Vets First Podcast

In this episode you are introduced to the hosts of the Vets First Podcast, Levi Sowers and Brandon Rea. They discuss the origins of the podcast and their goals surrounding it.  You will get to know the hosts as they discuss their backgrounds and what brought them to this point in time. You will also hear about the research they work on and its relevance to Veterans.  Along the way in their work, Levi and Brandon noticed a disconnect between Veterans and research.  Many Veterans did not know research was being done at the VA at all.  Additionally, a major concern of Veterans was not being earnestly listened to. As researchers wanting to give back, they felt a need to convey research focus and findings to Veterans in an easily understood manner and well as provide a platform for Veterans to talk about their experiences.  We’d like to thank the Iowa City VA research foundation for funding this endeavor and giving us a chance to build bridges in understanding.Levi grew up in rural central Iowa near a town called Perry. He went to the University of Iowa where he graduated in 2012 with his PhD in molecular and cellular biology. In 2014 he joined the VA Center for the Prevention and Treatment of Visual Loss and Dr. Andrew Russo’s laboratory at The University of Iowa where he now studies traumatic brain injury induced headache and migraine. Levi’s work aims to identify brain regions that are important in the development of post-traumatic headache and photophobia (light sensitivity) in Veterans. A great profile of Dr. Sowers’ research interests can be found here.Brandon Rea grew up in a small rural town called Bernard, Iowa. He went to the University of Iowa where he graduated in 2012 with a Bachelor of Science in Biology. He is now a researcher in Dr. Russo and Levi’s lab where he works closely with Levi on multiple migraine-related projects. Brandon’s research expertise focuses on pain-related behaviors in migraine, particularly facial grimace.  Brandon and Levi were recently co-first and senior authors, respectively, of a paper published on these findings in the publication PAIN. 

This is part one of a two-part series on traumatic brain injury-induced headache (this episode and episode 4). 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. 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. Migraine is a type of headache that is more than just a bad headache. It is often accompanied by other neurological abnormalties including photosensitivity, sound sensitivity, widespread painful touch, and nausea and vomiting just to name a few. It represents a significant problem in the both the active military and Veteran populations. Of the military personnel with chronic daily headache, 66% have been diagnosed with migraine and an additional 28% experience multiple migraine features such as headache and light sensitivity.  Notably, headaches are often comorbid with symptoms of post-traumatic stress disorder, sleep disturbances, depression, and suicide.  Finally, the Migraine Research Foundation estimates a direct economic burden of $13 billion in the United States per year with respect to the general population.In this episode, we hear from our first Veteran, Doug Lanphier. Doug is originally from Oskaloosa, Iowa and made the trip today from Memphis, Missouri.  He comes from a military family and joined the Air Force at age 18 in 1981. Doug served as an intelligence operations specialist supporting briefing and debriefing in sorties (maneuvers) during Operation Desert Storm. During his deployment, Doug suffered a traumatic brain injury from a scud missile fragment while on an air base and lost consciousness.  The Defense and Veterans Brain Injury Center (DVBIC) reported more than 408,000 TBIs among U.S. service members worldwide between 2000 and early 2019. TBI can include a range of comorbidities, from headaches, irritability, and sleep disorders to memory problems, slower thinking, and depression. These symptoms often lead to long-term mental and physical health problems that impair Veterans' employment and family relationships, and their reintegration into their communities.  Doug shares his extensive experiences throughout his service, how his injury changed his life, and how he has suffered for more than 20 years with disabling headaches. He also explains his experience with the VA and how a phone call with a VA phone operator saved his life. Finally, he discusses why he thinks research is critical for the treatment of headache and how the VA has attempted to treat his headaches.   If you served in the Gulf War in Operation Desert Shield or Desert Storm and are concerned about related health risks, the VA has a comprehensive list of these risks and steps that can be taken.

As one of the three pillars of the VA, research plays a critical role in the treatment of Veterans. This episode starts with a description of research at the VA. Levi and Brandon discuss different achievements that have been accomplished through VA funded research.  We also hear from Dr. Randy Kardon, director of the VA Center for the Prevention and Treatment of Visual Loss(CPTVL).  The CPTVL is one of 14 centers nationwide that are funded by the Rehabilitation, Research and Development service under the Office of Research and Development within the VA. Additionally, the CPTVL focuses on a multitude of visual disorders that affect Veterans ranging from glaucoma to light sensitivity after traumatic brain injury as well as migraine.Dr. Kardon was born and raised in Iowa, spending his formative years in Des Moines.  During summers he worked at his father’s auto parts store with aspirations to later attend college. After high school Dr. Kardon came to the University of Iowa on a full scholarship as a freshman with an interest in science.  With the guidance of his mentors, he finished his undergraduate studies in three years and was part of the first sponsored Medical Scientist Training Program to pursue both a PhD and a medical degree. During medical school, Dr. Kardon experienced “love at first sight” with ophthalmology, and the eye as a window into the human body.  His dedication to treating Veterans occurred during his medical school rotations.   Now with over 30 years of experience as an ophthalmologist at the Iowa City VA Healthcare System, Dr. Kardon specializes in neuro-ophthalmology.  Neuro-ophthalmology is a subspecialized part of eye care and ophthalmology dealing with vision problems of unknown cause.  These ophthalmic problems are often connected to problems in different areas of the body like the brain. Dr. Kardon shares with us his expertise, health issues he focuses on, and how he provides specialized care. Finally, we discuss the goals of the center and how the VA Center for the Prevention and Treatment of Visual Loss hopes to aid Veterans through its research.

In this episode, we hear from an anonymous Veteran about her struggle with light sensitivity and headache after a traumatic brain injury during Operation Enduring Freedom in Iraq.  She describes how she suffered daily headaches from 2013 until her first dose of a new anti-migraine drug in December 2018 which changed her life. During that period from 2013-2018, she experienced such severe light sensitivity that she had to wear sunglasses even indoors. Additionally, she experienced constant debilitating pain that significantly impacted her life.  She recounts that after her first dose of this new anti-migraine drug, she sat on her bed in amazement. This was her first headache free period of time in 6 years. She goes on to tell us how this treatment has impacted her life henceforth. A visual presentation of traumatic brain injury can be found here.In this episode, we also hear from an expert in the field of migraine and post-traumatic headache, Dr. Andrew Russo, a professor of physiology at the University of Iowa and director of animal research at the VA Center for the Prevention and Treatment of Visual Loss. In a roundabout way, Dr. Russo became interested in migraine by being interested in how plants grow. Early in life weeding his grandmother’s garden, he learned how plants respond to light and their environment and became curious how other organisms respond.  Dr. Russo views migraine as our brain responding too much to a stimulus like light, sound, touch, etc. Primarily, his studies focusing on a peptide in migraine known as CGRP and its actions has helped Dr. Russo contribute to a new class of anti-migraine drugs that have shown success in treating migraine.Dr. Russo’s father served in the Navy and received his primary care through the VA healthcare system.  He was impressed with the VA’s commitment to treat Veterans not only in the hospital setting but in all walks of life.  He branched into researching traumatic brain injury and post-traumatic headache because the similarities to migraine as well as a moral obligation to support Veterans.  

The kidneys are organs in the body that filter the blood, removing wastes and extra water are essential for life.  They also maintain a healthy balance of water, salts, and minerals to keep the body functioning normally.  Chronic kidney disease is a condition in which the kidneys are damaged and cannot filter blood as well as they should, causing a multitude of health problems.  In this and the following two episodes, we hear from Veterans and their care givers about their experiences with chronic kidney disease and how they or their loved ones came to get kidney transplants through the VA. In episode 7, we will also hear from a nephrologist at the VA healthcare system.Our first guest is Alysha Scott, care giver for a Veteran, Jan Scott.  Alysha and Jan are from Kokomo, Indiana and have come to Iowa City to be a part of the collaborative kidney transplant program between the University of Iowa and the Iowa City VA Healthcare System. Jan served 4 years in Louisiana during the Vietnam War and was a firefighter for the city of Kokomo for 20 years.  Experiencing renal failure, Jan was on dialysis 3 times a week for 4 years and on the transplant list for 2 years before receiving his kidney. Alysha discusses what it is like to have a significant other with end stage kidney disease and their experiences as a post-operation kidney transplant patient continuing to receive care through the Iowa City VA Healthcare System.Our second guest is Rob Siwek, a high school baseball coach from Mansfield, Ohio. Rob is a post-operation kidney and pancreas transplant patient who received his kidney, pancreas, and continuing care through the Iowa City VA Healthcare System. He served in the Army from 1987 to 1989 in Fort Jackson, South Carolina and was diagnosed with diabetes during his service. His long battle with type 1 diabetes led to kidney disease and eventually the need for a kidney and pancreas transplant.   He discusses his many first-hand experiences involving kidney disease, dialysis, his surgery, and how grateful he is for organ donation. 

In this episode we first hear from Vince and David, a father and son pair,  two days before their kidney transplant surgery. David is donating his kidney to his father Vince, an Air Force Veteran of 8 years.  Vince was born in Michigan, moved to California, New Mexico, and then Alaska in 1978.  He joined the Air Force in 1955 and served until 1963. Roughly two years ago Vince’s bloodwork began to show his kidney functions were elevated.  Shortly after, Vince was diagnosed with polycystic kidney disease and eventually would require a kidney transplant. David was more than ready to step up and help his father with a kidney of his own after compatibility tests had shown he could donate to Vince. Also, in this interview we hear from their two caregivers Darlene and Jennifer and get their perspective on the upcoming surgery and how important family and friends are. The group made the trip down from Alaska to Iowa City VA Healthcare System for this life-changing event. In the second half of the episode, we hear from Veteran Jack Jones and his wife Martha from Asheville, North Carolina.  Jack grew up in New Bern and followed in his father’s footsteps in joining the Navy after high school in 1975. He served as a boiler operator from 1975 to 1979 and shares some of his experiences on his ship.  Being a diabetic and through normal checkups, Jack was informed that his kidneys had dropped to 20% functionality and got on the kidney transplant waiting list in 2015. Previously being cured of Hepatitis C, Jack was presented with the unique opportunity to receive a kidney quickly.  He received the first Hepatitis C positive kidney through a pioneering new program at the Iowa City VA Healthcare System, where medical advances have made Hepatitis C positive kidneys viable for transplant into patients without developing the disease. Jack shares with us some of his military experiences, his developing need for a kidney transplant due to diabetes, what dialysis entails, his care at Iowa City VA Healthcare System, and how appreciative he is for his new kidney.

Dr. Christie Thomas, a nephrologist at the University of Iowa and the Iowa City VA Healthcare System, joins us on this episode to discuss his favorite organ, the kidney, and why Veterans come to need transplants. He discusses with us the functions of the kidney in the body, some of its surprising roles in human health, as well as how and why kidneys fail. Additionally, he shares with us some details about dialysis and the Hepatitis C positive kidney transplant program we highlighted in our previous episode.In adults, the most common cause of kidney disease in the United States is diabetes and the second most common cause is presumed to be high blood pressure or hypertension.  The most common hereditary cause of kidney disease in the United States is polycystic kidney disease which affects between 1 and 500 to 1 and 1,000 people. Overall, about 37 million adults in the United States are estimated to have chronic kidney disease with most being undiagnosed. Blood tests are the most common method for detecting kidney disease by looking at kidney function.  Other health consequences of chronic kidney disease include increased occurrence of infections, low red blood cell count, loss of appetite, and depression.  Dr. Thomas highlights all this in detail and more.Dr. Thomas was born and raised in India, having come to the United States at the age of 2 and returning to India at the age of 4. He did his undergraduate studies in India and postgraduate studies in England. He returned to the United States in his early thirties and was drawn to Iowa City, which had the largest public hospital in terms of the number of beds in the country at the time, as well as Iowa City VA Healthcare System, which was known for the strength of its research.  Since then, Dr. Thomas has come to love Iowa and working with Veterans who he describes as some of the best patients he’s ever had. 

In this short wrap up episode, Levi and Brandon look back on the season and discuss what surprised them about starting a podcast, some of the difficulties experienced as novice podcasters, and some of the striking takeaways from the interviews. Partway through our recording we were able to acquire higher quality microphones, put our clicking pens away, and Brandon even found his voice a bit more.This podcast journey began with us introducing ourselves, where we come from, what we do, and how we got to this point in time.  Early on, we weren’t certain how many people would be interested in talking to us.  That uncertainty didn’t last very long.  All our guests this season were great, and we feel privileged to be able to provide a platform for sharing their stories.  Though we are only scratching the surface, we feel like we gained a deeper understanding into the experiences of Veterans suffering from traumatic brain injury, post traumatic headache, migraine, and kidney disease.  Even better, being able to give Veterans a platform to share these experiences as well as researchers and healthcare providers to convey their work to aid our Veterans has been a wonderful undertaking.  Next season, we will discuss topics such as drug addiction, glaucoma, chronic pain, and suicide. You can look forward to these episodes and more around June 2020. We thank you all for listening and look forward to producing many more episodes. 

            In this episode Levi and Brandon interview Keith Queen, Visual Impairments coordinator at the Iowa City VA. Listeners will hear how Keith navigated his life with his own visual impairment and his career with the VA, the blind rehabilitation services the VA offers, and expectations for Veterans beginning to lose their eye sight.             Keith Queen struggled with his vision, beginning in his youth, and was diagnosed with rare juvenile onset macular dystrophy, Stargardt disease. Keith did not receive services until he was connected with the Commission of the Blind, following his diagnoses which funded his college education. Keith has two undergraduate degrees, a master’s degree, and served in the Peace Corps. He has pursued a career in blind rehabilitation services and has worked with 5 different VA organizations across the Country. Keith now is a part of the Visual Impairments Services Team.            Visual Impairments Services Team (VIST) connects blind or visual impaired Veterans to multiple programs and services. VIST supports Veterans with learning basic life skills, financial management, technological support and training, counseling, etc. Veterans meet with the Visual Impairments Coordinator in their area to conduct an exam, learn more about their condition, discuss expectations, and refer to services. Click the link to learn more about VIST and connect with a coordinator near you. You can also check out the latest research being done at the Center For the Prevention and Treatment of Visual Loss.            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.             Also listen to episode two to hear from Dan Standage on his own journey with vision loss during his time in the military and life after. 

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. 

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.

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.