Veterans Day is a wonderful opportunity to thank our veterans for their selfless service to our country. It is also an important opportunity to ensure that veterans and their loved ones are aware of the health issues that are all too frequently faced by those who served in the military.
Unfortunately, we know that our veterans experience myriad health problems, both soon after their service and in the years thereafter. At Kaiser Permanente, we are working to ensure our physicians know when a patient has served in the military so we can easily identify and detect health conditions associated with service. By creating tools to support this community, we are better able to diagnose and treat their health conditions in a comprehensive fashion.
Veterans’ health is of particular importance to me both as a physician and as a veteran myself. I trained in the military system for residency at the Naval Medical Center Balboa in San Diego. I served as an attending physician at the National Naval Medical Center (now Walter Reed Medical Center) in Bethesda, Maryland, and on the U.S. Naval Ship Comfort. These experiences have given me a first-hand glimpse of the impact of military service on my colleagues and friends. My hope is that by raising awareness of these issues, we can be more proactive in recognizing and preventing serious illnesses.
Here is an overview of some of the health conditions common among our military service members and veterans. This is not an exhaustive list but will provide insights into some common health conditions that may be related to time in service.
Mental Health and Behavioral Health Concerns
There are several mental health conditions that can stem from, or be aggravated by, time in service. These conditions can include anxiety, depression, psychosis, post-traumatic stress disorder, and traumatic brain injuries. These conditions can result from, or lead to, behavioral health issues such as substance abuse, chemical dependency, erratic behavior, and even suicide.
Post-traumatic stress disorder, or PTSD, affects roughly 10 to 20 percent of veterans who served in Operations Iraqi Freedom, Enduring Freedom, and the Gulf War. PTSD can occur from either a single traumatic event, from multiple stressful events, and even from the stress of being in a war zone, away from family, and going through extensive training and other challenging circumstances. Service members may also experience PTSD without being deployed or serving outside of the country.
Many service members find ways to cope with these stressors, but others develop PTSD. Symptoms of PTSD may either appear immediately or shortly after a traumatizing experience or develop weeks, months or even years after the event. PTSD is characterized by sleep disturbances, including nightmares; persistently feeling anxious and jittery; flashbacks; and feeling irritable and angry, especially due to experiences that are reminiscent of what happened. PTSD may be triggered by new traumatic events or stressful experiences.
PTSD can also be linked to traumatic brain injuries (TBIs). A traumatic brain injury occurs as the result of a single trauma or multiple traumas to the head, such as a concussion or gunshot wound. The brain may bruise or swell. Symptoms of a TBI include headaches, vision problems, dizziness, memory problems, sleep problems, and feeling nervous, among others. TBIs can make PTSD worse, and PTSD can make TBIs worse.
Those who grapple with PTSD or TBIs may develop behavioral health challenges, such as substance use disorders and addiction.
Veterans also are at increased risk of anxiety, depression, and suicide following a deployment. Symptoms may include changes in eating and sleeping habits, feeling sad and helpless, and losing interest in previously enjoyed activities. Giving away personal possessions, talking and writing about death, and withdrawing from friends and family are among the signs of suicide. Help is available by calling the Suicide and Crisis Lifeline at 988.
It’s important to note that not only are veterans at increased risk of anxiety and depression, so, too, are their partners and children. Please reach out for help at the first signs of a mental health challenge. There is no stigma in seeking help. As a community, it is important for us to be on the lookout for these signs and symptoms, so we can intervene early and provide the support and resources needed by our veterans.
Respiratory Health Concerns
For years we have been tracking the impacts of exposures during times of war. One of the most commonly known exposures is Agent Orange. In more recent years, another type of exposure has been linked to certain medical conditions, notably respiratory disorders. In Afghanistan and Iraq, burn pits were used to burn excess waste, such as plastics, rubber, chemicals, and medical waste. Exposure to the fumes from these burn pits puts military personnel at higher risk for respiratory illnesses, such as asthma, bronchitis, chronic cough, sinusitis, and sleep apnea. Additionally, some rare cancers of the larynx, trachea and lungs also have been linked to burn pit exposure.
Military personnel may experience symptoms of respiratory problems soon after exposure, or years later. Respiratory symptoms may include coughing and irritation of the eyes, nose, throat, or lungs. A symptom as minor as a cough can be a sign of something more serious, so tell your doctor details of your military service so you can get the right testing, diagnosis, and treatment.
Musculoskeletal problems are conditions that affect the muscles, bones, joints, ligaments, and tendons. Veterans may develop overuse injuries from intense physical training, carrying heavy equipment, and serving in combat. Problems such as knee, ankle, back, and hip pain are common. Arthritis is also a concern. Many female veterans experience chronic pelvic pain.
Veterans should be aware of any pain in their muscles, joints, and bones and seek treatment. Chronic pain — pain that lasts at least three months — can lead to serious complications, such as substance use disorders, depression, anxiety, and suicidal thoughts. Seeking help at the early signs of pain can lead to better outcomes.
Headaches, including migraines, are very common among veterans, particularly among those who have experienced a concussion or traumatic brain injury. There are many treatments available for headaches, so discuss your symptoms with your doctor.
Studies show that veterans have an increased risk of developing Lou Gehrig’s disease, also called amyotrophic lateral sclerosis. This serious neurological condition is a wasting away of the nerve cells in the brain and spinal cord. Early symptoms include weakness in a leg, hand, or the face and difficulty talking and swallowing. Researchers are examining the reason behind the link between ALS and military service.
Depending on where service members and their families were stationed, they may be at high risk of contracting infectious diseases, such as malaria, West Nile Virus, shigella, nontyphoid salmonella, Q fever, and more. Symptoms of many infectious diseases include fever, nausea, vomiting, and diarrhea. Veterans and their families should tell the doctor where and when they served so they can be tested for infectious diseases if symptoms develop.
Other Health Conditions
Veterans also are at increased risk of developing:
- Breast cancer. Women who served in the military are encouraged to discuss a mammogram schedule with their doctors.
- Heart problems. Veterans are at high risk of developing cardiovascular problems, including coronary artery disease. Symptoms may include chest pain, sweating, shortness of breath, and a fast or irregular heartbeat.
- Certain types of uncommon cancers. Veterans are encouraged to share their military history with their doctors.
Our life experiences shape and influence who we are and our overall health. Serving in the military is a great honor and privilege. Not only is it important for us to recognize and thank veterans and their families for their service but also identify service-related mental and physical health conditions early and provide support and resources as needed.
I encourage veterans and their families to be aware of symptoms of illnesses that may be connected to their service, and to be honest and upfront with their physicians. There is a lot of resources available through military service organizations and the U.S. Department of Veterans Affairs.
I wish all of my fellow veterans and their families the best of health.
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