With more older troops on battlefield, Army sees rise in noncombat ailments

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With more older troops on battlefield, Army sees rise in noncombat ailments


By Russ Rizzo, Stars and Stripes
European edition, Sunday, March 13, 2005



In many ways, Maj. William Wolfe is a typical Army reservist.

The 47-year-old high school history teacher from outside Hershey, Pa., has served 21 years in a variety of roles as an active-duty and Reserve soldier.

Before deploying with his transportation brigade in January, Wolfe had no major medical problems and worked full-time behind a desk.

But once he arrived at Camp Spearhead in Kuwait, Wolfe soon found his body was not ready for the rigors of deployment: the long shifts lifting cargo and climbing stairs; the stress of a daily commute on roads insurgents were known to attack; the lack of sleep from living with others in a tent.

Within a month, Wolfe?s body sent him a warning. A nagging pinch developed near his heart, and he found himself dizzy and out of breath ? signs of possible heart trouble he feared could lead to an attack if ignored.

?You can?t work 14- to 16-hour shifts when you?re 47 years old when you haven?t been in that kind of environment and expect to be fine,? Wolfe said recently from a bed at Landstuhl Regional Medical Center in Germany.

To doctors at Landstuhl, Wolfe represents a new reality for the U.S. military. As reservists and National Guardsmen are called to duty in unprecedented numbers, they are bringing new medical challenges with them.

Part-time soldiers now make up about 40 percent of the 150,000 troops in Iraq, a Pentagon spokesman said. Overall, more than 184,000 reservists in all services are deployed worldwide, according to the Army National Guard Web site.

And because these troops tend to be older, military doctors find themselves dealing more with illnesses and injuries common in older patients.

The average age of reservists in all services is 33, according to the Office of the Assistant Secretary of Defense for Reserve Affairs. A quarter of all reservists are over age 40.

At Landstuhl, where most soldiers injured downrange go for medical treatment, more troops arrive with noncombat injuries than fighting wounds. Eight out of 10 soldiers airlifted from battle zones since the beginning of the war in Iraq were treated for noncombat injuries, according to the reserve affairs office.

They suffer from diseases such heart problems, joint pain or noncombat injuries such as fractures suffered during training.

Atop the list of ailments is chest pain, followed by back pain and hernias.

For Dr. (Col.) Randolph Modlin, chief of cardiology at Landstuhl, the figures are easy to explain.

?We?ve never gone to war with guys as old as this before,? he said.

In 2004 alone, Landstuhl physicians treated 559 soldiers who suffered from heart disease or experienced chest pain downrange, according to hospital statistics. That?s an average of almost 11 heart patients a week.

By comparison, the hospital treated an average of 24 patients a week for all types of war wounds combined last year, according to hospital statistics.

While most heart patients are over age 40, like Wolfe, Modlin said doctors have seen clogged arteries in reservists in their 30s.

?It?s just amazing how much coronary disease we?ve seen,? said Dr. (Maj.) Michael Huber, a cardiologist at Landstuhl.

Just last month, doctors found a 95 percent blockage in an artery of 37-year-old Sgt. 1st Class Kris Barrett, a National Guardsman from Michigan. They later discovered Barrett came to war with another artery partially clogged that he knew nothing about.

While guarding Abu Ghraib prison in Baghdad, Barrett felt a pain in his chest and found himself out of breath while walking.

His first reaction: ?I thought I needed to work out more,? Barrett said from a bed at Landstuhl before flying to Walter Reed Army Medical Center in Washington, D.C., for heart surgery.

Like Barrett, some patients go to war with heart trouble they do not discover until they push their bodies carrying heavy flak jackets in the desert heat.

For others, heart disease develops in combat because of habits common to the battlefield, including stress, poor diet and smoking, doctors said.

?An average 40-year-old there puts on 40 pounds of gear in that heat and lets people shoot at him ? that?s a recipe for heart failure,? Modlin said.

Back pain is the second most common noncombat injury Landstuhl doctors see. Like heart patients, back patients tend to be older, because bones and joints naturally deteriorate over time, doctors said.

?That low-back twinge a reservist felt at home suddenly becomes a war-stopper,? said Michael Kilpatrick, deputy director of deployment health support in the reserve affairs office.

Hernias are the third most common noncombat injury seen at Landstuhl. Most of these patients are reservists and National Guardsmen because of their older ages, said Dr. (Col.) Tyler Putnam, a general surgeon who treats hernias.

The Army and military doctors are doing a variety of things to address illnesses in older troops, such as adding new surgical specialties and beefing up physical training for reservists. The Army plans to add a program to better monitor the health of its reservists, Kilpatrick said. That may include requiring certain older reservists to take an electrocardiogram, or EKG, every year.

An EKG test likely would have shown Barrett?s early heart trouble, preventing him from going to Baghdad in the first place.

But Wolfe?s diagnosis was different. After days of evaluations at Landstuhl, doctors released the reservist back to Kuwait. His heart showed no problems.

?I guess it was just the stress,? Wolfe said.