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Scott Webb (Host): Veterans need and deserve compassionate treatment for their mental and physical trauma and wounds. And joining me today to discuss the plight of veterans and how Sierra Tucson is working to assist both our brave veterans and first responders, is Bill Reynolds. He's a retired Naval Veteran and Director of First Responder and Military Trauma Recovery at Sierra Tucson.

This is Let's Talk Mind, Body, Spirit by Sierra Tucson. Sierra Tucson ranked number one best addiction treatment centers, 2020 in Arizona by Newsweek. I'm Scott Webb. So Bill, thanks so much for your time today. When we think about the plight of veterans, maybe you could describe what that means and maybe help listeners understand the conditions that they face.

Bill Reynolds, PA-C (Guest): When I say the plight of the veterans, there's a lot of issues that are facing our current veterans. And especially the United States is leaving Afghanistan after having been there for 20 years. And, you know, for 20 years, there's a lot of veterans that have deployed multiple times, not only to Afghanistan, but also to Iraq. And it's just been a very, you know, high intensity time in the military, for 20 years. We've never been involved in wars that long.

Some of the big ticket items are homelessness. Certainly we have substance use disorders. You know, alcohol by far is the most common substance. More and more vets struggling with opiates. Many veterans have been injured severely while serving overseas and they come back and they have chronic pain. And then of course we have PTS, which has post-traumatic stress.

And I don't like to say the word disorder with that. It's not a disorder. PTS is a normal reaction to an abnormal situation. So, and then of course we have, you know, traumatic brain injury. So there's a lot of our veterans that are coming back with pretty severe, not only emotional, but physical injuries as well.

Host: Yeah, I think you're so right. And when we think about the massive commitment that we've made in being involved for 20 years and all the veterans going there and redeploying and what they're coming back with. And as you say, a lot of them are suffering from PTS. So maybe just to kind of set the stage for listeners, how do you define PTS and what does that really mean for our vets?

Bill: So PTS, more commonly known as PTSD you'll hear in the media, is not only something that affects veterans. It's not uncommon in civilian society with people that suffer, you know, abuse, childhood abuse or sexual abuse, but with veterans it's typically PTS involves being exposed to a traumatic event, you know, and basically fearing for your life. It's an episode of intense terror. And what happens is some people develop symptoms of hypervigilance, you know, where they just can't relax. They're always on the alert. There's a term called hyper-arousal. And that refers to your nervous system. You know, normally we just go into fight or flight mode when we have to, right, like if I see a bear, I'm going to go into fight or flight mode, I'm going to run, well, a lot of vets stay in that mode. Some people, some of the vets have nightmares. Some of them have what's called intrusive thoughts. And some people that have PTS, just kind of feel numb inside.

Like they don't feel the same. Like they can't feel the same emotions that they had before they were exposed to trauma. Not every veteran has PTS. I want to be clear about that. Some people, whether it's from resilience or, you know, whatever, you can have two guys in the same foxhole and one comes back and he's got PTS and the other one doesn't. But, yeah, it's not uncommon. It's estimated I think 15 to 17%, is the PTS rate amongst veterans.

Host: Yeah, I think you're right. You know, I think a lot of us do associate PTS or PTSD with those who serve, but that's really more a people thing, a human thing. We all suffer from this, as you say, whether it's something from childhood or whatever it might be, think, especially your analogy that fight or flight, you know, some of us fight when there's a bear and some of us choose the flight option, a really good analogy. And I think we can all kind of connect to this. So I'm wondering what are some of the treatment options for veterans suffering from mental and physical effects of serving? And are there any new treatment options that you're kind of excited about telling listeners?

Bill: The VA, the Veterans Administration is an extremely busy organization. I don't think that when we went into Afghanistan, we ever anticipated that we would be there this long. So the VA is, they have their hands full. There's a new law or an act that went into effect that if the VA cannot provide those services to the veteran within 30 days, they have to be sent out in town. So, here at Sierra Tucson, we have more than a few VA people here at the Red, White and Blue Program. The big treatment is part of it is, is medication. You know, medication can certainly help. And when I say medications, I'm not talking about meds, like, you know, Valium and Klonopin, which are very addictive meds. It is indicated sometimes short term, but the kind of the cornerstone medications are your SSRIs, you know, medications like Prozac or Zoloft, things like that, but even more important than medications is therapy, right?

So there are many different types of trauma therapy that are available to veterans. One of them is called EMDR. Which is a eye movement desensitization reprocessing. There's another one called somatic experiencing. We have cognitive processing therapy. So there's a variety of individual treatments and, you know, vets like to be around other vets too.

So, you know, working in process groups, support groups, and just basically feeling like you're not alone is a big cornerstone of that. Now, as far as like new treatments go, the VA is researching, hallucinogenics like ketamine, that's not widely available as of right now.

There's another treatment called stellate ganglion block injection, which is a procedure where you go into the operating room and you get an injection into the specific nerve that can sometimes help diminish symptoms. So, the research is always changing as far as treatment goes. The other thing too is, not every vet, but most vets have some kind of substance use thing going on because it's natural to some degree to self-medicate. Right? We have to get them sober. And getting people appropriate treatment for alcohol or other substance use is cornerstone, because you can provide the best treatment in the world for somebody that has PTS, but if they're drinking and smoking weed and taking drugs, it's not going to be benefitial.

Host: Yeah, I see what you mean. And I didn't want to skip over this. You mentioned the Red, White, and Blue Program. I wondered if you could tell listeners about that?

Bill: Yeah, sure. First of all, a little bit just background on me. I did 30 years in the Navy and I was in Navy Medicine and I got out in 2012. And then, you know, I've been at Sierra Tucson for about seven years and we started a program called the Red, White, and Blue, which is specifically for our military veterans and also for first responders.

So when anybody comes to Sierra Tucson, you know, we'd have like a PTS program. We have a mood program, we have an addiction program. The Red, White, and Blue is specialized for that population. And we do not do cookie cutter treatment here. It's a little bit more intimate, I guess, is the best way to describe it.

For example, we have a Memorial here on campus where we met this morning. I brought the guys in coffee and we did the pledge of allegiance and we had a moment of silence and we just individualize the services they need. And I'm telling you, when you meet another veteran or, you know, like a veteran meets a first responder, there's sort of an instant brotherhood, instant sisterhood.

So it's that camaraderie. And, you know, coming back to what I said about not feeling alone. So we also have a chronic pain program. We have a physical therapist. So we basically, for my program, we treat the whole person. We don't just prescribe meds and say, okay, you're going to be good. It's a variety of different therapies. Physical examinations. We do blood work on people. I mean, we look at the whole person and that's the best way to do treatment.

Host: Yeah, I agree. And I just love the Sierra Tucson model, the mind, body, spirit approach, treating the whole person. And of course we just passed a Veteran's Day. Thank you for your service. Yeah. And I'm sure you're so right. There's just sort of, I don't know if it's a safety in numbers, but there's just that, that instant comradery, you know, between vets who've served and first responders.

So what a cool program and you know, this time of year, especially as we head into the holidays, I want to know, and I'm sure listeners do too. How can we best support veterans and not just this time of year, not around just the holidays, but really all year long?

Bill: You know what we're hearing a lot commonly as many people thank us for our service, which is nice. I mean, the current generation of veterans, certainly is supported by the vast majority of Americans. And that's in stark contrast to the people that came back from Vietnam. I mean, not only did they suffer, you know, there's a lot of PTS associated with their service and it was actually Vietnam veterans that pushed to have the formal diagnosis of post-traumatic stress disorder created. A little trivia for you.

But yeah, just acknowledging vet, you know, saying thanks, asking him about his service and just having a little bit of interest. It doesn't take much. I mean, you know, most veterans are pretty low maintenance and we don't really like a lot of attention, but just acknowledging them because you know, less than 1% of Americans serve in the military. So it's kind of a big deal for people that choose to sign up on the dotted line.

Host: Just shifting gears a little bit. When we think about the workplace. And it's probably not been an easy time for employees and also HR directors during COVID. But when we think specifically about vets, how can HR directors, you know what can they do to support those who have served so bravely?

Bill: So, first of all, I'm not an HR guy, but I can tell you what appeals to me. And I think the biggest thing, you know, there are certain companies out there that have branded kind of programs for their military. Like some of your larger organizations, like, you know, Amazon or FedEx, whatever. But I think even for, you know, most companies, which obviously are smaller, just being able to identify your vets. Like I've worked at places where HR was completely unaware of who was a veteran. You know, so like for veteran's day, you know, honoring those. Many veterans, require special assistance, like for disabilities or whatnot. And I think just having a really thoughtful program of some type, for example, the onboarding process, sitting down face-to-face with an HR person and having them ask about your military service and seeing if there's any special accommodations that need to be taken.

There are a lot of veterans that have service connected disabilities and that you know, that doesn't necessarily mean like they're in a wheelchair. I mean, a lot of it is post-traumatic stress, for example. So I think just a welcoming attitude is probably the best thing any HR company can do. And I'm sure there's all kinds of resources out there for veterans associated with HR.

Host: Yeah. I think you're right. I think one of the things that happens is it's sometimes people conflate politics with serving and those things kind of get co-mingled and the reality is, listen, if they signed on the dotted line, if they served, like you did, served our country bravely, then they should be treated as such, treated as heroes that they are, maybe not more special than anybody else, but just acknowledge them. Right? Ask, did you serve, what was that experience like? Are there any accommodations that we can make for you mentally, physically, or otherwise just seems like such a basic human thing, but I'm so glad you spoke to that today. And, you know, as we wrap up here, anything else you want to share with listeners about PTS or PTSD, about the Red, White, Blue Program, about how Sierra Tucson can help veterans?

Bill: So with Sierra Tucson, specifically with the Red, White and Blue Program, we get people from, VA's all around the country and there's kind of a, you know, a funny saying that we have, it says if you've seen one VA you've seen one VA. They're all very, very different in how they operate. So each VA does have an office of community care. And if there's any veterans out there that are struggling and they, you know, their local VA cannot provide the services, you know, I would strongly encourage them to engage with the community care network and say, hey, I want to go to a program that's, you know, veteran specific. But the biggest thing, Scott is just engage with the veteran.

Not every veteran has seen heavy duty combat. So, not everybody has post traumatic stress, obviously. So, just engaging with them and don't be afraid to ask the question. Also, if you notice that one of your veterans is struggling, you know, like calls in sick frequently, or maybe suspected of drinking or just having difficulty getting along with others, just bringing them in and asking them if you know what's going on. There's no shame in seeking treatment. I guess that's what I'm trying to say. Oftentimes the hardest questions are just approaching somebody and saying, hey, do you need some help? You know, and being encouraging of that. We've had a lot of people that come here for treatment that have wonderful support from their employers.

And when you have that support from your HR department, I mean that really kind of lights a fire under the veterans, like, okay, I'm going to do this. The last thing I wanted to add Scott, is there are a plethora of resources available for not only veterans, but also for employers that may just want to learn more about some of the challenges that our vets are facing. The VA has a website it's called the National Center for PTSD. If you type that in your search engine, it will come up and it is just such a well-designed website with tons of information. I mean, it even has a video there on cultural competence, like how to deal with the military culture, which HR departments may find interesting, but it doesn't just talk about post-traumatic stress. It has information on like traumatic brain injury, military sexual assault, and it's just got a bunch of very well done educational videos, if anybody's interested in learning more about the veteran. Great website.

Host: I think you're just so right. Not All veterans have PTS. They just want to be treated fairly, treated as people, acknowledged for their service. And we of course want all the vets to know about the Red, White, and Blue program, the services that are available at Sierra Tucson. So Bill, this has been really great. I wish we could speak longer, but maybe next time, thanks so much. And you stay well.

Bill: All right, Scott, take care, man.

Host: Visit Sierratucson.com or call 800-842-4487. Sierra Tucson, we work with most insurance. And if you find this podcast to be helpful, please share it on your social channels. And be sure to check out the full podcast library for additional topics of interest. This is Let's Talk Mind, Body, Spirit from Sierra Tucson. I'm Scott Webb. Stay well.