2009 Trauma Spectrum Disorder Conference

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2009 Trauma Spectrum Disorder Conference

Postby lisalu0 on Tue Dec 01, 2009 10:11 am

The 2009 Trauma Spectrum Disorder Conference is aimed at increasing the level of awareness and understanding in regards to issues surrounding veterans, active-duty military, National Guard and Reserve and their families. Please read the following theoretical case scenario and answer one or all of the discussion questions, dialogue with others as their comments provoke thought exchange and/or provide suggestions to what [we] can do as a community to assist with building resilience and promoting reintegration and recovery.

Case Analysis:

Lt. Colonel Kevin Miller is a 3rd generation US Naval Academy graduate with 18 years of Military Service in the Marine Corps. Currently, he is stationed with the I Marine Expeditionary Force (I MEF) at Camp Pendleton, California. His wife, Stephanie, is a Family Nurse Practitioner at the Naval Hospital at Camp Pendleton and also serves as a Commander in the Navy Nurse Corps for the Naval Reserves.

The Miller’s have two children, Peter (14) and Laurie (16). Peter is more reserved and enjoys book clubs with friends, where Laurie, is more of a social extrovert and is able to get along with anyone she encounters. Peter has proven to be more proficient than his sister in school and is destined to become a 4th generation US Naval Academy graduate.
Several deployments have concluded with Kevin receiving numerous awards while being in theater. His exemplary leadership during combat has earned him the Bronze Star. Kevin has acknowledged with each deployment, the level of danger has increased. He, unfortunately, has witnessed many killed or severely injured, including many innocent people going about their everyday lives.

He and his Marines took part in rebuilding a girls’ school. His family shipped care packages filled with school supplies to aid in their effort. However, a suicide bomber later destroyed the school a month before his re-deployment out of theater, killing nine young girls, a teacher and injuring the others.

However, after coming home, Kevin discovered that alcohol had become a crutch for his wife, Stephanie. She would have a glass of wine to relax after a hard day at the clinic. Kevin rarely consumed alcohol, but had no issues with Stephanie having it in the house. He hadn’t realized that during his last deployment, alcohol started becoming a coping mechanism for Stephanie as she dealt with two attempted suicides, one resulting in death as well as the increase of spousal abuse being reported.

Kevin had fallen asleep around 7 o’clock on a Saturday night and Stephanie was drinking a second glass of wine. She had processed several new Wounded Warriors for their initial assessments while working reserve duty that day. Kevin decided to have Laurie pick up Peter from soccer practice and gave her keys to the car. Shortly after, the military police arrived at the Miller’s informing them that Laurie had been driving erratically and when they searched her person, a zip-lock baggie of pills was found. The MP’s had escorted Laurie to the station for detainment. Peter was in the cruiser awaiting parental release.

Discussion Questions:

1. What are the major concerns impacting Kevin, Stephanie, Laurie and Peter as individuals or as an entire family?
2. What services or resources would be appropriate for the concerns previously identified?
3. What multi-disciplinary approach should be used to mitigate the areas of concern surrounding the Miller’s, individually or as a whole?
lisalu0
 
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Re: 2009 Trauma Spectrum Disorder Conference

Postby ERS74493 on Mon Dec 07, 2009 2:31 pm

1. What are the major concerns impacting Kevin, Stephanie, Laurie and Peter as individuals or as an entire family?
Kevin going to sleep at 7pm on a Saturday night.
Kevin exposure to increased danger in theater, eyewitness to death, eyewitness to non combatant death (specifically children).
Kevin acceptance of Stephanie increased drinking as long as she is in the house.
Kevin possible withdrawal from family.
Peter’s withdrawal and reservation.
Stephanie drinking.
Laurie substance use.
Stephanie exposure to secondary traumitazation (PTSD) events at clinic.
Stressors at work for Stephanie and the violence

2. What services or resources would be appropriate for the concerns previously identified?
§ Substance abuse evaluation for Stephanie and Laurie
§ Assessment for secondary traumatization for Stephanie, Laurie and Peter
§ Assess if Laurie is taking on parental roles and responsibilities to compensate for any parent difficulties?
§ Kevin PTSD Screening
§ Individual counseling first for Kevin before any family work
§ Family therapy

3. What multi-disciplinary approach should be used to mitigate the areas of concern surrounding the Miller’s, individually or as a whole?
Involve Family Advocacy program, SAC, MP/JAC.
Work with Kevin individually first
Family Assessment
Family Systems Approach
ERS74493
 
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Re: 2009 Trauma Spectrum Disorder Conference

Postby jb23 on Mon Dec 07, 2009 3:43 pm

It seems like the wife is having the most trouble in this situaiton. I'd want to get a good handle on the amont, frequency of her drinking as well as her level of anxiety and/or depression. It's hard to know the extent of the daughter's drug abuse or dependence without a lot more information but I would want to know the kind of drug, how long she's been taking it, how much she takes, if she uses alone or only with friends, etc. Also, was she under the influence when she was driving (a worse prognosis).
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Re: 2009 Trauma Spectrum Disorder Conference

Postby AWS on Tue Feb 02, 2010 5:16 pm

Although I do have the the medical answers, I'd like to provide my story of the long term impact of PTSD; from a Vietnam Veterans perspective. Please feel free to use my story if it can help get any young and old warriors to seek medical assistance, by breaking through the stigma barriers.


The Demons’ of War are Persistent
My name is Schade: I am a Veteran with PTSD
Prelude

Forty years have passed since my deployment as a combat Marine in Vietnam. Like many Veterans’ of war, the ‘Demons’ have persisted to haunt me over a lifetime of tears, altered persona, and secretive fears. The purpose of this story is to help Veterans of all eras recognize, there is no longer a need to fight the ‘Demons of War’ alone. Today, the Veterans Administration and civilian medical communities understand the psychological transformation that haunts Veterans of war. It is no longer a dishonor, nor are you less of a warrior if you seek medical assistance from within or outside the Military.

It took me more than two years to complete this personal message. It forced me to muster memories of my past, albeit grudgingly, and glance back through the cloak of shadows I have fought alone for so many years. So, please take a few minutes to read this story – before your future, becomes a reflection of mine, and many other Veterans’ past. For the ‘Demons of War’ will fester in your mind. More haunting, if not confronted early their persistence will remain unshakable throughout your lifetime, until they eventually imprison your soul.

My Story:

Friends' and family gather to celebrate another joyful holiday. Nonetheless, encircled in the cheerful atmosphere I am often melancholy, as vivid memories of lost friendships and battlefield carnage randomly seep from the vulnerable partition of my mind; a secret place I concocted decades ago to survive in society. Thoughts I silently struggle to keep inaccessible for fear of unleashing the worst of wars' nightmares, which continue to blockade my endeavors to reminisce of the innocence and joy of my pre-war past.

Although this story is of one warrior, it pertains to countless more. For entrenched within our spirit, humanity has sought expedient motives to send the young to war. My pledge to God, Country, and Marine Corps was Forty years ago, or more. At eighteen, like many others, I adorned the timeless stench of death and carnage, in the jungles of Vietnam.

As a young unproven warrior, I consented willingly to the ancient rules of war. Too naive to understand the twisted “Demons’ of War” had already begun a lifelong quest for possession of my soul.

My journey began as many others, a bus ride to New York’s legendary Induction Center at 39 White Hall Street. We went through lines of examinations, and stood around for hours. We had no choice but notice one another’s bare asses, before we had the chance to learn each other’s name. Nor did we know so many of us would remain together, building deep-seeded bonds of friendships through Parris Island, Camp Pendleton, Okinawa, to the deadly battles in the theatre of war - Vietnam.

We argued and fought among ourselves, as brothers often do. Yet, we never lost sight of the bonds we had – as friends, and United States Marines.

Aware of our destination we partied hard in every port, covering each other’s back in countless bar room brawls. In confidence, we spoke about our hardships, growing-up, family, girlfriends, and future plans. As well, the dreams of going home again and the years of lasting friendships we faithfully agreed to share.

We transferred to a converted WWII aircraft carrier, which carried helicopters not jet planes, to transverse the coast of Vietnam to be deployed by helicopter to combat zones from the DMZ, DaNang and the outer fringes of Saigon.

Within sight of land, we heard the roar of artillery and the familiar crackling of small arms fire. We loaded into helicopters to descend into the confrontation. With ambivalence, we assured ourselves that we were young, invincible warriors eager to engage in the battle. Indoctrinated in training, we knew the South Vietnamese people needed us, as we found many of them did. Our mission was to save the lives of the innocent and banish the enemy into Hell.

The helicopters plunged from their soaring formation to hover a few feet off the ground where we nervously leapt, some fell, into the midst of heated battle. The enemy was ready and sprung a deadly assault upon us. I was unaware that was the moment my psyche began to change, as I became engrossed in the shock, fear and ‘adrenaline rush’ of battle.

It was surreal! Nevertheless, not the time to ponder the finality of killing another human being, the sight of friends shot dead, the rationale behind the illusionary ethics of war or absorbing the inherent fury of men slaughtering one another. Nor, was it time to grapple with the thoughts of Demon seeds being sown.

When the killing ceased and the enemy withdrew, I remained motionless, exhausted from the fighting. With only a moment to think about what occurred, shock, hate and anger surrendered to the gratitude of being alive. However, time was not a luxury. I had to find out which brothers did or did not survive.

As I turned to view the combat zone, I witnessed the reality of war; dreams, friendships and future plans are fleeting thoughts for combatants.

We knelt beside our brothers, some dead, many wounded and screaming in pain – while a few lay silently dying. As I moved about the carnage, I noticed a lifeless body, face down, and twisted abnormally in jungle debris. I pulled him gently from the tangled lair, unaware of the warrior I had found. Masked in blood and shattered bones, I was overwhelmed with disgust and primal obsession for revenge, as I realized the warrior was my mentor, hero and friend.

I shouted at him, as if he were alive: “Gunny you can’t be dead, you fought in WWII, and Korea. Wake up! Wake up Marine; I need you to fight beside me!” Tears flowed down my face as I held him close and whispered he would never be forgotten. I placed him gently in a ‘body bag’, and slowly pulled the zipper closed above his face, engulfing him in darkness.

Our extraordinary brothers, Navy Corpsmen, worked frantically to salvage traumatized bodies. We did our best to ease the pain of the wounded, as they prayed to ‘God Almighty’. “With all my heart I love you man,” I told each friend I encountered. However, some never heard the words I said, nor aware of the survival guilt inside me.

When our mission was completed, we flew by helicopter from the jungle to safety on the ship. Yet, none of us rested; we stayed up most of the night remembering faces and staring at empty bunks of the friends who were not there. I prayed the sun rose slowly, to delay the forthcoming ceremony of the dead.

Early the next morning we stood in military formation on the aircraft carrier's deck; temporarily suppressing my emotions as I stared again upon the dead. Rows of military caskets, identical in design with an American flag meticulously draped over each of them, made it impossible to distinguish which crates encased the closest friends of mine.

When TAPS played tears descended uncontrolled and for the first time I grasped that I never had the chance - to say goodbye. I pledged, they would never be forgotten. A solemn promise I would fail to keep. Unaware, that a time would come forcing me to suppress all memories of my past, the only option that made sense, if I was to live a somewhat normal life.

Combat is vicious, rest is brief, but destroying the enemy was our mission. We fought our skillful foes in many battles, until they or us, were dead, wounded, or withdrew when overwhelmed.

Weary, I was not aware of the progressive change in my demeanor. In time, I adjusted emotionally to contend with the atrocities and finality of war. I acquired the stamina to endure the stench of death, eliminate enemy combatants with little or no remorse, suppress memories of fallen companions, shun new deep-rooted friendships and struggled to accept the feasibility of a loving Lord.

I was a warrior who led others in battle. Yet, I was never taught to recognize the Demons’, and that the war for my mind and soul had already started.

My tour of duty complete, I packed minimal gear and left the jungle battlefields of Vietnam for America. Never turning to bid farewell or ever again wanting to smell the pungent stench of death and fear. Within seventy-two hours I was on the street I left fourteen months before; a street untouched by war, poverty, genocide, hunger or fear. I was home – yet, alone. Aged psychologically beyond my 19 years and emotionally confused, I had to adjust immediately, from a slayer, to a so called
Civilized man.

Except for family members and several high school friends, returning home from Vietnam was demeaning for most Veterans. There were no bands or cheers of appreciation from the country so many gave their lives to serve. Instead, many were shunned and ridiculed for fighting in a war that our government assured us was a crucial and honorable cause.

Yet, family, friends and even myself, never truly understood the changes that transformed me in fourteen months from a teenage boy, to a battle hardened man.

I was not able to engage in trivial conversations; nor, take part in adolescent games many friends still played. For them, life did not change and the realism of struggle was a job, or the unbearable pressures of college. It did not take long to realize they would never understand, there is no comparison between homework, and carrying a dead or dying man.

The media played their bias games, downgrading the military and never illuminating the thousands of Vietnamese saved from mass execution, rape, torture, or other atrocities of a brutal Northern regime. Nor, did they highlight the stories of American heroes who gave their lives, shattered bodies and emotional self-sufficiency to save innocent people caught in the clutches of a controversial war.

For years, my transition back to society was unclear, as I struggled against unknown Demons and perplexing social fears. I abandoned searching for surviving comrades or engaging in conversations of Vietnam. Moreover, I fought alone to manage recurring nightmares, in a cerebral chamber I code named - Do not open! Horrors, chaos, lost friends from Vietnam.

However, suppressing dark memories is often not to be. As random sounds, smells, or even words unleash nightmares, depression and seepage of the bitterness, I still fight to keep locked inside me.

Today, my youth has long since passed me by and middle age is drifting progressively behind. Still, unwelcome metaphors and echoes of lost souls seep through the decomposing barrier I fabricated in my mind, so many years ago. Vivid memories of old friends, death, guilt and anger sporadically persevere.

No end, no resolution, nor limitations to a time, demon voices that began as whispers, have intensified over decades in my mind. “Help me buddy!” I still hear them scream, as nightmares joust me from my slumber. I wake and shout, “I’m here! I’m here my friend”, and once more envision their ghostly, blood soaked bodies.

Even today I frequently wonder if more Marines would be alive, had I fought more fiercely to reach them, before so many of them died. “I had to kill!” I tell myself, as visions of lost friends and foe hauntingly reappear at inappropriate times. Guilt consumes my consciousness as I question why I had, and they did not, survive.

More retching, however, is the conflicting anguish I feel, when I admit to myself - I am thankful it was them, and not I.

This story has one purpose, to extend a helping hand. Regardless of the wars you fought, your memories are similar to mine and mine to yours.

To all past and current warriors, I rise to applaud your valiant stand. Nonetheless, to control Wars’ Demons takes time and the battle is much harder, should you choose to challenge them alone. I never realized how swift the demons had matured; disguised and deep-rooted; I thought anxiety, loneliness, depression, alcohol binges, nightmares and altercations, were traits necessary to be a man.

Do not wait for medical assistance, as older Veterans were forced to do. For far too many Veterans were less fortunate than me, and succumbed, unknowingly to the Demons’ stealth assault of suicide, hate, anxiety, depression, alcohol and drug addition, and the gloom
of solitude.

PTSD is real my friends, and easily recognizable. More important, if not confronted early it will shape your future and relationships with your spouse, children, family, associates and career.
Remember, you will always be a warrior and hero to us all. However, do not fool yourself without help from the VA or outside professionals, the ‘Demons of War’ may overpower you - and eventually win your soul!

Semper Fi!
To ALL America's Warriors

[January 2010: AW Schade; a Marine, Vietnam 1966/67. Schade is a retired corporate executive and author of the award winning book; "Looking for God within the Kingdom of Religious Confusion."] awschade@gmail.com www.awschade.com
AWS
 
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