After a tour of the Tucson VA last month, U.S. Rep. Gabrielle Giffords, D-Ariz., praised the Arizona facilities and was especially impressed with Tucson’s Polytrauma Network Site, the only one in Arizona.
Legislation proposed by Giffords to improve Department of Defense monitoring of service members experiencing post-traumatic stress disorder was approved March 20 by the House Armed Services Committee.
The proposal is part of the Wounded Warrior Assistance Act of 2007, a bipartisan measure overhauling military medical care for service members wounded in combat.
“We owe our men and women in uniform nothing less than the very best medical care,” said Giffords, whose southeastern Arizona congressional district is home to Davis-Monthan Air Force Base and the Fort Huachuca Army post. “Our soldiers, sailors, airmen and Marines are prepared to make the ultimate sacrifice for their country. We must be prepared to make sure their health needs are met.”
One of the Tucson VA’s star programs is its polytrauma system of care. Known as a Polytrauma Network Site, the Tucson VA polytrauma unit is an outpatient program for veterans with more than one injury who have already been patients of one of the VA’s four polytrauma rehabilitation centers in Richmond, Va., Tampa, Fla., Minneapolis, Minn., or Palo Alta, Calif., all termed Level I centers.
“These centers provide comprehensive inpatient rehabilitation services for all acute care patients eligible for VA care who have sustained varied patterns of severe and disabling polytrauma injuries,” said Florence Gores, an RN and the clinical director for the VA’s Geriatrics and Rehabilitation Center in Tucson.
Polytrauma is defined as two or more injuries to physical regions or organ systems, one of which may be life threatening, resulting in physical, communication, cognitive, psychological or pyschosocial impairments and functional disability.
Traumatic brain injury frequently occurs in polytrauma in combination with other with other disabling conditions such as amputation, musculoskeletal injuries, auditory and visual impairments, spinal cord injury, post traumatic stress disorder and other mental conditions.
Such injuries may be the result of combat from such sources as blasts or explosions, gunshot wounds, motor vehicle accidents and blunt force trauma.
Veteran John Popaditch, 49, a Tucson resident since 1989, recently spent several weeks at the rehabilitation center receiving treatment for a fractured leg resulting from being struck by a car. Popaditch has recently been working with a VA physical therapist on what’s called a “confidence course,” which features a variety of walking surfaces he may encounter after he leaves treatment.
“I feel very happy about the care I’ve received at the VA,” Popaditch said. “The therapy taught me about getting around on crutches and also what I should and should not do until my leg heals.”
James R. Rae, 57, an Army veteran and also a Tucson resident, has recently had a right hip replacement after having his left hip replaced several years before. He too, has been at the Tucson VA for several weeks of rehabilitation.
“When I was in Vietnam, I got wounded with mortar fragments and quite a large piece went in my left side,” he recalled. “They can’t determine if that did vascular damage at the time that lead to this, but one thing lead to another and I’m very thankful for the VA. They came through for me and the staff and doctors have been very helpful.”
“We get out and moving and even got to go to a ball game with one of the therapists,” Rae said. “ The place is clean and the food is good. What more could any patient ask for? When I get better, I’m taking my grandkids fishing.”
There are 21 Level II polytrauma sites nationwide, and only one in Arizona— the Tucson VA. In January 2006, the Tucson hospital was selected as the polytrauma network site for Veterans Integrated Service Network (VISN) 18 which includes Arizona, New Mexico and parts of Texas. Currently, there are approximately 50 patients being treated in Tucson in the program.
“Patients, upon returning to their VISN area, require multidisciplinary rehabilitative training that is provided by specialized teams that have been established at these sites,” Gores said. “Care is coordinated by the case managers of the team who also assist other medical centers in the VISN with the ongoing health care needs of these veterans.”
The polytrauma staff are happy to share the program with those who wish to learn about all that can be done for patients.
“There is so much we can do to help veterans get back their lives again, “ said Kent Wilson, coordinator and speech therapist in physical medicine and rehabilitation at the VA Geriatric and Rehabilitation Center. “The most common problem we are seeing is traumatic brain injury because of the blast and explosions they encounter in the field. It can be mild or severe, so we’ve asked that the primary physicians screen for it and then refer them to the polytrauma unit for more intense evaluation.”
Kent said hearing loss and amputation is common as well.
“We have a great prosthetics department here too,” Kent added. “In addition, we have a clinical psychologist who is most involved with these patients because of the emotional and psychological state they come back with. The VA also works with the family.”
The Tucson VA works with patients in chronic pain and has a program to deal with pain management.
Tucson patient Kelli Garcia, 33, a mother of two, is currently receiving about six different treatment programs at the polytrauma unit for a variety of disabilities including impaired speech and movement and an inability to walk. She was injured while on duty in Germany in 2004 and also suffers traumatic brain injury.
To add to her situation, she recently was missing appointments because a ride to the VA wasn’t always available.
“That’s when they said I could stay here for a while,” Garcia explained. “The hardest thing for me to do is get out of bed.”
Garcia said she’s learning to walk and speak more clearly.
“I can brush my hair now and they give me Botox to help the muscles in my hands,” she added. “They care about me and are really trying to help me.”
Dianne Lethaby, polytrauma nursing case manager and certified rehabilitation RN has been working with Garcia.
“One of her biggest challenges is walking,” Lethaby said. “We are working on pain management and we encourage her to stay as active as she can.”
Lethaby is also assisting Garcia in getting regular transportation to her appointments at the VA. Lethaby works with outside community organizations and volunteer groups who also help veterans, as part of VA outreach.
Lethaby said the polytrauma program is for all veterans who need it and qualify for the program.
“It’s important to note that the polytrauma program helps veterans who most need it, and not just those who were injured in Iraq or Afghanistan,” she said. “Many of our patients were injured in other situations besides combat, so it’s critical that they get the help they need too.”
The VA polytrauma staff encourage veterans and health care professional to contact the polytrauma team to discuss potential referrals of any combat and non-combat injured veterans who may meet criteria for the program.
Polytrauma SW Case Manager: Shaun Rudth at 520-792-1450, ext. 5910 or e-mail shaun.rudh@va.gov or Polytrauma Nurse Coordinator Dianne Lethaby, RN, 520-792-1450, ext. 4656 or e-mail: dianne.lethaby@va.gov.
rford@gvnews.com | 547-9740
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