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This is a very important report, and more related to our illnesses than you may yet know!

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Martha Murdock, DirectorNational Silicone Implant Foundation | Dallas Headquarters"Supporting Survivors of Medical Implant Devices"4416 Willow LaneDallas, TX 75244-7537

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Sent: Monday, March 24, 2003 11:04 PM

Subject: Subject Reference: In Search of a Gulf War With No Gulf War Illness read the

In Search of a Gulf War With No Gulf War Illness

Officials at the Department of Veterans Affairs and the Defense Department say they learned valuable lessons from their attempts to grapple with the mysterious illnesses — known collectively as gulf war syndrome — that plagued some veterans of the last gulf war.This time, they are coordinating their efforts in an effort to forestall another outbreak of symptoms or, if one does emerge, to understand it. The endeavor involves intense monitoring and measurement of the health of the troops and their exposures to microbes or potential toxins. Doctors and researchers will be able to track the medical records of troops before, during and after the war, and will have more detailed information on the location of troops during the war, what drugs and vaccines they received and when, and what substances they might have encountered in air, water and soil. "We weren't as prepared following the last gulf war as we will be with this one," said Dr. Roswell, the under secretary for health at the V.A.Veterans groups have been closely following the new effort. O'Rourke, the assistant director of health policy for the Veterans of Foreign Wars, a group with 2.7 million members, said he was encouraged. "I believe we learned some lessons," Mr. O'Rourke said. The lessons emerged from a chastening experience after the last gulf war. About 700,000 men and women were deployed in 1991 and about 15,000 to 20,000 of them later complained that they had a troubling chronic illness with symptoms like fatigue, aches and pains, difficulty thinking or faltering memories. The complaints became known as gulf war syndrome or gulf war illness, and they took doctors by surprise. Medical experts have been unable to identify a specific cause for the symptoms, and when they suggested they might be a reaction to stress, some veterans were scornful, suspecting that the government knew of a problem and was covering it up. Suspicions grew when the Pentagon sporadically increased its estimates of how many troops might have been exposed to toxic substances. But researchers who were asked to investigate threw up their hands in dismay. There was so little medical and exposure data that scientists could not fully investigate possible causes of the symptoms. They said they lacked crucial data on the troops' health before, during and after the war, they lacked necessary information on who might have been exposed to what in the Persian Gulf, and doctors with the V.A. did not have clinical guidelines for assessing veterans' health. With data that were skimpy and unreliable, it was almost impossible to conduct good studies. "We didn't have the base line information we needed," said Dr. Winkenwerder Jr., the assistant secretary of defense for health affairs. "We didn't have good capture of events in the theater, and there wasn't a systematic capture of information when they came out." Until then, he said, such data were not viewed as important. "It was never viewed as a critical thing to do for the service member," he said. That will not happen this time. "People will come back with symptoms, of course, and they will believe they are related to the gulf," said J. Principi, secretary of veterans affairs. "But I believe we will be able to find answers: Was it the vaccine? Was it low levels of exposure to chemical or biological agents?" (He added that it would be immediately clear if troops were exposed to high levels of chemical or biological agents because they would get sick.) Finding the answers to those questions was the goal repeatedly stressed by expert committees that investigated the illnesses reported by veterans of the previous gulf war. "One of our recommendations from the first report was that the military collect the data that might be useful" in investigating the illnesses, said Dr. C. Bailar III, who was chairman of an Institute of Medicine committee that published its report in 1996. "Even if the ultimate result is to rule out any exposure, that is worth noting." Another Institute of Medicine committee gave the same advice in 2000. "We were calling for better monitoring," said Dr. Harold Sox, the editor of The ls of Internal Medicine and the committee's chairman. The new effort to build a research database involves careful health assessments of troops before and after the war, including information that is essential for research on health effects. Doctors will use a structured set of questions and exams so that the clinical data will be comparable "Part of the problem we had with the Persian Gulf war is that V.A. physicians were not familiar with the exposures the troops had had, and they could not relate to vets coming back and saying things like they took these pills and didn't know what they were," Dr. Roswell said. "Some vets complained that the doctors were not familiar with the issues of gulf war deployment. "The Defense Department is also assessing the air, water and soil wherever troops are deployed and keeping records of who was exposed to what. And it is telling service members exactly what vaccines and drugs they are getting to prevent or treat diseases and those records too are being kept in a central database. In the last gulf war, Dr. Winkenwerder said, "we just sent teams forward to vaccinate." "There was not good record keeping," he added, "and different people got different amounts of shots." Many worried about what they had received and whether they had been given experimental vaccines or drugs that might have made them ill. In addition, the Veterans Affairs and Defense Departments are working together for the first time to compile data, Mr. Principi said. The agencies will have blood samples from the troops before and after deployment that will allow researchers to search for exposure to toxins. Details on troop locations and potentially dangerous substances encountered will also be available. Medics and doctors in the gulf are also carrying personal digital assistants to collect information on every medical complaint or illness. The data will be useful if any of the troops report symptoms later. But the data could also be crucial in surveillance for biological or chemical attacks. Dr. Winkenwerder said he was optimistic that, this time, there might not be a gulf war syndrome, a mysterious undiagnosable illness and swirling accusations of a government cover-up. "We think we can prevent it," he said. Mr. O'Rourke of the veterans group said he hoped Dr. Winkenwerder was right. "Right now, I'm saying a lot of prayers," Mr. O'Rourke said. Researchers say the syndrome from the last gulf war remains a raw reminder of what is at stake. Congress held hearings, committee after expert committee at the Institute of Medicine investigated, but the illnesses remained mysterious. "I don't think it's a single syndrome; I don't know what it is," said Dr. Nelda P. Wray, the chief research officer for the V.A. "I have no idea of its etiology. "Many medical scientists concluded that the symptoms were probably a response to stress — every war, from the Civil War on, has had a syndrome, with similar symptoms. Only the names have changed, said to Dr. Roswell, the V.A. under secretary, who also published a paper on the syndromes on Sept. 1, 1996, in The ls of Internal Medicine. Certainly, the last gulf war was stressful, Dr. Wray said, even before hostilities began. "Not knowing what is going to happen, waiting for it to happen is very stressful," she said. "Just sitting in a hot tank in a desert waiting is substantially stressful."But researchers' conclusions that they could not fully explain the illnesses only fed conspiracy theories. Some doctors and veterans held fast to a variety of convictions: the syndrome was a reaction to toxins in vaccines, or a reaction to infectious microbes, or a reaction to a drug the troops took to protect against nerve gas. Doctors opened medical clinics where they diagnosed disorders and treated veterans, using expensive tests and drugs."A small number of doctors are absolutely convinced that they understand the gulf war syndrome and know what to do about it," Dr. Bailar said. "They don't always agree," he said of those doctors, "but, boy, do they know what to do." Doctors have long noted that soldiers exposed to combat — particularly unusually harsh, prolonged or chaotic conditions — may suffer an array of long-lasting symptoms.Over the years, doctors have called the problem by different names, but experts say it usually shares eight or more of these symptoms: fatigue or exhaustion, shortness of breath, heart palpitations, chest pain, headaches, muscle or joint pains, diarrhea, excessive sweating, dizziness, fainting, disturbed sleep, memory problems and difficulty concentrating.gigi* they toxically poioned the Gulf War individuals, an are still trying toescape there liabilities. It's been proven they were toxically poisoned, aswe have been, yet they are not being treated with respect or compensatedeither, sad isn't it. and we have brave soldier's in the same area, who've been given the vaccinations again, protecting all of us now. Please pray forthem, we've lost to many now. my heart is breaking over this war, Godbe with every nation, peace among men. http://www.nytimes.com/2003/03/25/health/25SYND.html

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