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camidonHP

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Posts posted by camidonHP

  1. IF you already have a service-connected mental disorder, you might be able to get OSA connected:

    Here's the research I have on the relationship(s) between Obstructive Sleep Apnea and mental disorders:

    Correlation/Comorbidity between OSA and PTSD
    Sharafkhaneh et al (2005) Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort SLEEP, Vol. 28, No. 11
    "Our data show that the prevalence for comorbid psychiatric conditions is significantly higher in individuals with diagnosed sleep apnea than in individuals not diagnosed with sleep apnea.
    This pattern was most pronounced for mood disorders (depression and bipolar disorder), PTSD, and other anxiety disorders."
    “Our data strongly support an association between sleep apnea and PTSD.”
    11.85% of the PTSD group has OSA, compared with 4.74% of the non-PTSD group. Odds ratio=2.70
    (Note: Also supports depression/anxiety as secondary to sleep apnea.)
    Krakow et al (2001) Complex Insomnia: Insomnia and Sleep-Disordered Breathing in a Consecutive Series of Crime Victims with Nightmares and PTSD BIOLOGICAL PSYCHIATRY 949 49:948–953
    Study of crime victims with PTSD. “Sleep-disordered breathing was diagnosed in 40 of 44 patients; 22 patients met OSA criteria.”
    Sharafkhaneh et al (2005) Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort SLEEP, Vol. 28, No. 11,
    Compared the prevalence of sleep-apnea diagnoses in subjects with and without specific psychiatric diagnoses. 11.85% of the PTSD group has PTSD, compared with 4.74% of the non-PTSD group. Odds ratio=2.70
    PTSD Causes sleep disturbances
    Orr (2011) Sleep Disturbances and Posttraumatic Stress Disorder Medscape Pulmonary Medicine
    This isn’t peer-reviewed, just a web article, but is a good review of research that shows sleep disturbances are related to PTSD. The only time it mentions apnea is when it references Krakow (2011)
    Krakow et al (2002) To Breathe, Perchance to Sleep: SleepDisordered Breathing and Chronic Insomnia Among Trauma Survivors Sleep and Breathing/volume 6, number 4
    Good review of research that shows higher rate of sleep disordered breathing and fragmentation.
    Sleep Deprivation Causing or Worsening Apnea
    Series F, Roy N, Marc I.(1994) Effects of sleep deprivation and sleep fragmentation on upper airway collapsibility in normal subjects. Am J Respir Crit Care Med 150:481–5
    Sleep fragmentation (such as is prevalent in PTSD [see: van Liempt, 2011]) increases the propensity for upper airway collapse in patients with sleep apnea.
    Krakow, 2001 Complex Insomnia: Insomnia and Sleep-Disordered Breathing in a Consecutive Series of Crime Victims with Nightmares and PTSD
    Guilleminault C, Rosekind M. (1981) The arousal threshold: sleep deprivation, sleep fragmentation, and obstructive sleep apnea syndrome. Bull Eur Physiopathol Respir. 1981;17(3):341-9.
    Shows that sleep deprived patients have increased frequency and length of apneic events, similar to the effects of alcohol.
    (Also useful for nexus, as it talks about how prolonged shift work (such as military watches) can cause the sleep deprivation that worsens apnea. )
    Leiter JC, Knuth SL, Bartlett D Jr (1985) “The effect of sleep deprivation on activity of the genioglossus muscle)” The American Review of Respiratory Disease [132(6):1242-1245]
    Sleep deprivation appears to increase the severity of obstructive sleep apnea, due to decreases in genigoglossus activity.
    Eckert et al (2011) Sleep Deprivation Impairs Genioglossus Muscle Responsiveness Am J Respir Crit Care Med 183;2011:A6163
    These data indicate that acute sleep deprivation leads to potentially important reductions in genioglossus muscle activity. In particular, muscle responsiveness to chemical (hypercapnia), and mechanical (resistive loads) stimuli is impaired by approximately 60% following acute sleep deprivation. These data suggest that sleep deprivation may initiate or worsen OSA, at least in part, via impaired upper airway dilator muscle function.
    Persson, Svanborg (1996) Sleep Deprivation Worsens Obstructive Sleep Apnea Chest. 1996;109(3):645-650
    Showed an increase apneic events and longer apneic events after sleep loss.
    PTSD decreases Slow Wave Sleep, which worsens apnea
    McSharry et al (2012) A Mechanism for Upper Airway Stability during Slow Wave Sleep SLEEP, Vol. 36, No. 4, 2013
    This shows that the severity of apnea is diminished during slow wave sleep. The next study shows that slow wave sleep is greatly diminished in PTSD.
    Fuller, K. H., Waters, W. F., & Scott, O. (1994). An investigation of slow-wave sleep processes in chronic PTSD patients. Journal of anxiety disorders, 8(3), 227-236.
    “Overall, PTSD subjects had a decreased percentage of slow-wave sleep relative to controls, which may explain their increased arousals during the first half of the night.”
    Stress from PTSD symptoms worsen OSA
    Nakata et al (2007) Perceived job stress and sleep-related breathing disturbance in Japanese male workers Social Science & Medicine 64 (2007) 2520–2532
    Shows that sleep-disordered breathing increases with proportion to occupational stress, as well as anxiety and depressive symptoms. (Kind of a weak paper, scientifically, though.)
    Sleep Deprivation/Fragmentation occurs with PTSD
    van Liempt et al (2011) Decreased nocturnal growth hormone secretion and sleep fragmentation in combat-related posttraumatic stress disorder; potential predictors of impaired memory consolidation Psychoneuroendocrinology (2011) 36, 1361—1369
    Sleep was more fragmented in patients with PTSD, with more awakenings in the first half of the night. (Also shows that these awakenings lead to lower GH production, which may explain the memory problems in PTSD patients)
    Insomnia and other sleep disturbances occur frequently in patients with PTSD and they can be severe.
    Sleep problems worsen PTSD
    Belleville, Guay, Marchand (2009) “Impact of Sleep Disturbances on PTSD Symptoms and Perceived Health” The Journal of Nervous and Mental Disease Volume 197, Number 2, February 2009
    The present study highlights the important role sleep plays in PTSD. Sleep appears to have a unique contribution in accounting for the severity of PTSD symptoms. Sleep also impacts how individuals with PTSD perceive their own mental health. Most individuals with PTSD present significant sleep difficulties regardless of their clinical presentation.
    Spoormaker (2008) Disturbed sleep in post-traumatic stress disorder: secondary symptom or core feature? Sleep Med Rev. 2008 Jun;12(3):169-84.
    This article is about how PTSD may be worsened or aggravated by sleeping issues, and suggests sleep disturbances may be risk factors for PTSD.
    Benzos/Meds worsen apnea
    Dolly FR, Block AJ. Effect of flurazepam on sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic subjects. Am J Med. 1982;73:239–43.
    Hanly P, Powles P. Hypnotics should never be used in patients with sleep apnea. J Psychosom Res. 1993;37:59–65
    Berry RB, Kouchi K, Bower J, Prosise G, Light RW. Triazolam in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 1995;151:450–4.
    Hope this helps!
  2. This should be enough to show that it's at least as likely as not that PCBs were in the smoke from the fire, as long as you have documentation for the fire.

    "It has been reported that of about 1.4 billion pounds of PCBs produced in the U.S. between 1929 and 1977, about 750 million pounds are still in use in some form. Approximately 25% of this is estimated to be associated with the electrical utility industry where PCBs are used primarily in two types of equipment: transformers; containing mixtures (askarels) of PCBs and PCBZs, and capacitors; containing only PCBs

    . .. As discussed, various researchers have shown that PCDFs are formed when PCBs are heated and that PCDFs and PCDDs are fonned when PCBZs are heated. It is therefore possible that large-scale formation of PCDFs (and PCDDs) from PCBs and askarels could occur. Fires involving electrical equipment or inefficient PCB incineration may give rise to conditions ideal for the formation of PCDFs and PCDDs.

    Formation of Polychiorinated Dibenzofurans and Dioxins during Combustion, Electrical Equipment Fires and PCB Incineration

    (oops, I saw someone already linked to that one. Although mine's the full pdf.)

    "At Paducah, various types of cable insulation were analyzed and many samples tested had positive results ranging from 41 parts per million (ppm) to 3446 ppm PCBs. Then in 1996, PCBs were found in electrical cable from an old test reactor at the Savannah River site. At Savannah River, the PCBs may be linked to facilities with specifications for fire protection, heat or thermal cycling, water proofing, and/or chemical resistance. This is consistent with findings of the U.S. Navy, where many vessels utilize transformers, wiring, and other components that contain PCBs."

    in Hazardous Materials Management: PCBs in Insulated Electrical Cable, Lessons Learned from Electrical Upgrades at the Holifield Radioactive Ion Beam Facility at the Oak Ridge National Laboratory

    "EPA believes it is often practicable to remove non-liquid PCBs. including: air handling system gaskets; robber; plastic; dried applied paint that is flaked-off; electrical cable insulation;" "

    EPA Letter to the navy regarding sinking Navy boats.

    "In 1990, the US Navy contends that, in many instances, the jackets insulating wire cables on Navy vessels contained PCBs in concentrations greater than 50ppm." (See: statement of facts #11)

    PCBs aboard the USS Lexington

  3. My opinion has been that the culprit is TCP from my limited research. It is heavily present in hydros, it is also in pesticides and I believe has been indicated in both AO and GWI and I see no possible scenario where it was not present in the burn pits we both got "used to" during our time there. Here is the problem I keep running into though, stated on MSDSs and here directly quoted from the UN report: "There is no direct information on absorption via the inhalation route." Herein lies a problem for vets trying to claim burn pit issues. My opinion of the reality of the burn pit registry? We are the test group because...(Again, UN report quote) "There is wide interspecies variability for the various toxic end-points (e.g., acute lethality, delayed neurotoxicity) of TOCP exposure..."

    In reality, they don't know and by not knowing and not giving benefit of the doubt they have made themselves inculpable. I am fortunate (I guess), in that I had diagnostics done for many nerve issues on AD and they are all in my SMRs. I am expecting the government to be in a position where they cannot try and force an impractical Nexus. That seems to be their #1 way to screw people out of their disability awards for issues like ours. If I had gotten out when they wanted to medically retire me, I would be in a bad place with a lot of difficulty proving connections, like you, and if I come across anything I think may help, I will share it. I feel they know more than they let on (I believe there is a similar thread thru AO/GWI/Burn pits, etc and we are the confirming or refuting data that will be used by doctors and scientists in the future to prove or disprove varied lofty hypotheses, mostly to the betterment and defense of corporate enterprises and not individuals. But, heck, what do I know? It's probably just the PTSD, right? It's not like there is a long history of these things happening, even predating the industrial revolution. Man, I sound like some conspiracy theorist!

    I honestly don't know enough about TCP to be able to state for sure, but I plan on doing some research on it now that you've brought it to my attention. As far as a common thread between AO and Burn pits, there is definitely evidence that there was/is TCDD (the dioxin contaminant found in AO) in burn pit smoke as well.

    I think the VA tends to pick and choose which data they use to make decisions, or else maybe use a magic 8 ball of some sort. They don't acknowledge salivary gland cancers as being caused by AO, but yet there are studies showing that vets exposed to agent orange had seven times higher risk of salivary cancers than would normally be expected.

    I'm really sorry you're going through such hardship. I can't believe how difficult they make this process on vets.

  4. Not trying to sound ungrateful, these are excellent posts with grand research. In my case, I've had more exposure being a tank rat with my Air Force federal employee career. However, in Iraq I and others were breathing in that burn pit smoke for at least 9 months. Trying to find a doc to put it in medical terms with the bridge to tie it to service has been an insanely difficult task. In my particular case I believe it's a combination of both, however, skin exposure to jet fuel I totally feel and believe that would be more likely to be related to my time as a kc135 tank rat. Unfortunately in DOL there is no benefit of doubt.

    I will defend definitely look at those. Both my hand and ITP claims are headed to DC. Might be fun, and maybe it will time out to be in DC for both my appeals. VA and DOL. Haven't seen the White House in quite a few years.

    Also look at smoke from Oil Well fires. Burn pits and oil well smoke, especially in combination, are like the perfect storm of chemical exposures. I mean, there's just so many chemicals that are plainly harmful to so many systems, from TCDD (the Agent Orange contaminant) to vinyl chloride. I mean, there's just so many.

    Not exactly sure on what you're trying to get service connected, but as far as hypothyroidism:

    -Sometimes, the closest cohort to study with regards to burn pit exposure are firefighters, as burning household good are supposedly what's burning in burn pits (I'm sure in reality, there's way more toxic stuff in burn pits.) This study found a nearly two-fold increase in the incidence in thyroid cancers in firefighters. Same researcher, this time studying cause of death of the firefighters found a nearly five-fold increase in deaths from thyroid cancer than what we'd expect.

    Benzenes are shown to be toxic to the thyroid.

    You could also try and connect your thyroid problems with PTSD. There have been studies that show a high correlation between PTSD and thyroid dysfunction.

  5. Talon, thanks. That's really interesting info about how the command put the kibosh on testing the fluid. I agree the MSDS isn't a very good source, and there are often contaminants. I sometimes use them as jumping off points. This paper has a ton of great info, including known contaminants. While I certainly agree that different manufacturer's oils, and even different batches from the same manufacturer can have different constituent components and contaminants, I would think providing evidence in the article I linked to that says the contaminants or components are common SHOULD be sufficient to show "at least as likely as not." Is it a scientifically sound proof that you were exposed or that health problems are a direct result of exposure? No. I'm not a lawyer, but it would seem to me that you just need to provide enough evidence to show that it's at least as likely as not. Of course, it's the VA, so who knows.

    Your list of conditions sounds terrible. If I were making an argument to connect a lot of them to your time in service, I would likely focus on jet fuels rather than the oils, and there are just an insane amount of constituent components in JP fuel that can cause so many problems.

  6. I have taken multiple baths in JP-8 but it is the 7808 hydro fluid that I breathed in that I believe is causing me the most problems, especially neurologically. I was an AGE mechanic for 8 years before becoming a Flight Engineer and we used to joke about our lunch not tasting right if it didn't have hydro, JP-8 or 83282 (synthetic oil now 87257, I believe) on it. I always tried to wear all the required safety gear, but sometimes it is not practical or enough to avoid exposure. I got bathed in JP-8 in Iraq 3 times in a row on the same day at Al Asad trying to refuel from a series of broken Marine fuel trucks. The last time, I was actually able to get fuel in the aircraft, but the "line drain" for the truck malfunctioned. When I removed the QD from the SPR, it was "limp" but still had some fuel pressure, so it splattered off of the SPR and drenched me head-to-toe. I swapped into a spare uniform from my bag, wiped off as much as I could with paper towels and headed back to Balad before our flying day expired.

    I do have to wear a heavy beard now to cover up the seborrheic dermatitis I get on my face. I also get it on my scalp chest, armpits and groin and use shampoo/topicals to try and keep it under control. I also get weird "heat rashes" on my upper arms when the conditions are right (Hot like the desert) and I do know other flyers that get the same thing in the same place (outer, upper arm). I never was able to get the docs to do more than give it a cursory look, but I never had that before I went over there and the same goes for the others I know with this. The dermatitis started in my arm pits, so I thought it was a reaction to the type of deodorant I used. It was several years later before it started to show up on my face and I thought it was razor burn at first. Weather changes seem to impact the dermatitis as well. At least I never got hydrazine exposure to my knowledge.

    I did get a lot of vaccinations as well, since I was "well traveled" on AD and I was a special operator for around 7 years. As a matter of fact, we had to keep ALL vaccinations up-to-date for all areas, to include ones like "Japanese Encephalitis" that only special operations and possibly some other aviators were required to maintain. My 5th or 6th Anthrax shot has caused pain at the site it was injected for almost 10 years now. I can put light pressure on that spot and it will hurt for 10-15 minutes. My AD neurologist a few years back said that was most likely from the needle and not the actual vaccine, but who knows?

    According to Mobil's MSDS, these are the components of 7808 Fluid:

    1-NAPHTHYLAMINE, N-PHENYL-

    90-30-2

    1%

    ALKYLATED DIPHENYL AMINES

    68411-46-1

    1 - < 5%

    TRICRESYL PHOSPHATE

    1330-78-5

    1 - < 3%

    Tricresyl Phosphate (TCP) is definitely known to have dermatological and neurological effects. See the WHO's report here. I haven't found too much on the long-term effects of chronic exposure, or a definitive link to dermatitis. It seems to be excreted fairly quickly.

    I'm not sure what your neurological symptoms/diagnoses are, but it's clear that exposure to constituents in JP-jet fuels can cause many neurological problems:

    The n-hexane found in JP-4 has been shown to cause peripheral neuropathy, and distal nerve fiber degeneration throughout the nervous system.

    In some cases, the peripheral neurodegeneration caused by chronic exposure to n-hexane and its metabolites can lead to atrophy of the skeletal muscles.

    The toulene and xylene (along with trichloroethylene (TCE,) which is a solvent many in the military use on a regular basis, including many who are regularly exposed to JP-jet fuels, such as aircraft mechanics and electronics technicians) have both been shown repeatedly to cause symptoms of brain atrophy, reduction in nerve conduction, loss of both grey and white matter, and a general “clinical syndrome of premature aging of cortical function.”

    Chronic exposure to toulene has been shown to affect the function of the N-methyl-D-aspartate (NMDA) receptors in the hippocampus. This leads to an average of 7% decrease in cognitive function, including visual memory, verbal memory, visual pattern perception, and even manual dexterity.

    It's fairly easy to link JP jet fuels to parkinsons, dementia, and alzheimer's as well, and possibly even ALS and Huntington's. Jet fuels are no joke.

    I'm not a doctor, but I have read that chronic seborrhoeic dermatitis CAN be a sign of parkinson's. If you're also having other neurological symptoms, you may want to double check with a specialist to be sure.

  7. No problem. I honestly don't think it will be difficult to get OSA connected as a secondary condition.

    As far as your health issues, I would need more specifics, but I can most likely help find supporting research connecting them to your time in service.

    I've done a TON of research involving kerosene based jet fuels, and likely have research linking it to your conditions in one way or another.

  8. The problem with the STS listed cancers is that VA does not recognize carcinomas in that list.

    Of course not. Carcinomas are not sarcomas.

    Just to clarify, there are three main types of cancer based on the type of cell they originate in:

    Carcinomas are cancers that originate in epithelial cells, and are the most common types of cancers (80-90%)

    Lymphomas are cancers that originate in the blood and lymphatic system (7%), and

    Sarcomas begin in connective tissue (1%).

    The VA admits SOME carcinomas are related to the TCDD in AO. (i.e. Lung Cancer, Cancers of the lung, larynx, trachea, and bronchus.)

    Now, the VA is basing this on epidemiological evidence, NOT pathogenesis, not the underlying mechanism of the cancer. So the more common cancers, (i.e. lung cancers, prostate cancer) which show up more often on epidemiological studies, get more attention.

    What I'm saying is that any carcinoma-ANY cancerous epithelial cells at any site in the body- SHOULD be covered under VA law.

    It's just a scientifically incorrect decision on the part of the VA, based on faulty logic. It's like observing that most burns on the human body happen on the feet and hands, therefore the buttocks are fireproof!

    VA logic!

  9. If cancer in a non-presumptive site is thought by the VA to spread to a presumptive site, I've seen them reject it. It's ridiculous. I'm assuming that the original site (base of tongue) was squamous cell carcinoma?

    This is how I would argue it from a science standpoint:

    1. TCDD isn’t actually damaging that original cell-it was likely a carcinogen in cigarette smoke- but TCDD prevents apoptosis (“cell-suicide”) from happening. The research shows that this happens even when researchers give mice a chemical that is specifically designed to trigger “cell-suicide.” The research is pretty clear on this. It even happens in that study when they introduce a chemical that specifically causes "cell-suicide."

    2. Another “hallmark of cancer” is when damaged cells keep replicating themselves. The signal to replicate comes from other cells. TCDD is believed to be disruptive to genes that regulate the switch that tells the cell to make copies of itself, known as the epidermal growth factor receptor (EGFR.) Research shows us that in colon cancer cells, TCDD flips this switch, and causes cancer cells to start reproducing like crazy. This is obviously NOT a good thing.

    Now, the research above use lung epithelial cells and colon epithelial cells. But, really, what the VA is not getting is that the SITE DOES NOT MATTER. Any carcinoma involves epithelial cells, no matter where it is, and the vast majority of cancers are carcinomas.

  10. If they can't find something physical, and you're already service connected for PTSD and/or Depression, then your only real option is to say the weight loss is either secondary to the psych disorders, or a side effect of the meds.

    A second opinion is probably a good idea, though I doubt they will find anything. Maybe see an endocrinologist if your bloodwork didn't include a hormone panel.

    Do not go see a "homeopathic physician."

  11. Here's the research I have on the relationship(s) between Obstructive Sleep Apnea and PTSD:

    Correlation/Comorbidity between OSA and PTSD
    Sharafkhaneh et al (2005) Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort SLEEP, Vol. 28, No. 11
    "Our data show that the prevalence for comorbid psychiatric conditions is significantly higher in individuals with diagnosed sleep apnea than in individuals not diagnosed with sleep apnea.
    This pattern was most pronounced for mood disorders (depression and bipolar disorder), PTSD, and other anxiety disorders."
    “Our data strongly support an association between sleep apnea and PTSD.”
    11.85% of the PTSD group has PTSD, compared with 4.74% of the non-PTSD group. Odds ratio=2.70
    (Note: Also supports depression/anxiety as secondary to sleep apnea.)
    Krakow et al (2001) Complex Insomnia: Insomnia and Sleep-Disordered Breathing in a Consecutive Series of Crime Victims with Nightmares and PTSD BIOLOGICAL PSYCHIATRY 949 49:948–953
    Study of crime victims with PTSD. “Sleep-disordered breathing was diagnosed in 40 of 44 patients; 22 patients met OSA criteria.”
    Sharafkhaneh et al (2005) Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort SLEEP, Vol. 28, No. 11,
    Compared the prevalence of sleep-apnea diagnoses in subjects with and without specific psychiatric diagnoses. 11.85% of the PTSD group has PTSD, compared with 4.74% of the non-PTSD group. Odds ratio=2.70
    PTSD Causes sleep disturbances
    Orr (2011) Sleep Disturbances and Posttraumatic Stress Disorder Medscape Pulmonary Medicine
    This isn’t peer-reviewed, just a web article, but is a good review of research that shows sleep disturbances are related to PTSD. The only time it mentions apnea is when it references Krakow (2011)
    Krakow et al (2002) To Breathe, Perchance to Sleep: SleepDisordered Breathing and Chronic Insomnia Among Trauma Survivors Sleep and Breathing/volume 6, number 4
    Good review of research that shows higher rate of sleep disordered breathing and fragmentation.
    Sleep Deprivation Causing or Worsening Apnea
    Series F, Roy N, Marc I.(1994) Effects of sleep deprivation and sleep fragmentation on upper airway collapsibility in normal subjects. Am J Respir Crit Care Med 150:481–5
    Sleep fragmentation (such as is prevalent in PTSD [see: van Liempt, 2011]) increases the propensity for upper airway collapse in patients with sleep apnea.
    Krakow, 2001 Complex Insomnia: Insomnia and Sleep-Disordered Breathing in a Consecutive Series of Crime Victims with Nightmares and PTSD
    Guilleminault C, Rosekind M. (1981) The arousal threshold: sleep deprivation, sleep fragmentation, and obstructive sleep apnea syndrome. Bull Eur Physiopathol Respir. 1981;17(3):341-9.
    Shows that sleep deprived patients have increased frequency and length of apneic events, similar to the effects of alcohol.
    (Also useful for nexus, as it talks about how prolonged shift work (such as military watches) can cause the sleep deprivation that worsens apnea. )
    Leiter JC, Knuth SL, Bartlett D Jr (1985) “The effect of sleep deprivation on activity of the genioglossus muscle)” The American Review of Respiratory Disease [132(6):1242-1245]
    Sleep deprivation appears to increase the severity of obstructive sleep apnea, due to decreases in genigoglossus activity.
    Eckert et al (2011) Sleep Deprivation Impairs Genioglossus Muscle Responsiveness Am J Respir Crit Care Med 183;2011:A6163
    These data indicate that acute sleep deprivation leads to potentially important reductions in genioglossus muscle activity. In particular, muscle responsiveness to chemical (hypercapnia), and mechanical (resistive loads) stimuli is impaired by approximately 60% following acute sleep deprivation. These data suggest that sleep deprivation may initiate or worsen OSA, at least in part, via impaired upper airway dilator muscle function.
    Persson, Svanborg (1996) Sleep Deprivation Worsens Obstructive Sleep Apnea Chest. 1996;109(3):645-650
    Showed an increase apneic events and longer apneic events after sleep loss.
    PTSD decreases Slow Wave Sleep, which worsens apnea
    McSharry et al (2012) A Mechanism for Upper Airway Stability during Slow Wave Sleep SLEEP, Vol. 36, No. 4, 2013
    This shows that the severity of apnea is diminished during slow wave sleep. The next study shows that slow wave sleep is greatly diminished in PTSD.
    Fuller, K. H., Waters, W. F., & Scott, O. (1994). An investigation of slow-wave sleep processes in chronic PTSD patients. Journal of anxiety disorders, 8(3), 227-236.
    “Overall, PTSD subjects had a decreased percentage of slow-wave sleep relative to controls, which may explain their increased arousals during the first half of the night.”
    Stress from PTSD symptoms worsen OSA
    Nakata et al (2007) Perceived job stress and sleep-related breathing disturbance in Japanese male workers Social Science & Medicine 64 (2007) 2520–2532
    Shows that sleep-disordered breathing increases with proportion to occupational stress, as well as anxiety and depressive symptoms. (Kind of a weak paper, scientifically, though.)
    Sleep Deprivation/Fragmentation occurs with PTSD
    van Liempt et al (2011) Decreased nocturnal growth hormone secretion and sleep fragmentation in combat-related posttraumatic stress disorder; potential predictors of impaired memory consolidation Psychoneuroendocrinology (2011) 36, 1361—1369
    Sleep was more fragmented in patients with PTSD, with more awakenings in the first half of the night. (Also shows that these awakenings lead to lower GH production, which may explain the memory problems in PTSD patients)
    Insomnia and other sleep disturbances occur frequently in patients with PTSD and they can be severe.
    Sleep problems worsen PTSD
    Belleville, Guay, Marchand (2009) “Impact of Sleep Disturbances on PTSD Symptoms and Perceived Health” The Journal of Nervous and Mental Disease Volume 197, Number 2, February 2009
    The present study highlights the important role sleep plays in PTSD. Sleep appears to have a unique contribution in accounting for the severity of PTSD symptoms. Sleep also impacts how individuals with PTSD perceive their own mental health. Most individuals with PTSD present significant sleep difficulties regardless of their clinical presentation.
    Spoormaker (2008) Disturbed sleep in post-traumatic stress disorder: secondary symptom or core feature? Sleep Med Rev. 2008 Jun;12(3):169-84.
    This article is about how PTSD may be worsened or aggravated by sleeping issues, and suggests sleep disturbances may be risk factors for PTSD.
    Benzos/Meds worsen apnea
    Dolly FR, Block AJ. Effect of flurazepam on sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic subjects. Am J Med. 1982;73:239–43.
    Hanly P, Powles P. Hypnotics should never be used in patients with sleep apnea. J Psychosom Res. 1993;37:59–65
    Berry RB, Kouchi K, Bower J, Prosise G, Light RW. Triazolam in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 1995;151:450–4.
    Hope this helps!
  12. Hello, everybody.

    My name is Greg. This is my first post. I'm 28, an was deployed to Iraq/Kuwait in 2005-2006. Shortly after coming home, I started noticing a lot of trouble with funning, and general energy issues. I went to a doctor (I was on active duty, but at a reserve post, so I had Tricare Remote), and I was diagnosed with depression. That didn't fit, because I'm generally happy. I can't really explain why I feel this way, but I have always felt this was a physical issues. Literally, within a span of a week, I went from running a 12-minute two-mile to failing my PT test. Ever since then, I struggled with feeling weak, fatigued, and just not 100%. I also have pain. I ache quite a bit, and sometimes it feels like I have a persistent, under the skin sunburn.

    So, after I got off active duty (i'm still in the reserves), I started seeing my own doctor. She put me on a few anti-depressants that didn't do anything to help me. I asked for her to do some blood work, and it came back with slightly lowered T-levels, as one would expect from somebody who doesn't feel like exercising anymore. Finally, after testing my heart, lungs, thyroid, and blood tests, she diagnosed me with Chronic Fatigue Syndrome. She said that fibromyalgia also fits some of my symptoms, but she didn't diagnose me with that.

    Anyways, I submitted my CFS to the VA for a disability after reading that it fell under the category of presumptive illness. I filed for a few other things (bursitis in my shoulder, broken wrist, nothing major), and was turned down for everything. The wrist and shoulder were issues I was in physical therapy for while I was on active duty. I do not have a LOD on them. For CFS, they said that my slightly decreased Testosterone levels accounted for all of my symptoms. They did not conduct an exam. I had one appointment with the VA where I went in and they read of the items I was filing for and asked me to confirm that was it. I confirmed and left. It was literally less than 5 minutes.

    I work a regular job. My condition does affect my performance (I feel hazy quite a bit and have trouble concentrating, I am often late for work because I have trouble getting out of bed, ect.) Luckily, my job has flex scheduling and generous time off, or I'd have been fired. I don't know how I'm going to convince the VA to recognize my conditions. I am not out for money or anything (its nice, but I have a job), but I want the recognition that I'm not crazy. I'm also fairly young, and I feel like crap all the time. I'm afraid this issue is going to get worse when I'm older, and I want the VA support system there in case things become too much for me and my family to handle.

    I posted here because CFS/FM symptoms are more closely related with Gulf War Illness than the OIF/OEF stuff, and figured I might get more insight from these forms. If you guys have some advice on how to approach this situation, I'd greatly appreciate it. I recently got in contact with a VFW VSO, and am working on filing my NOD. I got my denial in January, and I should have been working harder on fixing this sooner...I just kind of got depressed and didn't feel like dealing with it for a bit.

    Thanks for any help you guys offer.

    Gredge, Were you exposed to burn pits or jet fuel, or exposed to degreasers like trichloroethylene? Not sure what branch or what sort of duties you performed, but there is some research linking PCB exposure (PCB's are found in plastics that were burned in the pits), kerosene-based (JP) jet fuel exposure, and TCE exposure to lower serum testosterone.

  13. Thanks for the info and excellent advice. The biggest hurdle I think at least in my case, and most others it is difficult to find doctors that will take the time to do so. Also to eliminate other conditions that cause the same symptoms. Say for instance fatigue or rather chronic fatigue. I have sleep apnea, hypothyroidsm, and am in constant chronic pain. The pain in part has to do with my back injury, along with nerve damage and muscles spasms. For a doctor or specialist it would be difficult to state what is causing what and what percentage of the disease is causing it. That's where you get into difficulties. Mind you this is not counting the "deny at all costs" mentality approve if you must, low ball as much as possible theories. The stance that I was healthy before service and now am not doesn't fly. Even when you have the records (mostly private) the booger of it all is getting the doctors to state it in VA speak, and that you will have a rater or board that will be objective about going through the information.

    I haven't tried it all but, honestly, it wears on you. It drains you and it doesn't help when most, even the hired guns, don't want to fight the good fight. It's a big conundrum of exponential lies and traps. But I have to say, when you start something see it through even if you have to go solo. Call in the big guns and the RECON when you need to.

    I've been through many tests but like most others out there, still no definitive answers. Gotta keep going if only to stay sane. :mellow:

    Do you have service-connected PTSD? You may be able to claim your sleep apnea as secondary to your PTSD. There's a fairly large body of evidence that the sleep deprivation many PTSD sufferers experience can cause problems with sleep apnea. Not to mention anti-anxiety meds.

  14. How are we supposed to know what we were exposed to? I have asked all of the doctors/specialists I have seen if they thought my issues could be related to exposure. Most of them look at me cross-eyed and/or hand me a pamphlet about burn pit registry. There seems to be a huge lack of understanding across the board, and we're the ones left to suffer.

    I know we had burn pits, but we also moved into an abandoned building and sucked in a lot of dust and inside and out. I was hit by a mortar round and remember not being able to breathe from all of the dust and gunpowder. Whose responsibility is it to connect the dots?

    Well, I find it's better to start with what your disability is, and work your way back. If you're Iraq/Gulf War, there's Burn Pits, Oil Well Smoke. If you were around jets and helos, there's JP jet fuel exposure, if you were electronics or mechanic you may have trichloroethylene exposure, diesel fumes, I mean there are so many exposures it's really much easier to figure out what exposure more likely than not can cause or aggravate your disability.

  15. There's a study here that shows a 5.71 times increased rick in pancreatic cancer in Vietnam nurses compared to non-Vietnam nurses.

    The problem is with these rarer cancers. The studies usually only get 1 or 2 people developing the rarer cancers, and more getting the more common cancers, so the data is skewed. Also, minute doses of TCDD can actually HELP some cancers, so people who were only minimally exposed are LESS likely to develop certain cancers, and people with a great deal of exposure are much MORE likely to develop them. There's even been some research USING TCDD to TREAT pancreatic cancers.

  16. Phillip, what is your disability specifically? It may be just as easy, or easier to connect your disability to another exposure, pesticide, JP-4, solvents, something like that.

    As far as the Thailand vet layover tactic, it's been used before, and worked. However, the vet had managed to save his boarding pass for all those years. However, there are some documents here that have been floating around that could help.

    Testimony of pilot attesting to the fact that it was customary for flights to Thailand to stop in Vietnam

    Testimony of Flight attendant stating that those going on to Cambodia, Laos, and Thailand would TRANSFER in Vietnam, showing "boots on the ground."

    WTAF routes, showing that those destined for Bangkok went through Vietnam.

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