Traumatic Brain Injury (TBI) represents a massive underserved personal and economic burden in the United States, with an estimated $80 billion in lifetime costs alone. According to the Centers for Disease Control and Prevention (CDC), from 2006-2014, the number of TBI-related emergency department visits, hospitalizations and deaths increased by 53% to 2.87 million, of which more than 837,000 events were among children.
TBI disproportionately affects vulnerable populations, particularly military service personnel, at an alarming rate. According toDefense and Veterans Brain Injury Center, from 2000-2019, more than 413,858 service members have been diagnosed with TBI with more than 15,000 cases of mixed severities in 2019 on its own. Recent news reports indicated more than 100 U.S. soldiers are suffering brain trauma after Iran’s missile strike on Al Asad Air Base in Western Iraq.
TBI is often caused by a bump, blow or jolt to the head that disrupts normal function of the brain. According to the CDC, injuries related to blasts, objects hitting head and falls commonly occur to those in the military.
Severity of TBI can be mild and temporary, or severe and life-altering, presenting patients with many complications and comorbidities. Those affected often suffer from a cascade of life-altering health conditions, including movement and sensation, anxiety/depression, epilepsy, sleep deprivation, personality changes, alcohol or opioid abuse and memory loss. Among veterans with positive TBI screens in VA facilities, 80% indicate comorbid psychiatric diagnoses.
Healthcare System Difficult to Navigate
Upon diagnosis, individuals with TBI transition through many stages, from acute patient in the hospital, to long-term care in medical intervention and rehabilitation. Long-term care can range from weeks up to 20+ years of ongoing symptom management. During this time, individuals living with TBI require a wide array of medicine, including high use of anticonvulsants, opioids and muscle relaxants to antidepressants, antipsychotics and sleep medications.
To better address this staggering public health issue, the Department of Health and Human Services (HHS) must create a National TBI Registry to assist with prevention, surveillance, and to help develop a standardized level of care for individuals living with TBI. The current tracking system, which is decentralized and relies on states and regions to construct their own registries, is inadequate and leaves millions without resources to manage their TBI comorbidities.
Nationwide Centralized Registry Needed
A centralized comprehensive registry would collect data on individuals with TBI in the U.S. and include pertinent information like how they obtained a TBI, how they were treated, outcomes and long-term effects. This type of information would facilitate more – and better – prevention development, surveillance/tracking, and development of clinical trials for new innovative approaches to advance treatment options. It also would serve as a resource for individuals with brain injury and caregivers to better navigate the healthcare system for support. Ultimately, the goal is to find a cure, but in the meantime, there is progress to be made.
There is currently an experimental stem cell therapy in clinical trials that aims to treat paralysis, uncontrolled movements and other motor deficits that often accompany TBI. It is exactly this kind of research that should be accessible to everyone affected by motor deficits after brain injury.
I’m pleased to share that there was a Brain Injury Task Force Congressional Hearing on Capitol Hill this March, where Reps. Bill Pascrell Jr. (D-N.J.) and Don Bacon (R-Neb.) showed their support for one centralized TBI Registry. This proves the leaps and bounds we’re already making in the TBI space to improve care and ultimately save individuals with TBI from overspending on treatment options for their comorbid condition. TBIs are an epidemic amongst our service members and veterans, which deserve first-in-class care and treatment options – yet our current processes and infrastructure are falling short by a long shot when it comes to TBI knowledge and resource-sharing nationwide.
Written By: Stephanie A. Kolakowsky-Hayner, PhD, CBIST, FACRM; National TBI RegistryCoalition (or President Elect, American Congress of Rehabilitation Medicine)
Military spouses have obstacles to employment but they are not insurmountable. It is definitely harder to get hired as a military spouse, after all, if it’s a choice between a candidate who is tied to the area, vs. a candidate who might only be in the area for two to three years, the decision seems clear. Actually, though, it’s not. Technically employers may not ask if a person is a military spouse, and in my opinion, being vague is in order in these situations. “Yes, I am new to the area.” “We are here for the foreseeable future.” “We moved here because we like the area.” Or, if the employer clearly knows you are a military spouse, you can honestly state that you are hoping to stay as long as possible.
In an interview, make it clear that, in addition to your work experience, your role as a military spouse has trained you with valuable skills. We adapt well to change, and are used to project management, budgeting and logistical planning. We are highly committed to the task at hand and know how to compartmentalize; and we are so glad the employer took a chance on us, that we put all of our efforts into working hard for the company. Tell the employer that because of your drive, passion and experience, you’ll give more to the company in whatever time you do have there than other, longer term, employees would.
There are definitely some career paths that are more conducive to military life than others. I know a lot of nurses, speech therapists, teachers (I’m a teacher), and freelance artists of all sorts- writers (me), graphic designers, etc., and consultants who work from home. Plus, many people have home businesses. There are plenty of online university programs to get various certifications, and there is scholarship money, through MYCAA, (The Military Spouse Career Advancement Accounts Program is a career development and employment assistance program sponsored by the Department of Defense’s (DoD) Spouse Education and Career Opportunities (SECO) program) for instance. Some people find jobs they are happy with on military bases, where the people hiring know how the lifestyle works and are especially open to hiring spouses. For more sources on education and employment, visit Military One Source.
Since military spouses, because of the nature of the military, have no choice but to take second chair to their Soldier, Sailor, Airman or Marine, it’s best to focus on something that brings you joy and try to find a career/hobby/job that fits into it.
I taught when my husband and I were first married, but once we had kids, I stayed home. I wanted to be a Stay At Home Mom. Besides, his job is so unpredictable, and deployments long and frequent, I could never have counted on him to help in a pinch. At first, I got frustrated by his odd hours and having to take odd phone calls in the office in the middle of the night, etc., and I’d speak my mind, after all, I felt I knew how to run things better, until one day, he got tired of me trying to tell him how the military could run better. He said, “I have my job and you have yours.” At first I was really angry, but then I decided that he was right. At that point in our lives, it was my chosen job to take care of the kids, which is no easy feat in any situation, but especially in military life (we have moved 12 times, and been through years of deployments). I made it my mission to be the best mom possible and raise really great kids, and I think I’m pretty good at my job.
Find what makes you happy, and make it happen.
Military personnel are posted either CONUS or OCONUS. This means within the Continental United States or Outside of the Continental United States. We have thousands of personnel stationed OCONUS, both on and off military bases. Horatio has been in the Navy for 27+ years and we’ve spent 17 of those living OCONUS, including Hawaii, Scotland, China and Taiwan. There are pros and cons to all situations and living OCONUS is no exception.
Living OCONUS can be great.
I’ll leave it there, 5 pros, 4 cons. There are more of each, but I encourage you to discover them for yourself. I wouldn’t trade our time overseas for anything. We’ve had invaluable experiences and our children, all four, are better citizens of the world having lived life as third culture kids; but that’s a whole other post.
To coincide with Veterans Day, nationally regarded Florida-based personal injury law firm Lawlor, White & Murphey, is pleased to announce an annual scholarship for both current and aspiring college students with a parent or family member that has served their country.
The scholarship will provide students with $2,000 to go toward the costs of tuition or any other related expenses at a college or university of their choice, anywhere in the United States. An additional $1,000 will be donated to the Vietnam Veterans of America, whose mission is to “promote and support the full range of issues important to Vietnam veterans, to create a new identity for this generation of veterans, and to change public perception of Vietnam veterans.”
The cause is near and dear to all partners within the firm, especially Benjamin Murphey, who served in the United States Army Infantry where he earned, among other things, his airborne wings and had the honor of serving as a sentinel at the Tomb of the Unknown Soldier.
In order to be awarded this scholarship, you must be a current undergraduate or graduate student with a 2.0 GPA and a parent or guardian that is a Veteran or currently a member serving in the United States Military.
The deadline for all applications is midnight, December 31st, 2019. The winner of the award will be announced on the firm’s Facebook page on or around January 15th, 2020.
To find out how to qualify, apply, or to learn more, please visit https://www.lwmpersonalinjurylawyers.com/scholarship/.
On Jan. 1, some copayments for your prescription drugs will increase. If you get your prescriptions through the TRICARE Pharmacy Home Delivery or at a retail network pharmacy, you’ll pay anywhere from $2 to $7 more starting Jan. 1. Congress made this change in the National Defense Authorization Act for Fiscal YearClick to closeOctober 1 – September 30 2018.
There’s still no cost to fill your prescriptions at military pharmacies. And these cost changes don’t apply to active duty service members (ADSMs). If you’re an ADSM, you still pay nothing for your covered drugs at military and network pharmacies.
“Military pharmacies remain to be your lowest cost option,” said U.S. Air Force Lt. Col. Melissa Pammer with the Pharmacy Operations Division at the Defense Health Agency. “Your next lowest cost is if you use the TRICARE Pharmacy Home Delivery.”
TRICARE Prescription Drug Categories
Your prescription copayments vary based on pharmacy type. Also, they vary based on the drug category. TRICARE groups prescription drugs into one of four categories. This grouping is based on the medical and cost effectiveness of a drug compared to other drugs of the same type.
As outlined in the TRICARE Pharmacy Program Handbook, the drug categories include:
To learn more, you can download the TRICARE Pharmacy Program Handbook from the Publications page.
Pharmacy Copayment Increases
TRICARE Pharmacy Home Delivery
If you use home delivery, your copayments for up to a 90-day supply of generic formulary drugs will increase from $7 to $10. For brand-name formulary drugs, your copayments will increase from $24 to $29. Your copayments for non-formulary drugs when you don’t have a medical necessity will increase from $53 to $60.
TRICARE retail network pharmacies
At a retail network pharmacy, your copayments for up to a 30-day supply of generic formulary drugs will increase from $11 to $13. For brand-name formulary drugs, the increase is from $28 to $33. Non-formulary drugs will increase from $53 to $60.
At a non-network pharmacy, you must pay the full price of the drug. After meeting your annual deductible, you may submit a claim for partial reimbursement. Non-network pharmacy costs remain the same if you use TRICARE Prime. With TRICARE Prime, you’ll pay a 50% cost-shareClick to closeA percentage of the total cost of a covered health care service that you pay. after meeting your point-of-service deductible for covered drugs.
For all other health plans, non-network pharmacy costs are as follows:
Copayments for survivors of ADSMs are the same as the 2017 rates. The copayments remain the same for medically retired service members and their family members, too.
Shared from Tricare.mil
Almost a year ago, the Trump Administration declared that the United States would withdraw from the Universal Postal Union (UPU), a United Nations organization that regulates international mail delivery. The withdrawal could cause severe disruption of international mail, including military mail, to and from the United States.
The 144 year old UPU regulates global mail systems and rates. The Administration’s chief complaint is on behalf of some US companies who are frustrated by the fact that packages sent to the US from other countries, particularly China, have much lower rates than what Americans pay. In many cases, Americans pay three times what China and other countries pay to ship their mail internationally. The UPU will meet at the end of this month to consider changes to the rules and rate structures. If the issue is corrected, the Administration will remain in the Union. If not, major changes will affect military, foreign service and other governmental agency personnel stationed around the world.
Yes, this means that we might not be able to ship our Amazon packages to our overseas duty stations. Our family members won’t be able to mail holiday presents to us, nor us to them, but the disruption is far more serious than what some may perceive as luxuries (I assure you, they are not) as shipment of medical supplies and medications travel through these systems to our Posts, Bases, Embassies and Consulates. Our APO, DPO, and FPO mail, which we’ve come to depend on because it allows us to use the US mail system and its rates, could see significant disruption, if not altogether stoppage. The United States government would then have to negotiate a new bilateral postal service agreement with each country to allow smooth transport of mail, and this will take time.
Military family and other government family associations are working to warn Congress of the destructive implications of the withdrawal from UPU, but it’s the Executive Branch that has the legal authority to withdraw from the Union. The Department of Defense is developing contingency plans, in case the withdrawal occurs and countries do not continue to allow for the special situation of APO, DPO, and FPO mail, to minimize any potential disruptions and continue providing support to families serving abroad.
The immediate reaction by troops and families should be to place orders now to ensure that letters and packages will reach you before the possible withdrawal in mid October. Check on your mail order prescription situation now so that you have plenty of medication on hand, should mail be disrupted.
By Julianne Price
Summer is here again! Popsicles, pools, parties, and—drumroll please—PCS-ing!
For those of us who move more frequently than we buy new running shoes, summer transfer season is as normal as June sunburns. But just because it’s routine, doesn’t mean it’s easy. Packing up, researching a new home, and trying to help our children manage their expectations while we temper our own is always a struggle—whether you’re moving to a new town or a new country.
It can be particularly tricky with small kids. I have an entire micro-library of kids moving books. Berenstain Bears Moving Day, Big Dan’s Moving Van, A Kiss Goodbye… I could fill half a page. But after years of reading these to my children and students at the international schools where I teach, I found they all have a common theme. They treat moving as a challenge to be overcome.
Which it is. No doubt about it. But for families that move every year or so, the language of “overcoming adversity” can get a little tired. I wanted to find a book that treated moving as an adventure. After years of looking, I was still coming up empty handed. So, I decided to write the book I wanted to read to my children. The Adventurers Club is the result.
The book follows the adventures of a sibling duo and their pet turtle as they turn packing boxes into pirate ships, new rooms into art canvasses, and a house into a home. It was published last fall by A15 Publishing, a publishing group formed by a team of combat veterans, and I hope it can be a useful resource to families whose service moves them around the globe.
The Adventurers Club is available on Amazon, or through the A15 Publishing website. Also, for more information, coloring pages, and resources on moving with small children, check out Adventuremoves.com.
Happy summer and best of luck with your upcoming adventures!!
Julianne has taught for 14 years in US and international schools. She is a mother of two
adventurous girls who have grown up in Madrid, Tokyo, Washington DC, and Vienna.
Most military children will say goodbye to more significant people by age 18 than the average person will in their entire lifetime. Most military kids don’t know how to answer the question: Where are you from? They’ll answer with any combination of the following: Do you mean where was I born? Where do I live? Where do my parents own a house? Where do my grandparents live? There’s no simple answer because military families relocate so frequently. It’s not uncommon for kids to attend two or more high schools. Military families serve our country too, and kids’ contributions and commitment are often overlooked.
Our second born Homefront Kid will graduate from high school next month. He attended two high schools, two middle schools, two elementary schools and three preschools. As luck would have it, he is graduating from the international school at which he started Kindergarten because The Navy sent us back to China after we’d been away for seven years. While it can be difficult for military kids to make connections with classmates, Dwight was able to use the social skills he learned from starting fresh so many times to become a good friend and leader among his peers. He was even chosen as the graduation speaker for the class of 2019, and as Most Likely to Change the World.
Some military kids struggle to form lasting, meaningful relationships throughout their whole lives. They build proverbial walls around themselves to prevent the emotional pain that comes when they have to leave yet another home and group of peers. Military kids who have lived on bases and immersed in military culture most of their lives can struggle to feel anchored to civilian life. The transition to college life can be especially tough. I recommend that parents read the book, The Global Nomad’s Guide to University Transition. I read it when Homefront Kid #1 was preparing to leave our overseas home for college and I’m rereading it now that #2 is leaving the nest. It’s helpful if the kids read it too, but since that’s unlikely to happen, parents can read it and impart the knowledge on their children.
The military’s migratory lifestyle can impede potential for building concrete relationships with people and developing emotional attachments to specific places. It’s important to also consider the stresses of having a parent deployed for long periods to undisclosed locations, and possibly to a war zone, and also the psychological aftermath of war in dealing with returning veteran parents. In some cases there is also the loss of a parent in combat, or a drastic change in a parent due to a combat related disability. Many military kids personally know another child whose parent was killed or wounded (physically or psychologically) in action. All of these factors shape our military children.
As parents, and a community, we can make every attempt to help military kids handle all of the adverse side effects of military life, but when the side effects are significant enough that they are above our paygrade, so to speak, we might have to seek counseling for the child or whole family. Military One Source is a good place to start, as many of their approved counselors are experienced in dealing with military issues. Also, psychiatric services are covered by Tricare. If someone in your family needs help, get it for them, it’s easy to find.
Despite all of the stumbling blocks that military kids encounter, they often end up as the most resilient among their peers. Adversity can lead to dynamism and adaptability. The skills military kids are forced to develop serve them well in the future, where they proceed to do great things. Military kids are not brats. They are brave, sensitive, adaptable, and above all, solid citizens. Take a minute to recognize one in your life.