Tuesday, March 4, 2008


VA failing Iraq war vets


STRESS -- "Within the next three to five years, the flood of

vets seeking help is probably going to overwhelm the VA."

Iraq War veteran Christopher M. Kreiger — at home since Thursday with wife, Melissa, and sons C.J., 6, left, and Cole, 4 — suffers from seizures and hallucinations and has been in and out of VA hospital seven times. (photo: Bill Wippert / Buffalo News)

For a previous story about Christopher Kreiger, click here...

Story here... http://www.buffalonews.com/home/story/290243.html

Story below:


‘Flood’ coming as soldiers return home needing care

Veterans returning from wars find VA under strain


Another surge is putting pressure on the nation’s military.

It is the surge of veterans from the wars in Iraq and Afghanistan returning home with physical and psychological wounds, and the question is: Are the nation’s veterans hospitals equipped and staffed to handle it?

“The flood is coming,” said Patrick W. Welch, director of veterans services for Erie County. “Within the next three to five years, the flood of vets seeking help is probably going to overwhelm the VA.”

It started with a trickle. Just 61 of these newest war veterans sought help at the local VA hospital in 2003.

But in the years after, nearly 1,800 vets returning from Iraq and Afghanistan went to the Buffalo VA and its seven community clinics.

Local VA officials acknowledge the growing demand, and they say they are keeping up with it and will hire 150 more people to continue what, they insist, is success in providing prompt and comprehensive health care.

The VA’s optimism is not shared by everyone.

Jeremy Lepsch, a Marine who served with an anti-terrorist unit in east Africa, says his most recent admission to the Veterans Affairs Medical Center’s psychiatric unit exposed him to staff shortages and overworked psychiatrists.

Dana Cushing, who served twice in Iraq and once in east Africa, says she has to make a 300-mile round-trip drive to the Syracuse VA because she can’t get timely appointments here with a women’s doctor.

And then there’s Iraq War veteran Christopher M. Kreiger.

He has several physical and psychological problems and has been in and out of the Buffalo VA Medical Center seven times. In the last six months, his condition has worsened as he suffered from mysterious seizures and hallucinations and has been unable to sleep. Kreiger was released Thursday from the hospital and says he still does not know what is ruining his health.

Despite repeated promises by VA doctors to send the Town of Tonawanda father to a facility better equipped to diagnose and possibly cure him, Kreiger remains here.

Even in the face of these criticisms, U.S. Department of Veterans Affairs officials say they provide top-notch care, and veterans, in satisfaction surveys, give the local VA Medical Center an approval rating of 75 percent or better, which is consistent with national ratings.

But in the same breath, the local VA officials say they are looking to hire 150 more staff members this year, from clerical support to medical personnel. That would raise the overall hospital staff here to 2,025.

Over the last five years — since the Iraq War began in 2003 — the hospital has added 86 employees.

The 1,800 new patients who arrived during that same time make up only a fraction of the overall number of veterans receiving VA medical treatment in Western New York. The VA estimates that it assists more than 40,000 local veterans annually.

Michael S. Finegan, the top VA health care administrator in Western New York, says the system is on solid footing with staff and resources. Its 2008 budget, he said, is $200 million, which is $70 million more than the $130 million allocated in 2003.

“If we don’t have the service in the building, we buy it in the community,” Finegan said. “Every two weeks, I get a report on who’s waiting more than 30 days for an appointment. Job number one is to get vets in within 30 days.”

Because of patient confidentiality, Finegan says, he cannot identify veterans who have had successful recoveries at the VA.

But he says they are many, including veterans who have been helped through anger issues and now work full time, as well as vets who have learned how to handle panic attacks and other psychological issues. He also cited a vet who regained his speech after recovering from a traumatic brain injury.

Some veterans, nevertheless,

tell a different story of waiting months for care when it comes to appointments with specialists and getting diagnostic tests.

Funding falls short

When Kreiger began having seizures, doctors ordered an MRI on his brain, but because the machine was broken, he said he waited about a month before a portable machine was brought in to do the scan.

Even with the results, doctors were unable to diagnose his problem, Kreiger said, and they took him off most of his medications and sent him home with a supply of morphine.

At 8 p.m. last Monday , he was rushed to the VA Medical Center on Bailey Avenue suffering from hallucinations, double vision, slurred speech, and severe head and neck pains.

A doctor thought blood vessels in his brain had burst, and Kreiger was admitted to the cardiology ward — a move that Kreiger’s relatives said they found baffling.

“Why would he be placed in the cardio ward if he had a brain injury?” asked Melissa Kreiger, his wife. “We later found out he was overmedicated and it was poisoning his liver. Every time he goes there, they either give him medicine or increase it.”

She said that on Tuesday, she met with Finegan to inform him that his doctors continued to break their promise of sending her husband to a VA hospital better equipped to deal with brain injuries.

She says she’s still waiting to hear back from Finegan.

During his time in Iraq, Kreiger was wounded four times. And he had a close call when a 15-year-old Iraqi boy shot at him and two other soldiers. Kreiger, a medic, shot the boy and then saved his life with first aid.

A big part of the problem for Kreiger and other veterans who say they are not receiving adequate medical treatment is insufficient national funding of the VA, according to Welch, the local veterans services director and a Vietnam War veteran.

“Congress will not fund the VA properly to do the job,” Welch said, in predicting that the VA will be overwhelmed by returning combat veterans. “One of the things we advocate is that Congress has to look at the VA as part of the cost of war.”

At last count, 31,000 members of the armed forces were listed as wounded in Iraq and Afghanistan.

But Finegan says the federal government is aware of the situation and is budgeting for it. Returning troops, he added, have many problems, and that presents greater challenges for the VA.

Welch acknowledges that VA funding has increased nationally but “not at the level that the nine major veterans services organizations feel is appropriate.”

Finegan and his staff cite steps they have taken to meet current and future needs, particularly in the area of hiring mental health workers: three additional psychiatrists, bringing the total to 13; five more psychologists, increasing those ranks to 15; and doubling the number of psychiatric social workers to 32. Also, two care coordinators have been hired to help returning veterans.

Still, some veterans with persistent health problems, including combat-related mental illness, say they feel ignored and betrayed.

Delays breed disgust

Lepsch, the Marine who served with an anti-terrorist unit in east Africa and passed through Iraq, said he suffers from multiple psychological and physical ailments.

When recently admitted to the VA’s psychiatric ward, Lepsch said that he spent most of his time watching television and that after two days, he left in disgust.

“I felt I was doing more harm than good to myself,” said Lepsch, who is currently on “medical hold” awaiting retirement. “They pretty much are treating everybody up there like they are a drug addict or an alcoholic. In my case, I have 300 sheets of paper in my medical records explaining about my [post-traumatic stress disorder] and my back and other ailments.”

Short staffing while he was at the ward, he said, resulted in psychiatric patients not being taken outside to a courtyard for fresh air each day.

“Psychiatrists just basically give you a medication and you see the doctor once a day. The doctor asks if your medication is working and that’s it,” said Lepsch, 24, of North Tonawanda.

Cushing, a former Marine, described her efforts to get comprehensive treatment from the VA as a major challenge, since she received a medical retirement two years ago.

“They’re supposed to have four women’s doctors at the VA hospital here, but my VA social worker told me two quit because of the big workload and a third got tired of working here and one doctor is left,” Cushing said of why she now travels to the Syracuse VA for care.

VA officials offered a clarification, explaining that while there might have been more than one women’s doctor, they were part time and equaled one full-time position only. As for the long trips to Syracuse, Dr. Thomas Mahl, a 17-year VA employee and administrator, acknowledged that this some- times happens but noted that 90 percent of veterans receive medical care locally.

“The big problem with the VA is they don’t have the doctors. They keep giving you to physician assistants, and that’s even if you can get an appointment,” Cushing said.

The VA says veterans do have the option of seeing a medical doctor. The ratio between primary-care physicians and local VA patients is 1 doctor to every 1,200 patients, according to the VA. That number is close to the statewide ratio of primary-care physicians to patients.

Sharon M. McGrath, a longtime veterans’ advocate, said that other veterans do have “good experiences,” though she believes that the VA has lost ground since she worked for it in the mid-1980s.

And newer combat veterans such as Cushing and Kreiger by no means have the market cornered when it comes to concerns over VA health care.

A psychiatric nurse who left the VA in 1985 to open C.O.P.I.N. House in Niagara Falls for troubled Vietnam veterans, McGrath says she has to take an aggressive stand every time she sends a veteran to the VA.

Staff ‘being mobbed’

“I know it’s staffing, and I know they’re being mobbed,” McGrath said. “They’ll placate me because I have a big mouth, and I’m not afraid to pick up the phone, but I feel for the staff. I see the staff is working itself to death.”

VA staff members, in fact, told The Buffalo News that they often work beyond their normal workday to assist veterans and do not seek extra compensation.

That, however, does not lessen McGrath’s frustration with how veterans are sometimes released before receiving proper care.

“We just had one of our vets picked up the other day from the VA hospital; he had not shaved,” McGrath said. “When questioned, he said he wasn’t even offered a razor. He wasn’t suicidal. He was in because he’s an alcoholic.”

Finegan said that there are plans to expand the Buffalo VA Medical Center’s psychiatric ward and noted that the VA’s overall national budget for mental health spending increased by $300 million last year.

Dr. Sudha Krishnaswamy, the local VA’s chief of psychiatry, said other steps are being taken to make psychiatric care more accessible.

“We have telepsychiatry, where the patient and psychiatrist are hooked up live [on closed-circuit television] at our community clinics,” she said.

That same type of technology is used to conduct dermatologic and diabetic eye exams at the clinics, making it more convenient for patients, according to Finegan and his staff.

But McGrath says there are shortcomings in talking with a mental health expert over closed-circuit TV.

“How would you like to talk to a psychiatrist by television? This is more convenient for the staff,” said McGrath, who has worked with vets who have complained about having to see a psychiatrist by way of TV.

And while the VA defends its practices, noting that capital improvements are modernizing its facilities, including a state-of- art dental clinic, other veterans advocates are less enthusiastic and say problems here mirror those in other VA regions across the country.

“After monitoring the VA for 30-plus years, it seems they treat the symptom, not the root problem. They will push as much medication as they can on you and then tell you get in line and wait for an appointment,” said Russell K. Terry, cofounder and chief executive officer of the California-based Ira q War Veterans Organization.

Terry, who served two tours of duty in Vietnam, says he is disturbed by what he hears from veterans and those who know of their plight.

“I have talked to many many coroners who have gone into the homes of veterans after their death, either from natural causes or by suicide, and they were absolutely stunned at how much medication the veteran had in his or her bathroom.”

He is quick to say that the VA often succeeds at its job.

“But when it fails,” he said, “it can cost a human life.”



posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

Sphere: Related Content

No comments: