Wounded Warriors Report Improvements in Care Continuity

At the second annual USO Wounded Warrior and Family Caretakes Conference in Fayetteville, N.C., I had the rare opportunity to listen to the concerns of some of America’s most severely wounded troops, their families, and their caregivers.

A common concern quickly bubbled to the surface: continuity of care.

“The military case managers are great and did a lot for us in the beginning,” said Luana Schneider, caretaker of her severely wounded son, Army Staff Sgt. Scott Stephenson. “But they were handling multiple cases and didn’t have the nationwide reach and tape-cutting abilities we needed for continued, specialized care when we got back home.

“The real savior for us has been our federal recovery coordinator,” added Schneider. “It’s a fairly young program with limited resources, but it’s become critical to us to have someone who knows Scott and his medical history. Without someone to coordinate and do some of the administrative legwork for us, we would be lost out there in Kansas where there are no VA surgeons specializing in burn treatment.”

The Federal Recovery Coordination Program (FRCP) is a VA program that provides support for the recovery, rehabilitation and reintegration of those wounded warriors dealing with what the VA considers “catastrophic” injuries, such as severe burns, amputations, traumatic brain injuries and post-traumatic stress.

Each coordinator develops an individual recovery plan with input from the multidisciplinary heath care team, the veteran, and their family or caregiver. They track the care, management and transition of recovering veterans all the way through recovery, rehabilitation and reintegration into the civilian world.

Stephenson didn’t have a “designated red-tape cutter” when he get out of the hospital in 2007, but according to his mom, it was his specialized needs that helped launch the program just one year later. His coordinator has since been working behind the scenes to get him the highest level of care by the top surgeons in the field of burn care and management.

“I truly believe I’ve received the best care possible with the technology available at the time,” said Stephenson.

“I was actually pretty impressed when I researched and visited the top civilian burn surgeon out in California to see what he could do about getting me a prosthesis,” said Stephenson. “When I mentioned my surgeon was Dr. [Steven E.] Wolf, he looked at me with wide eyes and said, ‘Son, burn surgeons don’t come any better than Dr. Wolf.’ That made me feel like I was really being cared for by the best, and I can’t ask for anything more than that.”

Health care professionals like Dr. Wolf continue to learn from our combat wounded to improve the treatment of unique combat burn injuries, and the VA continues to improve programs like FRCP to give veterans the continuity in care expected from the most medically advanced country on Earth.

In addition to burn care, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury also continues to develop best practices for case management in its own field.

In fact, on Thursday, Sept. 22, DCoE will hold a public webinar on that very subject. The session is free and open to the public. — By Joseph Andrew Lee, USO Staff Writer

Mom Drops Everything to Care for Wounded Son

Finding out your child has been severely wounded in combat is something no mother can prepare for. In fact, the news alone can be just as traumatic to the parent as the actual injury was to her son or daughter.

Luana Schneider, guest speaker at the second annual USO Wounded Warrior and Family Caregivers Conference this week, is all too familiar.

Just two days after Thanksgiving in 2006, she learned that her son, Army Staff Sgt. Scott Stephenson, had been “hit” by an improvised explosive device in Iraq.

She was told that he was severely wounded and badly burned. She was also told her son was going to die.

Two days later her son was transported to Brooke Army Medical Center in San Antonio, Tex. She was at her home in Kansas when she got a call from the hospital.

“He’s not responding,” a male nurse said desperately over the phone. “You need to get here now.”

“What do you mean he’s not responding?” Schneider frantically replied. “What are you calling him?”

“Robert. That’s what his medical records say,” the nurse said.

“He doesn’t go by Robert,” she said. “Call him Scott. Call him Scotty. Call him Bubby Bubble-Butt! That was his nickname as a kid. she said, sobbing.

“For God’s sake, don’t call him Robert, nobody calls him that,” the panicked mom added.

“Hold on,” the nurse said as he shouted in the background. “Scotty! Wake up! Scotty! Wake up, open your eyes and show me you’re alive!”

Scotty opened his eyes.

“He’s responding,” said the nurse. “You need to get here now.”

She was on the next flight – crying the whole way.

She realized in the air that only she could have known how to get Scott’s attention in that critical second. Only she could give Scott the attention he needed to stay alive.

“Reality sucks,” Schneider said, reflecting on the moment she received that horrific phone call. “Even though I was waiting for that sort of call, I wasn’t ready for it. Nobody is.”

When she arrived at the medical center, she didn’t even recognize her own son.
“He was in pieces. Swollen. Bloody. Burned,” she said. “I thought it was going to be bad but it was way worse.”

The reality of the situation was beginning to settle in. Her son would need an extraordinary amount of care for a long, long time. She would need to drop everything to do anything he needed.

“They told me when I got to the hospital that this would make me or break me,” Schneider said. “And you have to be honest with yourself and admit it – bow out – if you can’t handle it. Because the last thing you want to do is make your loved one suffer because you can’t handle it.

“It’s not about you,” she added. “It’s about your child, your husband, your sister or your brother.”

Her son would undergo kidney bypass, several major operations to remove shrapnel, and skin grafts to repair the burns that covered more than 60 percent of his body. Staff Sgt. Stephenson would eventually have his charred left leg amputated without the hope of a prosthetic, as his burned skin was “just too fragile.”

“When you have an adult child that you have to lift, you have to carry, you have to hold, have to bathe … the things that you have to do change you. I’ve had to scrub my child ‘till he bleeds,” Stephenson’s mother and caregiver said. “That creates this intimacy that normal people cannot comprehend. An intimacy that, while amazing how it bonds us today, I wouldn’t wish upon anyone.”

Adjusting to a “new normal” has taken time for Scott and his mom, but it’s a certain balance, a certain patience, and a certain resiliency of a strong caregiver like Luana that has made it possible for him to recover.

His unique injuries required the blazing of new paths. With no road map, an empathetic caregiver like Luana became absolutely essential for Scott’s survival.

“She’s a warrior,” Staff Sgt. Stephenson said of his mother. “She didn’t visit me in the hospital, she lived there. We’re closer now than we’ve ever been.”

It has taken years to find “new normal,” but she and Scott declared there is indeed hope for those just getting started down the road to recovery.

“It’s not something you would ever see coming, but it’s something you accept fully or not at all,” Schneider said. “At this point in my life I was looking forward to traveling with my husband. I thought, ‘We raised six, they are out of the house, we’re good, and we’re on our way!’

“It didn’t turn out that way,” the mother said, shaking her head. “It didn’t turn out that way.” — By Joseph Andrew Lee, USO Staff Writer

Staff Sgt. Scott Stephenson

Staff Sgt. Scott Stephenson