followed because some doctor or dietician or another has advised me blah blibitty blah… What I mean is that I have very few of what people generally consider vices.

Recently I had some issues where I have been vomiting in my mouth, acid reflux, heart burn, all kinds of fun stuff. They gave me a nice, handy laundry list of things I need to give up in order to help alleviate the symptoms now that they have prodded around my duodendum with a camera.

Things like coffee, and chocolate, and anything spicy (or tomato-based in general), which are three of my favorite things. All citrus foods are right out, which I expected, but they snuck in things that surprised me, like mint and mint flavoured things, which took half of my herbal teas out as well. Finally, I find myself with no vices if I am to follow all of the doctorly advice to maintaining my health.

Let me tell you that I have not been a pleasant person to be around lately. I depend on that Super Human tolerance for things like caffeine and chocolate (sometimes at the same time!) to fuel things like my snark and ability to write 2,000+ word blogs posts. I have sustained myself on coffee and little else at times. It is often the centerpiece of friendly chats and family gatherings.

It leaves me to wonder, how many straws do we lose before we say “that’s the last one? I can’t take any more!”?

What lines do we draw when we get all of that medical advice, when things that we enjoy or that we once did have been stripped away from us one by one, to balance a quality of life for ourselves so we don’t sit around stewing about what we can or can’t do anymore, and to make sure that we do actually pay attention to the call of our bodies as they try to tell us something (if they do send us signals at all)? Where do we draw the lines between telling our bodies to piss off because we need that comfort, that thing that helps us get through the day when we feel like everything else has been taken from us?

Or am I making mountains out of molehills here?

Photo credit: ashleigh290

The Balkans: They Call It Balkan Syndrome: War, Terrible Legacies, and Pointing Fingers

The Balkans are a hub between East and West. This diverse region of Europe has rippled with conflict for centuries and like other areas repeatedly subjected to violent conflict and military actions, a significant legacy has been left behind. Rates of disability are higher in war torn regions for all the obvious reasons, support is often lacking, and in places like the Balkans the issue is complicated by the consequences of decades and centuries of conflicts between not just enemy nations, but friends and neighbors; as in Rwanda, people are struggling with the psychological aftermath of turning on each other. The toll of war in the Balkans has been immense.

In the 1990s, the Balkans exploded with a series of conflicts as the former Yugoslav republics battled amongst themselves. The North Atlantic Treaty Organization (NATO) intervened on several occasions in an attempt to bring peace to the Balkans, and they brought a little something extra with them.

Depleted uranium (DU) is a radioactive material made from recycled nuclear fuel. It’s favored by militaries because it is extremely dense, which makes it useful for developing armor penetrating rounds. DU rounds can stop tanks in their tracks and easily penetrate body armor. This makes them immensely popular when the primary goal is stopping power which can be used to bring a conflict to a close quickly. Between 1994 and 1995, the United States Air Force (USAF) alone dropped 2.3 tons of DU ammunition in the Balkans. In 1999, during Operation Allied Force, 10.2 tons of DU were delivered by the USAF to military targets.

Dropping radioactive materials willy nilly may not seem like a wise idea, but numerous military authorities argue that DU poses no threat and can provide ample studies to back up the claim. This despite the fact that DU rounds break up on impact, spreading fine radioactive powder around the areas where they are delivered. When tank penetrating rounds are used, for example, the interior of the tank is covered in radioactive material. In the Balkans, abandoned and radioactive vehicles could still be seen by the side of the road five years after Operation Allied Force was over. Children played in them. Independent research teams have demonstrated that pockets of radioactivity are still present in areas which received large payloads during conflicts in the Balkans.

DU doesn’t stay confined to the area where it was delivered. It penetrates the soil and enters the water and is carried away by the wind. Thus, a radioactive contamination problem in the Balkans is a radioactive contamination problem for neighboring areas as well. Survey teams in the Balkans and neighboring areas have identified radioactive dust in the wind, in groundwater, in surface water, and in soil. While there have been some cleanup efforts, many recommendations suggest that DU should be left in situ because it is not believed to be a risk and disturbing contaminated ground may be more dangerous than cleaning it up.

Tell that to Allied soldiers who worked in the Balkans, who are currently experiencing unusually high rates of cancers, notably lymphoma. French and Italian soldiers are experiencing cancer at rates in excess of the norm. Residents of the Balkans may be facing what has been described as a “cancer epidemic” and DU is certainly one possible cause. In Serbia, unusual rates of chromosomal variations have been documented; radiation exposure is certainly one possible cause and the fact that radiation has been found in Serbian water supplies should certainly give one room for pause, at the very least.

There’s a name for it: They call it Balkan Syndrome.

NATO studies continue to insist that DU does not pose a threat, either to the people who were involved in peacekeeping missions in the Balkans or to the residents of the region. Their studies have primarily focused on soldiers, not residents, and long-term epidemiology studies are hard to find. Things like fertility problems can be difficult to recognize in the immediate wake of a conflict. I would also note that there is a long and established history of military denial of epidemiological trends when those trends look bad for the military.

The continued use of DU munitions is problematic. The fact that cancer rates consistently rise among people exposed to such munitions certainly suggests a very strong correlation which could merit further exploration. It is also notable that reports on the danger of such munitions conflict rather wildly, depending on the source or sponsoring agency of the report, which seems to suggest that more independent oversight would be a wise idea.

For those who trust NATO’s reports and believe that DU is not an issue in the Balkans, something still needs to be done about people with disabilities in the region, including those unusually high numbers of people with cancer and congenital disabilities. And this is complicated by the fact that repeated conflicts created masses of refugees, many of whom had no homes to return to and who were set adrift by conflict as borders were moved and redrawn. Many of these same refugees also experience psychological issues related to war. While the refugee crisis has eased, the aftereffects linger.

Post traumatic stress disorder is not uncommon among survivors of the wars in the Balkans who were refugees, some of whom are also trying to care for young children and disabled family members in a culture where disability is often treated as a sign of moral failing. Some of these children are the result of systematic military rape. Providing intervention is difficult on many levels; there are language and cultural barriers, the lack of fixed and stable homes makes it difficult to follow up, it is difficult to track people for demographic purposes, and it can be challenging to ensure that children have access to consistent education. People who have been refugees are also more likely to experience poverty, which can be a significant barrier to accessing needed services.

As the Balkan states slowly join the European Union, conversations need to shift from where responsibility lies to what we want to do about it. Intervention in the Balkans can only be effective, however, if residents of the region are empowered by it and that intervention remains respectful to cultural and social traditions of the region. Is the EU up to the challenge?

Here are some organisations working in the Balkans on disability issues:

Capacity Building of Disabled People’s Organisations in the Western Balkans (CARDS Project)

Center for Independent Living Serbia (supported by CARDS)

Self-Help and Advocacy for Equal Rights and Equal Opportunities South East Europe (SHARE-SEE)

Association of Disabled Persons (UDAS), Banju Luka, Bosnia

For Cereal, Stars and Stripes? Mocking “Paranoia” is Headline-Worthy?

OK, so I saw this one in my paper edition because I get it the night before (and technically a day late, since I am in the future!), but you can find it online too.

In the 16 March edition of Stars and Stripes writer Jeff Schogol wrote an article containing letters from people who sent letters to the Defense Department website. He calls the letters he said the DoD provided to him “the more bizarre feedback it gets” and notes that “[t]he authors’ names were withheld, but all spelling, grammar and paranoia are authentic“. (emphasis mine)

The article, titled “Airborne bears to catch bin Laden and other letters to the Pentagon” seems little more than a great way to laugh at people for myriad reasons. Let’s poke fun at their lack of intelligence! See how they can’t construct proper sentences? Those silly people without proper educations and who aren’t newspaper columnists or Pentagon officials! Ha ha! That’s so funny!

There were several letters published by Jeff Schogol in his article that I don’t feel comfortable publishing here, because I don’t feel that it is proper to display these letters that were meant to be private correspondence and won’t further his ableism. I don’t want to further hurt a person who might already be pained by finding hir something they never meant to have public spattered all over the internet and a military wide newspaper. They were not meant for this type of dissemination, and I think it was vile of whichever Pentagon employee thought it was appropriate to release them to a newspaper. I also don’t feel that it is in good taste to print a letter in a newspaper with the intention of laughing at the “crazy” person, as it is clear here that is what is meant. We are supposed to have a good chuckle at the supposed ludicrous ideas that are put forth by the letter writers. Schogol obviously feels that it is OK to call people paranoid and make light of mental illness and disability. Har har.

I am going to invite you to write to Jeff Schogol at Stars and Stripes and let him know that you don’t think it was a great idea to run this article, or that it was in good taste to reprint these letters. Or if you feel inspired, maybe you would like to use the same venue as the original letter writers who thought that they were writing private correspondence to the DoD, and let them know just how unprofessional it was to release those emails to a newspaper for a chuckle.