Tornado cleanup is more than physical; loss and suffering take emotional and psychological tolls that can be harder to deal with

Downtown Mayfield is pictured on Feb. 2. (Photo by William Widmer for The New York Times)

About 40 percent of the debris from the gigantic tornado that plowed through 200 miles of Western Kentucky Dec. 10 has been picked up, but Rick Rojas of The New York Times reports, "Communities along that path are now confronting another form of devastation that is less tangible but just as staggering: the emotional and psychological toll that comes from enduring so much loss and suffering."

Rojas adds, "The long and unforgiving reach of the storm is evident in nights that are sleepless or disrupted by harrowing dreams, unexpected bursts of tears, flashes of anger, fuzzy memories, a diminished appetite — the multitude of ways that trauma can manifest itself after a disaster. Now, more than a month after the storm, some — because of resources or simple luck — have been able to emerge from the shock of the storm. On the other side of a growing gulf, though, are the many others whose lives were upended and are still being whirled by turbulence. For them, mental health experts warn, the sense of security and calm integral to recovery remains elusive."

The focus of Rojas's story is Mayfield, a town of 10,000 "walloped by the initial shock of seeing entire stretches pulverized by the worst of the storm. Downtown remains mangled," he writes. "People point to piles of debris and refer to them by what they used to be: a church, a shop, a family home."

Steven Elder, the president of the Mayfield Community Foundation, which is raising money to help residents recover, told Rojas that it has been hardest for people who were already disadvantaged: “People were hurting long before Dec. 10. That’s the disaster that’s going to set these people back a lifetime. They’ve fallen into a hole they’ll never get out of.”

Rojas focuses on several victims, primarily Isaiah Holt, who "sustained nerve damage while trapped in the rubble of the candle factory where he worked and fears it will be permanent. His skin is etched with cuts and chemical burns. A strong gust of wind or an exploding building in an action movie can unleash in him a rush of terror. Lately he has spent $400 on DoorDash deliveries, as the pain — physical but also psychological — makes it difficult to venture outside."

“I felt good today,” Holt told Rojas after making phone calls and taking a shower, but "He confessed that it was only the second one he had taken in 2022."

“That’s what ‘feeling good’ means, just be feeling normal,” Holt said. “What makes it hard is I have nothing to do right now. I’m single with no kids, and I have no job.” So, Rojas writes, "He sits and he stews."

Holt was "pinned under the rubble for hours," Rojas reports. "He drained the battery on his cellphone posting videos on Snapchat, desperate to tell his family and friends he loved them. He feared he would not make it out. He feared for his brother, who worked there too and was similarly trapped. Weeks later, Mr. Holt is grateful to be alive and for the company of his brother, who spent several days in a coma but is now recovering at home. But he is also depressed and saddled with new fears."

Holt "lost 20 pounds in the hospital and feels out of shape. He is even more concerned about his mental health," Rojas writes, quoting him: “An able mind is 10 times better than an able body.” Holt has already had post-traumatic stress, after serving in the Army as a door gunner on a helicopter.

"Before he started at the candle factory about three months ago, Mr. Holt was working with young people, coaching them in sports and taking them on college tours," Rojas reports. "In a way, he is still coaching. He is often on the phone with his candle factory co-workers, trying to help them deal with the trauma. “Instead of sugarcoating,” he said, “I’m just letting them know: There are going to be bad days.”

Family members of the injured are affected, too: "Darryl Johnson, whose sister was killed at the factory, has checked in just about every day with his nieces and nephew — her grown children. He was trying to give his brother-in-law some space. He could tell he needed the room to grieve," Rojas reports.

“Eventually, it got to me,” Johnson told him. “I’m a fisherman. I was at the lake one day. I turned into the lake — that’s how hard I cried. You cry so hard your throat gets sore and you can’t speak, and finally, it was over. I just put my feet on the ground and said, ‘Get back to work. You’ve got a job to do.’”

Medical marijuana bill shelved on 14-4 committee vote; legislature is fast running out of time to pass such a controversial bill

After three straight days of discussion, Kentucky lawmakers shelved a controversial but apparently popular bill to legalize medical marijuana, increasingly known as cannabis (its biological genus).

Jack Brammer of the Lexington Herald-Leader reports that supporters of the measure pledged to continue to their fight, with some in tears over the 14-4 vote by the House Judiciary Committee on March 7 to pass over the bill. With less than three weeks left in the legislative session, the vote probably ends debate on the bill for now.

Rep. John Sims

The bill's sponsor, Rep. John Sims, D-Flemingsburg, told Brammer that it's doubtful the proposal will be revisited this legislative session, but "anything is possible." The session must end by Sunday, April 15, and will be in recess for most of the preceding two weeks to allow reconsideration of any bills vetoed by the governor.

Sims's House Bill 166 would require a "medical order" from a health-care provider for distribution of marijuana through a state-regulated dispensary, with limits on how much cannabis a person could have at one time. Also, a city or a county would have a local-option vote to allow medical cannabis to be sold, and if the local government didn't act within two years, residents could petition for a vote. Participating governments would receive some revenue from an excise tax on the drug.

The bill would also prohibit public smoking of cannabis, and would require any person or business that wants to cultivate, distribute or sell it to have state-approved licenses.

The bill, which attracted a long list of bipartisan supporters, does not include a list of conditions that could be treated by cannabis. Jaimie Montavio of the nonprofit Kentuckians for Medicinal Marijuana gave the Louisville Courier Journal a list of conditions that would be in a substitute version of the bill, which Sims hasn't introduced. Some of those conditions include cancer, glaucoma, irritable bowel syndrome, multiple sclerosis, post-traumatic stress disorder and seizure disorders.

Rep. Jason Nemes

Rep. Jason Nemes, R-Louisville, who moved to pass over the bill after saying he supports the concept of medical marijiuana, told reporters that there’s still a chance it could be reconsidered this year if changes are made to it. For example, he said he especially didn't like the provision that would allow each medical patient to possess up to 12 mature cannabis plants, which “seems excessive.”

Secretary of State Alison Lundergan Grimes, a Democrat who formed a special panel last year headed by Sims to work on the legislation, told Brammer she hopes Nemes is serious about reaching a compromise. "Kentuckians overwhelmingly support medical cannabis," she said. "They are tired of waiting and will remember inaction at the ballot box in November."

The 2013 Kentucky Health Issues Poll found that 78 percent of Kentucky adults favored legalization of marijuana for medicinal purposes, and several legislators have said it is the issue that constituents contact them about most.

Grimes and Sgt. Dakota Meyer of Columbia, a Marine veteran who was awarded the Medal of Honor, wrote in a Herald-Leader op-ed that medical cannabis has helped several Kentuckians with varying health conditions, including Eric Pollack, who gets tremendous relief from marijuana for his PTSD and chronic pain suffered in combat. "Eric faces this impossible conundrum: be a criminal who is healthy at home or leave Kentucky for a place where medical cannabis is legal," they write.

So far, 29 states and the District of Columbia have authorized medical use of cannabis, including three neighboring states: Ohio, Illinois and West Virginia. Virginia and Tennessee are considering similar proposals this year.

The Louisville Metro Council overwhelmingly voted for a resolution urging lawmakers to pass a medical-marijuana law. Councilwoman Angela Leet told WDRB that of more than 600 responses to a survey, more than 90 percent of Louisvillians favor the idea. The Lexington-Fayette Urban County Government and the Bullitt County Fiscal Court have passed similar resolutions.

Proponents of the bill say medical marijuana would help people struggling with pain and other health conditions, noting that many people have already exhausted all other options and resources. Others say it would decrease use of opioids for pain.

Opponents, led by law-enforcement officers, say that medical cannabis would end up in the wrong hands, that it is often a gateway drug, that it sends the wrong message that marijuana is safe, and that we need more research on the long-term effects of the drug and whether it truly reduces opioid use.

#MeToo reminds health-care providers: trauma survivors carry experiences with them and need 'trauma informed care'

As millions of men and women joined the #MeToo social medial campaign to tell their stories of sexual abuse, harassment or domestic violence, Elizabeth Starr, a licensed clinical social worker, reminded caregivers that people who have had these experiences carry them with them into their health care settings.

In an opinion piece for the Louisville Courier Journal, Starr, who is also WellCare of Kentucky's manager of advocacy and community based programs, wrote: "Most of us know that if someone is in a bad accident, they may be scared to drive. And soldiers who experienced battleground trauma may be anxious during fireworks celebrations. But have you thought about the anxiety a rape victim may feel even years later, sitting alone, in a paper gown, in an exam room – or during the exam itself."

Star noted that health-care providers and others who attended a recent WellCare-sponsored conference learned how to create an environment where everyone is as comfortable as they can be when seeking care.

She used the term "trauma informed care," a phrase she said is used by those who work in mental health care to talk about ways doctors' offices, health clinics and hospitals can learn to recognize the signs of past trauma, understand that those traumas affect current mental and physical health, and to find ways to create a safe environment for everyone who seeks care .

For example, she notes the importance of making sure trauma survivors are comfortable enough to get the routine care everyone needs, like mammograms, pap smears and blood pressure checks: "We must eliminate all the barriers that keep people from these types of screenings - including the discomfort and fear that trauma survivors may feel."

Fort Campbell works to address post-traumatic stress disorder, common ailment of Afghanistan-Iraq veterans

Research shows almost 14 percent of veterans returning home from Iraq and Afganistan suffer from post-traumatic stress disorder (PTSD), and as an estimated 2 million veterans are coming home, Fort Campbell has quickly acted by reaching out to the medical community in Kentucky to help address the challenges of PTSD.

Top behavioral health and brain injury research experts came to Ft. Campbell on Tuesday to teach civilian behavioral health professionals about the military's current PTSD and brain injury research and treatments, reports Kristin Hall of The Associated Press.

PTSD can be one of war's ugly side effect, and it is an anxiety disorder that can develop after exposure to a terrifying event in which ther's potential for grave physical harm, such as "violent personal assaults, natural or human-caused disasters, accidents, and military combat," says the National Institute of Mental Health. Not properly treating PTSD symptoms can lead to alcohol or drug use, spouse or child abuse, depression or suicide

The clinics at Ft. Campbell will focus on PTSD and brain trauma treatment and will each have 13 mental health professionals to offer more personalized, focused care, which is expected to reduce "cases of psychiatric problems, spouse or child abuse, sexually transmitted diseases, suicides and drug use," like the pilot program at Fort Carson in Colorado, reports Adam Ghassemi of News Channel 5.

Some Kentucky veterans, like Mike Jeffrey who spoke about his physical and mental battles after his two tours in Iraq at a Veteran's Recognition Program, are addressing other problems associated with PTSD, which are that many veterans won't talk about it, and they both families and veterans lack awareness about treatment options. Jeffrey talked about the struggles he had when returning home and his "baby steps" toward normalcy.

“I woke up and had kicked down my apartment doors overnight without knowing it,” he said. “It was hell just living with myself,” reported Tracy Harris of The News Democrat. Jeffrey started counseling for his PTSD and is now using a service dog trained specifically for veterans, Seal Team.

“Seal Team is his security blanket,” said Jeffrey's wife, Shelly, who contacted four service dog organizations before finding K-9 trainer Mike Halley, a Vietnam veteran living in Florida, reports Harris. In addition to suggesting use of a service dog, Jeffrey said veterans shouldn't bury their own experience with PTSD, which many are reluctant to talk about.

“We all grew up in the suck-it-up-and-drive Army,” he said. “But you can only suck it up for so long,” said Jeffrey.

Efforts like the ones made by Ft. Campbell and Mike Jeffrey represent progress in treatment of mental health issues. And while these efforts alone won't address the problem, work within local communities can make a world of difference for struggling veterans.

Retired Maj. Gen. Mark Graham said "there is no quick way to eliminate the stigma often attached to seeking out mental health care, but the key is partnerships with the communities," writes Hall.

The story of returning veteran's is a big one that may be hard to cover, so click here for journalism tips. Click here to learn more about PTSD programs in Kentucky, or click the link below to watch news coverage about the behavioral health clinics in Ft. Campbell.

Ft. Campbell Opens Behavioral Health Clinics To Fight PTSD - NewsChannel5.com | Nashville News, Weather & Sports

New, 4-volume veterans' health handbook reflects UK expertise

It is not just about post-traumatic stress and re-entry into the job market anymore, as if it ever was. In topics as diverse as how to best get electronic medical records to how to treat the severely injured who would not have survived earlier wars, The Praeger Handbook of Veterans Health: History, Challenges, Issues and Developments has plumbed the expertise of 65 professionals -- many with ties to the University of Kentucky -- to teach anyone who cares how it's done.

Mary Meehan of the Lexington Herald-Leader reports that the editor of the four-volume set is Dr. Thomas Miller, professor emeritus and senior research scientist in psychiatry at UK, who began working on the handbook in 2006. The book makes wide use of Miller's many decades of work with veterans as well his network of experts from other countries.
 
 Miller told the Herald-Leader that he hopes the book will not only show people the scope of services available and how to get the help they need, but help shape the future of veteran care and by extension health care in the United States. The set is designed as a resource for libraries, health care offices and universities. It is available at online bookstores for $257. (Read more)

State task force will look at substance abuse, mental health care for military members, veterans and families

To help the increasing number of veterans and military service personnel who are needing treatment for substance abuse and mental health issues in Kentucky, a task force has been assembled to come up with strategies that show the most promise in providing care.

The team, made up of military personnel as well as health care experts, will go to a conference in Washington, D.C., to gain learn what is working elsewhere. The goal is to strengthen statewide behavioral health care systems and services, a press release from Gov. Steve Beshear's office says.

Over the past three years, the number of veterans seeking mental-health care has risen dramatically, according to the U.S. Department of Veterans Affairs. About 335,000 veterans live in Kentucky. There are also 45,000 active-duty personnel in Kentucky and about 8,400 members of the Kentucky Army National Guard and Kentucky Air National Guard.

"This is an extremely important and timely topic that requires collaboration across federal, state and local lines," said Col. David Thompson, executive director of the Kentucky Commission on Military Affairs. Task force members include Thompson; Maj. Gen. Edward W. Tonini, Kentucky adjutant general; state Rep. John Tilley, D-Hopkinsville; representatives from the Cabinet for Health and Family Services, the Kentucky Department of Veterans Affairs, military and civilian health facilities and the Kentucky court system. (Read more)

Caregivers of wounded soldiers find their lives are also changed; getting compensation

The wars in Iraq and Afghanistan disproportionately affect rural areas, which provide more than the average number of recruits. The soldiers who make it home alive come back changed, with traumatic brain damage, post-traumatic stress syndrome or other injuries that require full-time care. Mostly wives and older parents are left bearing the burden.

Catrin Einhorn of The New York Times reports that many caregivers have to quit their jobs and are forced to spend their savings and retirement funds to pay for treatment. A growing number of caregivers suffer from anxiety, depression and exhaustion as a result of their new routines. Rosie Babin, 51-year-old mother of a severely wounded 22-year-old son, was managing an accounting office before her son's injury. Though she's happy to have her son home alive, she now has to take blood-pressure medicine and sleeping pills. "I felt like I went from this high-energy, force-to-be-reckoned-with businesswoman to a casualty of war," Babin told Einhorn. "And I was working furiously at not feeling like a victim of war."

According to research by Joan Griffin, a research investigator with the Minneapolis Veterans Affairs Health Care System, most of the injured are in their 20s and 30s, making this the first time since Vietnam the V.A. has seen such an influx of youth, which extending the length of care to years and sometimes decades. On average, Griffin found that family members spend more than 40 hours a week providing care, making it nearly impossible for them to keep a job.

Organizations like the Wounded Warrior Project have tried to ease the financial burden on these families by lobbying Congress to provide direct compensation and other benefits to caregivers and their families. In 2010, the veteran's agency approved 1,222 applications and awarded monthly stipends of $1,600 to $1,800 to caregivers. Along with the money, they can receive health insurance and counseling, Einhorn reports. This law only applies to caregivers of service members injured after Sept. 11, 2001, and it's uncertain who will qualify and how compensation will be determined.
(Read more)

Fort Campbell using simulated battlefields to assess brain injuries

Doctors at Fort Campbell are using a mock battlefield to assess whether or not soldiers who have suffered a traumatic brain injury are ready to return to combat. The clinic has been recognized by the Department of Defense as a national model.

"Soldiers are making life and death decisions, so doesn't it make sense to use demonstrated competence as the standard for returning someone to duty?" Dr. David Twillie told National Public Radio's Blake Farmer.

In exercises meant to simulate scenarios they face when fighting in Iraq and Afghanistan, soldiers sweep a gravel road for possible roadside bombs, take fire from insurgents and are told to insert chest tubes and tie tourniquets while listening to sound from a scene in Saving Private Ryan. The goal is to assess how well the soldiers handle the stress of the situations. Patients must also take written tests that assess their competence. The combination of both simulated and written assessments is important.

"Very recently we had a soldier that had a desire to stay in, had done well in all our simulations," Twillie said. "But when all the different sights, sounds, smells came back, he just wasn't able to change his focus, and that's very important in combat."

Memory loss, mood swings and difficulties balancing are common symptoms of a traumatic brain injury. About 115,000 soldiers have experienced such an injury, the Defense Department estimates. (Read more)

Fort Campbell soldier who went AWOL, and says his Kentucky PTSD treatment was inadequate, is set to return to Afghanistan

A Fort Campbell-based soldier who went absent without leave because of alleged post-traumatic stress disorder will return to finish his tour in Afghanistan.

"My family doesn't want me to go, but I am not disobeying a command order," Spc. Jeff Hanks, 30, told Kristin M. Hall of The Associated Press. Hanks, right, said his mental health issues date back to a 2008 deployment in Iraq. Last year, he spent six months in Afghanistan, during which he sustained a concussion when a mortar landed near him. Since turning himself in on Nov. 11, 2010, he said he has been treated for nightmares and headaches and was told to get counseling when re-deployed. Hanks told the AP he does not feel his PTSD has been treated adequately.

Hanks, a married father from North Carolina, said he will likely serve another four months in the country to complete his one-year tour. He has committed to serve in the Army another two and a half years. A Fort Campbell spokeswoman told the AP that Hanks is scheduled to re-deploy in the coming days. (Read more)

Hanks was deployed overseas in May 2010 and did not return after a mid-tour leave in October, reports Jake Lowary of The Leaf-Chronicle in Clarksville, Tenn. After turning himself in on Veterans Day, the Army opted to send Hanks for treatment at a facility in Hopkinsville, Ky., rather than send him back to Afghanistan. (Read more)