Military experts say better technology will help treat new veterans
Sunday, April 13, 2003
BY CAROL ANN CAMPBELL
Star-Ledger Staff
For a decade, Mike Bann, a 39-year-old Teaneck firefighter and Gulf War veteran, has been sick with headaches, sinus infections, aching joints and fatigue.
There are days he cannot concentrate. Sometimes, his heart beats wildly. He blames his time in Desert Storm, the 1991 conflict in the Persian Gulf that left thousands of veterans with a constellation of unexplained medical illnesses known collectively as Gulf War Illness.
Now, as a new generation of fighting men and women battle the same enemy in the same hostile desert, Bann and other veterans fear that history will repeat itself, and that more veterans will return home with a perplexing disorder that doctors do not know how to treat — or even diagnose.
Military leaders, however, say that they have learned from past mistakes, and they are determined to closely monitor food, soil, air and water samples in Iraq. Individual medical records are now computerized. The health of troops will be assessed before and after deployment through a questionnaire.
“We may be in the same location and fighting the same enemy, but this is not the same war. Not from a technological or medical standpoint,” said Michael E. Kilpatrick, a physician and deputy director of deployment health support in the Office of the Assistant Secretary of Defense.
Military experts have not linked a specific toxin to any particular set of symptoms. Doctors said they do not have proper records from Gulf War I. Now, Kilpatrick said, if an incident occurs, say, where chemical weapons are released, the military will document which troops were in the vicinity, and their health will be monitored. The military does not want a repeat of the Agent Orange fiasco, when it took many years to link the pesticide used in the Vietnam War to the health problems of veterans.
Kilpatrick also said daily medical reports are closely monitored for trends. For instance, during recent sand storms in Iraq, American troops reported a slight, and temporary, increase in respiratory difficulties. The military also is trying to better educate troops about illnesses endemic to the Gulf, such as leishmaniasis, a parasitic disease that can affect the skin or intestines. It is transmitted by sand flies and difficult to treat if not caught early.
Other advances are better chemical protection suits and far superior systems to detect chemical and biological attacks. The military is being more careful with pesticides, and it’s unlikely the troops will demolish another chemical weapons depot, as they did in Khamisiyah in the 1991 war. Veterans in the area were not informed about their possible exposure until 1997.
Bann was one of those who got a letter got from the Office of the Secretary of Defense reading, “‘You may have been exposed to low levels of a chemical agent resulting from the demolition of munitions in Khamisiyah.”
Not everyone is convinced, however, that the military is doing enough.
Steve Robinson, a former Army Ranger and now the executive director of the National Gulf War Resource Center in Washington, D.C., said the pre- and post-deployment medical evaluations should be more than just questionnaires, and should include full physicals and blood screenings.
“We need evidence to determine if soldiers were exposed to something,” he said.
Benjamin Natelson, the physician who directs the War Related Illness and Injury Center at the Veterans Affairs medical facility in East Orange, said that he wanted to study recruits headed for the Gulf — and then study them upon their return — but could not get funding.
“I have been very frustrated,” he said.
Natelson, an expert in chronic fatigue syndrome, said 2.3 percent of Gulf veterans have been diagnosed with chronic fatigue syndrome, a prevalence that is six times higher than among civilians. A study by the U.S. Centers for Disease Control and Prevention, meanwhile, found that veterans stationed in the Gulf were far more likely to report symptoms such as fatigue and joint pain than veterans not stationed in the Gulf.
A study in the April American Journal of Public Health, by Rutgers University researchers William K. Hallman and Howard M. Kipen, tried to group ill Gulf War service members by their symptoms — all those with headaches, for instance, or joint pains.
Instead, the researchers found that many of the veterans reported a multitude of symptoms and “hurt all over,” not just in specific places. Many reported feeling tired and unable to concentrate. Some 100,000 — or one in seven — signed up with a Gulf War health registry to notify the government about their health concerns.
Are Gulf veterans sicker than those returning from other wars? After the Civil War, doctors diagnosed veterans with palpitations as suffering from “irritable heart.” Traumatized veterans of World War I were called “shellshocked.” “Combat fatigue” plagued World War II veterans who couldn’t sleep.
Natelson said comparisons are impossible, since no generation of returning veterans has been studied as closely as those coming back from the Gulf. He said there is not enough data to know whether toxic exposures worsened the after-effects for Gulf War veterans, but he said he has no doubt that the trauma of battle and deployment is a powerful cause of medical illnesses following war.
Robinson said he does not believe that stress is a primary cause of Gulf War Illness.
“This is not a mystery. We were exposed to investigational new drugs and vaccines, chemical weapons, oil well fires, endemic diseases and depleted uranium,” he said firmly. Uranium coating was used to make shells more powerful.
Doctors at the East Orange center said their goal is not to solve the puzzle of Gulf War illness, but to help the sickest Gulf veterans.
“We say, ‘Let’s make you better even if we don’t know what’s causing your problems,'” said Drew Helmer, the physician who is the center’s clinical director.
Mike Bann said he is seeking help through herbal medicines and exercise, and taking each day as it comes.
“What we want is help for the guys now, and help for the guys coming home so they don’t go through the same things we did,” he said.
Carol Ann Campbell covers medicine. She may be reached at ccamp bell@starledger.com, or (973) 392-4148.
