Nine of 10 have mental disorders. Two of every three suffer from PTSD, and 40% suffer from traumatic brain injury. Nine of 10 are on 100% disability. Four of five also suffer from diseases of the nervous system, and diseases of the musculoskeletal system and connective tissue. Many are living with moderate to extreme pain.
Yet amid all this bleakness, there is some good news: more than four of every five also say their “life is full.”
They are the 838 U.S. military veterans who lost a leg or arm in Afghanistan and Iraq (2.6% had three or four limb amputations). A new study from the Department of Veterans Affairs focuses on troops who suffered at least one “major amputation”: the loss of a leg at or above the ankle, or of an arm at or above the wrist. As of last Oct. 1, 1,288 U.S. military personnel had suffered such wounds; 450 remained on active duty, either undergoing rehabilitation or back with regular units. Among the 838 vets, 681 had lost some or all of a leg, and 149 had only an upper-extremity amputation.
The Department of Veterans Affairs inspector general, responding to a request from Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, decided to conduct “the first ever study to characterize the population of 1,288 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn servicemembers with major traumatic amputations.” It combed military and VA data seeking information on the 838 vets with amputations, and conducted telephone and face-to-face interviews with many of them.
“Despite the challenge of major limb amputation, we estimated the majority (91.0 percent of lower limb and 80.0 percent of upper limb only) of veterans considered (agreed or strongly agreed) their `life is full,'” the study concluded. “In fact, we were very inspired by the high spirit of veterans we visited.”
While “some” veterans “reported receiving excellent care at VA facilities, many veterans indicated that VA needed to improve care” when it comes to prosthetic expertise and access to care.
The report says that “in response to the growing need to provide patient-centered amputation care to a younger population of combat-injured veterans, VA developed the ASoC” – the Amputation System of Care – which is a nationwide network of facilities designed to help vets cope with their wounds.
The report says the troops who have suffered amputations:
— averaged 25.3 years old when they were wounded.
— 98.3% are male.
— 68.3% were in the Army
— 28% were in the Marines
— 3.6% were in the Air Force or Navy
— 7% were officers (roughly half their proportion in the force)
— 62.8% were wounded in Iraq
— 37.2% were wounded in Afghanistan
Those who lost a leg did better than those who lost an arm:
We found that OEF/OIF/OND veterans generally were adapting to living with their amputations. Veterans with lower extremity amputations have good mobility…Veterans with upper extremity amputations only are functioning similarly to their counterparts in the general population; however, over half of these veterans reported experiencing moderate to severe pain. We found that veterans with upper extremity amputations consistently did not fare as well as those veterans with lower extremity amputations in their psychosocial adaptation, activity limitation, and prosthetic satisfaction.
There are inspirational tales:
One veteran we interviewed had relocated and was going to college full-time. He had one leg amputated at the hip, the other leg amputated high above the knee, and one arm amputated below the elbow. He praised his prosthetist, stating he never would have been able to walk again if it was not for the detailed time and attention he got from the prosthetist. He reported using a manual wheelchair to get around at school. He uses forearm crutches to walk with his prosthesis, for limited distances. He reported a high satisfaction with life and his prosthetic limbs.
Even though he has a right above knee amputation and left below knee amputation, one young veteran continues to participate in activities he enjoyed before he was injured including mountain climbing, hunting, skydiving, and water sports. He attends a local university and has a goal of becoming an engineer. To “give back,” he is an advocate and spokesman for various community and VA programs. This veteran is able to live alone, continues to maintain his independence, and has a close relationship with his father.
But not all are so lucky:
A veteran who initially had a[n ankle] amputation was able to run a marathon but later developed complications which resulted in several surgeries on his residual limb, that is now an above the knee amputation. He continues to have pain, skin breakdown, and infections that have made fitting his prosthesis difficult. He told us that now he would simply like to be able to mow his own yard again.
It’s a strange inspector general’s report. The reader is quietly pulling for every veteran, and silently cheers each marker of progress or success the IG documents. But then there are sections that give one pause:
Among the 838 amputee veterans, 8 had 3 or 4 limbs amputated. We tried to contact all of the eight for an in-person visit and for telephone interviews, but were able to interview only one by telephone; however, this veteran’s responses to our telephone interview were inconsistent. Thus, we excluded him from our analysis. We were able to interview two in person. We made at least three call attempts to contact each of the five remaining veterans. One did not return our calls, and the other four declined to participate.
We contacted [an unidentified VA] medical center twice on behalf of a veteran after he told us during the in-person visit that he had made multiple requests about his prosthetic clothing allowance from previous years but had not received a response. On December 14, 2011, the Office of the Inspector General again contacted the Director’s office but did not get a response. The day after we briefed [VA health officials], the medical center contacted the veteran about his request.
Some things in some parts of the VA, most vets will volunteer, never seem to change.