Multiple challenges face military personnel during and after war
(Oct. 28, 2008)
Reintegration, readjustment and redeployment are some of the cyclical challenges facing military personnel during an extended war. But the residual effects will linger years after the war is over.
A panel of health care and military experts met on East Carolina University's health sciences campus Oct. 27 for the fourth annual Rehabilitation and Allied Health Symposium to discuss innovative partnerships for serving wounded warriors. About 140 people registered for the event, organizers said.
Some challenges facing military personnel returning from deployment are health-related such as recovery from blast injuries and post traumatic stress syndrome. Others include employment and financial difficulties and the stress of readjusting to family and community life.
"There are a lot of readjustment challenges. They won't be the same as when they left," said Capt. R.W. Vince Arnold, U.S. Navy (Ret.) and head of the Deployment Health Center at Camp Lejeune.
ECU, its sister institutions, health care and military partners are responding to veterans and active duty soldiers' needs by providing physical and mental rehabilitation, biofeedback, occupational and physical therapy, telemedicine, workforce training and research.
Arnold vividly described what it was like to land in Iraq for the first time. Geared in battle attire, weapons locked and loaded, soldiers fly in on a "rollercoaster from hell" in total darkness preparing to land in a noisy war zone.
"For me, as a non-combatant, my adrenaline was up to my eyeballs and for the next six months it never got lower than my neck," said Arnold, who spent 25 years as an active duty Navy chaplain. "I could only imagine what their (soldiers) adrenaline was like."
Hyper-vigilance is needed to stay alive on the battlefield, said Col. Edward O. Crandell, chief of behavioral health at Womack Army Medical Center at Fort Bragg. Problems arise when personnel remain hyper-vigilant after they get home.
Risk-taking such as driving fast in cars and on motorcycles, increased drug and alcohol abuse and other activities occur. Some exhibit dissociative symptoms. There is a feeling of invincibility since they survived a war deployment, officials said.
Arnold said his center expects to screen 10,000 Marines for combat stress between now and February alone. "Our goal is to prevent stress injuries and illnesses when we can and quickly identify and treat when we can't," he said. Normal stress reactions include being easily startled and having nightmares.
He would expect to see a decrease in PTSD as fewer casualties are seen. However, repeated deployments have kept numbers high, Arnold said.
Dr. Carmen Russoniello, associate professor of recreation and leisure studies and director of the psychophysiology lab and biofeedback center in the College of Health and Human Performance, works with soldiers who have PTSD, head trauma or a combination of symptoms.
The Training for Optimal Performance, or TOP, is a cooperative program between ECU and the U.S. Marines. It provides a circuit of biofeedback that gradually exposes the marine to stressors, from math to a virtual Iraq, while working on coping strategies and life enhancement.
"We're finding exposure therapy allows military personnel to see their reactions, and they can choose to employ strategies to bring down their reaction to that stressor," he said. The strategy is four-pronged: stop, breathe, reflect and choose, Russoniello said.
With head injuries, it is hard to predict the outcome because some are severely debilitating and others do well, said Capt. Tim Johnson, staff neurologist at Naval Hospital Camp Lejeune. The bulk of patients at Lejeune have suffered what is classified as mild injury after having been deployed. Injuries