When this editorial charms (or lands with a thud) on the masthead page of the May 2023 edition of US Medicine, Pam and I will be back on the road again. These past few months hanging out in Virginia during Pam’s recovery have been challenging for both of us. We are not used to being this static, physically or existentially. I have been writing extensively during this period, which necessitates a protracted amount of time on my bum (I do my best work with pressure on my brain). This has caused my long-term affair with lower back pain to flare up with a vengeance. I am certainly not alone in this painful condition. Researchers suggest that 8 in 10 Americans will experience back pain at some point in their lives. When I retired from the Army, I noted back pain as an issue during my exit physical review. In response, every corner of my body seemed to be scanned and/or X-rayed. The Army concluded I had the well-used spine of a fifty-something soldier. In short, like so many other humans, I have classic musculoskeletal lower back pain.
VA Slowly, Steadily Rolls New Pay, Hiring Authorities Those Could Increase Salaries for Some Staff
While VA is moving quickly to roll out new pay and hiring authorities, the impact might take time to trickle down to VA staff in non-supervisory roles or those whose salaries are not near the top of their profession’s pay cap.
Republicans Seek to Overturn VA Policy to Provide Abortion Services
Republicans in the House and Senate have reintroduced a resolution to reverse VA’s recent policy change that allows for limited abortion counseling and services at its facilities.
Outpatient Prolonged Exposure Therapy Is Effective for Combat-Related PTSD
Outpatient prolonged exposure therapy, a type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations, is a fast and effective treatment for combat-related post-traumatic stress disorder (PTSD) in active-duty military and veterans, according to a new study.
VAMCs Struggle to Find Mental Health Staffers for Primary Care
For years, VA has been working to integrate mental healthcare into primary care and requires facilities serving at least 5,000 veterans annually to have a mental health provider available within primary care settings.
Diabetes Drug Metformin Shows Promise for Reducing Incident Osteoarthritis
Metformin is recommended as first-line therapy for Type 2 diabetes at the VA and elsewhere. Among the benefits, according to the VA PBM, is that the drug, which has been in use for decades, is low-cost and safe to initiate in most patients, even those with moderate renal dysfunction.
Sequential Electrical Stimulation Device Relieves Pain in Veterans Study
Despite changes in physical training routines and equipment designed to reduce musculoskeletal injuries in servicemembers and veterans, veterans experience back and joint pain at a higher rate than their contemporaries who have never served.
Veterans Surviving COVID-19 at Much Higher Risk of Gastrointestinal Disorders
Survivors of COVID-19 are at heightened risk of developing gastrointestinal (GI) disorders within a year after infection compared with those who were never infected, according to a new study of veterans being treated by the VHA.
Most Servicemembers Hospitalized With Exertional Rhabdomyolysis Have Heat Illness
Most hospitalizations in military servicemembers for exertional rhabdomyolysis, a syndrome of muscle breakdown following exercise, are associated with heat illness and present with lower creatine kinase levels than cases without associated heat illness, according to a recent study.
Advanced Liver Fibrosis Increases Risk of HCC Diagnosis
While it is well-understood that both nonalcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV) infection commonly result in hepatic fibrosis and might lead to cirrhosis, it has not been clear whether advanced fibrosis, determined by measurements of liver stiffness, increases the incidence of hepatocellular carcinoma in veterans.
Native Americans Diagnosed With More Severe HCC
Native Americans are among the racial/ethnic groups who are more likely to be diagnosed with more-severe hepatocellular carcinoma (HCC), according to a new study.
HCC Surveillance Rebounded at VA, Still Low
How did the first two years of the COVID-19 pandemic affect hepatocellular carcinoma (HCC) surveillance and factors associated with completion at the VA?
Legislators Want More Accountability in VA’s New EHR Contract
VA is in the process of renegotiating its agreement with Oracle-Cerner over its new electronic health records (EHR) system, and legislators on both sides of the aisle are concerned that the new contract be more favorable to the VA and hold the EHR manufacturer more accountable for ongoing problems with the system.
VA Spent Millions on HPV-Related Cancer But No Vaccination Promotion
Vaccinations for Veterans, Servicemembers Half of Civilian Rate ST. LOUIS—Eligible active-duty servicemembers and veterans have dramatically lower rates of human papillomavirus (HPV) vaccination, placing them at much greater risk of related cancers, according to a new...
Military Surgeons Deployed to Combat Environments Face Moral Injury, Distress
A new VA study may be the first to examine moral injury and distress at the intersection of these populations—that is, military healthcare professionals, specifically surgeons
Higher Melanoma, Other Cancer Rates in Aviators, and Crew Remain a Mystery
Military aviators and the ground crews that service their planes are at a greater risk to develop melanoma and other types of cancer, according to a Pentagon study released last month. Just what factors are contributing to that risk remains unknown, however.
Stimulant Use Could Be a Key Factor in Heart Failure Development
Chronic heart failure affects an estimated 5% of veterans in the VA Health System, and annual mortality in heart failure patients is 15%
HIV Patients Have Worse Long-Term Survival Following Coronary Procedure
The burden of cardiovascular disease among HIV patients has tripled over the past few decades, and cardiovascular mortality has steadily risen.
VA Analysis Sought to Determine Best Approach for Treatment of Alcohol Misuse
A new study sought to determine that. Noting that psychosocial approaches are “the hallmark of treatment for harmful alcohol use,” the report in the journal Addiction added, “We aimed to compare the effectiveness of psychosocial therapy for harmful alcohol use using a network meta-analysis approach.”
Measuring Ability to Resist in Alcohol Abuse Treatment
While about half of patients with alcohol use disorder prefer non-abstinence based approaches to treatment, it is not clear when that approach is beneficial.
Substance Use Disorders Increasing Fastest Among Older Veterans
The past few years have seen significant increases in diagnoses for cannabis and stimulant use disorder at the VA, especially among older adults.
Ovbiagele Focuses on Disparities in Stroke Among Veterans, Others
Many factors play into why some populations have a higher risk of having and dying from a stroke: genetics, blood pressure, cholesterol, diabetes, access to healthy food, lifestyles that do not allow for regular exercise.
This may be the age of automation, but love is still being made by hand
I am pleased to report that my wife, Pam, is now weeks into her recovery from spinal fusion surgery. Her surgical staples are out, and she is healing nicely. As I have noted previously in this column, it had been an educational experience living on the receiving end of healthcare. One of the realities of modern healthcare I have observed is the incredible increase in automation that has crept into medical practice. I had undoubtedly noticed this change over the 30+ years of my career. Still, the pace of change appears more intense than I have experienced before.
Clinicians Puzzled by Sharp Rise in Colorectal Cancer Patients Younger Than 50
Colorectal cancer (CRC) is the third-most-common cancer globally and ranks second as the most-common cause of cancer-related mortality.
Primary Tumor Sidedness Increasingly Important in CRC Diagnosis, Treatment
In colorectal cancer, left-sided colorectal cancer (LCC) is associated with better survival compared to right-sided colon cancer (RCC) in metastatic disease, according to a study involving VA researchers.
Vitamin D Supplementation Shows Promise for Reducing Suicide Risk
Supplementation with Vitamin D appeared to be associated with a reduced risk of suicide attempt and self-harm in veterans, especially those who are Black and have low blood serum levels, according to a VA-funded study.
COVID-19 Pandemic Spotlighted Weaknesses in VA Healthcare System
During the first months of the COVID-19 pandemic, the VA was called on to serve in its “fourth mission” role as a backstop to the nation’s healthcare system.
Tool Effective in Detecting Elder Abuse in Veterans Visiting EDs
A standardized tool designed for intermediate care technicians and nurses to screen high-risk older veterans in emergency departments for injury,
Highly Rural Areas Appear to Have Lower Uptake of COVID-19 Vaccines
Public health officials can better target their message if they better understand where COVID-19 primary and booster vaccine uptake is low. A new VA study suggests that whether the potential recipient lives in a rural or urban area can be an important factor.
New York’s Operation COVID-19 Is Largest Domestic Mobilization in US History
On March 7, 2020, then-Gov. Andrew Cuomo signed Executive Order 202 declaring a state of emergency for the state of New York. Within days, military forces in the state mobilized to respond to the pandemic with the deployment of 270 servicemembers from the New York Army National Guard and Air National Guard to New Rochelle in Westchester County
