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Sunday, January 7, 2007

Heart attacks and PTSD

Study: War Trauma May Raise Heart Risks

Associated Press Writer
I have no idea how to make that a link.
This is a really good study and about _______ time.
A few years ago, a famous psychiatrist [George Valliant, MD. I remembered!] whose name escapes me at the moment (Halfheimers, when you don't quite have altzheimers, or is it CRS... can't remember) did a study of all the WWII vets who had gone to Harvard. They had thorough medical histories of them when they got into Harvard, so they looked for PTSD in those who had seen combat. He, of course didn't find much (Ha ha. The old school) but he did find that by age 65 most of the WWII Harvard combat vets were either physically very ill or DEAD, which was incredible!
There have been other studies connecting PTSD with stress related diseases.
One of the earliest descriptions of PTSD, in Civil War veterans, was published in 1876. Dr. Da Costa described a set of heart symptoms and called them Soldier's Heart. My husband had this when he came back from Vietnam, but since it was old medicine, no one had ever heard of it, and they told him he could probably die of it anytime. Wonderful for a person diagnosed with "nervousness" since there was no diagnosis of PTSD at that time.
And when he had his last C&P exam a couple of years ago the young woman doctor didn't KNOW that no one was diagnosed with PTSD in 1968 because the Diagnostic and Statistical Manual II of the American Psychiatric Association had no such diagnosis. As a matter of fact, they had just discarded the "Gross Stress Reaction" of the first edition and decided, on no scientific evidence whatsoever, that if a trauma affected you for more than 6 months, you were screwed up before the trauma...
How could a person like that be doing compensation exams for the VA? Of course she was better than Umesh Mahtre, MD, who asked my husband how he was doing. Bob said "about the same." They talked about flying for a few minutes. We thought he was trying to put Bob at ease, but that was the end of the interview and his report was, "The patient reports no problems." He was famous among the local veterans for never seeing PTSD even when it was in his face.(If this has happened to you, the exam is "inadequate for compensation purposes" and you can immediately in writing ask for another exam on that basis.)
The VA compensation system (which is different from and separate from and, as far as I can see, IGNORES the doctors at the VA Hospitals and other treatment facilities) in many areas of the country does it's best to see that those who need help die before they get it, some of the deaths no doubt brought on by stress related heart attacks.
If you want to help, write your representative and senator and ask for more funding for treatment at the VA, and for forced retirement of any old hack in the VA Compensation system who routinely denies PTSD claims or denies them with insane criteria such as this one, which a friend of mine received: "Since you were an infantryman and seeing the death of a friend in combat is not outside the range of usual human experience for an infantryman, you do not have a traumatic stressor." Totally wrong, but he still may have his job...


  1. I love reading your blog Patience! Thank you for sharing it! I do disagree about understanding trauma. By definition,
    1. The quality or condition of one who understands; comprehension.
    2. The faculty by which one understands; intelligence. See Synonyms at reason.
    3. Individual or specified judgment or outlook; opinion.
    a. A compact implicit between two or more people or groups.
    b. The matter implicit in such a compact.
    5. A reconciliation of differences; a state of agreement: They finally reached an understanding.
    6. A disposition to appreciate or share the feelings and thoughts of others; sympathy.
    1. Characterized by or having comprehension, good sense, or discernment.
    2. Compassionate; sympathetic.


    The second statement you used was more accurate. No one can know what it was like to be in combat if you weren't there. Anyone can have a comprehension of the effects of trauma, and be compassionate and sympathetic. Matter of fact, no one I know has more understanding about the affects of ptsd than you my dear friend and Mentor. I think it's safe to say that you understand the symptoms of ptsd and how they affect our lives.
    LOL, how would you speak rationally to this automatic thought
    "I can't possibly understand ptsd!"
    I can understand what it does to you, and what the survivor skills do for you.
    Even though I don't know what it's like to be in a war zone. I think there's a differance between knowing, and understanding too. One of the reasons ptsd sufferers don't talk about their experiences is because they belive (possibly irrationally?)that NO ONE can understand. Frankly, it scares me to think of anyone telling a survivor I can't possibly understand (comprehend,have compassion and sympathy) what you've experienced.How likely is a survivor to be willing to share their misery with you if you tell them I can't understand?

    What gets me is the way people act surprised that ptsd affects the heart. Anyone who actually has ptsd knows that reality first hand.I was reading this the other day. In "Feeling Good" by David Burns, : "Drugs that are categorized as sympathomimetics are particularly dangerous because they are contained in many over-the counter drugs for common ailments such as colds. They are called sympathomimetics because they tend to mimic the effects of the sympathetic nervous system, which is involved in the control of blood pressure."

    Having my own first hand experience with ptsd, at times it bothers me that it's catagorized as a "mental disorder" What's the first thing that happens when a person with ptsd doesn't feel safe or in control of their environment, when they feel threatened in ANY way? The sympathetic nervous system is triggered to fight or flee. (freeze too, but in my experience, that only happens when a visious dog is around. Opps, or a visious husband perhaps, LOL) And, since the sympathetic nervous system controls blood pressure, what's the first thing that's going to happen? The blood pressure shoots up.

    If you live with a stress disorder, and experience any stress, it's normal to have high blood pressure because your sympathetic nervous system is working in overdrive. It doesn't even have to be major stressors. A door slams, a cell phone rings unexpectedly, the dog barks, or my vet barks, and bam, the heart is pounding blood to give me energy to fight or flee. Jim has to take medication to lower his blood pressure. Most veterans with ptsd that I know do too. Yet, as far as I know, the VA doesn't compensate them for high blood pressure secondary to ptsd. (which is really primary I guess because it's a symptom?) It may happen in rare cases, but generally I think high blood pressure is overlooked.

    When my ptsd was out of control, my doctor gave me a perscription for Inderal. I think it's a beta blocker. I read in Dr Burns book that it's also perscribed for seizures. I never took it, but I did feel better knowing I had something if I couldn't get my high blood pressure under control myself. The first drug Jim took for high blood pressure was a beta blocker, Attenenol. I think it's the most commonly perscribed blood pressure medication for vets because it costs the VA about half a penny a pill. The doctor warned Jim that sexual side effects were common, so when he had those side effects, he was too ashamed to talk about them, and since he knew it was a side effect, he thought he just had to live with it. Not being able to make love to his wife was so depressing for him, he didn't feel like a man anymore, that he often had death wishes. Eventually the medication was changed to a calium channel blocker and in time, his numbness wore off. For a while he was scared the feelings would never return. Even with the new drug, he says he misses the excitment, the way his heart would pound when he was having sex, or hunting. I wasn't willing to sacrifice my feelings, so I used biofeedback instead to control my heart. It works for me. (last night I was afaid I was going to have a heart attack because I was working around the house like a mad woman, and I was so pumped up. I eventally noticed my heart was beating too fast.It was nice to have all that energy, but I have a damaged heart so it scared me. Then the fear of having a heart attack makes it beat faster. So, I laid in Jim's arms while I calmed and cleared my thoughts, and practiced deep breathing, and my heart rate went back to normal) I can do that anytime my sympathetic nervous system is activated but it takes practice to keep it under control.

    The sympathetic nervous system is an appropriate name. I would like to see ptsd reclassified as a central nervous system disorder. That alone may dispel the stigma that comes along with ptsd, and people feeling there is something wrong with them for having it. My brain knows I am safe when a cell phone rings. My sympathetic nervous system hasn't gotten that message yet, LOL. It's hardwired to look for danger, and to react.It's normal for the heart to race and blood pressure to sky rocket when you feel in danger.

    For those of us who love a combat veteran with ptsd, who don't suffer from the disorder themselves, having sympathy for them will activate your sympathetic nervous system too. If you think your veteran is in danger, your heart rate will excelerate, that's normal. If he's abusing drugs or alcohol for example, or driving wrecklessly, your heart rate will excelerate when your scared. It's part of the stress response, in anyone. People with ptsd are scared, a lot of time. (whether they acknowlede it yet or not) If there's a lot of stress in your home, you might suffer from chronic high blood pressure too.

    Why do the proffesionals act like it's some big mystery that people with ptsd die early or have heart conditions? It's basic science. Plus, stress is a bigger predictor of death than even heart disease and smoking. Maybe they can't know because they haven't experienced Post Traumatic Stress Disorder first hand?

    I love you sissy. Thanks for listening to me rant this morning. Keep up the excellent work angel face. Big healing hugs and all my love, Chris

  2. I am a two tour VietNam veteran. Flew DustOff '67-'68 , flew Chinooks "69-'70. I was shot down 5 times and wounded once flying DustOff shot down twice in Chinooks. Because I was able to remain on active duty flying helicopters for quite a while my PTSD did not surface right away due to self medication with adrenalin and alchohol. When I was no longer able to fly for the Army due to needing 8 separate medical conditions waivered I was given a ground job and was in the hospital in less than a year. I still have no clear recollection of the events that put me there. I managed to retire before being medically boarded out. I now know that I have had PTSD since 1970 at least and have been diagnosed with Congestive Heart Failure for the last 10 years that I know of. I believe you when you say that heart disease is related to PTSD. It just makes so much sense when you consider it. I am already rated at 100% by the V A but I know my heart disease is not part of the rating I suppose we will have to get a VA Psychiatrist to do a paper on the subject and then await the acceptance of the causation.

    I am glad to hear that you have been able to control your heart with calming techniques.

    I met Patience at a gathering of Wounded Warriors in Montana a few years back. I hope she is thriving as well as she seemed at the time.

  3. Very useful article and bother other replies give me more knowledge. During the 10 and 15 years after completing the questionnaires, the vets with more PTSD symptoms were more likely to have heart attacks. Although the men had different levels of PTSD symptoms, very few had enough symptoms for a certain diagnosis.