TRICARE NEWS
(AND HEALTH RELATED NEWS/INFORMATION)
TRICARE information is intended for active duty and retired TRICARE
beneficiaries of all the military services, reserves, guards, and their
families.
1. To contact TRICARE Help Desks, call the following toll-free numbers:
o General TRICARE information/assistance: 1-877-874-2273
o TRICARE Pharmacy: 1-877-363-6337
o TRICARE For Life: 1-888-363-5433
Posted: 15 FEB 02
TRICARE Toll-Free Numbers and Web Sites
1. National Toll Free Numbers
==============================
Senior Pharmacy Program 1.877.DOD.MEDS (1.877.363.6337)
TRICARE For Life 1.888.DOD.LIFE (1.888.363.5433)
TRICARE Prime Remote (TPR) (active duty and family members)
1.888.DOD.CARE (1.888.363.2273)
TRICARE Retiree Dental Plan - Deltal Dental 1.888.838.8737
TRICARE Dental Program (TDP) - United Concordia 1.800.866.8499
National Mail Order Pharmacy - Merck Medco 1.800.903.4680
Defense Enrollment Eligibility Reporting Systems (DEERS) 1.800.538.9552
Active Duty Claims (MMSO) 1.800.876.1131
TRICARE Claims Information
2. Regional Toll Free Numbers
==============================
Northeast (1) 1.888.999.5195
Mid-Atlantic (2) 1.800.931.9501
Southeast (3) 1.800.444.5445
Gulfsouth (4) 1.800.444.5445
Heartland (5) 1.800.941.4501
Southwest (6) 1.800.406.2832
Central (7/8) 1.888.874.9378
Southern California (9) 1.800.242.6788
Golden Gate (10) 1.800.242.6788
Northwest (11) 1.800.404.2042
TRICARE Pacific
Alaska and Hawaii 1.800.242.6788
WESTPAC 1.888.777.8343
Latin America & Canada 1.888.777.8343
Puerto Rico & Virgin Islands 1.888.777.8343
Europe 1.888.777.8343
-----------------
Posted: 15 FEB 02
Toll Free Numbers for Contacting the VA
Toll Free Numbers for Contacting the VA
=======================================
1. VA Benefits: 1-800-827-1000
For information about:
Education
Home Loan
Disability
Medical Care
Burial
Life Insurance
Sexual Trauma
2. Life Insurance: 1-800-669-8477
3. Education (GI Bill): 1-888-442-4551
4. Health Care Benefits: 1-877-222-8387
5. Income Verification and Means Testing: 1-800-929-8387
6. Mammography Helpline: 1-888-492-7844
7. Gulf War/Agent Orange Helpline: 1-800-749-8387
8. Status of Headstones and Markers: 1-800-697-6947
9. Telecommunications Device for the Deaf (TDD): 1-800-829-4833
10. For health care services, contact your nearest VA medical facility. To
locate the nearest VA medical facility, go online to
11. CHAMPVA:
by phone... 1-800-733-8387
by FAX..... 1-303-331-7804
by mail.... VA Health Administration Center
CHAMPVA
PO Box 65023
Denver CO 80206-9023
-----------------
Posted: 15 FEB 02
PTSD -- Women Veterans
The October 2001 Agent Orange Review just arrived in the mail,
February 5th.
"VA Studying Women Veterans Who Have PTSD"
"PTSD Common Among Women Veterans"
"Volunteers Sought for Study"
are articles on pages 4 & 5.
VA Studying Women Veterans Who Have PTSD
Many women are traumatized while serving in the military. A recent study of
female veterans estimated that 60% had experiences at least one traumatic event
during military service. The prevalence of serious trauma appears especially
high among veterans who have served since Vietnam, who now constitute the
majority of female veterans. Most often, military trauma in women involves
sexual assault or rape, but other sources are physical assault, accidents,
disasters, and even war-zone exposure, including medical assignments that
involve exposure to seriously injured personnel.
Women also experience trauma before and after entering military service. In
fact, the prevalence of sexual assault during childhood and adolescence appears
to be higher in military women than in the general U.S. population.
Traumatic exposure can have profound effects on a person's well being and
functioning, and may lead to the development of Post-Traumatic Stress Disorder.
PTSD occurs not only in combat veterans but also in other survivors of traumatic
events such as natural disasters and interpersonal or sexual violence. Among
civilian adults in the U.S., the lifetime prevalence of PTSD is 5% of men and
10% in women.
A new research project, sponsored by the Department of Veterans Affairs (VA)
Cooperative Studies Program, and the Department of Defense, is designed to
address the needs of female veterans and active duty personnel who have PTSD.
The new VA study, identified as VA Cooperative Study #494; A Randomized Clinical
Trial of Cognitive-Behavioral Therapy for Women, also will test the helpfulness
of exposure therapy for female veterans and active duty personnel with PTSD.
PTSD Common Among Women Veterans
PTSD is a prevalent condition among women who have military service
experience. A recent population sample of active duty Navy and Marine Corps
personnel found that among women, 17.4% had PTSD at some time and 8.3% had
current PTSD. The VA National Vietnam Veterans Readjustment Study estimated that
26% of women who served in Vietnam had PTSD at some point since their service,
and 8.5% has PTSD at the time fo their assessment in the 1980s. Current PTSD
prevalence in women who served in the Gulf War is 8-10%. Prevalence is
substantially higher among women who seek VA treatment for stress-related
problems: one study found that 50% of those women had current PTSD.
PTSD is associated with a range of comorbid (occurring at the same time)
conditions and functional difficulties, including other anxiety disorders,
depression, substance abuse, psychological impairment, poor physical health, and
greater service utilization. Thus, PTSD has far-reaching effects on many aspects
of the military and veterans women?s lives.
A variety of drugs and phychotherapies are used for treating PTSD. Among
phychotherapies, cognitive-behavioral therapy appears to be the most promising
approach. One useful cognitive-behavioral technique is ?exposure,? in which a
patient is guided through a vivid remembering of a traumatic even repeatedly
until the patient's emotional response decreases through habituation.
Volunteers Sought for Study
The Study will enroll 384 women, who will be randomly assigned to receive
either exposure therapy or therapy that focuses on current life problems. Both
treatment will last 10 weeks, and the women will be followed for 6 months after
the end of treatment to evaluate how PTSD and other symptoms respond to
treatment.
The study represents a collaboration between the VA and the Department of
Defense. Co-Chairs of the project are Paula P. Schnurr, Ph.D., and Matthew J.
Freidman, M.D., Ph.D., from the VA?s National Center for PTSD and LTC Charles C.
Engel, M.D., from Walter Reed Army Medical Center. The VA National Center for
PTSD is located at the Veterans Affairs Medical Center in White River Junction,
VT, where Dr. Freidman is the Executive Director and Dr. Schnurr is the Deputy
Director. The biostatistician is Ken James, Ph.D., and the study is coordinated
by the VACSPCC at Palo Alto, CA.
Women will be enrolled at 11 VA sites around the country: Albuquerque,
Atlanta, Baltimore, Bay Pines/Tampa, Boston, Cincinnati, Cleveland, Dallas
Denver, New Orleans, and Portland. There also will be a Department of Defense
site in Washington, DC. Women who are interested in participating in the trial
may contact the project at :
csp494@nmbus.dartmouth.edu for referral to participating medical centers.
The above article was prepared and submitted by Dr. Schnurr, identified
above, especially for the "Review."
Posted: 15 FEB 02
Force Health Protection and DOD Population Health and Health Promotion
Conferencees
PUBLIC AFFAIRS OFFICE
U.S. ARMY CENTER FOR HEALTH PROMOTION AND PREVENTIVE MEDICINE
ABERDEEN PROVING GROUND, MARYLAND 21010-5403
PR 05-02
12 February 2002
ADAPTING TO A CHANGING GLOBAL ENVIRONMENT
Joint Conferences to be Held in Baltimore
BY: Evelyn B. Riley
The Fifth Annual Force Health Protection Conference and the Second Annual DOD
Population Health and Health Promotion Conference will be held jointly 9 - 16
August 2002, at the Baltimore Convention Center, at the Inner Harbor in MD.
The theme for the joint conferences is "Adapting to a Changing Global
Environment". The U.S. Army Center for Health Promotion and Preventive
Medicine, Aberdeen Proving Ground, MD will host both conferences.
The conferences will provide the multidisciplinary military and civilian force
health protection community with the opportunity to increase knowledge and
awareness of current issues, attend short courses for professional
development, mentor, network, and earn CEUs or CMEs. The first three days, 9
- 11 August, will be skills training workshops designed primarily for, but not
limited to, the DOD Conference attendees. The core conference, beginning on
12 August, will include both plenary and breakout sessions designed to provide
an exchange of information that has a wide application within the DOD
community in the areas of homeland security, environmental health, population
health, complimentary and alternative medicine, behavioral health, veterinary
medicine, medical research and development, injury prevention, nutrition, and
spiritual health. In addition, service-specific breakout sessions will be
offered. Topics and lessons learned relating to the events of 11 September
2001 will be presented. The DOD
Conference and the three tracks that make up the FHP Conference are described
below:
The Second Annual DOD Population Health and Health Promotion Conference -
designed to unite the population health and health promotion specialties in an
integrated environment that will provide scientific and technical training
necessary for the diverse specialties; allow participants to address relevant
and significant force health protection issues; and provide mentoring and
networking opportunities. It will begin with three days of pre-conference
Skills Training Workshops focused primarily on humanitarian assistance, risk
communication, behavioral health - post deployment issues, tobacco cessation,
dental health promotion, and HIV/STD.
Life Sciences Track - the technical aspects of prevention/detection of
environmental, occupational, and disease threats to the health and performance
of DOD personnel. This track will include research and development in support
of the soldier, toxicology, and veterinary services.
Clinical Sciences Track - the science and delivery of preventive medicine
services. Clinical and general preventive services to include immunization,
occupational medicine services, hearing conservation, vision conservation, and
behavioral health and associated services.
Environmental Sciences Track - topics related to identifying, assessing and
providing recommendations for protecting soldier health. This includes
environmental health topics such as industrial hygiene, food and water
sanitation, medical surveillance, entomological services, health physics,
environmental noise, field sanitation, and disease prevention.
Participants are invited to prepare and display technical posters that will be
judged for content and aesthetics by a panel of subject matter experts. The
winners will be announced on the final day of the conference. USACHPPM will
judge all posters, selecting the ten best submissions for partial central
funding of travel and per diem.
Technical presentations are also being solicited for the conference. Both
military and civilian vendors are encouraged to exhibit during the
conference.
The website will be available for registration in March. POC: LTC Roxanne E.
Baumgartner, Director, (DSN) 584-7387/(Commercial) 410-436-7387 or Ms. Jane
Gervasoni, (DSN) 584-5091/(Commercial) 410-436-5091.
===============
SOURCE: U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM),
Ms. Jane Gervasoni,
Jane.Gervasoni@APG.AMEDD.ARMY.MIL , (DSN) 584-5091/(Commercial)
410-436-5091.
Posted: 15 FEB 02
DoD, TRICARE Play Big Roles in Homeland Security Planning
By Gerry J. Gilmore
American Forces Press Service
WASHINGTON, Feb. 12, 2002 -- TRICARE personnel and assets are playing a big
part in DoD's preparedness plans in support of other federal, state and local
emergency medical response teams in dealing with possible terrorist acts
committed on American soil, a senior DoD official said here
today.
Ellen P. Embrey, DoD's new deputy assistant secretary of defense for force
health protection and readiness, outlined the president's homeland security
goals and plans and steps participants of the annual TRICARE conference here
can take to support them. She advises the assistant secretary of
defense for health affairs on all DoD medical readiness and deployment
medicine policies and activities, and national medical disaster support.
"As the direct provider of beneficiary care and a respected military health
professional in your local community, you will be asked to participate in
local, city, county or statewide disaster and terrorism emergency management
contingency planning and exercise activities," she said.
Former Pennsylvania Gov. Tom Ridge, director of the Office of Homeland
Security, coordinates and implements national homeland security strategy,
Embrey noted.
In his fiscal 2003 budget request, she said, President Bush called for $38
billion to support homeland security efforts contained in four key objectives:
support first responders first; defend against bio-terrorism; secure America's
borders; and use 21st century technology to secure the homeland.
Embrey told conference attendees the first two objectives are relevant to them
and DoD. First responders -- local police, firefighters and civilian and
military emergency medical professionals -- "have the greatest potential to
save lives and limit casualties after a terrorist attack," she explained.
On the second objective, current homeland security plans recognize that
bio-terrorism defense will require the nation to invest significantly in its
healthcare system, "of which you are a critical part," Embrey told attendees.
Almost $2 billion is being proposed to bolster state and local public
healthcare systems, Embrey said, to manage both contagious and noncontagious
diseases, to expand healthcare surge capacities, to upgrade public health
laboratory capabilities, and to provide training for medical personnel.
Funds are also provided, she added, to support mutual regional medical aid
agreements and communications networks linking acute care assets, including
military, with local communities' public health organizations.
Embrey said the military stands ready to assist. Its emergency response
capabilities include the Army's Chemical/Biological Rapid Response Team,
Technical Escort Units, the Marine Corps' Chemical/Biological Ready Response
Force, and the National Guard's Weapons of Mass Destruction
Civil Support teams.
The president and Congress, she said, have also taken steps to create national
supplies of smallpox vaccine and an antibiotics stockpile to treat potential
anthrax victims.
"Our success or our failure as a nation to respond to bio-terrorism will
depend in large measure on the quality and effectiveness of our diagnostic
tests, vaccines and therapeutic drugs," Embrey noted.
She said military commanders depend on TRICARE healthcare professionals' plans
and preparations for possible bio-terrorism attacks -- and "don't
underestimate their need to rely on you," she told conferees.
"The chemical and biological agent awareness training, personal protective
equipment stocks, medical supplies needed to support chemical/biological
wartime support operations are (what) your installation commander wants you to
have ready in case of a potential attack," she added. Embrey said
TRICARE personnel also could be called to help in local relief efforts.
Related Site of Interest:
Posted: 8 FEB 02
TRICARE For Life, a new health benefit extended by the Department of Defense (DoD)
to approximately 1.5 million beneficiaries aged 65 and over, provides pharmacy
benefits and TRICARE coverage secondary to Medicare. More than 3.1 million
health care claims have been paid since the program started in October 2001.
Payment for some health care claims, however, was initially denied by TRICARE
for individuals recorded as being ineligible for TRICARE in the Defense
Enrollment Eligibility Records System (DEERS). In many cases, these denials
were based on persons who have "expired eligibility" in DEERS, meaning that
their eligibility has not been re-verified in the last four years as required
by DoD policy.
DoD announced today that TRICARE claims will be paid for a limited time for
TRICARE For Life (TFL) beneficiaries with "expired eligibility" in DEERS.
Claims filed beginning October 1, 2001 but denied due to "expired eligibility"
will be automatically reprocessed. Neither beneficiaries nor providers will be
required to resubmit the denied claims.
Beneficiaries are required, however, to ensure their eligibility is updated in
DEERS by August 1, 2002.
"We want to ensure that our beneficiaries, some of whom are re-entering the
Military Health System, and using TRICARE for the first time, have the best
possible experience and receive their rightful benefits. We will do everything
we can to overcome initial difficulties that may arise," explained Dr. William
Winkenwerder, Assistant Secretary of Defense for Health Affairs. "We
understand that some of our elderly beneficiaries who have not used military
benefits in many years may not have kept their military eligibility files
updated or they may be unable to make contact with the military."
"We are working with DoD leaders who manage the DEERS system and with The
Military Coalition and the National Military and Veterans Alliance to redouble
our outreach to these beneficiaries," said Winkenwerder.
After August 1, 2002, claims received for beneficiaries with expired
eligibility will be denied until the eligibility information is updated.
Mr. Charles Abell, Assistant Secretary of Defense for Force Management Policy
is working with the Personnel community on the Department's outreach effort.
"We will help our beneficiaries understand how to update their eligibility
information," said Abell. "And we are exploring how we can make this process
easier for those unable to travel."
To learn how to update or re-verify eligibility for those persons 65 and
older, beneficiaries who have received an Explanation of Benefits (EOB)
stating that they need to get a new military ID card should call
1-800-361-2620.
For more information on TRICARE for Life, interested persons can visit the
TRICARE Web site at
www.tricare.osd.mil, or call the TRICARE Information Center, toll-free, at
1-877-363-5433 (1-877-DOD-LIFE).
---------
Posted: 8 FEB 02
New Deployment Health Care Guideline Announced
NEWS RELEASE from the United States Department of Defense
(703)695-0192(media)
IMMEDIATE RELEASE
February 7, 2002
(703)697-5737(public/industry)
NEW DEPLOYMENT HEALTH CARE GUIDELINE ANNOUNCED
Assistant Secretary of Defense for Health Affairs Dr. William Winkenwerder
announced today the implementation of a new clinical guideline for use by
military and Veterans Affairs physicians in caring for the unique needs of
military personnel and their families. Informed by a decade of lessons
learned from the Gulf War, military and Veterans Affairs (VA) physicians are
now better prepared to provide care for military personnel returning from
Afghanistan and other deployments. The cornerstone of this new health
initiative is the Clinical Practice Guideline on Post-Deployment Health
Evaluation and Management:
http://www.pdhealth.mil/PDHEM/frameset.htm developed jointly by the
Department of Defense and the Department of
Veterans Affairs. Service members and their families will begin to experience
the benefits of this guideline starting in early March.
"Keeping our active duty members healthy is an important aspect of force
health protection. This guideline assists physicians and patients by focusing
on specific health concerns that may be deployment related," offered
Winkenwerder.
The development of the guideline represents a two-year multidisciplinary
effort involving experts from the VA, Army, Navy, Air Force, and DoD.
Specialty experts included clergy, social workers, nurses, toxicologists,
epidemiologists, risk communications specialists, psychiatrists, and family
practitioners. Health care providers at Fort Bragg, N.C., Camp LeJeune, N.C.,
and McGuire Air Force Base, N.J., were part of a guideline demonstration
project.
"This guideline, which provides a structure to assess and manage
post-deployment health, is primarily about improving the medical care for
post-deployment concerns among all our patients, whether an active duty
servicemember, a spouse, a child, a veteran or reservist," explained Army Lt.
Col. Charles Engel, a collaborator in the development of the guideline. Engel
directs the Deployment Health Clinical Center, a DoD center based at
Walter Reed Army Medical Center, Washington, D.C. Since the Gulf War,
"opportunities for change and improvement have emerged as a result of lessons
learned through the implementation of the DoD's Comprehensive Clinical
Evaluation Program and the VA's Gulf War Registry, research studies, and
feedback from veterans," said Engel, a practicing psychiatrist and a Gulf War
veteran.
"The guideline," said Mark Brown, Ph.D., director of the VA's
Environmental Agents Service, "was developed in response to the health care
needs of Gulf War veterans with difficult to diagnose yet sometimes
debilitating deployment-related symptoms." Brown added, "In the long-run the
Clinical Practice Guideline will give VA primary care providers the tools
needed to diagnose and treat veterans returning from
combat and peace-keeping missions abroad."
The guideline also applies to individuals who were not deployed, but who link
their concerns to a military deployment, for example, family members of
recently deployed active duty personnel. The guideline also will offer
physicians support in monitoring the long-term health of patients with
deployment health issues and provide patients with the education they need to
take an active role in their health care delivery.
"In the new approach we will disseminate up-to-date information to all
clinicians about all deployments and essentially make them more knowledgeable
about deployment health issues," said Engel whose Deployment Health Clinical
Center will be responsible for monitoring the improvement of post-deployment
care in primary care settings and insuring improvements in the quality of data
gathered. The major route for disseminating this information is the Center's
new Web site, PDHealth.mil, located at
http://www.PDHealth.mil
. The guideline, as well as
the proceedings of a satellite broadcast about the guideline, may be found on
this Web site.
Posted: 8 FEB 02
Tricare Basic and Advance Student Course (TBASCO) - 2002
For information/assistance concerning the below listed course, please contact
Mr Theodore Moore, Course Administrator, at Theodore.Moore@tma.osd.mil or (DSN)
926-3744 or (303) 676-3744.
--------------------
Training conducted by Military Liaison Division
The TRICARE Basic and Advance Student Course (TBASCO) is sponsored by the
Military Liaison Division (MLD). The course is open to anyone who wishes to
attend. The audience typically includes representation from all services,
including Active, Reserve, and Guard personnel, as well as retirees, Health
Benefits Advisors/ Beneficiary Counseling and Assistance Coordinators, other
hospital personnel, contractors affiliated with the federal government, and
beneficiaries. There is no cost for the course, in terms of registration, etc.
The course will being held at the Double Tree Hotel, located at 32nd Street
and Quebec, Denver, Colorado (about 6 miles East of downtown Denver). Hotel
telephone # is (303) 321-3333.
Registration for the course is done online through the TRICARE web site:
www.tricare.osd.mil.
Click on "Training" on the pull-down menu, and then
select TRICARE Basic & Advanced Student Course (TBASCO).
Following is a list of training dates. Any necessary changes to training dates
will be posted on the web site:
February 26-28,2002 ..... Basic Course only
April 2-4, 2002 ......... Basic Course only
May 14-17, 2002 ......... Basic and Advance Course
August 13-15,2002 ....... Basic Course only
September 24-26, 2002 ... Basic Course only
November 5-7,2002 ....... Basic Course only
December 10-13, 2002 .... Basic and Advance Course
Posted: 8 FEB 02
Clark: TRICARE Delivers on Promise of Quality Healthcare
By Gerry J. Gilmore
American Forces Press Service
WASHINGTON, Feb. 4, 2002 - Young service members expect military leaders to
issue equipment and orders, and to pay attention to their quality-of-life
concerns, the chief of naval operations said here today.
Adm. Vernon Clark, keynote speaker at the annual TRICARE conference being held
Feb. 4-7 in a downtown hotel, said today's troops want fair pay, good housing
-- and quality medical care. That last item, he told hundreds of military and
civilian healthcare professionals, is a "covenant," a
promise, made between leaders and the rank-and-file.
In that respect, TRICARE, the military's healthcare system, has made "truly,
truly remarkable" gains in the past few years, Clark noted. TRICARE health
providers are "seeing to it that this institution keeps its promise," he said.
"I want you to know that I appreciate what you're doing," he told his
audience.
The quality healthcare and customer service provided by TRICARE is "one of the
best-kept secrets out in the (healthcare) industry," the admiral noted.
Clark acknowledged the system once had negative issues, such as patient
access, that have since been fixed. The admiral noted that the master chief
petty officer of the Navy recently reported to him: "We're not hearing much
(bad) about TRICARE these days."
Now is not the time to rest upon laurels, Clark noted, adding that TRICARE
needs to be made "as effective and efficient as we can."
Related Site of Interest:
Posted: 1 FEB 02
Exercise is Good -- As Long As You Go About It Intelligently
Special to the American Forces Press Service
WASHINGTON, Jan. 31, 2002 -- Innovations in equipment for the home and office
have made quick work of chores. More and more of our waking hours are spent
sitting, in front of a computer, in our cars commuting to and from work, and
shuttling our families to and fro. While our brains may get a workout,
unfortunately our bodies are not.
"Our bodies truly prefer to be in a balanced state, a balance between activity
and rest, calorie intake and calorie expenditure, stress and relaxation," said
Karen Friedman, a physical therapist with the Deployment Health Clinical
Center at Walter Reed Army Medical Center in Washington. "When a person
experiences too little exercise, many complications can occur."
Complications can include loss of flexibility, muscle mass strength, bone
density, endurance and weight gain; activity intolerance; stored stress; poor
sleep, cardiac concerns, elevated blood pressure, and more. On the other hand,
she said, a well-planned and consistent exercise program can
positively impact on all of these concerns.
When we talk about exercise as part of a healthy lifestyle, Friedman said, we
are speaking of making significant long- term changes in daily habits. A
healthy lifestyle is not a hobby that you do whenever you feel like it. It
involves making a commitment to look better, feel better and, in
turn, perform our jobs and life roles more effectively.
For most of us, exercise does not happen unplanned. Implementing and
maintaining a lifelong exercise program involves commitment and strategy. Two
key strategies in adopting an exercise routine are to make it realistic and
enjoyable.
"Exercise is beneficial for everyone. Our military personnel are in a culture
that encourages physical fitness as part of daily routine and readiness
requirements, Friedman said. "Civilians may also be in a climate that fosters
a healthy way of life, but too often members of both groups find themselves
with too little time and too much to do and no time to exercise."
A balanced exercise program, she continued, contains stretching for
flexibility, cardiovascular activity to increase endurance, strengthening
exercises to increase muscle mass and bone density, and variety to avoid
repetitive stress injuries and boredom. Try to exercise 30 to 40 minutes at
least three times a week, she recommended.
She discussed a sample program for five exercise sessions a week. Try three
sessions of cardiovascular exercise followed by stretching, she said, and two
days of strength training with either machines or free weights followed by
stretching.
Good choices among cardiovascular activities, she suggested, include walking
or running on a treadmill or track; bicycling on a regular or stationary bike;
swimming or water walking; and using cross-training, stair climbing and rowing
machines.
Friedman shared some thoughts for beginners and veterans alike:
Set a comfortable level for the first few exercise sessions. Too many people
mistakenly start so ambitiously ("no pain, no gain") that they become sore and
discouraged. Then they quit. If you haven't exercised for a while, a 15-minute
neighborhood walk is a good start.
Begin your exercise session with a warm-up and end with a cool-down. Follow up
your exercise with stretching to help ward off soreness and to increase your
flexibility.
Slow, gentle stretching exercises are more effective than fast or abrupt
movements. Stretching should not cause pain. Never bounce when you stretch.
Dress appropriately. Wear loose, comfortable clothing in light layers that you
can remove as you warm up.
Wear the right shoes. Knee, hip and back problems can occur if the shoes don't
support your feet properly or they're worn out. Also, orthopedic problems in
your legs or feet may require medical treatment or special shoe fittings
called orthotics.
Some people shy from weight training because they don't want to "bulk up."
Friedman said the key to gaining strength but not large muscle masses is to do
more repetitions (two or three sets of 10 "reps") using light weights.
Exercise when you're most geared up for it. For instance, don't do mornings if
you're the kind of person who needs a coffee transfusion to open your eyes.
Try not to exercise after dinner, because raising your metabolism when your
body is trying to wind down for sleep invites insomnia.
Find out what motivates you to stick with your program. One person might need
company and encouragement while another prefers being alone to decompress and
ponder.
Get a medical check-up before starting an exercise program, and especially if
you've had a recent or current health problem.
Learn proper technique. Exercises done improperly won't give you the results
you want, but they will put you at risk for injury.
"Exercise is good for everyone as long as you go about it intelligently," she
said. "If you are already fit, think about adding variety to your workout. If
you have not been exercising but want to start, be patient, be realistic in
setting goals.
"Whatever you do, select activities you enjoy," Friedman insisted. "You will
not stick with a program you hate."
(From the Office of the Assistant Secretary of Defense for Health Affairs.)
Posted: 1 FEB 02
Post-Deployment Health a DoD Priority
By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
WASHINGTON, Jan. 30, 2002 -- DoD officials believe caring for service members
after a deployment should be a national priority. They've taken the lessons
learned since the Gulf War and devised a set of guidelines for healthcare
professionals to care for service members with deployment-
related health concerns.
Beginning March 1, healthcare providers will ask service members who seek
medical care if their visit is related to concerns stemming from a deployment.
"We're not necessarily asking patients to make a diagnostic call and tell us
whether their disease or ailment is caused by that deployment," said Army Lt.
Col. (Dr.) Charles Engel, "but is that part of the concern that's driving
their care that day?"
Engel is the director of DoD's Deployment Health Clinical Center at Walter
Reed Army Medical Center here. He also serves as the DoD consultant for the
new clinical practice guidelines.
If the service member answers, "yes," the new guidelines require the provider
to take certain steps, including a specific evaluation and arrange follow-up
visits. Engel said patients receiving routine check-ups or wellness visits
would not be asked the deployment question.
After the 1990-1991 Gulf War, DoD realized veterans were suffering from
unexplained health problems, typified by fatigue, diffuse pain, and sleep and
memory problems, Engel explained.
He said DoD officials have come to realize deployment-related health
conditions may not show up during or immediately after a deployment.
"A certain proportion of people return (from deployments with) valid and real
physical symptoms, and unfortunately diagnostic testing doesn't give us the
exact answer as to what their disease is or ailment is," Engel said. "And what
we have found after the Gulf War is that even 10 years
later, the best science doesn't give us a discreet answer as to what exposure
on the battlefield may be responsible for this."
However, he said, DoD medical professionals are trying to do a better job of
acknowledging patients' concerns than has been done in the past. That's where
the Clinical Practice Guideline for Post-Deployment Health Evaluation and
Management comes in.
"Part of what the guideline does is essentially teach doctors how to meet and
greet service members returning from a hazardous workplace with valid physical
concerns and address those concerns in an expeditious way -- the sort of way
that they're entitled to after having served their
country and made important sacrifices," Engel said.
He said this helps patients trust their healthcare providers, which helps
clinicians provide better care.
"A big part of the guideline is informing providers as to what sorts of tests
that they should run, but I'd say an even bigger part of the guideline is
helping clinicians to recognize that there are strategies they can use to
embrace the returning veterans' health concerns," Engel said.
The guidelines don't contain a strict definition of "deployment." Engel
explained there are countless situations in which military service members
might
experience hazardous exposures -- be they psychological, industrial or
environmental.
"This is an evaluation for people who've been to what essentially amounts to a
hazardous workplace -- a deployment of some sort -- in service to their
country," he said. Engel said the team developing the guidelines didn't want
to use a strict definition of deployment, because that
might exclude people from being treated properly under the guidelines.
"It becomes a way that many veterans feel like they're being cut out of care
rather than brought into it," Engel said. "If the person relates their health
concern to a deployment, however improbable the healthcare provider might
think that is, they are cared for under this guideline."
Posted: 2 FEB 02
CHAMPVA OnLine News Registration
As of Monday, January 28, the Department of Veterans Affairs Health
Administration Center (HAC) web site at
http://www.va.gov/hac
will have a link that will allow CHAMPVA beneficiaries and other interested
personnel to automatically subscribe to the HAC mailing list.
The HAC mailing list is used to distributes updates to CHAMPVA policies and
programs. It is also used to send out beneficiary and provider newsletters.
If you (or someone you know) are interested in getting on the HAC mailing
list, please visit
http://www.va.gov/hac on or after 28 January to do so.
Please report web page and/or mailing list problems, questions, comments,
etc., to Glenn.Johnson@med.va.gov
--------------
SOURCE: Public Affairs Officer/EEO Manager, Public Affairs Officer/EEO Manager
Department of Veterans Affairs
Posted: 1 FEB 02
TRICARE Fiscal Year Catastrophic Cap Reduced for Retirees, Their Family Members
and Survivors
TRICARE Fiscal Year Catastrophic Cap Reduced For Retirees, Their Family
Members
And Survivors
January 25, 2002
No. 02-02
The TRICARE fiscal year "catastrophic cap" has been reduced from $7,500 to
$3,000 for uniformed services retirees, their family members and survivors.
The cap is the maximum amount of out-of-pocket costs these beneficiaries are
required to pay for medical care during a fiscal year (Oct. 1 through Sept.
30).
For active duty family members, the catastrophic cap remains $1,000 per fiscal
year.
The catastrophic cap reduction is retroactive to Oct. 1, 2000. Retirees, their
family members and survivors who have paid more than $3,000 out-of-pocket for
TRICARE-covered services are eligible for reimbursement. The managed care
support contractors (MCSC's) will search their files and identify
beneficiaries due refunds.
Beneficiaries who have saved their receipts and choose to initiate a request
for reimbursement, may do so by contacting their regional claims processor for
guidance on where to submit their receipts and claims.
It is not necessary for beneficiaries to resubmit claims already paid by
TRICARE to qualify for reimbursement of the amount paid over the catastrophic
cap.
For retirees, their family members and survivors enrolled in TRICARE Prime,
there is an enrollment year cap. The enrollment year cap begins on the
anniversary date of enrollment in TRICARE Prime, and applies to all enrollees.
Catastrophic caps, both fiscal year and enrollment year combined, will not
exceed $3,000 in a given 12-month period for retirees, their family members
and survivors, and $1,000 for family members of active duty members.
Once the catastrophic cap and enrollment year cap (combined) are met by
TRICARE Prime enrollees, TRICARE will pay up to the TRICARE allowable amount
for all covered services (excluding point-of-service charges which do not
count toward the catastrophic cap).
For beneficiaries who are not enrolled in TRICARE Prime, TRICARE will pay up
to the TRICARE allowable amount for all covered services for the remainder of
the fiscal year after the fiscal year cap is met.
Retirees, family members, and survivors remain responsible for the cost of all
services and treatments received which are not TRICARE covered benefits.
Some beneficiaries mistakenly believe that the $3,000 catastrophic cap is the
ceiling on the amount that TRICARE will cover for a family during any given
year, however the opposite is true. The cap will protect retirees, their
family members and survivors from paying more than $3,000 out-of pocket for
medical care.
For additional information on catastrophic cap reduction, beneficiaries are
encouraged to contact the nearest TRICARE service center or military treatment
facility beneficiary counseling and assistance coordinators for assistance.
TRICARE benefit information is also available on the Military Health System/TRICARE
Web site at
http://www.tricare.osd.mil , or by calling 1-888-DoD-LIFE
(1-888-363-5433).
--End --
NOTES FROM POSTMASTER:
Posted: 1 FEB 02
New Parenting Booklet Puts Decades of Research Into Easy-to-Read Guide
"Adventures in Parenting: How Responding, Preventing, Monitoring, Mentoring,
and Modeling Can Help You Be a Successful Parent" highlights many of the
toughest challenges that parents face in rearing happy and healthy children
and suggests ways to become a more effective, more consistent, and more
attentive parent.
This new booklet offers strategies on parenting practices that are based on
scientific research that can be used by parents and guardians of children of
any age. It also includes stories of how some parents have incorporated these
strategies into their own day-to-day parenting activities, as well as insights
from parenting experts.
--------------------
healthfinder® is a free Web guide to reliable health information, developed by
the U.S. Department of Health and Human Services. Each month, we choose a few
exciting new resources and announce them through the healthfinder-l listserv.
The Web address for healthfinder® is
www.healthfinder.gov.
If you are new to the site, please take a minute to visit our page for first
time users at
Please review selection guidelines at
http://www.healthfinder.gov/aboutus/selection.htm if you have any
questions about the type of resources that healthfinder® will consider for an
announcement. Please note: As a U.S. government Web site, healthfinder® does
not accept advertising or endorse any commercial products or services.
Posted: 1 FEB 02
Scams Target Veterans for Identity Theft
NOTE: Below listed message isn't exactly health related. It's being provided
for the information of the many retired and soon-to-be retired members on this
mailing list -- Postmaster
------
by Staff Sgt. Marcia Triggs
WASHINGTON (Army News Service, Jan. 22, 2002) - An e-mail circulating
about a retiree who had his identity stolen after filing separation papers at
a county courthouse is no urban legend, according to Transition Center
officials.
Soldiers separating from the military are now being advised to ignore
the old recommendation to file their Department of Defense Form 214 (Military
Discharge) with their local county courthouse. Instead, transition counselors
are advising soldiers to safeguard their personal information to guard against
credit fraud, said Deborah Snider, Transition Center personnel analyst at the
U.S. Total Army Personnel Command.
Between 600,000 to 700,000 cases of identity theft were reported by
the Federal Trade Commission in 2000. Identity theft is the fastest growing
crime today, according to the FTC, and many victims don't find out that their
personal information has been stolen until they are trying to buy a house or
get a loan.
"I don't think anyone ever thought about this happening, which is the
reason there are no provisions to 'unfile' records," Snider said. "This is a
serious problem, and soldiers are a prime target because everything is tied to
the soldiers' Social Security number."
The victims of identity theft suffer tremendously because the burden
of proof is on them, Snider said. It's hard to believe that a person's
life could
be destroyed by this, she said, but it happens.
A Navy retiree learned that someone had stolen his personal
information and established credit in his name when he received a phone call
from a clerk at American Express saying that someone was trying to cash a
$9,000 check in his name made out to a Muslim or Arabic-sounding name.
The clerk was suspicious and called the retiree because the address
she had on file for him did not match the address on the check. After the
retiree's case was investigated, he found out that a lawyer stole his
identity. The lawyer also had a laptop with several thousand military
names, Social Security numbers and other information on it. The common link
between the veterans on the list was that they had filed their DD 214s
with their county courthouse.
"Someone stole my identity, now I feel I am no longer me," said a
victim of identity theft. "I reside in the pocket of a felon who can see that
she is allowed to steal me without penalty. She carries me casually, and each
time she pulls me out a small piece of me falls away."
To help guard against identity theft the Transition Center is no
longer placing Social Security numbers on discharge and retirement
certificates,
Snider said. Anything that might be hung for display will not have a soldier's
Social Security number on it.
When soldiers separate from active duty, Snider said the most vital
document they receive is the DD 214. It contains their Social Security number
and birth date. In the past, soldiers were advised to file the form with their
local courthouse to ensure that they would always be able to get a certified
copy. They need a certified copy to receive any Veterans Administration
benefits.
Once the DD 214 is filed at a local county courthouse, however, it
becomes a public record. Some courthouses have put this information online,
and even more plan to do so in the future, Snider said.
"Our recommendation is to safeguard the form as you would any vital
papers such as a will, marriage license or insurance papers," Snider said. "A
safe deposit box would be a good investment."
Forty-six states now have identity theft laws, up from just three in
1996, according to the Federal Trade Commission. And many state lawmakers are
considering toughening laws already on the books.
Under a new Montana law that took affect in October, the maximum
penalty for identity theft involving more than $1,000 in gains is a $10,000
fine and 10 years in jail. In Missouri, identity theft is punishable by up to
six months in jail for the first offense; up to one year in jail for the
second
offense; and one to five years imprisonment for the third or subsequent
offense.
Link to original news item:
Posted: 1 FEB 02
'Silent Disease' Plagues Millions
by Richard Zowie
12th Flying Training Wing Public Affairs
01/16/01 - RANDOLPH AIR FORCE BASE, Texas (AFPN) -- It is a painless, chronic
disease that currently plagues about 3 million Americans. Half of those with
this disease, which has no known cure, do not even know they have it.
This disease, glaucoma, is also known as the "silent disease" since it slowly
deprives a person of sight without any noticeable signs.
Glaucoma is the second leading cause of blindness in the United States and the
leading cause of preventable blindness, Glaucoma Research Foundation officials
said. About 120,000 Americans are blind because of glaucoma.
Blacks suffer glaucoma six to eight times more frequently than Caucasians.
Glaucoma is also the leading cause of blindness among blacks, including
baseball star, Kirby Puckett, officials said.
Glaucoma is a group of diseases that limit or eliminate vision by causing
damage to the optic nerve. This nerve carries images from the eye to the
brain.
The most common form of glaucoma is primary open angle glaucoma.
With this disorder, the eye's drainage canals become clogged and cannot
properly drain. As a result, the intraocular pressure within the eye rises. A
person suffering from this form of glaucoma will eventually lose their
eyesight if the problem is not diagnosed or detected.
Glaucoma does not initially affect a person's color or fine vision, said Lt.
Col. (Dr.) Greg Young, Randolph Clinic's optometry flight commander.
People with 20/20 or even 20/15 vision could still have glaucoma, he said. "We
highly recommend that at-risk people have glaucoma exams more often than
others," Young said. "At-risk people include African-Americans, people over 40
and those with a family history of glaucoma. If we target those who are
high-risk, we can detect and treat it earlier. These are the people we want to
screen for glaucoma every year."
If a medical screening detects glaucoma, patients are given eye drops or
referred for more specialized treatment.
Eye drops are used for patients with mild cases of glaucoma, Young said. The
drops work to decrease a person's intraocular pressure low enough to prevent
damage to the eye.
"Usually, through an assortment or a combination of the drops, you can get the
required effect," he said.
Young encourages people in at-risk groups to have eye exams every year. For
people not in risk groups, he recommends an eye exam every two to three years.
"Bottom line, it's important that detection and prevention come before
intervention and treatment," he said.
There are some things people can do to keep pressures low and damage to a
minimum, Young said. Studies have shown that long distance runners have
lowered their pressures significantly. Also, keeping the optic nerve nourished
with a healthy blood supply can be accomplished through regular exercise along
with eating a well-balanced diet or taking multivitamins.
For more information on glaucoma, people should call or visit their optometry
clinic. (Courtesy of Air Education and Training Command News Service)
--------------------
Posted: 1 FEB 02
Advance Medical Directives
It is the right of every person to have an "advance medical directive." The
following guidance is provided to help military beneficiaries decide if the
choice of an advanced medical directive is in their best interest.
An advanced medical directive is a written document that sets forth a person's
desires concerning what medical care he will receive should he become
incapable of making healthcare decisions on his own, or that gives another
person the legal authority to make healthcare decisions on behalf of a person
who has become mentally incapacitated.
Living wills and durable healthcare powers of attorney are both advanced
medical directives. The advanced medical directive is often simply referred to
as an advance directive.
A living will is a written document that sets forth a person's desires
concerning the medical care that he will receive should he become terminally
ill or when his death is imminent.
A living will may specify which medical treatments should be provided, as well
as which medical treatments should not.
A durable healthcare power of attorney is a written document which
gives another person (known as the agent, proxy or surrogate) legal
authority to make healthcare decisions. This document is valid for any period
of mental incapacitation.
All competent adult patients have the moral and legal right to participate in
their medical treatment decisions and to refuse medical treatment even in
life-saving or life-sustaining situations. This includes the right to prepare
advanced medical directives concerning their medical care.
In general, active-duty patients have the same rights as non-active-duty
patients. However, active-duty soldiers may not refuse certain life-saving
medical or surgical procedures. When an active-duty soldier refuses such
treatment, the matter is referred to the office of the staff judge advocate
for
resolution. Guidance concerning this is covered in Army Regulation 600-20.
(and applicable regulations for the other military services)
An advanced medical directive is voluntary in nature. Patients are not
required to have one to be admitted or treated. Patients' care will not be
compromised if they do not have advanced medical directives.
Patients having advanced medical directives must inform their primary care
managers accordingly. They must also provide copies of their advanced medical
directives to their physicians or the outpatient records room as soon as
possible.
Patients who desire to make cadaver donations must coordinate with the medical
institutions of their choice. Advance arrangements must be made between the
donor and the medical institution that will be receiving the body.
An advanced medical directive may be revoked or changed at any time. Patients
may verbally inform their primary care managers or providers if they wish to
change it.
To formally change an advanced medical directive, patients must contact their
legal assistance office.
If a patient does not currently have an advanced medical directive and would
like to get one, the legal assistance office is available to provide legal
advice and assist individuals in preparing one.
Discuss the information in your advanced medical directive with individual
physicians and family members. Since local laws vary from state to state, it
is suggested that patients verify that an advanced medical directive prepared
in one state continues to be valid when a move to another state has taken
place.
(Reprinted from the Fort Leonard Wood, Mo., Guidon)
============
SOURCE: Army Medicine web site at
Posted: 1 FEB 02
Vaccine Ban for Pregnant Servicewomen Strengthened
NEWS RELEASE from the United States Department of Defense
No.026-02
(703)695-0192(media)
IMMEDIATE RELEASE
January 16, 2002
(703)697-5737(public/industry)
VACCINE BAN FOR PREGNANT SERVICEWOMEN STRENGTHENED
Assistant Secretary of Defense for Health Affairs William Winkenwerder issued
policy guidance today that reiterates and strengthens long-standing DoD policy
to avoid immunization of servicewomen of childbearing age during pregnancy.
This action was taken because of issues raised about preliminary data from a
non-peer reviewed Naval Health Research Center Study
of women who received the anthrax vaccine.
"Although these study results are preliminary and there are significant
concerns about the database that require further investigation before any
conclusions can be made, we are taking these steps to reaffirm our existing
policies," stated Winkenwerder.
The preliminary data, which has not been scientifically peer reviewed and will
require further validation, identified a possible relationship between
maternal anthrax vaccination in the first trimester and higher odds of birth
defects. Because the data supporting the study showed that a number of women
might have received the anthrax vaccine beyond the first trimester, study data
is now being re-validated. The peer-review publication process usually takes
several months. The final report will be available then.
At the Department's request, the Centers for Disease Control and Prevention
will issue a report next week in its Morbidity and
Mortality Report:
http://www.cdc.gov/mmwr/ that provides further details of the study.
Winkenwerder's memo is on the Web at
Posted: 1 FEB 02
Keeping Those Healthy Resolutions
Whether you've made a 2002 resolution to cut calories, quit smoking, or eat
better, healthfinder® can help you stay on track.
Keeping resolutions is in the news these days, so you might take a look at
this recent story for some tips:
Top 10 Diet Blunders at
abcnews_health_eng-abcnews_health_060150_4389445422917884933
And don't forget the current Dietary Guidelines for Americans from USDA and
HHS at
If you haven't set some health goals for the coming year, why not visit
www.healthfinder.gov
today and write your own prescription for health with
the help of the Surgeon General?
Surgeon General's Prescription for Health at
Also on the healthfinder® home page, you'll find our today's online checkup
feature. Every day, we highlight an interactive health checkup or quiz
(today it's an Interactive Menu Planner) and you can also search our
collection of tools by topic. These include cancer, cholesterol, smoking,
For more detailed recommendations for preventive health care, try one of these
three Put Prevention Into Practice handbooks:
Child Health Guide
Personal Health Guide
Staying Healthy at 50+
healthfinder® is a free Web guide to reliable health information, developed by
the U.S. Department of Health and Human Services. Each month, we choose a few
exciting new resources.
The Web address for healthfinder® is
www.healthfinder.gov
. If you are new to the site, please take a minute to visit our page for
first time users at
-----------------
Posted: 14 Jan 02
CDC: Health Related Hoaxes and Rumors
1. Consumer Alert: Buying antibiotics online: Consumers who are visiting Web
sites and/or receiving e-mail claiming to sell Ciprofloxacin (Cipro) and other
antibiotics should consult "Offers to Treat Biological Threats: What You Need
to Know," produced by the Federal Trade Commission in conjunction with the
Centers for Disease Control and Prevention (CDC) and the Food and Drug
Administration (FDA). These fraudsters often follow the headlines, tailoring
their offers to prey on consumers' fears and vulnerabilities. The Consumer
Alert is available online at
http://www.ftc.gov/opa/2001/11/alert.htm
2. Emails about Anthrax from CDC: There are several emails being circulated
with the false subject line: "Important information about anthrax from CDC."
CDC has not conducted a mass email campaign to consumers, therefore, these
emails do not originate from CDC.
8. False Email Report: Hantavirus Spread by Contact With Soda Cans or Grocery
Packages
----------------
SOURCE: Centers for Disease Control and Prevention (CDC) web site at
Posted: 21 Dec 01
DoD, VA Study Finds Lou Gehrig's Disease in Gulf War Vets
By Rudi Williams
American Forces Press Service
WASHINGTON, Dec. 21, 2001 A large epidemiological study conducted by the
departments of Defense and Veterans Affairs found preliminary evidence that
Persian Gulf War veterans are nearly twice as likely as their non-deployed
counterparts to develop Lou Gehrig's disease.
The disease, amyotrophic (am-ee-o-trow-phic) lateral sclerosis, or ALS, is
often called Lou Gehrig's disease
because the baseball star died from it. It's a fatal neurological disease that
destroys the nerve cells that control muscle movement. Scientists don't know
what causes ALS, and there is no cure for it.
DoD provided the lion's share of the money for the $1.3 million jointly funded
study, which began in March 2000.
The investigation involved nearly 700,000 service members who served in
Southwest Asia during operations Desert
Shield and Desert Storm during the period Aug. 2, 1990 and July 31, 1991. More
than 1.8 million service members who did not deploy to the Persian Gulf were
also interviewed.
"We found 40 cases of Lou Gehrig's disease among veterans who served in the
Gulf area -- almost twice as many
compared to those who didn't serve in the gulf," said VA Secretary Anthony J.
Principi. About half of the 40 veterans have died.
"These findings are of great concern and warrant further study," Principi
noted at a Washington press conference
earlier this month. "I intend to make certain that VA's medical resources and
research capabilities are fully focused on this issue."
He emphasized that VA will compensate Desert Shield and Desert Storm veterans
with ALS. "And we'll do so quickly," he said. "We'll immediately contact those
who were identified by the study and will help them to file new
claims or prosecute existing claims -- and we'll pay benefits retroactively to
the date their claims are filed," Principi said.
VA is moving so fast because veterans who have contracted the disease can't
wait for the peer review process to be
completed, the secretary said.
"They need help now, and we'll offer it to them," he said.
Lou Gehrig's is a degenerative disease of the nervous system affecting the
brain cells that carry impulses from the brain and spinal cord to the muscles.
The disorder results in muscular weakness and the progressive wasting of
muscles. The problem usually starts in the hands and arms and then spreads to
other parts of the body. Patients eventually have difficulty speaking,
swallowing and breathing.
Early symptoms include slight muscle weakness, clumsy hand movements and
difficulty performing tasks that require
delicate movements of the fingers or hands. Veterans afflicted with the
disease can also experience weakness of
the lips and impairment of the tongue, mouth or voice box. Other symptoms
include uncontrollable twitching of muscles,
stiffness in the legs, and coughing.
Death usually follows diagnosis within three to five years. VA health
officials said even with the increased diagnosis
among Gulf War veterans, the disease is extremely rare, affecting only about
one in 25,000 people. Among Gulf War
veterans, it's one in 17,500. There's no evidence about higher rates of ALS
among other groups of veterans. However, researchers plan to explore the
possibility in later studies, officials said.
VA is providing free medical care and disability compensation for veterans who
have the disease. Officials urge veterans or family members who believe they
qualify to contact their nearest VA medical center, regional office or
benefits office.
Survivors of veterans who died from the disease are eligible for dependency
and indemnity compensation,
enrollment in VA's healthcare program for survivors, educational assistance
and vocational assistance, among
other benefits, officials said.
Related Site of Interest:
Phone: (800) 497-6261
Mail: 5113 Leesburg Pike Suite 901
Falls Church, Virginia 22041
Posted: 21 Dec 01
Gulf War Vets - Where To Get Help
Active duty military personnel with questions or concerns about their service
in the Persian Gulf region: contact your commanding officer or call the
Department of Defense (DoD) Gulf War Veterans Hotline (1-800-497-6261).
Gulf War veterans with concerns about their health:contact the nearest VA
medical center. The telephone number can be found in the local telephone
directory under Department of Veterans Affairs in the "U.S. Government"
listings. A Persian Gulf Registry examination will be offered. Treatment will
be provided to eligible veterans.
Gulf War veterans in need of marital/family counseling, contact the nearest VA
medical center or VA vet center. For additional information, call the VA Gulf
War Information Helpline at 1-800-PGW-VETS (1-800-749-8387).
Gulf War veterans seeking disability compensation for illnesses incurred in or
aggravated by military service: contact a Veterans Benefits Counselor at the
nearest VA regional office of health care facility or call the VA Gulf War
Information Helpline at 1-800-PGW-VETS (1-800-749-8387).
Gulf War veterans interested in learning about the wide range of benefit
programs administered by the VA: contact a Veterans Benefits Counselor at the
nearest VA regional office or health care facility or call the VA Gulf War
Information Helpline at 1-800-PGW-VETS (1-800-749-8387).
Individuals with first-hand information about "incidents" that occurred in the
theater of operations during the Gulf War and that may be related to health
problems experienced by individuals who served in the War: call the DoD
"Incidents" Hotline at 1-800-472-6719.
Veterans and military service organizations:
National veterans and military service organizations provide assistance and
representation for millions of veterans, servicemembers and their families
through world-wide networks.
Office of the Special Assistant for Gulf War Illnesses (OSAGWI) personnel meet
regularly with representatives of these organizations. The meetings give
OSAGWI an opportunity to provide an update of OSAGWI activities and other
actions in DoD for discussion with their membership. In turn, OSAGWI receives
feedback and requests for information on topics of interest to their
members. A recap of the meetings along with briefing slides and related
information materials are available on the DeploymentLINK web site
http://www.deploymentlink.osd.mil
OSAGWI also participates in activities hosted by the veterans and military
service offices. An activity calendar is available on the DeploymentLINK web
site at
If you have suggestions for OSAGWI participation or support, please contact
send E-mail to
5113 Leesburg Pike Suite 901
Falls Church, Virginia 22041
Note: Veterans service organizations are also available to assist Gulf War
veterans. A listing follows:
Air Force Association
1501 Lee Highway, Arlington, VA 22209-1198
American GI Forum
206 San Pedro, Suite 210, San Antonio, TX 78205
American Legion
1608 K Street, NW, Washington, DC 20006
American Legion Auxiliary
c/o Harper and Company, 11961 Tech Road, Silver Spring, MD, 20904
AMVETS
4647 Forbes Boulevard, Lanham, MD 20706
Association of the U.S. Army
2110 Washington Blvd., Arlington, VA 22204
Disabled American Veterans
807 Maine Street, SW, Washington, DC 20024
Enlisted Association of the National Guard
1219 Prince Street, Alexandria, VA 22314
Fleet Reserve Association
125 N. West Street, Alexandria, VA 22314-2754
Jewish War Veterans
1811 R Street, NW, Washington, DC 20009
Marine Corps League
8626 Lee Highway, #201
Merrifield, VA 22031
Marine Corps Reserve Officers Association
110 N. Royal Street, Suite 406, Alexandria, VA 22314
National Association of the Uniformed Services
5535 Hempstead Way, Springfield, VA 22151
National Guard Association of the US
1 Massachusetts Ave., NW, Washington, DC 20001
National Military Family Association
6000 Stevenson Ave., #304, Alexandria, VA 22304
Naval Enlisted Reserve Association
6703 Farragut Ave, Falls Church, VA 22042-2189
Naval Reserve Association
1619 King Street, Alexandria, VA 22314-2793
Navy League
2300 Wilson Blvd., Arlington, VA 22201
Non-Commissioned Officers Association
225 N. Washington Street, Alexandria, VA 22314
Reserve Officers Association
1 Constitution Ave., NE, Washington, DC 20002
Retired Officers Association
201 N. Washington Street, Alexandria, VA 22314
Veterans of Foreign Wars
200 Maryland Avenue, NE, Washington, DC 20002
Veterans of Foreign Wars Auxiliary
406 W 34th Street, Kansas City, MO 64111
Vietnam Veterans of America
1224 M Street, NW, Washington, DC 20005
============
SOURCE: GulfLink Web Page at
http://
Posted: 21 Dec 01
TRICARE Dental Plan Premium Rate Change
NOTE: TRICARE Retiree Dental Program (TRDP) information is available online
at
******
Harrisburg, PA (Dec 13) - TRICARE Dental Program (TDP) members will notice a
slight increase in their monthly premiums beginning January 2002. The new
rates are effective on February 1, 2002; however, since premiums are collected
one month in advance, TDP members will notice the change with their January
2002 billing statement, payroll allotment or deduction.
Effective February 1st, TDP premiums will increase by about 3.5 percent or a
little less than the annual increase in the dental services component of the
Consumer Price Index.
The new monthly premium rate for active duty family members and members of the
Selected Reserve, Individual Ready Reserve (Special Mobilization Category) and
family members of reservists who are on active duty for more than 30
consecutive days is $7.90 for a single enrollment and $19.74 for a family
enrollment. Members of the Individual Ready Reserve (Other than Special
Mobilization Category) and their family members and the family members of the
Selected Reserve will pay a new monthly rate of $19.75 for a single enrollment
and $49.36 for a family enrollment. (See chart below for monthly premium rates
applicable to each type of enrollee).
"Since the government will continue to pay 60 percent of the total monthly
premium for most categories of TDP enrollees, the actual increase for the
majority of TDP members will be fairly small - 27 cents a month for a single
enrollment and 66 cents a month for a family enrollment," said Tom Harbold,
Senior Vice President for the TDP at United Concordia Companies, Inc.
While the TDP premium increases are due primarily to increases in the cost of
dental services, part of the increase is the result of enhancing the general
anesthesia benefit. Effective February 1, 2002, the requirement that general
anesthesia be performed by a provider other than the surgeon, assistant
surgeon or treating doctor is eliminated.
United Concordia Companies, Inc. administered the TRICARE Family Member Dental
Plan (TFMDP) from February 1996 through January 2001. In February 2001, the
TRICARE Selected Reserve Dental Program (TSRDP) and the TFMDP were combined to
create the TRICARE Dental Program (TDP). United Concordia was selected by the
Department of Defense to administer the TDP. Headquartered in Harrisburg, Pa.,
United Concordia is the fifth largest dental insurer in the country with more
than six million members worldwide. In 2000, the company processed more than
9.3 million claims and paid more than $781 million in dental benefits.
TDP Monthly Premiums
(February 2002 January 2003)
Shared Premium Single Family
-------------------------------- ------ -------
Active Duty Family Members $7.90 $19.74
Selected Reserve
IRR Special Mobilization Category
Full Premium
----------------------------------------------
IRR Other than Special Mobilization Category $19.75 $49.36
SELRES & IRR Family Members
=======
SOURCE:
Telephone Inquiries: 1-888-622-2256
Posted: 21 Dec 01
Cold, Altitude Threaten Troops' Health in Afghanistan
By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
WASHINGTON, Dec. 14, 2001 -- Cold and altitude are currently the most serious
environmental threats to troops
serving in Afghanistan. In a few months, they'll need to worry more about
malaria.
Many different issues can impact service members' health while serving in
Central Asia, but the most serious varies
depending on the area and the season, said Army Dr. (Lt. Col.) Bruno
Petruccelli. He's the epidemiology program
manager with the Army Center for Health Promotion and Preventive Medicine,
Aberdeen Proving Ground, Md.
"The most likely environmental or physical threats (now) would be the high
altitude and the cold," Petruccelli said.
"In the summer months, the heat can get pretty horrendous as well."
Tactics can make a difference in preventing health problems, such as those
from cold and altitude. But, Petruccelli said, military medical professionals
don't recommend changes in tactics. They give information, and it's up to
commanders to weigh the risks against the importance of the mission, he
explained.
"When it is possible, altitude illness is best prevented by ascending slowly,"
he said. Ascending slowly and spending
at least one night at altitude will prevent most cases of "mountain sickness"
and "make the mission go a little bit
more smoothly," he said.
But physical symptoms to altitude changes can occur as low as 5,000 feet in
particularly susceptible individuals, he
said. And for some missions, slow ascent just isn't an option. "Sometimes we
fly right into a high altitude,"
Petruccelli said.
Physical signs of altitude sickness include headache, dizziness, nausea and
fatigue. "All things that in their mildest form may not interfere with normal
functioning," Petruccelli said. "But they may predict a more serious event
later on."
"A more serious event" might even include life-threatening cerebral edema, or
fluid accumulating in the brain, he said. The condition's rare, he said, but
physicians in the area need to be aware of possibilities.
The threat of altitude sickness declines after the first 24 to 48 hours.
"After a while, our breathing adjusts and our
blood cells adjust and we do fine," Petruccelli said. "But it may take a few
days to get there."
Cold is easier for individuals to protect themselves against. The military has
excellent cold-weather gear that
can be mixed and layered depending upon weather conditions, Petruccelli said.
He recommended troops use it properly.
He said it's possible to overdress and become a heat casualty even in the
winter.
In the summer, some parts of Central Asia experience extremely high
temperatures. Petruccelli said the best way
to avoid heat injuries is to stay hydrated. He recommended sipping up to a
quart or more of water over the course of
each hour. Gulping large amounts of water at once is not as helpful, he said,
and can even be harmful.
As early as March, the threat of malaria goes up considerably. U.S. forces
deployed to areas where malaria
is present take one of two types of prophylactic medication.
The anti-microbial drug mefloquine is taken once a week and must be started at
least two weeks before going into the
region, Petruccelli said. "It takes that long for adequate blood levels to be
achieved," he said.
It also has to be taken for at least four weeks after one leaves the area in
order to keep killing the parasites that
emerge in the individual.
"Malaria can still emerge several weeks later. Parasites can stay in the body
and start to multiply after you stop
taking the drug," he explained. "The drug is a suppressant; it's not really an
agent that immediately eliminates any
parasite that gets into your body."
The other drug U.S. forces can take to prevent malaria is the antibiotic
doxycyline. Petrucelli said this drug is
taken daily when in the region and can be started as late as a day or two
before deploying and still reach adequate
levels in the blood.
The likelihood of contracting malaria depends mostly on the level of
individual protection, he said. "Going into the
winter, the likelihood of malaria transmission is very low," he said.
"However, there are some areas where
transmission remains possible throughout the year."
One form of malaria found in Afghanistan, falciparum, is particularly deadly
to individuals with no immunity built
up. Immunity is gained by living for a long period in an area where malaria is
present.
Americans have virtually no natural ability to fight malaria, but even those
who have some aren't safe from contracting the disease. Their partial immunity
would only help them survive a malarial bout, Petruccelli said.
In addition to taking preventive medication, it's important for service
members to wear insect repellent, sleep under
mosquito nets when possible, and have their uniforms treated with permethrin,
an insecticidal chemical.
Personal protective measures aside, being physically fit and eating
nutritiously are the best ways to fight illness,
Petruccelli said. Fitness also makes it easier to acclimate to extremes of
temperature and altitude.
"A person who is physically fit and well nourished has a much stronger immune
system," he said. "Heat casualties are
particularly notorious for someone who is not physically fit." That's because
people who have to acclimate to heat
and physical activity at the same time put much more stress on their bodies,
he noted.
Local food and water should also be considered hazardous. Diarrheal illnesses,
typhoid, hepatitis A and many other
infectious diseases can be transmitted via food and water, Petruccelli said.
Military members are vaccinated against
typhoid and hepatitis A, but many other serious diseases can be contracted
through infected food and water.
U.S. forces provide safe food and water sources for deployed service members,
but the risk of food- and water-
borne illness can be greater for special operations forces. These troops often
travel in small groups on their own
among local populations. Carrying large amounts of safe food and water is not
usually possible.
Still, Petruccelli said, these troops can minimize their risks. He recommended
service members with no options but
locally produced food should avoid poorly cooked meat, dairy products and raw
produce.
He explained there's a difference between a health risk and a threat. "A risk
is everything out there that could
possibly impact on someone's health," he said. A threat, on the other hand, is
the likelihood of being affected by that
risk even after you've taken personal protective measures into account, he
said.
Any photos, graphics or other imagery included in the article may also be
viewed at this web page.
####
Posted: 21 Dec 01
A Pound Here, A Pound There, and Talk Turns Weighty
Special to the American Forces Press Service
WASHINGTON, D.C., Dec. 13, 2001 -- The average American will gain about a
pound on holiday goodies this year.
That's not much, but medical studies unfortunately show the years disappear,
but the pounds don't.
DoD wants service members and their families -- especially children --
retirees and civilian employees to enjoy
lifelong health and fitness, said Air Force Col. (Dr.) Daniel L. Cohen, chief
medical officer and deputy operations director in the Office of the Assistant
Secretary of Defense for Health Affairs.
Cohen said the military medical system today stresses a "condition management
approach" to obesity. That means
working with beneficiaries to prevent the problem rather than have to treat
it. The approach marks a change in traditional thinking, one that requires a
close partnership with beneficiaries.
It's for their good, but also the military medical system's, he noted. There's
a healthier population of beneficiaries -- and also lower healthcare costs, he
said.
All the services have body weight and conditioning standards. The Body Mass
Index ratio developed by the National Institutes of Health in 1998 is one
indicator. Its is the ratio of weight in kilograms to height in meters
squared. A BMI of less than 25 is considered normal, 25 to 29.9 is overweight,
and over 30 is obese.
About a thousand of service members are discharged each year because of their
weight. That's sad, Cohen said, but
the active force's problem is minor compared to family members, who mirror the
general public. Using the BMI, he
said, studies suggest 60 percent of Americans are overweight or obese.
About 15 percent to 20 percent of children are overweight or obese, he said.
About 40 percent weigh over 80 percent
of their ideal body weight.
The services' elite forces are most effective at weight control, probably
because of their culture, which stresses
physical prowess, agility and team coordination, Cohen observed.
"My anecdotal experience is that you do not commonly see overweight and
obesity in our elite forces, though I
haven't really studied that scientifically," he said.
Whether or not his hunch is correct, he noted, one thing is certain for
everyone: It's easier to prevent overweight and
obesity than to treat them. They're illnesses, he said, but many overweight
individuals don't see themselves as sick or
needing treatment.
"They do not recognize the steep and very slippery slope on which they sit,"
Cohen said. Obesity is linked to higher
rates of chronic illness and worse physical quality of life than lifelong
smoking, problem drinking and poverty
combined, in the United States, he contended. Overweight and obesity are
clearly associated with type-2 diabetes,
gall bladder disease, hypertension, coronary artery disease, depression and
elevated cholesterol and triglyceride levels in the blood.
Considering that an overweight 25 year old might gain 10 to 20 pounds per
decade, he continued, it's not surprising
nearly 30 percent of Americans at any given time are trying to lose weight.
The cost is up to $50 billion per year, and
most of it's wasted because it's spent on foods, nutritional programs,
supplements and remedies of dubious value, he said.
"Losing weight and keeping it off is not easy, ever!" Cohen warned. The hardly
secret truth about weight control is
that it means adopting a lifestyle that combines prudent dieting and a
sustained exercise program. It's the only way
to prevent and to effectively treat overweight or obesity without resorting to
medications, he said.
"Sustained exercise means 30 minutes of exercise, preferably vigorous, three
or four times per week, and more often if one is inclined," Cohen explained.
"The benefits of frequent exercise are well documented. Even walking is
helpful as long as it is sustained. One should feel at least a little tired at
the end of it, in my opinion."
A caution regarding children: Severely limiting children's caloric intake can
adversely affect growth and development,
especially during adolescence, when their needs increase, he said. The best
ticket, he noted, is a balanced diet that's neither excessive in calories nor
excessively restrictive coupled with age-appropriate exercise. Children
attempting to lose weight should do so only under the care of physicians or
nurse health managers, he added.
Embarking on this life change, one can hope to lose 1 or 2 pounds per month.
Losing 12 to 20 pounds in a year is a
real success story, he said.
A pound of fat contains about 3,500 calories. Vigorous exercise for 30 minutes
may burn up to 350 calories, so
even with daily exercise at this rate it would take 10 to 12 days to burn a
pound of fat -- assuming you're eating
only a normal complement of calories. An average adult requires 2,000 to 2,500
calories daily, so the goal should
be to not exceed about 2,000, ever, Cohen said.
For more information on weight control problems and treatments, visit the
Surgeon General's Overweight and
Also of possible interest, the National Institutes of Health has a discussion
on drugs and weight loss at
(Adapted from materials from the Office of the Assistant Secretary of Defense
for Health Affairs.)
####
_______________________________________________________
Any photos, graphics or other imagery included in the article may also be
viewed at this web page.
Posted: 6 Dec 01
TRICARE Mid-Atlantic (Region 2) Designates Reserve Liaison Officer
TRICARE Mid-Atlantic Designates Reserve Liaison Officer
(Norfolk, Va.) - The TRICARE Mid-Atlantic Region now has a reserve liaison
officer (RLO) in its Norfolk office to help activated guardsmen and reservists
and their family members understand and use TRICARE, the military health care
benefit.
When reservists are called to active duty, they must quickly prepare their
families to manage all aspects of the household while they are activated.
Part of that preparation is becoming knowledgeable about TRICARE.
"When reservists are mobilized, they may wonder how their families will access
TRICARE," said Rear Admiral Clinton E. Adams, TRICARE Mid-Atlantic Lead
Agent. "We've designated our new RLO to answer their questions by phone and
e-mail, as well as to physically go to reserve units to explain the military
health care benefit."
Families of activated reservists and National Guard members become eligible
for health care benefits under TRICARE Standard or TRICARE Extra on the first
day of the military sponsor's active duty, if his or her orders are for more
than
30 consecutive days of active duty. When the orders for active duty are for
more than 179 days, family members may enroll in TRICARE Prime or TRICARE
Prime Remote. To use this option, they must complete enrollment forms and use
military medical facilities and TRICARE Prime network providers. Family
members who live in North Carolina and Virginia (excluding Northern Virginia)
are in the TRICARE Mid-Atlantic Region, regardless of where the service
member's mobilization station is located.
Captain David W. Munter, TRICARE Mid-Atlantic Executive Director, said, "Our
goal is to help the families transition into TRICARE. We don't want
reservists on active duty to be distracted worrying about health care for
their families."
Currently, the RLO is Lt Col Dominic Ubamadu, an activated reservist who is a
veteran of the TRICARE program. He has several years of TRICARE operations
experience, which includes a recent Active Duty tour as department head of
Communications and Customer Service at TRICARE Mid-Atlantic.
"I've worn many hats: first as an Army Reservist, then as active Army,
followed by active Air Force. I'm now an Air Force Reservist privileged to
work in the TRICARE office. I'm eager to help our activated service members
and their
families understand TRICARE," said Lt Col Ubamadu. "Many of them have never
used the benefit, or it's been a while since they were covered by TRICARE. We
hope to ease some of their health care anxiety while the reservist is away."
Captain Munter encourages reserve and guard units within the region to contact
the TRICARE Mid-Atlantic office to schedule meetings or briefings for their
service members or family members once they receive their mobilization warning
orders.
Activated reservists and National Guard members should check with their
reserve centers or unit commanding officers to make sure that all information
about themselves and family members is current and accurate in the DEERS
(Defense
Enrollment Eligibility Reporting System) database. Incorrect information can
result in enrollment and appointment disruptions, delayed claims processing,
problems with pharmacies and the National Mail Order Pharmacy (NMOP) benefit,
and other difficulties. For information about DEERS enrollment, they may
contact DEERS toll free from 6 am to 5 pm, Pacific time, at 1-800-538-9552.
For specific information on TRICARE for reservists, log on to the TRICARE
Mid-Atlantic Web site at
http://www.tma.med.navy.mil and click on "Reservists."
###
SOURCE: TRICARE Mid-Atlantic Press Release
POC: Deborah Kallgren at (757) 314-6471
Posted: 15 Nov 01
Smoking Costs DoD Plenty
By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
WASHINGTON, Nov. 14, 2001 -- DoD officials can't be sure exactly how much
smoking costs the department each year, but they know it's a bundle.
A 1998 DoD study estimated smoking costs the department $584 million per year
in medical care and $346 million in
lost productivity, Air Force Lt. Col. Wayne Talcott said.
Talcott is a psychologist assigned to the Air Force Medical Operations Agency
in San Antonio, Texas. He is also a
former head of DoD's Tobacco Use Reduction Committee.
His numbers are only estimates, he said, because it's impossible to quantify
what illnesses are caused by smoking
and which are naturally occurring.
Lynn Pahland, director of Health Promotion and Preventive Services Policy with
the Office of the Assistant Secretary
of Defense for Health Affairs, believes the estimates are conservative.
She said there needs to be a cultural shift against smoking throughout DoD.
Officials shouldn't rely on the medical
community to wipe out smoking single-handedly, she said.
"We are trying to instill a culture change where we point out and endorse that
we want a healthy culture," she said.
"We want to put a system in place throughout the Department of Defense -- not
just in the healthcare system -- that
healthy lifestyle choices are what we want from everyone."
"Smoking is the single most preventable cause of death in the United States,"
Talcott said.
Part of this departmentwide push is making tobacco products less accessible at
commissaries and exchanges. Talcott said cigarettes used to be much less
expensive at these stores than off base. DoD has since succeeded in having the
prices of tobacco products raised at commissaries and exchanges to make
smoking less attractive.
But Congress has said tobacco is a legal product, so the commissaries and
exchanges won't stop selling these items
any time soon, Pahland added. At the same time, though, store managers are
dedicating less shelf space to tobacco
and giving more prominent display to smoking cessation aids, such as nicotine
patches and gum, she said.
Smoking cessation aids are also available through many military heath clinics
and hospitals, but not all. Pahland
said smoking cessation aid isn't a TRICARE benefit per se, but many hospitals
and clinics offer cessation classes and
products to improve beneficiaries' health and cut down on healthcare costs.
Doctors in military medical treatment facilities can also prescribe
medications to help patients quit, Talcott noted.
A combination of medication and behavior modification therapy is the best
approach to kicking the habit, he said.
"The bottom line is we want our armed forces to be as healthy as possible,"
Pahland said. "It is a scientific
fact that tobacco use interferes with health and readiness from both a
short-term and long-term perspective. We want
to give people the tools to help them make healthy choices."
She noted DoD is concerned about the health of the entire military family, not
just service members. "If family
members are healthier, that's going to give peace of mind to our armed
forces," she said.
The Great American Smokeout Day is Nov. 15. For more information on quitting
tobacco for good, visit the
Additional information and materials about tobacco and smoking cessation
programs are available from the American Cancer Society,
www.cancer.org or call
them at 1-800-227-2345. Or visit the Centers for Disease Control Web site
##########
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