Veterans Serve their Country Twice: Another Healthcare Approach
There is a village in Africa where the people were starving from malnutrition and going blind from a Vitamin A deficiency while a billion dollar pharmaceutical company, who had donated a year’s supply of vitamins and nutrients, watched the goods they had donated sit and spoil in an airport’s hanger because no one had the money, knowledge or will to gas up the plane and have the medicine delivered.
We worked and strained on the heated, smoking “pile” of rubble which was once the mighty World Trade Center on that September 11, while our shoes melted, our bodies sweated and we had no water. When I left the site later in the evening, I was forced to traverse that mountain of concrete and steel like a lost urban Sherpa and like a hapless explorer, I discovered something on the other side of the mountain: a dustless, large, shiny, unattended truck loaded with water bottles.
In other words, mere yards (and ignorance) away separated the dehydrated workers, tormented by flame, and the very elixir that could quench their thirst and soothe their burns. So simple. So symbolic.
The story and metaphor is not lost to me as I examine the Veteran who must navigate the US healthcare system. Returning home to the richest nation in the world, the Veteran who suffers from painful, relentless ailments is not receiving the relief so deserved. Not because the technology does not exist. No, in fact there in lies the irony, if not the crime. On one side of the mountain there is a readily available, simple, wonderful solution in the form of medications that can fit in my pocket; on the other side is the disease – the fire and thirst – which steals life for a second time from our Veterans.
As every physician, layperson and politician knows, Veterans suffer from Post-Traumatic Stress Syndrome. Long after they leave the battlefield, our soldiers battle constant migraine and tension headaches. I have been treating these pain syndromes in my office for the better part of a decade, using the popular drug Botox.
This medication, which has made headlines in the media, and millions on Wall Street, as a cosmetic wonder drug, does not make a blip on the radar of public-awareness and military bureaucracy, as a pain reliever.
Even many physicians are not current or comfortable with injecting neurotoxin into patients for pain management.
As Botox is almost magical in its ability to treat headaches, the neurotoxins (neuro-modulators is a more PR-friendly term) which include Botox, Xeomin and Dysport can go beyond their cosmetic realm and treat areas such as muscle dystonia, bladder spasm and even sweaty palms and armpits.
And the frightfully painful and frustrating phenomenon of phantom limb pain, which resists most standard treatments.
These medications, which come in a little bottle and can be delivered to my office overnight, hold promise for Veterans who have suffered so long from the loss of a limb, and then the haunting pain that follows.
So there are two sides of the mountain: a known treatment and the patient who is not receiving the treatment. And this is where grassroots movements become as important as the technology itself. It is these grassroot movements which can unite the two sides, bringing the patient and the science together. These movements educate, promote awareness, decrease isolation and increase access.
Awareness is powerful medicine. These grassroot organizations can reach where governments and lofty medical attitudes have fallen short.
In medical school, we cynically said, “Veterans serve their country twice”, referring to Veterans who had served in harm’s way and again when they returned to face a confusing medical system.
It is time we served them. The healing power of technology and the compassionate outreach of grassroots movements are the “twice” needed forces to affect greater healthcare delivery.
If this country has the resources, our Veterans should receive it.
Tagged Botox, Pain Management, PTSD, Veterans

