Washington Evening Journal
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Neighbors Growing Together | Aug 27, 2014

Not just another day off

By David Hotle | May 24, 2013
Anita and George Moore

It is with pride in their son Steven’s accomplishments during the Afghani war, relief that he is now home, and sorrow that so many other parents’ children didn’t return from the war, that George and Anita Moore want to remind people of the meaning of Memorial Day.
“I just don’t want people to forget what Memorial Day is about,” Anita Moore said. “It is a day off for a lot of people and that is great, but I think we need to remember what Memorial Day is about. There are a lot of soldiers who have served our country and have come back in caskets.”
She said that Steven, now living in California, served as a sergeant in the National Guard. He left for Afghanistan on Aug. 3, 2010. After spending almost a year in country, his welcome home ceremony was July 18, 2011.
Anita Moore said that on the home front it is a constant worry for the family that their soldier is serving in harm’s way. She said deployment is “hell and back.” The family did a lot of praying that Steven would remain safe. She said that the last thing she thought of before going to sleep and the first thing she thought of when she woke was her son. The few communications that she shared with Steven while he was deployed were “like gold,” she said. She said communications were limited to e-mail and brief phone calls.
George Moore said that not a moment in the day goes by without the concern of a phone call or a soldier appearing at your door. He said there were times when a car turned around in his driveway that he was convinced it was a soldier coming to give bad news.
“If a soldier comes to your door, you know things are very bad,” he said.
During Steven’s deployment, George and Anita Moore served on the family readiness support group. He said they were on a calling tree that had been formed as a secondary notification of a soldier being injured or worse. Both said the readiness group had been very helpful in the time leading up to Steven’s deployment and while he was gone. The Moores said they learned as early as October 2009 that Steven was going to be deployed.
“That was a great thing for us to do, but when you do that and you make your phone calls, you are so relieved that it is not your soldier, but your heart is breaking because someone’s loved one is dead.”
In a list that Anita Moore had compiled, she honored some of the soldiers who were killed in Afghanistan. She said Steven had known one of them. One of the soldiers, Anita Moore said, had been scheduled to come home after one last mission. The others were from Iowa.
“All of those guys are someone’s family members,” she said. “I just don’t want people to forget there are soldiers who don’t come back. We’ll be watching something on TV or talking about maybe a wounded warrior and we think, ‘that could have been Steven.’”
George Moore said with a son in the war, the parents’ perspective or what is important changes. He said that he is thankful Steven had come home and had not been injured. He said there were instances Steven had told him about involving being involved in combat.
“That kind of thing is your worst fear,” he said. “When you don’t know, your worst fear is things like that are going on.”
Anita Moore said that both she and Steven had done everything they could to keep the other from worrying. She said that Steven hadn’t told them until he arrived home that he was in a situation in which he had been exposed to gunfire on a daily basis.
During the deployment the Moores trued to keep their daily routine the same. As they tried to keep business as usual, they couldn’t help but think of their soldier and constantly wondering what was happening. Anita Moore said that getting four or five hours of sleep was a “good night.” George Moore said that in some ways keeping busy kept the couple going.
“I couldn’t imagine what it would have been like to be retired and not be able to go to work and do things all day lone,” he said.
When they finally learned for sure Steven was coming home, he was already stateside. George Moore explained this is for the security of the troops overseas, to keep the enemy from learning of troop movements. They had heard rumors about units moving around, but didn’t know anything for sure.
Steven has since gotten married and moved to San Francisco, Calif. Both he and his wife are English majors in college and Steven is pursuing the goal of becoming a writer. Both also have day jobs. George Moore said that Steven loves San Francisco and has had some short stories published.
On Memorial Day, the Moores say they will have to work. Still, they plan to find time to go to the All-Veterans Memorial on Lexington Boulevard to show their respects to soldiers past and present.
“A lot of times we’ll go to the cemetery where my father who was in World War II is buried,” George Moore said. “It is awesome to see all the flags. A lot of towns do it, not just here. Freedom isn’t free and we need to remember the sacrifices made.”

Comments (5)
Posted by: Glen Peiffer | May 27, 2013 17:01

You make up a fraction of the American population, but in an age when so many people and institutions have acted irresponsibly, you did the opposite – you volunteered to bear the heaviest burden. And for you and for your families, the war does not end when you come home. It lives on in memories of your fellow soldiers, sailors, airmen and Marines who gave their lives. It endures in the wound that is slow to heal, the disability that isn’t going away, the dream that wakes you at night, or the stiffening in your spine when a car backfires down the street. You and your families have done your duty – now a grateful nation must do ours.--
 
President Obama



Posted by: Glen Peiffer | May 25, 2013 21:06

The Bill Gates Foundation spends hundreds of millions of dollars every year on mosquitoe nets to combat malaria in Africa when DDT was so effective. It seems to me a better cause would be building more head trauma centers for our U.S. military.
 
 
"Rachel Carson's Deadly Fantasies" (9/5/2012), wrote that her 1962 book, Silent Spring, led to a world ban on DDT use. The DDT ban was responsible for the loss of "tens of millions of human lives -- mostly children in poor, tropical countries -- have been traded for the possibility of slightly improved fertility in raptors (birds). This remains one of the monumental human tragedies of the last century." DDT presents no harm to humans and, when used properly, poses no environmental threat. In 1970, a committee of the National Academy of Sciences wrote: "To only a few chemicals does man owe as great a debt as to DDT. ... In a little more than two decades, DDT has prevented 500 million human deaths, due to malaria, that otherwise would have been inevitable." Prior to the DDT ban, malaria was on the verge of extinction in some countries.
 
The World Health Organization estimates that malaria infects at least 200 million people, of which more than a half-million die, each year. Most malaria victims are African children. People who support the DDT ban are complicit in the deaths of tens of millions of Africans and Southeast Asians. Philanthropist Bill Gates is raising money for millions of mosquito nets, but to keep his environmentalist credentials, the last thing that he'd advocate is DDT use. Remarkably, black congressmen share his vision.



Posted by: Glen Peiffer | May 25, 2013 19:44

I am puzzled as to why so many hospital emergency rooms and doctors seem  unaware of this treatment for head trauma victims. Something as simple as pumping an ice-cold saline solution into head trauma patient's veins.
 
As Buffalo Bills football player Kevin Everett was being rushed by ambulance to a hospital with a life-threatening spinal cord injury, he was already getting experimental treatment that may have saved him from paralysis.
 

Everett's spinal cord was damaged in his neck as he tried to tackle Denver Bronco Domenik Hixon during the Bills' season opener. Everett dropped face-first to the turf after his helmet hit Hixon on the left shoulder.

 

In the ambulance to Buffalo's Millard Fillmore Gates Hospital, a doctor injected Everett with steroids -- standard treatment to reduce swelling and potentially damaging inflammation. But, at the same time, paramedics started pumping an ice-cold saline solution into Everett's veins, to lower his body temperature, according to news reports. The approach, though experimental, has shown promise in stroke and cardiac arrest patients, and even in infants deprived of oxygen.

 

The theory behind the therapy: By lowering the core body temperature between six and eight degrees, doctors can tamp down swelling and inflammation, and limit the release of harmful chemicals -- such as free radicals -- that can cause even more damage than that left by the initial injury.

 

Still, Everett's prognosis was dim. Once at the hospital, however, the body-cooling efforts -- called moderate hypothermia -- were continued using an external system as well as intravenous saline that reduced his core body temperature by 8 to 10 degrees, according to published reports.

 

"The advantage of cooling is that it is a neuro-protective agent that is able to attenuate the amount of injury that occurs after a spinal injury," said Dr. David Greer, an instructor in neurology at Massachusetts General Hospital. "It decreases the amount of injury and the swelling that occurs from the injury and thereby, hopefully, affects the outcome for the patient."

 

For hypothermia to be effective, it needs to be started as soon after the injury as possible, Greer said. Usually, a patient remains cooled for one to two days and then is re-warmed, which takes about half a day.

 

Using cooling for a spinal injury is a new application of the technique, Greer said. "It has been used in traumatic brain injury for years as a neuro-protective agent," he said. In fact, soldiers who suffer severe traumatic brain injury in Iraq are being treated this way, he added.

 

"I like to think of hypothermia as a bridge from when the injury occurs to getting a more definitive therapy like decompressing the spine," Greer said.

Once at the hospital, Everett was diagnosed with a potentially fatal fracture/dislocation between the third and fourth cervical vertebrae in the neck. He underwent emergency decompressive surgery to prevent pinching of the spinal cord.

 

During the operation, surgeons repaired the break in the vertebrae and also reduced pressure on the spinal cord. They also made a bone graft and inserted a plate, held in place by four screws, and also implanted two small rods, also kept in place with additional screws.

 

Everett's doctors said there was not much hope that he'd make a full recovery. But, later, they announced that the tight end could move his arms and legs, and his spinal cord was intact.

 

"Walking out of this hospital is not a realistic goal, but walking may be," Dr. Andrew Cappuccino, the Bill's orthopedic surgeon, said at a news conference..

 

Greer said it's not known what role the cooling therapy may have played in Everett's condition. "Who knows if he wouldn't have done well without the hypothermia treatment. But it didn't do any harm, and it may have done some good," he said.

 

Therapeutic hypothermia is also used to treat stroke patients and patients who have suffered cardiac arrest.

 

For stroke patients, it serves the same purpose as it does for spine patients -- as a neuron-protector and a block against swelling. Stroke patients most likely to benefit from hypothermia are those with moderate to severe strokes, Greer said. "It's an up-and-coming technology that has shown great promise in stroke patients," he noted.

Dr. Mary Ann Peberdy, a cardiologist and assistant professor of medicine at Virginia Commonwealth University, said hypothermia is used for cardiac arrest patients who survive but remain in a coma.

Peberdy said cooling has several beneficial effects. It reduces metabolism. It also prevents harmful chemicals that develop in the blood after cardiac arrest from reaching the brain once blood flow has been restored -- called reperfusion injury, she said.

"Hypothermia blocks reperfusion injury," she said. "That's why it's important to start cooling as early as you possibly can."

 

Peberdy said that only about 5 percent of patients survive a cardiac arrest. "Of the patients who survive, a significant number have neurological damage. Using hypothermia, we have taken our neurologically intact survival from about 30 to 40 percent to about 60 to 80 percent," she said.

Greer said many patients with a spinal cord injury could benefit from hypothermia therapy. "I wouldn't say that there is a spinal cord injury that's too severe that I wouldn't want to at least try cooling early on," he said.

 

Greer said he expects this treatment to become more widespread. "At the same time that it's effective, it's very safe," he said. "The risks with hypothermia are very low and manageable."



Posted by: Glen Peiffer | May 25, 2013 16:06

Christmas 2001 my wife and I were plunged into a parent's worst nightmare - a car accident resulting in our teenager's traumatic brain injury. After a month long coma he gradually emerged with severe and disabling cognitive, emotional and physical deficits.
Eight months of grueling hospital therapies and the school district agrees with the hospital - Bart is not ready to return to class, and would be better served by placement in an institution. We railed against warehousing our 17 year old son in a convalescent home and fought time and again to win Bart a chance to struggle, heal and progress.
We were determined to keep the bar up, set difficult but attainable goals, and then raise the bar again and again. Who knows for sure how far anybody can go? It takes a little faith. These officials were not mean spirited so much as driven by economics and statistical models of probable outcomes, without taking into account the character of the boy or his family.
We began exploring nonconventional therapies, cobbling together an unofficial 'medical board' of trusted physicians. 'Members' didn't know each other or that they served on a 'board.' If we found a promising therapy, we'd ask each of them whether it might do any harm. Some exciting approaches failed this test. Eventually we tried several therapies - though harmless, some proved useless. Others including hyperbaric oxygen (HBOT) and craniosachral therapy (CST) were remarkably successful, gradually transforming Bart's life prospects. Successes were anecdotal, but a neuropsych exam several years after the accident reported that the examiner had hardly ever seen such improvement in someone so severely injured.
Today, with high school and a semester of college under his belt, plus a couple of years cognitive therapy, Bart is a lively, charming young man, living nearly independently in his own place. How different the outcome had we heeded the advice of busy bureaucrats. Brain injury is far and away the leading cause of death and disability in young people. It leaves roughly 2% of the population permanently disabled, yet remains largely an invisible epidemic.
TBI will remain a tragic legacy of wars in Iraq and Afghanistan for a lifetime. Today the VA is experimenting with HBOT for 1000 severely wounded warriors. Sheer weight of numbers presents a unique opportunity to improve outcomes for survivors, military and civilian.
HBOT and CST are relatively safe, inexpensive, easy to deploy and scalable. For the cost of a couple of F-16 fighters one could outfit and staff 300 TBI treatment centers in existing VA facilities around the country. Technicians and therapists can be trained to deliver HBOT or CST in months, not years; a medic, corpsman, LPN, or EMT are all suitable job candidates. As an alternative to setting up centers in VA facilities, one might issue vouchers directly to veterans' families. Private clinics should spring up to meet the demand.
After wounded veterans have been treated, centers could migrate to the civilian sector helping the wider fellowship of TBI survivors, most of whom have no access to these treatments. Thousands might leave nursing homes, cut back on their meds and live more fulfilling lives. Nothing we could do for so little could ease the suffering of so many.
Scientific proof is still the gold standard in medicine, but in its absence what risk is there in trying alternative therapies with well established safety records? (Divers have safely used HBOT to prevent the 'bends' for 200 years). Of course nothing is 100% safe and effective, not even aspirin or acetaminophen. In much of Europe HBOT is standard treatment for TBI. The obstacles to adoption here seem to be more bureaucratic - doctors, hospitals and insurers have yet to sort out reimbursement protocols.
For survivors of severe TBI, unconventional therapies are not merely a reasonable option, they are a necessity. Best practices of conventional medicine only take us so far, often ending at the nursing home door, or heavily medicated at home, facing long empty hours and overwhelming family resources. Survivors are already more susceptible to a number of conditions including Alzheimer's, Parkinson's and subsequent TBIs. To do nothing - to ignore safe alternative therapies - is to make a decision fraught with risk. Faced with this existential dilemma, we chose to try for a better outcome. Military families of wounded heroes, who have already sacrificed so much, deserve no less.


Joel Goldstein, author of No Stone Unturned: A Father's Memoir of His Son's Encounter with Traumatic Brain Injury, Potomac Books, has written about TBI for Exceptional Parent, Brainline.org., and Adoption Today



Posted by: Glen Peiffer | May 24, 2013 18:54

For 60 Minutes, CBS News correspondent David Martin reported on the brain damage we lately have come to associate with athletes in sports such as football. But medical research is proving that these types of injuries are also affecting the US military and up to a quarter million service members just in the past decade. What is the Pentagon doing about these invisible injuries? Watch  CBS "60 Minutes"
 



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