Iraq Vets Falling Through Health-Care Cracks

Despite lifesaving care, many with severe head injuries not getting follow-up they need, report suggests

By Amanda Gardner
HealthDay Reporter
Wednesday, December 20, 2006; 12:00 AM

Copyright © 2006 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Dec. 20 (HealthDay News) -- Sergeant Jason Pepper returned from the conflict in Iraq with a traumatic brain injury, symptoms of post-traumatic stress disorder, and a desperate need for help in navigating the U.S. health-care system.

But, like many of his peers, Pepper, who was also blinded in a blast from an improvised explosive device, is now largely invisible in a system ill-equipped to deal with the type and magnitude of injuries showing up in veterans returning from Iraq, according to a report published in the Dec. 21 issue of New England Journal of Medicine.

"He has sort of fallen through the cracks as far as medical care goes," said Dr. Susan Okie, contributing editor of the New England Journal of Medicine. "He has made, physically, a fairly remarkable recovery considering how badly he was wounded, but he has significant residual medical problems and symptoms."

Pepper, along with Sergeant David Emme, were first profiled in the pages of the journal last year while undergoing treatment and rehabilitation at Walter Reed Army Medical Center, in Washington, D.C.

Emme also has a traumatic brain injury (TBI) and symptoms of post-traumatic stress disorder (PTSD) as a result of his service in Iraq.

Okie revisited the two men, this time in their homes -- Pepper, an hour outside Nashville, Tenn., and Emme, north of Allentown, Pa.

Pepper and Emme are among some 22,600 U.S. soldiers who have been wounded in the conflicts in Iraq, Afghanistan and other locations, most commonly by blasts. Fifty-nine percent of those injured by blasts have been found to have a TBI, which has been called the signature wound of this war. This and other features of the conflicts may be overwhelming the veterans' health-care system.

"There are probably more people like these two guys who have a combination of PTSD and TBI, and that's probably something the VA has not seen in such numbers before," Okie said. "Because of the body armor, there is a higher survivor rate of those with multiple wounds, so a bigger influx of those with severe injuries and maybe head injury as well as amputations or wounds to the limbs. The VA's obviously got a big burden of people recovering from severe injuries, more than in previous conflicts."