Vets First Podcast

Latest Episodes:

Season 3 Episode 8: Understanding diabetes and vision loss: A walkthrough with Dr. Randy Kardon May 26, 2023

Show notes

In this episode Dr. Levi Sowers and Brandon Rea interview returning guest Dr. Randy Kardon. Dr. Kardon is a neuro ophthalmologist at the Iowa City VA Healthcare System and the University of Iowa in Iowa City who has had federal funding for over 30 years. This episode focuses on diabetic neuropathy and diabetic retinopathy. Diabetes affects many different types of body tissues, including the eye. With minimal invasiveness, the eye can be studied and provide information about how diabetes damages other tissues. Additionally, the eye can allow doctors to detect diabetes far earlier than other tissues with high resolution scans on the cells in the eyes. Early detection and management of diabetes can help minimize health effects of the disease and can prevent blindness. Control of blood sugar is the most important aspect to help prevent blindness with diabetes. Dr. Kardon explains how diabetes affects the eye and can lead to vision loss, as well as other effects on the body and available treatments. He explains that there are tiny blood vessels in the eye that are lined with endothelial cells. In diabetes these endothelial cells are damaged by the byproducts of high blood sugar and cause the tiny blood vessels to leak fluid into the tissue. When fluid gets into the tissue layers it disrupts the tissues' ability to function. This, however, can be managed with treatment. After the vessels begin leaking, the eye releases growth factors to allow new blood vessels to grow. Unfortunately, these vessels are weaker and begin to leak even more, and this is what leads to severe blindness in patients. Though there are treatments for the second stage of blood vessel leaks, when the leakage is too severe there is little that can be done. Dr. Kardon also talks about the different types of diabetes and how each type affects vision in patients.

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss.

Season 3 Episode 1: Introduction to season 3 May 25, 2023

Show notes

We are finally back! It has been almost 2 years since we last published a season. A lot has changed over that time. Dr. Sowers started a faculty position at the University of Iowa in the Department of Pediatrics where he is studying migraine pathophysiology in preclinical models. This is an exciting season! In total, we have 11 new interviews for your from across the spectrum. The Blinded Veterans Association was integral in the topic this season which is all about Vision and Vision related issues in Veterans. We interviewed many awesome Veterans who told amazing stories. One that stuck out to me was Tim Hornick. His interview was one of the most difficult interviews Brandon and I have ever done (in a good way). It is a captivating listen! Several wonderful practitioners join us this season who all have VA funded awards to study vision. We cover glaucoma, diabetic neuropathy, traumatic brain injury induced vision problems and much more! We also interview the former president of the Blinded Veterans Association.

Moving forward, the podcast will take a little bit of a different shape. We are going to stop doing seasons and attempt to release an episode every month or so. We are going to start bringing guest hosts on in future episodes and we may do join interviews with a Veteran and Researcher/practitioner at the same time.

Finally, thank you all for listening and we apologize for the long wait! The Vets First Podcast would not be possible without the people that listen. This project has been one of the most rewarding projects that Brandon and I have ever worked on. We would like to thank the VA Center for the Prevention and Treatment of Visual loss and the Iowa City VA Research foundation for aiding in the production of this season. We also want to give a shout out to Jayme Waite, Thomas Duong, and Michael Huebner who are wonderful undergraduates or VA employees that volunteered their time to edit blogs this season. Once again, thank you all for listening and we hope you enjoy and learn something along the way!

Season 2 Bonus Episode – First-hand experience in the trenches of Covid-19: Dr. Alejandro Pezzulo Mar 08, 2022

Show notes

In this episode of the Vets First Podcast, Levi and Brandon interview Dr. Alejandro Pezzulo, a pulmonologist, and Assistant Professor of Internal Medicine at the University of Iowa. This episode was recording back in August of 2021 during the height of the Delta wave. We think this is an interesting look into COVID-19 with a critical care provider.

Dr. Pezzulo was born in Caracas, Venezuela where he grew and eventually went to medical school. He became interested in biomedical research, particularly pulmonology, and established connections at the University of Iowa. Dr. Pezzulo wanted to include research with being a clinician and began work with the VA during his internal medicine residency. He enjoyed talking and working with Veterans while providing clinical care and continues to do so to this day. He notes that some of his favorite patients are Veterans.
In our discussion, Dr. Pezzulo shares with Levi and Brandon his insight into SARS-CoV-2, the virus that causes COVID-19. He breaks down how COVID-19 affects the body, why the body’s response to this virus is so severe, and how current treatments work to combat this disease. Particularly, Dr. Pezzulo illustrates the difference between how the body responds to a new virus never experienced before and how the immune response plays a role. He also comments on why COVID-19 is more harmful to some patients than others and what factors play a role. Additionally, Dr. Pezzulo comments on how the COVID-19 vaccines are made, getting the COVID-19 vaccine even if a person has already contracted the virus, the potentials of long COVID, and a brief history on vaccination efforts with other diseases like polio and measles. Finally, he discusses what it has been like for a critical care pulmonologist during the pandemic.

For the latest science and research on COVID-19, we highly encourage our listeners to consult the Centers for Disease Control and Prevention at:

https://www.cdc.gov/coronavirus/2019-ncov/science/science-and-research.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fmore%2Fscience-and-research.html

Season 2 Episode 6 – The ongoing battle: Josh Marino and Rob Otto share about PTSD, depression, and suicide Sep 20, 2021

Show notes

In episode six, Levi and Brandon interview Army Veteran, Josh Marino to discuss the traumatic brain injuries (TBI) and internal injuries sustained during his service. Listeners will hear about Josh’s early life, his time in the army, sustaining a head injury, and his life experiences managing the injury. Josh discusses the mental health struggles following his injury, social stigma surrounding internal injuries, and his struggle for identity and purpose after being discharged.

Josh Marino served as a 25 Sierra, specifically in satellite communication where he performed both tactile and strategic tasks. Josh was deployed in Korea, and then was stationed in Kansas to set up the brigade. Josh was again deployed in Iraq, where he sustained a head injury from the shock wave of an indirect fire attack. He suffered from TBI, post-concussion syndrome and headaches, which he still experiences to this day. Josh identifies suffering from post-traumatic stress disorder (PTSD), depression, and anxiety. Josh made headlines in 2017 after he rescued a stray cat, Scout. Josh attributes Scout for saving his life. Click the link to watch the heartwarming film of the mutual rescue between Josh and Scout. Josh currently seeks support from the VA and counsels Veterans at the VA.

Traumatic brain injury (TBI) is a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. The most common type of head trauma from recent conflicts are blast wave injuries. Two of the most prevalent problems reported by military personnel following traumatic brain injury are headache and photosensitivity (light sensitivity), which commonly occur together in migraine-like headaches.

The VA provides care and support for Veterans suffering from TBI. All Veterans who served in combat are screened for TBI. Treatment options for TBI include cognitive, speech, physical, and occupational therapy, coinciding with medication and assistive devices. Click the link to learn more about TBI treatment at the VA. VA also offers counseling services to Veterans to support treatments of related conditions.

In the second half of episode six, Levi and Brandon interview Rob Otto. Listeners will hear about Rob’s early life, career in the military, and life after service and his experience with mental health. Rob discusses PTSD among Veterans and suicide prevention at the VA.

Rob Otto is an Iowa native and Air Force Veteran. He began his military career in the Air Force ROTC and received his undergraduate degree in Sociology at the University of Iowa. Rob served in active duty for six years as a Captain, where he was a personnel officer leading teams, project management and administrative work. He attended the police academy and worked as a police officer. Rob is now the Suicide Prevention Coordinator and a social worker at the Iowa City VA where he counsels Veterans.

The VA is dedicated to changing the stigma surrounding mental health. Approximately 20% of Veterans suffer from post-traumatic stress disorder (PTSD). Veterans can receive treatment for PTSD at the VA through trauma-focused psychotherapies and antidepressant medication. The VA tailors treatment regiments specific to the Veteran’s key concerns and needs. PTSD often coincides with other mental health illnesses.

Season 2 Episode 9 – Supporting our active-duty military, Veterans, and first responders: Jim Ravella and the Gary Sinise Foundation Sep 20, 2021

Show notes

In this episode, hosts Levi and Brandon welcome Jim Ravella, Vice President of Programs at the Gary Sinise Foundation. They discuss the mission, programs and initiatives offered at the Gary Sinise Foundation to support our nation’s defenders and their families.

Jim Ravella grew up in a family that served in the military – his father served as a pilot during WW2, the Korean War, and the Vietnam War. Jim graduated from Texas A&M University with a Bachelor’s Degree in Metallurgical Engineering, and was inspired to become a pilot. He served as a fighter pilot in the United States Air Force for over 26 years.

Jim joined the Gary Sinise Foundation in May 2019 as Vice President of Outreach prior to his subsequent promotion to VP of Programs. Jim’s position involves overseeing the day-to-day running of the Gary Sinise Foundation’s programmatic services and the implementation of the Foundation’s four pillar programs. Jim is married to Ginger Gilbert Ravella, a Gold Star widow and Ambassador for the Gary Sinise Foundation, who speaks nationally raising awareness for Veterans and the families of our fallen. Jim and Ginger have seven children and have co-authored a book “Hope Found” about their experiences overcoming devastating loss and tragedy.

The Gary Sinise Foundation was established under the philanthropic direction of award-winning actor and humanitarian Gary Sinise, who has been an advocate for Veterans, active-duty military, first responders, and their families for 40 years. The Foundation’s four programmatic pillars include the R.I.S.E. (Restoring Independence Supporting Empowerment) Program, which builds 100% mortgage-free, specially adapted smart homes for severely wounded Veterans and first responders, and their families. These “forever homes” are tailored to the specific needs of each wounded hero and are specially designed to ease the daily challenges faced by disabled Veterans and first responders, and their families, who sacrifice so much alongside them. The R.I.S.E. program also provides home modifications, mobility devices, and adapted vehicles to Veterans and first responders with injuries and medical conditions.

The Gary Sinise Foundation’s Community and Education Program bridges the gap between defender and civilian communities through initiatives that honor America’s heroes, both past and present, and inspire the next generation to do the same, such as the Foundation’s Soaring Valor initiative. Soaring Valor sends WWII Veterans to New Orleans to tour the National WWII Museum built in their honor while recording their oral histories for future generations. Through this initiative, high school students accompany WWII Veterans to learn history first-hand and carry on their stories with a new appreciation for the sacrifices made by the Greatest Generation.

The Foundation’s First Responders Outreach Program, its third key program, provides funding to first responder departments across the country for essential equipment, PPE, emergency relief, and training to ensure first responders are able to perform to the best of their abilities. Gary Sinise and the foundation’s long history supporting first responders began in the aftermath of 9/11 with Gary’s support of the FDNY and NYPD and pivotal role in creating the Brooklyn Wall of Remembrance, and continues to this day: in 2020 alone, the Foundation’s First Responders Outreach program provided thousands of pieces of critical PPE and essential equipment needed for first responders to fight COVID-19, serving a total population of 8.5 million.

The Foundation’s last key program, the Relief and Resiliency Program, supports Veterans, first responders, and their families through any hardships they face, offering complete support before, during, and after the battle through flagship initiatives like Snowball Express, which provides year-round support to the families of fallen military heroes. The Foundation’s Mental Wellness initiatives are under the Relief and Resilience Program umbrella, and address the mental wellness needs of service members, first responders, and Veterans through many varying partnerships. One of the latest mental health initiatives, which is discussed on this podcast, is the Gary Sinise Foundation Avalon Network which focuses on providing transformative care to Veterans and first responders suffering from TBI, post-traumatic stress, and substance abuse, as well as supporting their families throughout the care process. The Gary Sinise Foundation Avalon Network is the first comprehensive traumatic brain injury and post-traumatic stress network available free-of-charge to Veterans and first responders nationwide and will establish 20 sites nationwide to serve thousands of Veterans and first responders.

Learn more about the Gary Sinise Foundation hereand in our latest episode of the Vets First Podcast.

Season 2 Episode 2 – Not broken, just doing things differently: Director of Disability in Education for the Student Veterans of America, Dan Standage Sep 20, 2021

Show notes

In the opening of season two interviews of Vets First Podcast, Levi and Brandon welcome Marine Veteran, Dan Standage. In this podcast, listeners will hear from the Arizona native, starting with a brief overview of his childhood and career in the Marines, his emotional and physical journey after becoming legally blind during his station in Japan, and finally his contributions and career in blind rehabilitation services. Levi, Brandon, and Dan discuss the importance of mentorship in the development as individuals, and the importance of adaptability and perspective in the face of change.

Dan has overcome a tumultuous health journey in which he became legally blind during his service. He managed the emotional stress as he adapted to the changes on his life such as fatherhood, driving, basic skills, etc. Dan utilized the VA to formally learn how to manage the changes to his daily life.

With a Bachelor of Science and Master’s degree in Blind Rehabilitation from University of Arizona, Dan worked at the time of this recording as the Vice President of Diversity and Inclusion at Student Veterans of America. His job focuses on connecting the fraternal order of the military to education and employment as Veterans become leaders.

Student Veterans of America (SVA) strives to support student Veterans to succeed after their services are completed. The organization provides on campus chapters, research, and advocacy for Veterans in higher education. Click the link to learn more about SVA.

Blind Veterans Association (BVA) strives to serve and support Veterans with vision loss. BVA advocates for visually impaired Veteran-focused issues and mentorships for Veterans and family. BVA offers four different programs: Veterans Service, Care Review, Operation Peer Support, and Scholarships. Click the link to learn more about BVA and how they can support you or your loved ones experiencing vision loss.

Listen to episode three with Keith Queen to learn more about blind and low vision rehabilitation services the VA and Visual Impairment Services Team offers Veterans.

Season 2 Episode 1 – Kicking off Season 2 of the Vets First Podcast Sep 20, 2021

Show notes

In the first episode of the second season, podcast hosts, Levi Sowers and Brandon Rea overview the guests and topics featured in the seasons and offer some of their retrospective thoughts. The season will interview doctors, experts, private organizations, and Veterans covering topics regarding blind Veterans, PTSD, addiction, and mental health. Some guests include Veteran Trever Siver, Dr. Erik Won, Keith Queen, and Dr. Carolyn Turvey. These episodes can be downloaded now at https://blogs.va.gov/VAntage/va-podcast-network/vets-first/ and we encourage our listeners to listen to these stories and more as we move forward with the Vets First Podcast. If you have not had a chance to listen to any of the episodes from season one, you can also go to the above link to find those episodes as well.

Levi and Brandon discuss hosting a podcast during the Covid-19 pandemic. Many of the episodes were recorded via zoom in the hosts’ basements. Both Levi and Brandon’s research jobs were moved remotely, similarly to many other individuals during the pandemic.

Levi and Brandon give a glimpse into the future of the podcast which they plan to continue for many seasons. The hosts would like to thank the VA for their support, the guests joining to speak on their experiences and knowledge, and the listeners for downloading and taking the time to listen to the episodes. They would also like to give a special thanks to Olivia Gaul, a very talented undergraduate who aided in writing the blogs this season. She is going on to do bigger and better things in graduate school where she will be studying social work.

Finally, we want to thank everyone that has supported the podcast over the past year. This was an undertaking that has moved Levi and Brandon out of the comfort zone of the laboratory and into the lives of Veterans and their stories. We hope this season is even better than the first and we look forward to many great things to come! In season three, listeners can look forward to a season dedicated to Veterans with vision problems.

Season 2 Episode 4 – Two candid discussions about drug use disorders: Trever Siver and Henry Uken Sep 20, 2021

Show notes

In this first part of the episode, podcast hosts, Levi and Brandon, interview army Veteran, Trever Siver. Trever candidly discusses trauma, mental health, and substance use. Trever recounts his childhood, time in the army as a cook, and his battle with addiction and journey to sobriety.

Trever was born and raised in Iowa. While in high school, Trever decided to join the army and served from 1999 to 2004, being stationed in Korea and Germany. Trever survived multiple traumatic injuries where he was introduced to opiates to manage the pain, eventually leading to a long-term battle with substance use. With the support of Dr. Miller at the VA, Trever worked to overcome addiction and continues to receive services from the VA.

In the second part of the episode, hosts interview Levi’s hometown friend and army Veteran, Henry Uken. Henry speaks openly about his experiences in the army, the traumatic brain injuries he sustained during deployment and the symptoms he still experiences today. He also details his recovery with substance use disorder and mental health treatment after being discharged.

Henry Uken grew up in Perry, Iowa with Levi Sowers. Henry served in army until May 2013, where he was deployed multiple times in both Iraq and Afghanistan. While serving, he sustained multiple blast injuries, resulting in traumatic brain injuries. After his discharge, Henry struggled with the change from military life into civilian life. Henry began using methamphetamine, which he identifies as a coping mechanism. He found a passion for disk golf, and his pursuit of the sport encouraged him to begin recovery. Henry is now in recovery and sober for two years.

More than 1 in 10 Veterans are diagnosed with substance use disorders. Veterans Affairs provides substance use treatments for Veterans battling substance use problems. VA offers medication options, counseling and therapy services, and treatment for related health conditions to substance use.

Substance abuse and suicide are significantly connected. Veterans managing substance use disorders are more than twice as likely to die by suicide than other Veterans. Individuals who struggle with substance use disorder are more likely to be depressed, engage in high-risk behaviors, and struggle with social and financial problems. Click the link to learn more about the connection between substance abuse and suicide.

The VA is dedicated to supporting Veterans. VA offers mental health services for Veterans managing PTSD, depression, anxiety, Military Sexual Trauma (MST), etc. Veterans can receive counseling, therapy, and or medication treatment either in person or via the telemental health program.

Season 2 Episode 7 – Perseverance through care and routine: Dr. Carolyn Turvey and Dr. Anne Sadler discuss research on depression and suicide risk with our Veterans Sep 20, 2021

Show notes

In the beginning of episode seven, Levi and Brandon speak with Dr. Carolyn Turvey to discuss her studies on functional impairment and depression in Veterans. Dr. Turvey grew up in the suburbs of New York City. She completed her undergraduate studies at the University of Connecticut and received her PhD in Clinical Psychology at Yale. From there, Dr. Turvey became a Professor at the University of Iowa, as well as the Director at the Veteran’s Rural Health and a member of the Center for Access and Delivery Research Evaluation at the Iowa City VA. Dr. Turvey goes into depth about her research observations and findings, tools for Veterans to overcome depression, and the value of establishing and maintaining routines.

The second half of the episode features Dr. Anne Sadler, a researcher with VA Health Services Research and Development and a Professor in the Department of Psychiatry at the University of Iowa. Dr. Sadler grew up in Virginia. She has a Bachelor of Science in Nursing and Psychology, a Masters in Psychiatric Nursing, and PhD in Marital and Family Therapy. She has worked both in research and clinical environments where she focused on women’s health. In this discussion, Dr. Sadler shares her knowledge on suicide risk factors, facts regarding suicide in the Veteran population, and service-women’s risk factors for sexual assault.

The suicide rate for Veterans is 1.5 times higher than that of the general population, with the rate among female Veterans to non-Veteran adult women being 2.5 times greater. More facts about suicide among women Veterans can be found at the link.

Suicide rates in rural Veterans compared to urban Veterans are reportedly higher. The Office of Rural Health is interested in addressing care needs and care disparities for Veterans in rural area and breaking down the barriers for Veterans to access quality care. The rate of suicide decreases among Veterans who receive VA care.

Season 2 Episode 8 – Exploring treatment of PTSD, headache, and depression through brain stimulation: Wave Neuro and TMS Sep 20, 2021

Show notes

In this episode, podcast hosts Levi Sowers and Brandon Rea dive into Transcranial Magnetic Stimulation (TMS), a treatment for depression, PTSD, and headache, with expert Dr. Erik Won.

Dr. Won, a Californian native, trained at the Naval Hospital in Portsmouth, Virginia and completed his General Medical Officer (GMO) tour as a flight surgeon in Pensacola, Florida at the Navy Aerospace Medicine Institute. After, he was stationed at Camp Pendleton and deployed from 2000-2001 with the 11th marine expeditionary unit primarily in the Middle East. He completed his residency at Harvard University in Occupation and Environmental Medicine, a subdivision of preventative medicine. Dr. Won is the President and Chief Medical Officer of Wave Neuro, a company dedicated to developing non-invasive and non-pharmacological technology to advance the treatment of brain related injuries and illnesses.

Based on the principals of physics, Transcranial Magnetic Stimulation (TMS) utilizes magnetic fields to stimulate nerve cells in the brain. TMS has been found to treat symptoms of depression. The typical protocol for TMS is a 30-minute session each day. Prior to treatment, an EEG is used to detect the frequency patterns of the individual’s brain and is analyzed for disparities. This analysis helps tailor the treatment to the individual’s specific brain frequency. An electromagnetic coil is placed over the head, near the scalp and forehead and delivers magnetic stimulation to the areas of the brain involved in mood and depression. The targeted neuron stimulation gradually trains the neurons to fire more synchronously. The benefit of this approach is that it is not dependent upon drugs and is also non-invasive.

The long-term goal of this research to is better treat individuals who may have any number of psychiatric and/or neurological disorders. As there are more advances in TMS technology are developed, the ability to treat more disorders will expand. The future is bright for the use of this non-invasive technique in Veterans.

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