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The Veterans Admininistration system undertakes a remarkable amount of research that helps improve lives.  Here's a rundown of some of the latest findings. Nursing home quality of care linked to cost (10/10/2018) Higher quality of nursing home care was linked to higher cost, in a study of 132 VA community living centers. Researchers looked at data from two years for all community living centers in the VA system. They measured quality of care by looking at rates of adverse health events (such as falls). Fewer adverse events were linked to higher predicted cost, suggesting that greater resources allocated to quality lead to better care. However, higher costs were not driven by higher nurse staffing levels. According to the researchers, more studies are needed to determine what precisely drives the relationship between quality and cost. (PLoS One, Sept. 19, 2018) Evidence lacking on outcomes of genetic testing for statin resistance (10/10/2018) Information is lacking on patient outcomes for statin-associated muscle symptoms (SAMS) after testing for the SLCO1B1 gene, according to a VA Boston Healthcare System literature review. SAMS refers to muscle pain and weakness sometimes caused by statin medication used to treat cardiovascular disease. Previous studies have shown that people with the SLCO1B1 gene are more likely to get SAMS. The researchers looked at 37 studies for evidence that testing for SLCO1B1 could lead to treatment changes and improved cholesterol levels in statin-intolerant patients. They found very few reports of patient outcomes after SLCO1B1 testing. More studies are needed to explore whether this type of genomic testing can lead to improvements in care, say the researchers. (Clinical Pharmacology and Therapeutics, Aug. 23, 2018) Study suggests adverse health impact on sexual minorities from religious freedom law (10/10/2018) A team including a VA researcher found that “unhealthy days” increased for Indiana residents identifying as sexual minorities after that state passed a religious freedom restoration act (RFRA). Statewide religious freedom restoration laws aim to protect the free exercise of religion by ensuring that any government interference must be for “compelling” interests, and must employ the “least restrictive means” possible. Some legal scholars have argued that RFRAs could potentially expose sexual minorities to more discrimination. And past research has shown that stigma and discrimination could worsen physical and mental health for sexual minority individuals. The researchers surveyed sexual-minority individuals in 21 states with RFRAs in 2015. They found the number of people reporting more than 14 “unhealthy days” per month increased quarterly in Indiana following the passing of an RFRA there. Unhealthy days did not increase for heterosexual people. This trend did not occur in other states. Indiana was the only state to pass and enact an RFRA in the time frame of the study. Other states already had RFRAs in place or had passed an RFRA but not put it into practice. Indiana also differed from other states in that its law applies to cases between private parties, not just those involving government. (American Journal of Orthopsychiatry, Sept. 24, 2018) Telehealth a viable way to improve antimicrobial stewardship (10/04/2018) A pilot telehealth program shows promise in improving infectious disease control at rural medical centers, according to a Louis Stokes Cleveland VA Medical Center study. Staff at two rural VA medical centers used videoconferencing to work with infectious disease physicians at other facilities. These videoconference antimicrobial stewardship teams (VASTs) held weekly meetings to discuss ways to combat antimicrobial resistance on a patient-by-patient basis. After a year of the program, one site accepted VAST recommendations in 73 percent of cases presented, and the other accepted 65 percent of the recommendations. Participants felt that the sessions improved their antimicrobial stewardship efforts and patient care. (Infection Control and Hospital Epidemiology, Sept. 6, 2018) Mental health disorders linked with more unintended pregnancy (10/04/2018) Women Veterans with mental health disorders are more likely to have experienced unintended pregnancy than those without, found a study by VA Pittsburgh Health Care System researchers and colleagues. They surveyed almost 3,000 women Veterans by phone. Sixty percent of women with at least one mental health disorder reported having an unintended pregnancy, while 51 percent of women without a mental health disorder said they had had an unintended pregnancy. Mental health disorders were linked to a greater number of unintended pregnancies. Multiple mental health disorders were also connected to a greater number of unintended pregnancies. More research is needed on how to improve reproductive health outcomes for women with mental health disorders, say the researchers. (Journal of General Internal Medicine, Sept. 5, 2018) Opioids not linked to better sleep for chronic pain patients (10/04/2018) Opioid use did not improve insomnia or fatigue for patients with chronic pain, in a Minneapolis VA Health Care System study. Insomnia is a common problem related to chronic pain. Researchers studied data on medication dosage and sleep disturbance for patients taking opioids or non-opioid medication for chronic pain. Over a year of treatment, neither group showed improvements in insomnia or fatigue despite improvements in pain severity. Medication dosage increased over the course of the trial. Patients with chronic pain commonly take extra opioid medication to sleep, but this increase did not lead to improved sleep. The results suggest that patients should be encouraged to used evidence-based behavioral sleep interventions to manage their insomnia, according to the researchers. (International Association for the Study of Pain, Sept. 13, 2018) Early nonadherence to diabetes drugs leads to more heart attacks and strokes (09/27/2018) Patients who did not adhere early on to their medication treatment for type 2 diabetes were more likely to have poor health outcomes, found a study by VA Mid South Health Care Network researchers and their colleagues. Researchers looked at data for more than 159,000 Veterans with type 2 diabetes over an 11-year period. They measured patients’ adherence to oral diabetes medication by how often patients filled prescriptions in the first year of treatment. Patients who did not take their medication as prescribed were 14 percent more likely to have a heart attack in the five years after starting treatment, compared with those who took their medication. Those not regularly taking their medication were 22 percent more likely to have a stroke. The less compliant patients were to their medication regimen, the higher their chances were of having a heart attack or stroke. Those not adhering to treatment were also more likely to have died. The results underscore the need to help patients understand the importance of taking their oral antidiabetes medication regularly, say the researchers. (Diabetes Medicine, July 6, 2018) Blood test could predict effectiveness of NSAID treatment in Alzheimer’s patients (09/27/2018) Blood tests could identify which Alzheimer’s disease patients will respond to non-steroid anti-inflammatory drug (NSAID) therapy, according to a study including a VA San Diego Healthcare System study. Previous research has shown the potential of NSAIDs to improve outcomes in Alzheimer’s patients because the disease has been linked to inflammation. An earlier study treated Alzheimer’s patients with two NSAIDs, rofecoxib and naproxen. In it, some patients improved and some declined in both groups as well as in controls. For the new study, researchers tested blood samples from these patients for four specific proteins that have been identified as inflammation biomarkers. They found that they could identify which patients in the rofecoxib group had cognitive improvements with 98 percent accuracy. They also predicted improvements in the naproxen group with 97 percent accuracy. The results show that a precision-medicine approach could identify which treatments will be most effective for specific patients with Alzheimer’s, according to the researchers. (Journal of Alzheimer’s Disease, Sept. 4, 2018) Benzodiazepine prescribing higher than evidence warrants in older adults (09/27/2018) Prescribing of benzodiazepines may be higher than appropriate in older adults, according to a study that included several VA researchers. The team looked at use of the drugs across various health systems, not just in VA. Benzodiazepines are sedative drugs commonly prescribed for conditions such as insomnia, anxiety disorders, and behavioral and psychological symptoms of dementia. However, evidence suggest that these drugs could be dangerous for elderly patients. The researchers looked at 31 studies on the effects of benzodiazepines in patients over age 50 with the above three conditions. They found 21 studies that demonstrated improved insomnia outcomes. Only one study showed a benefit of the drugs for patients with anxiety disorder. They also found only a single study that showed improvements in behavioral disturbances in patients with dementia. The results suggest that benzodiazepine prescribing in older adults is higher than what is supported by evidence, according to the researchers. Studies are needed on how to reduce use of this type of drug in older patients, they say. (Harvard Review of Psychiatry, Sept/Oct 2018) Brain peptide implicated in migraine pain VA and University of Iowa researchers may have identified one of the sources of migraine pain. Researchers injected mice with calcitonin gene-relate peptide (CGRP), a substance naturally found in the brain that is believed to be related to nerve hypersensitivity and photosensitivity in migraine. They found that CGRP caused spontaneous pain in the mice, regardless of whether they were in light or darkness. When the researchers gave the mice an antibody that blocks CGRP receptors, the pain went away. They also found that the nonsteroidal anti-inflammatory drug meloxicam did not block the effects of CGRP. The antimigraine drug sumatriptan partially blocked CGRP response in male mice, but not females. (Pain, Sept. 1, 2018) Suicide risk common in patients with anxiety (09/20/2018) A high number of patients with anxiety could be at risk for suicide, found a Syracuse VA Medical Center study. Researchers surveyed 182 primary care patients who had anxiety symptoms but were not in psychotherapy specialty care. Forty percent had elevated suicide risk, based on a standard assessment. Suicide risk was more common in patients who also had depression (51 percent) than in those who had anxiety alone (27 percent). The severity of anxiety symptoms did not affect patients’ suicide risk. The results suggest that primary care providers should assess suicide risk in patients with anxiety, even when patients are not seeking mental health treatment or when their anxiety symptoms do not rise to the level of an anxiety disorder, say the researchers. (Family Practice, Sept. 14, 2018) Oxytocin fails to boost social cognition in schizophrenia trial (09/20/2018) Oxytocin did not improve social cognition in patients with schizophrenia, in a study by VA San Diego Healthcare System researchers and their colleagues. Social cognition refers to how a person deals with other people, including aspects like social knowledge and emotional processing. People with schizophrenia often have impaired social cognition. The researchers prescribed schizophrenic patients oxytocin—a drug that has been shown to improve social cognition in the general population—over 24 weeks, along with cognitive-behavioral training. Patients taking oxytocin showed no improvements in social cognition over the course of the study, compared with patients taking placebo. The results add to growing literature suggesting that oxytocin may not be effective in this population. (Psychological Medicine, Sept. 6, 2018) Herbicide-related COPD rates differ between self-report and lung tests Herbicide exposure during the Vietnam War was linked to self-reported chronic obstructive pulmonary disease (COPD), but the link was not supported by lung tests, in a study by VA's Office of Patient Care Services. Researchers surveyed more than 3,000 Veterans of the U.S. Army Chemical Corps who served in Vietnam. Those who had actively sprayed herbicides during their service were nearly twice as likely to say they had been told by a doctor that they had COPD, compared with non-sprayers. However, when the survey respondents were examined with spirometry—a common test of lung function—people in the spraying group were not more likely to have COPD than the non-spraying group. The difference may be due to physicians diagnosing COPD based on symptoms rather than spirometry, according to the researchers. Spirometry is underutilized by physicians, they say. (American Journal of Industrial Medicine, Aug. 29, 2018) PTSD may disrupt parasympathetic nervous system during sleep (09/14/2018) Patients with PTSD had blunted parasympathetic nervous system modulation during sleep, found a Durham VA Health Care System study. The parasympathetic nervous system is the part of the nervous system that regulates rest and digestion. Heart-rate variability can be used to assess how well the parasympathetic system is working. Researchers studied the sleep of 62 post-9/11 Veterans and service members. They found that, for those with PTSD, high-frequency heart rate variability was lower during the non-rapid eye movement sleep phase, compared with those without PTSD. Impaired parasympathetic nervous system function increases the risk of cardiovascular events. This parasympathetic modulation could be one reason for the increased rates of cardiovascular disease among Veterans with PTSD, suggest the researchers. Patients with PTSD had blunted parasympathetic nervous system modulation during sleep, found a Durham VA Health Care System study. The parasympathetic nervous system is the part of the nervous system that regulates rest and digestion. Heart-rate variability can be used to assess how well the parasympathetic system is working. Researchers studied the sleep of 62 post-9/11 Veterans and service members. They found that, for those with PTSD, high-frequency heart rate variability was lower during the non-rapid eye movement sleep phase, compared with those without PTSD. Impaired parasympathetic nervous system function increases the risk of cardiovascular events. This parasympathetic modulation could be one reason for the increased rates of cardiovascular disease among Veterans with PTSD, suggest the researchers. (Sleep, Aug. 29, 2018) Development of a new non-addictive pain drug (09/14/2018) A team including a researcher from the W.G. Hefner VA Medical Center in Salisbury, North Carolina, is working on a pain medication that could potentially work as well as opioids without being addictive. They developed a new compound, AT-121, that works on the mu opioid receptor, a type of neuron that opioids interact with to block pain. AT-121 also activates the nociceptin receptor, which blocks the addictive side effects of opioids. Using non-human primates, the researchers showed that AT-121 gave the same level of pain relief as opioids without the risk of addiction that comes with opioids. The results suggest that this new drug could have potential to both safely and effectively relieve pain, and also treat prescription opioid abuse. More studies will be needed before AT-121 can be tested in humans. (Science Translational Medicine, Aug. 29, 2018) Circadian rhythm disruption linked to cognitive decline in older men (09/14/2018) Disruptions in circadian rhythm are linked to greater cognitive decline in older men, according to a study including a Minneapolis VA Health Care System researcher. Circadian rhythm refers to the body's natural sleeping and waking patterns. Over multiple follow-up visits during an average period of three years, the researchers found that men with disrupted rest-activity circadian rhythm had greater cognitive decline, as measured by a standard cognition test, compared with those without disrupted circadian rhythms. Rest-activity circadian rhythm was measured using an accelerometer that recorded any time a patient's wrist moved. Aging is often associated with altered rest-activity circadian rhythm. The results add to growing evidence that age-related disruptions to sleep pattern are connected to cognitive decline, say the researchers. (Journal of the American Geriatric Society, Aug. 23, 2018) Complex relationship between alcohol consumption and psychiatric distress (09/06/2018) Hazardous drinking was linked to higher likelihood of psychiatric symptoms, while results of moderate drinking were mixed, in a study by Durham VA Health Care System researchers and colleagues. Previous studies have linked heavy drinking with increased depression and anxiety, but the it is not clear what cause-and-effect relationships, if any, may exist. The researchers collected data on alcohol use and psychiatric conditions for 3,003 Veterans. They found that hazardous drinkers were more likely to have PTSD, depression, and suicidality, compared with moderate drinkers. For men, moderate drinkers were less likely than nondrinkers to have depression and suicidality. However, this relationship disappeared when nondrinkers with past alcohol use disorder were removed from the calculations. Women moderate drinkers had lower rates of PTSD than nondrinkers and light drinkers, even when those with past AUD were removed. More research is needed on the possible protective effects of moderate drinking, say the researchers. Also, patients with a history of AUD may benefit from mental health screening and treatment, they say. (Journal of Studies on Alcohol and Drugs, July 2018) Written exposure therapy effective as PTSD treatment Written exposure therapy (WET) could be as effective as cognitive processing therapy in treating PTSD, according to a VA Boston Healthcare System study. WET involves five weekly sessions in which patients write for 30 minutes in detail about a single traumatic event associated with their PTSD. Cognitive processing therapy (CPT), a common PTSD treatment, involves learning how to evaluate and change upsetting thoughts. WET is shorter than CPT, which usually lasts for 12 sessions and includes homework between each session. Patients in both a WET and CPT group showed similar improvement of PTSD symptoms when assessed 60 weeks later. Both treatments significantly reduced depressive symptoms, although the CPT group did have a more rapid decrease in symptoms. WET takes a similar approach to prolonged exposure therapy, another common psychological PTSD treatment, in that both focus on directly confronting memories of trauma. Prolonged exposure is usually based on talking with a therapist, and generally involves more sessions than WET. The results show that WET could be a short and long-lasting treatment for PTSD. (Depression and Anxiety, Aug. 24, 2018) Study shows two genes may be linked to suicide attempts (09/06/2018) Durham VA Medical Center researchers have identified two genes that may be related to suicidal behavior. They conducted a genome-wide association study, in which they compared the genomes of a large number of Veterans to look for variations common among those with history of suicidal behavior. The researchers found an association between a gene called KCNMB2 and suicide attempts. This gene plays a key role in neuronal excitability. They also found evidence that may link another gene, ABI3BP, to both suicide attempts and suicidal thoughts. While the results are interesting, the researchers caution that they are preliminary and need replication in further studies. (Psychiatry Research, July 17, 2018) Group treatment program curbs intimate partner violence (08/29/2018) The Strength at Home program can successfully reduce intimate partner violence use, found a study by Central Texas and Boston VA health care system researchers. SAH is a 12-week cognitive-behavioral and trauma-informed group treatment designed to reduce and end IPV use among military and Veteran populations. The pilot program is part of a national program within VA to help Veterans who use or experience IPV. It was implemented at 10 VA medical centers over a year. Seventy percent of sites successfully launched the program in the first year. Results from 51 Veterans who participated in the program showed a significant reduction in the number who exhibited violence toward a partner. The participants also showed reduced PTSD symptoms. While the pilot program showed overall successful implementation, more work is needed to reduce the time between initial training and the start of group treatment, according to the researchers. (BMC Health Services Research, July 24, 2018) Repeated ketamine infusions may ease PTSD and depression (08/29/2018) Repeated ketamine infusions may improve PTSD and depression symptoms, according to a Minneapolis VA Health Care System study. Researchers gave 15 people with both PTSD and major depressive disorder six intravenous infusions of ketamine—a medication used mainly for anesthesia—over two weeks. Eighty percent had remission of PTSD symptoms immediately after treatment. The remission lasted a median of 41 days. For major depressive disorder, 93 percent experienced remission of symptoms, which lasted a median of 20 days. The results suggest that repeated ketamine treatments are safe and may be an effective treatment for people with both PTSD and major depressive disorder, say the researchers. (Journal of Clinical Psychiatry, May/June 2018)
“I want to thank everyone at the Veterans of Foreign Wars and Sport Clips for giving me the opportunity for a second chance at an education" - Veteran Nikolay Maltsev The first time Maltsev attended college, he quickly realized he wasn’t prepared for this life change without real-world experience. “I went to the Army recruiter and decided to get some hands-on training as a wheeled vehicle mechanic to get another view of the world. I spent time in South Korea, Fort Riley and Kuwait.” While serving active duty in Kuwait, Maltsev began planning ahead for future educational opportunities and searching for financial aid. He stumbled upon the VFW’s “Sport Clips Help A Hero Scholarship” and filled out an application. Maltsev is thankful for the second opportunity to pursue a degree in economics at the State University of New York at Albany. “My passion has been ignited to study economics … in my opinion it is the best way to learn how the world works theoretically and practically. I truly want to know and think like the great minds in this field.” Even though he isn’t a VFW member yet, Maltsev intends to join in the future. “I plan to contribute everything I can to the VFW’s mission of serving veterans, the military and their communities.”  “The VFW’s investment in me will not be forgotten or wasted, which is why I work so hard to complete my college education,” Maltsev concluded. “I urge all student veterans to try harder and aim higher. I wish them success in everything they undertake.”
By Jack Monahan for the Legion I returned on Sept. 25 from a six-day visit to the Lorraine region of France, where the major battles that ended World War I were fought by the American Expeditionary Forces (AEF) of the U.S. Army in 1918. I was honored and privileged to participate in a number of events, visits and ceremonies marking the centennial of the major U.S. engagements at Saint-Mihiel and Meuse-Argonne, and to meet with numerous local officials and dignitaries, as well as with many American soldiers – from general officers to privates – who were there for the commemorations. My first visit on Thursday, Sept. 20 – a visit which for me was a matter of personal duty – was to the town of Seicheprey to meet with the mayor, Gerard André. The town was the scene of a horrific battle in April 1918, one of the first fought by the AEF, which resulted in the deaths of 84 Connecticut soldiers of the 102nd Infantry Regiment, 26th “Yankee” Division. It is a place which still resonates in Connecticut history and is sacred to the memory of those who died. The town has a beautiful monument to the French and American soldiers. It also has a granite fountain with a bronze plaque inscribed with a dedication to the Connecticut soldiers, donated by the citizens of Connecticut to the village. It is a point of pride for the mayor and the residents and is meticulously maintained. The next day, Friday, Sept. 21, I toured the battlefield at Verdun, scene of the horrific 1916 battle, including the fortress at Douaumont, the battlefield museum, and the memorial and ossuary, where the skeletal remains of the thousands of soldiers killed in the battle who could not be identified are deposited. I also visited Verdun City Hall, met the mayor and visited the city’s “Hall of Honor,” where artifacts and historically significant documents of the city are displayed. Among the displayed artifacts is a treasured Certificate of Appreciation and Friendship from The American Legion, given to the citizens of Verdun by National Commander Howard P. Savage during his visit there in 1927. I also visited the impressive American memorials at Montfaucon and Montsec. Saturday, Sept. 22, was devoted to the commemoration of the Battle of Saint-Mihiel, the first fully American engagement of the war. The day commenced with a ceremony in the town of Thiaucourt. A wreath-laying ceremony was led by local dignitaries. A French army band and a troop unit from the local logistics regiment participated, as well as a substantial U.S. contingent, including the 1st Infantry Division’s “Doughboy” Color Guard, a contingent of soldiers, Marines, sailors and airmen, as well as a marching contingent of soldiers bearing the flags of all the U.S. divisions that fought in Lorraine in World War I. Following the ceremony in town, the entire contingent – including French veterans carrying their unit colors – and local residents marched from the town to the American cemetery at Saint-Mihiel. A memorial ceremony was conducted there on a bright sunlit day. The graves of the 4,100 soldiers buried there had each been marked with both a French and a U.S. flag. Many graves had pictures or documents posted as well. Hundreds attended the solemn and beautifully fitting ceremony, including local citizens, officials and dignitaries. Large contingents of U.S. Armed Forces personnel and French soldiers participated. The U.S. Navy European Command band played, as well as a French army band. U.S. Gen. Scaparrotti, commander, U.S. European Command, and French Gen. Lillo, corps commander, gave remarks. A flyover by U.S. F-15 fighter jets in “Missing Man” formation occurred. Wreaths were laid by the senior officials. I had the honor to lay a wreath on behalf of the U.S. World War One Centennial Commission. I was profoundly moved by the entire scene and ceremony, a display which demonstrated beyond any doubt that the deeds of the Americans who fought and died for liberty in 1918 are not forgotten, neither by us nor by the French people. Sunday, Sept. 23, was devoted to the commemoration of the Battle of Meuse-Argonne. During the day’s 24 hours, the names of the more than 14,000 soldiers buried there were read. I attended a ceremony at the American cemetery, the largest of the World War I U.S. cemeteries, in the afternoon. A similar ceremony to that at Saint-Mihiel was held, though due to a driving rain, the ceremony had to be moved inside to the cemetery chapel. The chapel is decorated with stained glass windows depicting the unit crests of all the U.S. Army divisions that participated. That evening candles were placed on the graves, and the reading of names continued through the night. That morning, I had participated in a visit to the Argonne Forest, where an incredible trail through the battlefield area has been laid out by the French National Forests Office to commemorate the Americans. The trail system project was among the most moving things I observed during my visit, not least because of the massive expenditure in resources and time that had been devoted to it, but also because the project had clearly been one that came from the hearts of those who envisioned it. It was conceived by Daniel Georges, a forest warden for nearly 40 years and supervisor of the national forests in the Argonne. A highlight of the trail system is a space where 1,700 trees have been planted in the shape of the 1st Division “Big Red One” insignia. Douglas firs and sequoias for the shield, and red oaks in the shape of the Big Red One, pay homage to the 1,700 soldiers of the division who died in those woods in October 1918. I was deeply moved by the events I attended, and by the interactions I experienced with both French and Americans over the course of my visit to Lorraine. It was the experience of a lifetime. I was proud to have had the opportunity of representing the United States and The American Legion at the events in France commemorating the historic battles of Saint-Mihiel and Meuse-Argonne. It was a powerful reminder to me of the sacrifices made by the doughboys during the crucible of battle – and of the powerful forces, both good and terrifying, which would shape the values and attitudes they would later imprint upon the organization they would create, The American Legion. Jack Monahan, a member of Post 18 in Essex, Conn., is The American Legion’s representative on the U.S. World War One Centennial Commission, and serves on the Legion’s National Finance Commission.
Combat veterans can’t always leave behind what they saw and experienced on the battlefield when they return to the civilian world. While some ease back into their old lives with minimal problems, many suffer from post-traumatic-stress syndrome so severe that they need professional help to overcome both it and the depression that often accompanies it. For some, that means seeking relief from their condition through one of the many ketamine centers that have opened in recent years throughout the United States. At these centers, doctors administer ketamine infusions to treat such conditions as PTSD, depression, anxiety, OCD and chronic pain. Extremely good effect is found at stopping suicidality thoughts. “Some researchers have called the drug the most important discovery in half a century," says Aimee Cabo Nikolov, administrator of the Ketamine Medical Clinic (www.ketaminemedicalclinic.com)  in Miami , a division of the Neurosciences Medical Clinic. Nikolov, who operates the clinic with her husband, Boris, and a team of medical professionals, says about 35 percent of the patients the clinic sees are military veterans seeking treatment for PTSD. Nikolov, who has a background in nursing, has dealt with her own PTSD issues, though hers were caused by childhood abuse issues rather than combat. Like the clinic’s patients, she found ketamine to be a helpful ally in battling mental health problems. “Ketamine infusions have lifted a lot of my own depression,” she says. It’s only fairly recently that ketamine became popular as a drug for battling such troubling mental-health conditions as PTSD and depression. Originally, ketamine was developed as an anesthetic in the early 1960s, but it wasn’t long before people began using it as a recreational drug that was known on the streets as Special K. It’s still used as an anesthetic, but over time some in the medical profession began to realize it could be used to treat depression and PTSD. Studies have shown that Ketamine infusion can produce significant and rapid reduction in the severity of PTSD symptoms. Just what is PTSD? Here’s what the U.S. Department of Veterans Affairs says: The cause and symptoms. PTSD is a mental health problem that some people develop after going through some sort of trauma, such as experiencing or witnessing a life-threatening event like combat, a natural disaster, a car accident, or sexual assault. Some symptoms include reliving the event, avoiding situations that remind you of the event, having more negative feelings and beliefs, and feeling jittery or always on the alert. Trauma’s effects. Trauma is actually fairly common and doesn’t always lead to PTSD. About 60 percent of men and 50 percent of women experience at least one trauma in their lives, the VA reports. For women, trauma is more likely to be the result of sexual assault and child sexual abuse. For men, it’s more likely to be because of accidents, physical assault, combat or a disaster. Prevalence of PTSD. About 7 to 8 percent of people have PTSD at some point in their lives, and about 8 million adults in the U.S. have PTSD in any given year. Women are more likely than men to experience PTSD. About 10 percent of women will have PTSD, compared with about 4 percent of men.   Nikolov says that patients at the Ketamine Medical Clinic receive treatment that is individualized for their specific situation. Generally, though, that means six to eight initial ketamine infusions two times a week. That’s followed by boosters, which can be one infusion every two to six weeks. “Ketamine has been described as rapid-fire treatment for depression,” Nikolov says. “For many veterans suffering from PTSD, ketamine is providing hope after other kinds of treatment didn’t give them the results they needed.”   About Aimee Cabo Nikolov Aimee Cabo Nikolov is administrator of the Ketamine Medical Clinic in Miami (www.ketaminemedicalclinic.com). She is also president and owner of IMIC Inc., a medical research company. Nikolov has a bachelor of science degree in nursing and is also the author of Love is the Answer, God is the Cure. She and her husband, Dr. Boris Nikolov, have three children, Danielle, Sean and Michelle.
The effects of Hurricane Florence are still being felt in North and South Carolina, as flooding continues to be an issue after the deluge of rainfall from the storm earlier this month. The death toll from Florence has reached 43, and damage is estimated to be about $50 billion. In Shelby, N.C., home of The American Legion World Series, Post 82 members have helped load bottled water, cleaning supplies, pet food and other necessities donated by Cleveland County residents to help those impacted by the storm closer to the coast. “We were very pleased with the response from the community and the Legionnaires,” said Post 82 Adjutant Jim Quinlan. While Shelby and other cities in central and western North Carolina are in good shape, the eastern part of the state is in “desperate need,” Quinlan said. North Carolina Department Adjutant Randy Cash said Post 230 in Spring Lake, N.C., had been flooded out in Florence’s aftermath. On Tuesday, he was still waiting for assessments from other areas. In the meantime, the department has been working with agencies like Operation North State and Carolina Cavalry to get collected supplies to the areas where they’re needed. “And I’m waiting for the influx of NEF and TFA applications,” he said. The Department of South Carolina is waiting to see what sort of relief efforts might be necessary. “With the initial storm there wasn’t a lot of damage,” Adjutant Nick Diener said. “There’s a lot of flooding, but those areas we can’t get into anyway (to see what needs to be done).” Diener said Post 34 in Rock Hill, S.C., had collected care packages for the National Guard soldiers who have been sent out to help with relief efforts. Meanwhile, the Legion Family across the nation has been doing their part to help those affected by the hurricane. In Harveys Lake, Pa., Post 267 members and local borough officials have been collecting food, clothing and cleaning supplies to fill a trailer that will head to North Carolina next week. And in Fond du Lac, Wis., the local SAL chapter and Patriot Emergency Response Team are collecting donations at Post 75. Brian Stenz told KFIZ-AM that “one of the biggest needs right now with the flooding is that every person who has a house is going to have to basically gut the house out, clean it out and start over.” Cash said he’s been in contact with other departments, including the Department of Puerto Rico, where residents are still dealing with the effects of last fall’s Hurricane Maria. “We supported them and now they have returned the favor … it’s heartwarming,” Cash said. “This effort is going to take awhile,” Cash said. “We’re this far out from the actual storm but we’re still reeling from the floods. Wilmington and other areas are still in need of support. Continue to pray for us, and thanks to everyone for their outpouring of support.” For American Legion and Sons of The American Legion members who have been impacted by the hurricane, as well as Legion posts, The American Legion's National Emergency Fund (NEF) is available. NEF provides up to $3,000 for Legion and SAL members with an active membership, and up to $10,000 for posts that have been damaged by a natural disaster. For individual NEF grants submitted for Hurricane Florence, applicants: Must have been displaced from their primary residence which sustained damages from the hurricane and/or flooding. Should have receipts for out-of-pocket expenses (i.e., temporary housing, food while displaced, and other essentials to survive during the displaced period). The intent of the NEF grant is not to replace household goods or the living facilities, as these are insurance items. The grant is to be used to offset expenses needed in order to survive during the disaster period. Should have photos of damaged home, as well as hotel, gas and food receipts, or testimony from post, district or department officers attesting to damages or extraordinary circumstances. For American Legion post NEF grants, posts must state why they will cease to perform their duties and activities in the community due to losses sustained. Legion posts that served as community service centers during the disaster may also be eligible for a grant to offset their costs in providing food and other services to members of their community during these disasters. To apply for an NEF grant, please visit www.legion.org/emergency. Since Jan. 1, 2018, the NEF has provided more than $166,000 in grants. These grants are made possible by donations to the fund. To donate, visit www.legion.org/donate. Additionally, The American Legion's Temporary Financial Assistance (TFA) program is available to help meet the basic needs of minor children of eligible veterans. These needs include shelter, food, utilities, clothing and health expenses. TFA grants are available to children (17 years or younger) of active-duty servicemembers or American Legion members. No child can be considered eligible until a complete investigation is conducted at the post or department level, a legitimate family need is determined, and all other available assistance resources have been utilized or exhausted. To apply for a TFA grant, contact your local American Legion post or department (state) headquarters. For post/department contact information, click here.
Starting with just one hungry veteran years ago, Rich Synek launched an ambitious plan, and now he, his wife, Michele, and a team of volunteers provide nourishment to veterans and their families Since 2008, a grassroots, VFW-member-led effort has fed more than 15,000 veterans nationwide, distributed more than 1 million pounds of food and donated more than $80,000 in gift cards. And it all started with one postage stamp. VFW Department of New York member Rich Synek was postmaster in Vernon Center, N.Y., when he noticed WWII vet Orley Baker purchasing one stamp at a time because that is all he could afford to buy. Synek soon learned that Baker and his wife had only enough money to buy food for two weeks out of every month.  “I just couldn’t get over how horrible it was that a WWII veteran was going hungry,” said Synek, who earned the Navy Expeditionary Medal off the coast of Libya in 1986. “For that matter, anyone being hungry is unacceptable.” Soon after learning this about Baker, Synek and his wife, Michele, took food to the vet’s home, only to find empty cupboards and an empty refrigerator, other than a few condiments.  That’s when Synek knew what he had to do. He retired 11 years early and found his calling. And so was born Feed Our Vets, a New York-based nonprofit veterans-only food pantry.  With pantries in Utica and Watertown, Feed Our Vets also has a mobile unit that feeds veterans monthly in Syracuse. Additionally, the unit takes food to Binghamton, Buffalo and Albany. Numerous times, it has traveled as far away as Philadelphia. To receive assistance at the pantries, vets only need to bring in a DD-214 and a photo ID or a VA card. No questions are asked. How vets end up at the pantry is not important to Synek and the teams of volunteers. One such volunteer is Vietnam veteran Joe Ancona. He’s been the director of the Utica pantry for eight years. He retired from the Army after 20 years before going to work for the state. After he retired, he thought he would do some volunteer work. “Rich married my youngest sister and that’s how I got roped into this,” he said and laughed. “It’s really like having another job, but that’s OK.” Most weeks, Ancona puts in 25-40 hours a week. While the pantry is open every Wednesday from 3-6 p.m. and the third Saturday of every month from 8 a.m. to 11 p.m., it takes a lot of work to stock it. Each week sees about 50-60 veterans coming in for food, and the volunteer staff of 12 makes sure everyone receives a portion. “Some vets cannot make it in during our regular hours, and I’ll meet them after hours,” Ancona said. “There are a lot of hungry people out there, so you do what you gotta do, you know?” Ancona added that some people are hungry enough that they try to con him. They will say they were in the military but cannot prove it. In those situations, the volunteers will give a person enough food to get through the day and refer them to other places for assistance. “We’re never going to turn away a hungry person,” Ancona said. Selena Dewey also volunteers her time at the Utica food pantry. She’s been there about a year. October will mark three years since her husband died just one month shy of retiring after 30 years in the Air Force.  “People always say that the best way to heal is by helping others,” Dewey said. “I really wanted to get involved with something that would help veterans. This has truly helped my healing process.” Dewey is charged with weighing the food as it leaves the pantry. The IRS requires all food to be weighed both in and out.  She noted that veterans from WWII to Iraq utilize the pantry, adding that it’s particularly sad to see WWII vets in a position of needing assistance finding food.  “It has been the most humbling and rewarding experience,” Dewey said. “Each week, we, as volunteers, thank the veterans for their service. They always thank us. They are so appreciative of us. But it seems so wrong that they feel like they have to say thank you.” FRESH VEGETABLES APLENTYArmy veteran Carl Davis is one of the veterans who regularly visits the Utica pantry, which he calls a “society within a society.” Davis, who was severely injured years ago while serving as an Army welder at Ft. Ord, Calif., is 100 percent disabled and has three children. “I don’t know what I would do without this,” Davis said. “You know, they can shut off the cable and that’s fine because you don’t have to have that. But when you don’t have food for your family, it really hits home.” While talking on the phone for this article, Davis noted that he was cooking a pork roast with fresh vegetables that he had received at the pantry. He added that he always gets milk, eggs, cheese, bread and fresh vegetables.  “It’s not like you come in and they give you a box of macaroni and call it good,” he said. “They really care for us vets because they are vets, too. I pray for them every day.” Davis added that he appreciates the camaraderie at the pantry. They know how to relate to one another and “speak the same language.” FEED OUR VETS IS A ‘LIFESAVER’Besides the pantries and mobile unit, Feed Our Vets sends gift cards to veterans in 38 states. As of May 20, more than $80,000 in gift cards had been distributed around the country. The family of Amber and Anthony Hockensmith, from Georgetown, Ky., is the recipient of a $75 gift card each month.  Amber said the family, which includes four children, was doing pretty good on the couple’s dual income. But after Anthony’s two tours in Iraq with the Army, where he was wounded in multiple IED explosions, all of that changed. Diagnosed with PTSD and traumatic brain injury — with side effects including short-term memory loss, seizures and night terrors — Anthony is no longer able to work.  Amber, who previously worked in the medical industry in an administrative role, now is his full-time caregiver. From her caregiver support group, she found out about Feed Our Vets.  “I learned to coupon, and that $75 lasts us the entire month,” Amber said. “No words really describe how great Rich and his wife are. They are amazing.” Amber noted that the application process for Feed Our Vets was “simple,” easy and not invasive.  “There are no questions about why you need help or for how long,” Amber said. “They just help, no questions asked.” Nikiea Shelton agrees. Her husband, Dustin, was wounded in Iraq while serving in the Army. He was rated 90 percent disabled by the VA due to spinal cord complications. Last November, while pregnant with two children at home, Nikiea lost her source of income. She doesn’t recall how she heard about Feed our Vets but said she’s glad she did. The family in Georgia receives a $75 gift card each month from the New York operation. “Without this, we wouldn’t make it through the last week of the month,” Nikiea said. “Even if it was $20, it would help. Feed Our Vets has been a lifesaver on more than one occasion.” Synek recalled a woman he helped in Arkansas who wrote him a letter that nearly brought him to tears. She told him she hadn’t had anything to eat in days and then received a $75 Walmart gift card. She went out and bought a lot of food and came home and made a good dinner for her family. “I just can’t imagine,” he said. “I mean, it is food. It’s what the rest of us just take for granted.” ‘THE BEST FEELING IN THE WORLD’Since Feed Our Vets does not receive any federal or state funding, Synek said the group relies on individuals, businesses and community groups to help pay its bills.  “We have churches and other organizations that host food drives for us,” he said. “And we do different fundraising programs as well.” The latest such fundraising endeavor is the auctioning off of a restored 1990 AM General Humvee. Synek began researching this idea a few years ago, hoping to find someone to donate one. “I reached out to several donors with this idea and asked if they would like to be a part of this project,” Synek said. “After several months of talk, one of them donated one from Robbins Air Force Base in Georgia.” In January 2017, Feed Our Vets received the vehicle. The restoration was completed by Steve Hale from Steve’s Restoration in Frankfort, N.Y. Synek said Dewey secured a lot of parts for the restoration, saving “tens of thousands of dollars.” FOV 1, as it’s now called, is at the Saratoga Auto Museum in Saratoga, N.Y. At press time, a charity auction had been scheduled there for Sept. 22.  “All of this is more rewarding to me than anything else,” Synek said. “When a vet leaves one our pantries with a week’s worth of free food, it’s the best feeling in the world.” Synek said Feed Our Vets has no plans on slowing down. He hopes it does well enough on the auction that in a year or so they can have an FOV 2 to auction. For now, Synek and his volunteers will continue feeding as many as they can with what they have. “If I only fed one veteran, it was all totally worth it,” he said. “The people like Carl and Amber and all the 3,525 vets we fed last year are what keep me going.” For more information on Feed Our Vets and the vets they help, visit www.feedourvets.org or check out the Feed Our Vets Facebook page for updates. 
WASHINGTON — Veterans Affairs Secretary Robert Wilkie said his department “needs to be more welcoming to women veterans” and promised improvements at the bureaucracy in months to come. “We are on the cusp of a great change,” Wilkie told veterans attending the inaugural meeting of the Military Women’s Coalition in Georgia on Friday. “This is not my father’s or my grandfather’s VA. It is now your VA. We have to change how we do business, and that means making the institution more welcoming.” Wilkie did not offer specifics on policies or programs to “make sure the needs of our fighting women are taken care of,” but he did acknowledge that women veterans are the fastest growing demographic group under the department’s watch. About 10 percent of the veterans population in America today are women, and that number is expected to rise above 17 percent in the next decade. Wilkie, who previously served as the Pentagon’s top personnel official, said more than 250,000 women service members are stationed throughout the world today.
Two disabled post-9/11 veterans and their families will get beach vacations next week, courtesy of two Department of New Jersey American Legion posts. On Sept. 9, Morvay-Miley Post 524 in Ocean City will welcome U.S. Marine Corps veteran Lance Cpl. Bobby Raditz, his wife Erika and their 1-year old daughter Emma for a week's vacation through the post’s Rest and Relaxation Program. And on Sept. 12, American Legion Post 469 in Longport will host former Navy Chief Petty Officer Adam Fleck, his wife Christina and their 4-year-old daughter Penelope for a week’s stay in the beach community. Honoring “The Whole Family.” In Ocean City, Raditz – a service-connected veteran who served in Iraq – and his family will be greeted with a lunchtime welcome ceremony at Post 524 and then receive an escort into town by American Legion Riders, and local police and fire department vehicles. The Raditz family will stay, for free, in a condo for the week and receive gifts from Ocean City businesses. It’s the fifth year Post 524 has conducted the program. They annually provide two veterans with a week at the beach – one earlier in the summer, and one near the end of the summer season. Jerry Bonner, Post 524’s Rest and Relaxation Program chairman, said it’s important to make sure the veterans’ families are included in the week. “The deployment affects the whole family,” he said. “When these soldiers are deployed, their family’s under a lot of pressure, too. It impacts the whole family.” Bonner said that if the veteran has an older child, the post will present him or her with a medal, thanking the son or daughter for helping out while the mother or father was deployed. The post also provides the veterans’ children and spouses with various gifts. “We try to make it for the whole family,” Bonner said. “Everybody suffers when you’re deployed.” Local businesses and organizations contribute to the program, while Auxiliary Unit 524 member Gina Secrest is providing the condominium for the Flecks. “People come to me and search me out (to contribute),” said Bonner. The majority of Post 524’s members are Vietnam veterans, Bonner said. The reception some of them received when they left the military drives them to honor those both still serving in and separating from the U.S. Armed Forces. “I think they go out of their way to make it good for the soldiers nowadays,” Bonner said. “When these (veterans) come in for (the vacation), they always say they don’t deserve it. I always say ‘You’re helping us. You’re helping the Vietnam vet … feel better. “It’s a pretty good program. It’s a winner for everybody. It’s a winner for Ocean City, it’s a winner for the vet, and it makes our guys really like we’re doing something.” An “Interactive” Vacation. For the seventh year, Post 469 in Longport will host a wounded veteran and his family during its Wounded Warrior Week program. Fleck, a former Navy Special Operations Chief Explosive Ordnance Disposal Technician, was seriously injured during an attack against his unit in Afghanistan. He was medically discharged in June and earned a Purple Heart. He and his family will be honored with a welcome parade and escorted by American Legion Riders and local first responders to a reception. The Flecks will stay in a beach-block home and be presented with free restaurant meals, sports and beach activities, and shows in Atlantic City. Post 469 Commander Larry Pacentrilli said the first time the post sponsored a veteran’s vacation, there wasn’t much interaction between the veteran and the post during the week. But that has changed. “The local veterans organizations that participate and contribute (to the program) really look forward to doing this because it’s an interactive visit,” Pacentrilli said. “We don’t toss the keys to the wounded warrior and say ‘Hey, have a good week.’ They know before they come that this is an opportunity not only for them to have a nice vacation, but also … for the community to express its appreciation for all the troops and wounded warriors through them. So they’re kind of a surrogate in that respect. When they come now, just about every day we’re doing something almost with them. “It’s gone over so well. At first we were wondering ‘maybe we’re taking up too much of their time.’ But the feedback we’ve gotten each time is that they really loved the interaction and getting to know the people in the community. And the people in the community love it, too.” All of their expenses are paid through contributions from local residents, organizations and businesses. “We don’t have to twist any arms for money,” Pacentrilli said. "We send out the notices, we advertise and the money just comes pouring in.” Pacentrilli said the week gives the veterans a chance to see that “people care.” He referenced a Marine Corps veteran with PTSD who went through the program three years ago. A Marine he’d served with in Afghanistan had recently committed, and the Marine was at a point where he felt no one cared about him or his fellow servicemembers. “They come into town, they get the parade, and we showed them a good time for the week,” Pacentrilli said. “But … the week we had them in included (the veteran’s) birthday.” Post 469 reached out to the veteran’s wife and asked if he had any good friends who he’d served with that may be able to attend a party for the veteran. “We were able to fly in four Marines that served with him, plus the Navy Corpsman that saved his life,” Pacentrilli said. “I get a little choked up talking about it. And we’re still in contact with him. His wife told us that since then, he’s fine now. He knows people care.”
Patriot Day serves as a reminder of the cost of freedom KANSAS CITY, Mo. – Tomorrow, the Veterans of Foreign Wars of the U.S. will pause to honor Patriot Day and remember the 2,996 lives tragically lost 17 years ago in New York City, the Pentagon and in Shanksville, Pa.  Since that fateful day, our bravest have fought on multiple fronts, with thousands of our nation’s finest paying the ultimate price for defending our freedoms, and thousands more having returned home bearing the physical and mental scars of battle.  The events of 9/11 serve to remind the world of everything our great nation stands for, that we will fight for the freedom to live our lives free from tyranny and fear, and that the true price of freedom is never free. The more than 1.6 million members of the VFW and its Auxiliary encourage all Americans to take a moment tomorrow and throughout the week to reflect on all that has changed since Sept. 11, 2001, and to remember the victims, their families, and those who’ve selflessly sacrificed to ensure our way of life remains.
A life member of Arizona VFW Post 7401 WASHINGTON — The 1.7 million-member Veterans of Foreign Wars of the United States and its Auxiliary are saluting the life of one of their own, U.S. Sen. John S. McCain III, who died this evening after battling brain cancer. “The senator is being remembered as a maverick at the U.S. Naval Academy, as a naval aviator, as a five and a half-year prisoner of war, and as a two-term U.S. congressman and six-term U.S. senator from Arizona,” said VFW National Commander B.J. Lawrence. “But we remember Senator McCain as a 32-year Life member of VFW Post 7401 in Chandler, Ariz., and as a staunch supporter of a strong military as well as a champion for our troops, our veterans and their families.” To recognize that support, McCain was a two-time VFW national award recipient, having been presented the VFW Americanism Award in 1992 and VFW Congressional Award in 1995. He also shared in the receipt of the VFW Armed Forces Award in 1971, which was presented (in absentia) to American POWs in Vietnam. “John McCain was a patriot who cared deeply about the health and well-being of those who have worn the uniform of our country and their families,” said Lawrence, “and on behalf of the entire VFW family, I send our deepest condolences to his family for their loss, and thank them for their strength and support that enabled him to continue serving our great nation for so many years. Bravo Zulu.”