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Deployed servicemembers and civilian contractors suffering from the No.
1 disease non-battle injury are benefiting from a new procedure offered
at Landstuhl Regional Medical Center.
Heart-related problems are the second most common condition among
patients medevaced to LRMC from Afghanistan and Iraq. For those
requiring a stent to open clogged arteries, LRMC has treated 120 people
since its angioplasty center began offering the nonsurgical treatment
about a year ago.
Prior to the Global War on Terrorism, the procedure was not available
at LRMC and patients were either treated at host nation medical
facilities or by transporting patients back to stateside hospitals.
However, such local support proved costly and became complicated when a
large population of older servicemembers and civilians began deploying
to Afghanistan and Iraq in support of the GWOT, said Lt. Col. (Dr.)
Chris Thompson, chief of cardiology at LRMC.
About 50 patients arrive monthly from downrange suffering heart
problems, with an average of four of those suffering from heart
attacks. The two cardiologists on staff were qualified to perform a
cardiac catherization, which injects an iodine dye into heart arteries
to reveal blockages viewed on a computer screen. But those requiring a
stent to allow proper blood flow were sent either to the University of
Saarland at nearby Homburg, or, if the patient was deemed stable
enough, to Walter Reed Army Medical Center in Washington, D.C.
Patients received high-quality treatment at the German medical
university, but transporting patients to and from Homburg added two
additional moves. For some patients, Dr. Thompson said, their journey
to LRMC, which can vary anywhere from 12 to 24 hours, already consisted
of treatment at a forward operating base, a secondary medical treatment
facility, and a stay at Balad Air Base in Iraq which serves as the main
hub for medevac missions for Operation Iraqi Freedom.
Upon hearing of the need for an interventional cardiologist qualified
for the stent procedure, he convinced medical officials to allow him to
conduct a two-month study in 2005.
After conducting 15 procedures during April and May, Dr. Thompson was
convinced the need was valid, but creating a new position had more than
the usual bureaucratic challenges because there are a limited number of
interventional cardiologists in the military.
The solution seemed to come from a “Higher Power,” said Dr. Thompson –
or perhaps the work of an angry Mother Nature. The devastation of
Hurricane Katrina at Keesler Air Force Base, Miss., left two of his
counterparts without a hospital, and one of them was willing to assume
his role at Wilford Hall Medical Center, Texas. Since then, Dr.
Thompson was joined temporarily by fellow interventional cardiologist
Navy Commander Michael Ferguson, who was deployed to LRMC from the
National Naval Medical Center in Bethesda, Md.
Even after arriving at LRMC in July 2006, Dr. Thompson said there were
still doubts about the need for a full-time interventional
cardiologist. However, the composition of older servicemembers and
civilians serving in Afghanistan and Iraq proved differently. The
average patient he sees is about 48 years old, which is about the time
one is more prone to cardio risk factors such as high blood pressure,
high cholesterol as well as the effects of smoking. About 50 percent of
those treated are civilian contractors.
The success of the program has exceeded expectations, said Dr.
Thompson. So far, there have been no complications or heart attacks
related to the stent procedure, both are statistically below the
national average. And financially, the effect of performing the
treatment in house has created a savings of more than $2 million.
But the main issue, said Dr. Thompson, is the willingness of military
medicine to go that extra mile to serve the needs of its patients. “I think it’s comforting for everyone to know that if they are in Iraq,
and whether they are severely injured by an IED or start having a heart
attack, the military really spares no expense or trouble giving the
best care and as soon as it possibly can,” said Dr. Thompson.
