Healing America s Wounded Warriors

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1 Healing America s Wounded Warriors Luke Beckman Executive Director, TBI & PTSD Project, Director of Outreach and Social Media, International Hyperbaric Medical Foundation lukembeckman@gmail.com, ,

2 Overview Why are so many wounded? What is Post-Traumatic Stress Disorder/Traumatic Brain Injury (PTSD/TBI)? What will this cost the American taxpayer? What are we currently doing? What is Hyperbaric Oxygen Therapy (HBOT)? What is the National Brain Injury Rescue and Rehabilitation (NBIRR) Project? How do we properly heal our veterans?

3 Our Veterans Need Help As of Jan. 2010, 1.9 million service members had deployed to Iraq and Afghanistan. It is estimated that 1/3 of these service members suffer from Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and/or depression. 600,000 service members Source: RAND Corporation

4 Why so many injured? Improvised Explosive Devices (IEDs) are responsible for 60% of all American combat casualties in Iraq and 50% of all combat casualties in Afghanistan. Modern battlefield medicine is able to keep more service members alive after major injuries. Many service members have both visible and hidden injuries from head trauma- especially from the blast waves from IEDs. Source:

5 What are Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD)? Both TBI & PTSD are closely related, and in many cases, directly related. Explosions, by way of direct impact or form a blast wave, injures the brain- usually when it ricochets off of the skull. Blast-induced TBI is different than traditional brain injuries because of compounded PTSD causal factors Many symptoms of TBI are identical to symptoms of PTSD Depression Anxiety Forgetfulness Sleep difficulties Difficulty concentrating Muscle spasms Irritability Headache Nausea Fatigue Affects both the military and civilians

6 What does this mean for U.S. security? We have 600,000 service members with wounds to the head (whether they show it or not) Most of these individuals experience mild to severe psychological and physical symptoms yet still serve on the frontlines We do not yet have a way to heal these wounds

7 What are the military costs of PTSD/TBI to American taxpayers? Military Costs to Taxpayers Lifetime disability/medical costs for one brain-injured veteran $1,250,000 Lost tax revenue from each veteran $500,000 Lost tax revenue from the veteran's primary caregiver $500,000 Total taxpayer costs per one wounded veteran $2,250,000 Estimated # of PTSD/TBI veterans from Iraq and Afghanistan 600,000 Total taxpayer cost of 600,000 brain injured veterans $1,350,000,000,000 Military cost of war in Iraq* $705,940,000,000 Military cost of war in Afghanistan* $315,840,000,000 Total cost of both wars $1,021,780,000,000 These values do not include the costs of replacing trained soldiers with new ones *Cost only accounts for direct military war-fighting operations Source:

8 Cost of Traumatic Brain Injury (TBI) in American society as a whole Civilian Numbers on TBI as of Fall 2010 # of Americans living with a traumatic brain injury 5,300,000 # of Americans who will suffer a head injury this year 2,500,000 # of Americans who will be hospitalized from their injury 500,000 # of deaths caused by brain injury 50,000 # of TBI survivors per year 80,000 Total lifetime cost to treat one person with brain injury $2,250,000 Total cost of Traumatic Brain Injury to American society (non-military $17,550 trillion Source: Johns Hopkins Medicine

9 What treatments is the military using to treat brain injured veterans? Exercise Balance Hand-Eye-Coordination Cognitive Rehabilitation Medication (individuals often take up to 20 different types of drugs daily) NONE of the drugs currently used and paid for by Tricare and the VA to treat brain injured veterans are FDA-approved to treat TBI (only Paxil and Zoloft are approved to treat PTSD)

10 Where will we be 10 years from now? Total cost of $1.35 Trillion dollars to American taxpayers using current methodologies An estimated 15,500 veterans have committed suicide since Aug 2008 (17 suicides per day) The military openly declares they have a suicide epidemic Almost all drugs that are prescribed (Note: they are prescribed off-label) for PTSD carry Black-Box warnings against sustained use because of increased risk of suicide Using current treatments, a person who is reduced to 70% brain capacity often increases to 74% and still remains heavily dependent and addicted to medications.

11 What alternatives exist? Hyperbaric Oxygen Therapy

12 What is Hyperbaric Oxygen Therapy (HBOT)? The process of breathing in 100% pressurized oxygen. Used daily for 13 FDA-approved conditions Stroke, diabetic foot wounds, burns, crush injuries, carbon monoxide poisoning, etc

13 Why isn t HBOT used widely? HBOT at 1.5 atmospheres is not covered by insurance and military personnel cannot afford a full treatment cycle. Active opposition and stalling from the US military for a myriad of reasons (reasons below actually stated in open dialogue)- none of which are rational and/or true HBOT for TBI and PTSD is dangerous. HBOT is not clinically proven to work. HBOT is not an FDA-approved device for TBI or PTSD You haven t done a clinical trial with a placebo as part of the protocol. No matter how much evidence you gather, it is not backed by clinical trials. These people would have gotten better anyway. The brain cannot be healed. You can t prove that it was HBOT that caused the improvements. If it worked, military medicine would have already adopted it. We haven t studied it enough. You re biased in favor of HBOT; therefore, anything you say is suspect. Too many of the patients who say they have a problem really don t. You re out of your league. DOD will run the studies their way. You re giving these patients false hope. HBOT leads to premature aging and Alzheimer's. We ve spent over a billion dollars on research and studies. We re doing all that is humanly possible.

14 The US military is concerned about frontline readiness The US Army has fears about troops leaving the fight when they hear that treatments exist for their head injuries There's more TBI/PTSD out there than reported Soldiers have not been reporting claims and the Army isn't keeping track Without baseline data there is no way to "prove" that TBI and/or PTSD existed [Congress has mandated that baseline tests be given] Far too many new cases would be suspicious claims The system could not handle the surge of claimed injuries Once the "true" nature of TBI/PTSD occurrence was known, the volunteer Army would be threatened A sizeable number of boots-on-the-ground in Afghanistan would have to be pulled out of the line for past injury and every time a new injury occurred, again threatening the volunteer force. Several military combatant commanders are, however, pushing very hard to get their soldiers treated.

15 NBIRR is the Solution The National Brain Injury Rescue and Rehabilitation (NBIRR) Project has been launched to carry out a clinical trial for HBOT to treat TBI/PTSD Approved by the Western Institutional Review Boardthe Gold Standard of medical review Case study of 1,000 patients to build the pool of data to conduct proper analysis Treatments have begun on a sporadic basis with remarkable results using 1.5 atmospheres of pressure (HBOT 1.5)

16 What does HBOT 1.5 mean? Patient enters chamber (enclosed glass tube) and lies down Breathes 100% oxygen, at 1.5 atmospheres of pressure, for one hour 40 sessions over six weeks Patients typically begin to experience positive symptoms after 20 sessions 30-day break 40 more sessions

17 What is HBOT s potential effect on the brain? 84% of coma patients have awoken with exposure to HBOT 1.5 HBOT is the only non-hormonal FDA-approved treatment known to repair and regenerate human tissue. HBOT repairs and regenerates tissue by two oxygendependent processes Activates growth factors at the DNA level Improves blood supply to wounds throughout the body.

18 Initial treatment results are encouraging Consistent results: All patients who have been treated to-date by HBOT 1.5 have been able to return to pre-injury jobs MRI and SPECT scans show dramatic increased production in previously-damaged areas of the brain Automated Neurological Assessment Metrics show significant improved performance in treated service members

19 What do improved test scores really mean? When comparing behavior after treatment to after the injury was sustained Both simple and complex reaction time is faster Learning and memory is improved Headaches subsided Sleep patterns and length is improved Depression is decreased Cognitive functioning is improved

20 How do we scale, test, and validate this therapy? HR396 was written and proposed on the U.S. House of Representatives floor but removed from the DoD appropriations bill Would have mandated a five-year pilot program to attempt new treatments like HBOT in wounded veterans All injured veterans would have been notified Army lobbying removed this bill from the overall funding package Over 80 facilities are registered and approved with the IRB studythey can treat 1,000 patients in under six months. With the enactment of the NBIRR study, Bayesian analysis on a small number of patients will likely demonstrate results on how the rest of treatments will proceed This study on service members is the first step to generating the data set to allow the FDA to approve HBOT for TBI in the civilian population

21 What is the cost and where does the money go? Using free-standing, approved clinics will save millions of dollars One hour in a private hospital chamber costs around $1,300 One hour in an NBIRR-approved clinic chamber (all are lined up, ready to go) costs $200 This is a $88,000 savings for every patient treated Total treatment cost per patient is $20,000 from start to finish 1000 patients will be enrolled in the study (lasting six months total) Administrative fees over the six months across the entire country Total cost is $20,000,000 ($20,000 x 1000)

22 What is the cost and where does the money go? One hour in a private hospital hyperbaric chamber $1,300 Total cost of entire NBIRR HBOT 1.5 study if conducted in private hospitals $108,000,000 Total medical savings using private clinics vs. hospita $88,000,000 One hour in an NBIRR private clinic chamber $200 Total number of patients in NBIRR study 1,000 Number of treatments 80 Cost of 80 treatment for 1,000 patients $16,000,000 Administrative costs for 80 clinics across the country for six months $4,000,000 Total cost of entire NBIRR HBOT 1.5 study $20,000,000

23 What stands in our way? Tricare and the VA will not reimburse HBOT treatments because they are not FDAapproved for brain injury Note: NONE of the drugs currently used and paid for by Tricare and the VA to treat our brain injured veterans are FDA- approved to treat TBI.

24 What are the ultimate end goals? 1. Demonstrate the efficacy of HBOT in treating TBI/PTSD and in doing so 2. Ensure that Tricare and the VA accept HBOT 1.5 for treating TBI as a covered medical procedure 3. Heal our 600,000+ brain injured veterans and get them back to functional lives 4. Expand healthcare coverage across civilian insurance providers and ensure treatment to 7,000,000+ civilians suffering from TBI

25 How can you help? Donate money to fund the study 20,000,000 people donating $1 funds the entire study 1,000,000 people donating $20 funds the entire study 100,000 people donating $200 funds the entire study 16,000 people donating $1,000 funds the entire study The average American spends $323 per year on tobacco $457 on alcohol $558 on personal care $2,698 on entertainment

26 Think about it Cost of medicating veterans with current methods $1,350,000,000,000 Cost of healing brain injured veterans with HBOT $9,600,000,000 Total Savings to the American Taxpayer by using HBOT $1,340,400,000, veterans are killing themselves every day We can heal the brain It only takes $20 100% of your donation goes directly to treating wounded veterans Donate Here:

27 Thank you for caring Luke Beckman Executive Director, TBI & PTSD Project, Director of Outreach and Social Media, International Hyperbaric Medical Foundation This We ll Defend Semper Fi Honor, Courage, Commitment Service Before Self Semper Paratus

WOUNDED WARRIOR PROJECT CONNECTS, SERVES, AND EMPOWERS.

WOUNDED WARRIOR PROJECT CONNECTS, SERVES, AND EMPOWERS. As a medic for the National Guard in Iraq, Dan Smee was often the first person to treat warriors after injury. One particular warrior who he treated