Veteran with PTSD fights for effective care
By Julie Robinson
Staff writer http://www.wvgazette.com/News/200904110220
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CHARLESTON, W.Va. -- Tom Vande Burgt's daughter was turning 6, and he was in Iraq. He would have to say "Happy Birthday" to Destiny by phone. It's a call that probably saved his life.
His Army National Guard company was entrenched outside Baghdad. He was wrapping up the phone call and on his way to a meeting when his daughter asked one more question, keeping him on the phone for a bit longer.
Minutes later, his intended destination was wiped out by a mortar, killing one of Vande Burgt's friends. His unit was under a round-the-clock mortar threat for 10 weeks..
Vande Burgt's first assignment was perimeter security. Later, in Baghdad, his unit shared an open-bay warehouse with a medical unit. Stretchers holding wounded and dying soldiers were lined up in their living space.
"Our TV room was a triage unit and morgue," he said.
Then, suddenly, he was home in his own TV room. For those serving in the National Guard, the quick return to peaceful civilian life can be a surreal transition.
"It was nine days from the time I was on the ground in Iraq to when I returned to my cube at the job I had before I left," Vande Burgt said. "I'd been gone a year and a half, and it looked just the same as when I left."
Vande Burgt was in Iraq for about a year, from 2004 into 2005. Earlier in life, he served with the Marines for 15 years, then with the Guard for eight years.
About six months after his return from Iraq, he and his wife, Diane, sought marital counseling. They fought frequently. Vande Burgt routinely carried a knife. He ran red lights, a common behavior for veterans trained to avoid sabotage while driving. The couple used to socialize often, but he preferred to stay home.
A private-sector marriage counselor suggested that Tom might be suffering from post-traumatic stress disorder. She recommended he make an appointment with the Veterans Affairs center in Kanawha City. During his first appointment, the counselor diagnosed him with PTSD.
A VA psychiatrist prescribed Klonopin (an anti seizure/panic medication), Seroquel (an anti-psychotic medication) and Celexa (an anti-depressant). At least four local veterans have died in their sleep while taking Klonopin and Seroquel and other prescriptions for the treatment of PTSD.
The pharmaceutical cocktail made him less emotional, but Tom already felt numb.
"I haven't cared [about anything] for four years," he said. "I didn't cry when my dog died. You just don't feel anything."
As time progressed, his short-tempered responses made co-workers wary. The eight people who reported to him were unnerved by his unpredictable transitions from lethargy to anger and were reassigned.
"I still did my job, but I couldn't get too worked up if an order didn't get to the job site on time," said Vande Burgt, a purchasing manager. "After what I've seen and done, do you think I really cared that much about a pallet of bricks?"
Although Diane was relieved that her husband was receiving treatment, she suspected the drugs were causing him to be overly sedated. He began sleepwalking and developed other sleeping problems. During the day, he was irritable and tired. Doctors discontinued the Klonopin.
"You might wonder why I'd keep taking these drugs that made me feel like that," he said. "In the military, you're trained to keep following instructions until told to do otherwise."
Protocol for PTSD treatment through the VA involves patient evaluation, education, coping skill training, counseling and possibly medication, said Robert Huwieler, clinical psychologist at the Huntington VA clinic. Often, patients who should receive weekly counseling inquire about medication as an alternative to counseling.
"There are a lot of people who have been conditioned to believe that they can take a pill and they'll be fine," he said. "There are no pills to make PTSD go away."
'Why are we a special case?'
From 2006 to 2008, Vande Burgt was shuffled through different counselors and psychiatrists at the Charleston VA clinic. He was seen six times by psychiatrists for medication reviews, and never by the same doctor more than twice, according to his records. The Charleston clinic is open from 7:30 a.m. to 4:30 p.m., so he had to take time off from his job in St. Albans to attend appointments.
The Charleston facility has not had a psychiatrist on staff for at least six months, said Huwieler, but a psychiatrist has been hired for the position and will start the job in June. Patients in Charleston may have on-camera "telemed" appointments with psychologists and psychiatrists in Huntington.
Vande Burgt's other appointments were with social workers and primary-care doctors. His wife repeatedly called to report his increasingly violent behavior while he took the medication. The sedation, sleeping problems and unexplained behaviors were also getting worse.
She also requested therapy for their family, but was told none was available. Both the Vande Burgts were previously married and have nine children between them, four who live at home. They have two sons who are serving in the military.
As Diane tracked appointments, phone conversations and prescriptions, she noticed discrepancies between prescription orders and medicine that arrived through the mail from the VA.
Last October, Diane's sister visited and the two discussed Tom's behaviors and medications. Her sister was surprised he was taking Seroquel, which is used to treat bipolar disorder.
"I told her the VA docs prescribe lots of medicines for off-label use," Diane said. Seroquel was prescribed for Tom as a sleep aid. Diane threw the Seroquel away.
An FDA panel recently recommended Seroquel's approval as a supplementary treatment for depression, despite medical experts' testimony about a possible relationship between the drug and sudden heart problems and diabetes.
On Jan. 23, the Vande Burgts filed a complaint with the VA Office of the Inspector General regarding Tom's treatment. The case in under investigation. "It amounts to the VA investigating itself," Tom said.
On March 4, Tom and Diane met with William Lanning, administrative assistant to the chief of staff at the Huntington VA facility, to request authorization for Tom to be seen by an outside provider for counseling and dermatological care. Permission was granted for one year of outside care, paid for by the VA.
"They told us we were a special case," Diane said. "Why are we a special case? Why can't everyone get the care they need?"
The Vande Burgts, and other veterans and families such as Stan and Shirley White of Cross Lanes, whose son Andrew died while undergoing treatment for PTSD, say the VA needs to increase counseling services available to veterans. The Whites led a delegation of families who have lost soldiers while being treated for PTSD to Washington, D.C., in March to make their case to legislators.
Helping themselves
In February, Vande Burgt started meeting with Ted Grindstaff, a licensed therapist who volunteers through the Give An Hour program. Volunteers in this program provide free mental health care to soldiers and their families who served in current military conflicts. Tom attends weekly talk-therapy session with Grindstaff.
The Vande Burgts recently started a support group for veterans suffering from PTSD and traumatic brain injuries.
Their support group, "Lest We Forget," meets at 6 p.m. Thursdays at 1031 Quarrier Street in the offices of the Kanawha County Wellness and Recovery Center. Veterans of the Korean and Vietnam wars, as well as more recent conflicts and wars come to the meetings, where they share support strategies, war stories and wry humor. Vande Burgt encourages the veterans to bring family members to the meetings.
"We're trying to get the guys and their families together to heal," he said. "There's still a stigma in the military to seek help for PTSD."
"We don't want this to happen to any other families," Diane added. "It's inexcusable that they don't receive the help they need."
For more information on the support group, visit: www.lestweforgetptsdsupport.org or call 304 437-1604.
For information about the Give An Hour program, visit: www.giveanhour.org.
For information about Veterans Affairs and PTSD, visit: www.ncptsd.va.gov.
Reach Julie Robinson at jul...@wvgazette.com or 304-348-1230.
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