Kerri Childress, Editor VISN 21 3801 Miranda Avenue Palo Alto, CA 94304-1290 www.visn21.med.va.gov

Where to find us! VA MEDICAL CENTER VA MARE ISLAND OPC VA SAN JOSE OPC SAN FRANCISCO 201 Walnut Avenue 80 Great Oaks Boulevard 4150 Clement Street Mare Island, CA 94592 San Jose, CA 95119 San Francisco, CA 94121-1598 (707) 562-8200 (408) 363-3011 (415) 221-4810 OAKLAND MENTAL VA SONORA OPC Downtown S.F. VA OPC HEALTH and Substance 19747 Greenley Road 401 3rd Street ABUCE PROGRAM Sonora, CA 95370 San Francisco, Calif., 94107 Oakland Army Base (209) 588-2600 (415) 551-7300 2505 West 14th Street VA CENTRAL VA EUREKA OPC Oakland, CA 94607 CALIFORNIA HEALTH (510) 587-3400 714 F Street CARE SYSTEM Eureka, CA 95501 VA OAKLAND OPC 2615 E. Clinton Avenue (707) 442-5335 2221 Martin Luther King Jr. Way Fresno, CA 93703-2286 VA San Bruno OPC Oakland, CA 94612 (559) 225-6100 (510) 267-7800 1001 Sneath Lane VA SOUTH VALLEY OPC VA MAUI OPC San Bruno, Calif., 94066 VA FAIRFIELD OPC 1050 North Cherry Street 203 Ho’ohana Street, Suite 303 (650) 615-6000 103 Bodin Circle, Bldg. 778 Tulare, CA 93274 Kahului, HI 96732 VA SANTA ROSA OPC Travis AFB, CA 94535 (559) 684-8703 (808) 871-2454 (707) 437-1800 3315 Chanate Road VA CASTLE OPC VA HILO OPC Santa Rosa, CA 95404 VA PALO ALTO 3605 Hospital Road, Suite D 1285 Waianuenue Ave., Suite 211 (707) 570-3855 HEALTH CARE SYSTEM Atwater, CA 95301-5140 Hilo, HI 96720 VA UKIAH OPC 3801 Miranda Avenue (209) 381-0105 (808) 935-3781 630 Kings Court Palo Alto, CA 94304-1290 VA SIERRA NEVADA VA KONA CBOC Ukiah, CA 95482 (650) 493-5000 HEALTH CARE SYSTEM 75-377 Hualalai Road (707) 468-7700 VA MENLO PARK DIVISION 1000 Locust Street Kailua-Kona, HI 96740 VA NORTHERN CALIFORNIA 795 Willow Road Reno, NV 89502-2597 (808) 329-0774 HEALTH CARE SYSTEM Menlo Park, CA 94025 (775) 786-7200 VA KAUAI OPC (650) 493-5000 VA LA HONTAN VALLEY OPC 3-3367 Kuhio Hwy, Suite 200 VA MARTINEZ OPC Lihue, HI 96766 150 Muir Road VA LIVERMORE DIVISION 345 West A Street (808) 246-0497 Martinez, CA 94553 4951 Arroyo Road Fallon, NV 89406 (925) 372-2000 Livermore, CA 94550 VA GUAM CLINIC (925) 373-4700 VA SIERRA FOOTHILLS OPC 11985 Heritage Oak Place US Naval Hospital VA MEDICAL CENTER Wing E-200, Box 7608 SACRAMENTO VA CAPITOLA OPC Suite #1 1350 N. 41st Street, Suite 102 Auburn, California 95603 Agana Heights, GU 96919 10535 Hospital Way (671) 472-7250 Sacramento, CA 95655 Capitola, CA 95010 (530) 889-0872 (831) 464-5519 (916) 843-7000 VA CARSON VALLEY OPC VA AMERICAN SAMOA CBOC Old Army Reserve Building VA REDDING OPC VA STOCKTON OPC 925 Ironwood Drive, Suite 2102 500 W. Hospital Road Minden, NV 89423 Pago Pago, American Samoa 96799 351 Hartnell Avenue (684) 699-3730 Redding, CA 96002 Stockton, CA 95231 (888) 838-6256 (209) 946-3400 (530) 226-7555 VA PACIFIC ISLANDS VA CHICO OPC VA MODESTO OPC HEALTH CARE SYSTEM VA REGIONAL OFFICE 280 Cohasset Road 1524 McHenry Blvd., Suite 315 459 Patterson Road & OUTPATIENT CENTER Chico, CA 95926 Modesto, CA 95350 Honolulu, HI 96819 MANILA (530) 879-5000 (209) 557-6200 (808) 433-0600 United States Department of VA MCCLELLAN OPC VA MONTEREY OPC VA PTSD RESIDENTIAL Veterans Affairs 5342 Dudley Boulevard 3401 Engineer Lane PSC 501 Seaside, CA 93955 REHABILITATION PROGRAM McClellan Park, CA 95652-1074 459 Patterson Road FPO, AP 96515-1100 (831) 883-3800 (916) 561-7400 Honolulu, HI 96819 (011) 632-523-6300 (808) 433-0004 Veterans' matters

Serving Our Women Veterans

n November 1994, the accessing VA benefits and Center for Women health care services. (Contact I Veterans was established information for all Network 21 in the Department of Veterans Women Program Managers can Affairs (VA) under the Office be found on page of the Secretary. Its primary 2 of this issue.) mission is to review VA programs VA conducts research on a broad and services for women veterans, range of issues related to women’s and assure that they receive health care, including breast benefits and services on a par cancer, osteoporosis, mental with male veterans, encounter health, post-traumatic stress no discrimination in their disorder and access barriers attempt to access them, and are to health care. The results of treated with respect, dignity and these projects have contributed understanding by VA service to improve health care for all providers. veterans within the VA network. Currently, women make up VA regional offices and health approximately 15 percent of the care facilities have continued active force, are serving in all to enhance women veterans’ branches of the military, and are programs and initiatives related eligible for assignment in most inside this issue: to outreach and personal military occupational specialties, assistance. It’s important to except for direct combat roles. Women Veterans recognize that the availability The increase in the number of Program Managers...... p. 2 of specific programs may vary women serving in the military from facility to facility. Just as in significantly impacts the services Women’s Trauma your own community, not every provided by the VA. Projections hospital or service provider offers Recovery Program...... p. 2 show that by the year 2010, exactly the same programs and women will comprise well over services. VA National News...... p. 3 10 percent of the veteran population, an increase of six VA recognizes the importance of VA Facility Highlights.... p. 4 percent over current figures. the contributions made by women veterans in the service to their VA has developed initiatives for country and the price many have A Laughing Matter...... p. 6 women veterans to ensure that paid to preserve our freedoms. they receive the benefits Our goal is to ensure that all Word Search Puzzle...... p. 6 to which they’re entitled. Most veterans receive the benefits and VA regional offices, medical health care services to which Resilience: A Tribute...... p. 7 centers and vet centers have a they are entitled by Law and designated Program Manager to are afforded these rights in a assist women veterans in Where to Find Us...... p. 8 courteous and effective way. We take pride in being a provider of choice to millions of veterans. n

The Wellness Publication from the VA Sierra Pacific Network Volume 1, 2008 Women Network 21 Program Veterans Program Managers Serves Women Who Suffered Trauma Northern California Health ecently, several national emotional disaster and must Care System (Sacramento) and regional media share with each other secrets Julie LaGuardia, NP R outlets ran stories about many of them held inside for a special program for women at decades. Women are treated for [email protected] the VA Palo Alto Health Care both combat PTSD and military 925-372-2494 System at Menlo Park. Called sexual trauma. the Women’s Trauma Recovery The program at Menlo Park Program (WTRP), it was the was established in 1992, and VA Pacific Islands Health first VA residential program is a recognized model for for women suffering from post- Care System (Hawaii) women’s trauma recovery, traumatic stress disorder Janis Cruce, MSN, FNP combining leading research, (PTSD) and/or military sexual clinical expertise and an [email protected] trauma (MST). interdisciplinary approach 808-433-0477 The WTRP staff is reaching out to pursue a common mission – to women who can benefit from improving the mental health this 60-day residential program of women veterans. VA San Francisco Medical for women veterans who are “Our program is about Center coping with the aftermath of facilitating that miraculous drive trauma. “The program isn’t Cheryl Wenell, RNP, MS to recover,” said Dr. Westrup. for everyone,” said Dr. Darrah “We help women who’ve survived [email protected] Westrup, who oversees it. “The traumatic experiences learn how interpersonal demands pose a 415-221-4810 X3956 to live fulfilling lives, despite challenge to women who have carrying heavy burdens. It’s all been extremely isolated and find about helping women reclaim it difficult to trust others. If we VA Sierra Nevada Health their sense of self-worth and could just reach these women Care System (Reno) personal power.” early in their trauma years, Denise C. Haynes we could save them so much To learn more about the [email protected] pain,” she said. program and/or how to be recommended for it, please visit Women come to the program 775-328-1864 www.womenvetsptsd.va.gov, or from all ages and walks of life. talk to your local VA health care Most arrive on the brink of provider. n VA Central California Health Care System (Fresno) Dr. Adrienne French [email protected] 559-225-6100 ext. 5446

VA Palo Alto Health Care System Ann Thrailkill, RNP, MSN, CS [email protected] 650-493-5000, ext. 64153 n

2 Veterans’ health matters VA National News

New Secretary of Veterans Department of Veterans Affairs whether veterans are in Affairs Named (VA) – the Compensated Work need of help with activities In December, Dr. Therapy (CWT) and Incentive for daily living. Therapy (IT) programs – are no James B. Peake, Dependency and indemnity longer taxable, according to the a combat veteran of compensation (DIC) benefit IRS. Veterans who paid tax on the Vietnam War and payments for survivors of these benefits in the past three former Army Surgeon veterans who died in service years can claim refunds. General, was sworn or from a service-connected in by President George W. Bush Recipients of CWT and IT disability can range from $1,091 as the nation’s sixth Secretary payments no longer receive a to $2,499 per month. Survivors of Veterans Affairs. Form 1099 from VA. Veterans of wartime veterans receiving Secretary Peake stressed who paid tax on these benefits death pension benefits are also his commitment to easing in tax years 2004, 2005 or 2006 entitled to an increase. The the transition of our current can claim a refund by filing an maximum annual payment rate generation of returning, combat amended tax return, using IRS for a surviving spouse can range experienced men and women and Form 1040X. from $7,498 to $11,985. Under each benefit program, additional of “the opportunity to look to the The CWT and IT programs allowances may be payable for future of this newest generation provide assistance to veterans helpless, minor or school age of combat veterans returning unable to work and support children. from Iraq and Afghanistan – themselves. Under the CWT getting it right for them and for program, VA contracts with For more information about VA their families.” private industry and the public benefits and services, visit VA’s Peake, who retired in 2004 as sector for work by veterans, who website at www.va.gov, or call a three-star general, is a board- learn new job skills, strengthen 1-800-827-1000. certified thoracic surgeon. successful work habits and regain a sense of self-esteem VA Is Leader in Hospice and His commands included the Palliative Care U.S. Army Medical Command, and self-worth. Veterans are compensated by VA for their The Department of Veterans headquartered at Ft. Sam in Affairs (VA) is providing hospice Houston, Tex.; Madigan Army work and, in turn, improve their economic and social well-being. and palliative care to a growing Medical Center in Tacoma, number of veterans throughout Wash.; the 44th Medical Brigade Millions Receive VA the country as the need at Fort Bragg, N.C.; and the Cost-Of-Living Increases continues to rise for care and 18th Medical Command in Seoul, As of January 1, the Department comfort at the end of life. South Korea. of Veterans Affairs (VA) began VA provides palliative care providing a 2.3 percent cost- A native of St. Louis and a consultation services at each of-living increase in disability graduate of the U.S. Military of its medical centers, and compensation, pension, and Academy at West Point, Peake inpatient hospice care in many survivors’ benefits for millions attended medical school after of its nursing homes throughout of veterans and eligible family serving in Vietnam, where he the country. VA contracts members. Under the disability earned the Silver Star and with community-based hospice compensation program, tax-free Purple Heart. programs to enhance VA’s ability payments will generally range to provide this critical service As Secretary of Veterans Affairs, from $117 to $2,527 per month, when and where needed. Peake assumes leadership of the depending on the degree of Department of Veterans Affairs disability. Special payments up Nearly 9,000 veterans were (VA), the second largest cabinet to $7,232 per month apply to the treated in designated hospice department, with about 250,000 most severely injured veterans. beds at VA facilities in 2007, and employees and a budget last year thousands of other veterans were The maximum annual pension exceeding $82 billion. referred to community hospices disability rate for permanently to receive care in their homes. n Work Program Payments and totally disabled veterans Ruled Tax-Free or veterans over age 65 can Payments to veterans under range from $11,181 to $18,654, two specific programs of the based on household income and

www.visn21.med.va.gov 3 New 3D Imaging Laboratory Opens The San Francisco VA scanners and combined it with expanding use Medical Center recently graphical software to create of 3D imaging opened its newly remodeled two-dimensional and three in everyday 3D Imaging Laboratory dimensional images of the colon patient care. – an expanded state-of- that the radiologist can use for 3D imaging is the-art laboratory that patient diagnosis. now used for: offers the latest in 3D Coronary CT The clinical impact of the Virtual Judy Yee, MD, visualization methods. angiography, Radiology Service, Colonoscopy has been significant aneurysm SFVAMC The concept of a 3D and the SFVAMC was one of the evaluation. imaging laboratory was first in the country to make it musculoskeletal applications, developed in 2002 by available to veterans. This test is CT urography, and brain/body Judy Yee, MD, SFVAMC’s now used clinically at other sites san francisco perfusion techniques. Chief of Radiology. Dr. throughout the world. Yee conducted novel This laboratory will allow the The new 3D Imaging Laboratory research on Virtual Colonoscopy SFVAMC to continue to be a houses many state-of-the-art (CT Colonography) as a new leader in the field of 3D imaging, post-processing workstations technique for colorectal cancer and will provide for excellence with multiple different computer screening. This test made use in clinical care, research and platforms needed to address the of the data obtained from CT teaching. n Palo Alto VA Introduces New Women’s Center The Women’s Prevention, promotion, case management, who served in Iraq during part of Outreach & Education psychoeducation, and group and 2003-2004. “I was very impressed Center (WPOEC) is a new individual therapy. with the comfortable environment outpatient mental health that addressed women’s specific One new service available through program at VAPAHCS, needs and concerns.” WPOEC and collaboration with developed to meet the the Women’s Health Center is To learn more about the needs of our rapidly the Returning Women’s Health program, please call the WPOEC growing female veteran Connection Clinic, a primary general information number at population. WPOEC care clinic for women who have 1-888-4HER-1VA, or you may provides clinical care, recently returned from Iraq visit its website www.palo-alto. outreach, education or Afghanistan, stateside or med.va.gov/WPOEC.asp. For and research, with a palo alto overseas. “The one-stop shop specific questions regarding focus on the provision approach was a timesaving, eligibility or enrollment in of gender-specific care. efficient and effective way to get WPOEC or VA services, please Services include assistance a holistic perspective on your contact Renee Wagner, MSW, with enrollment and eligibility, current health,” said Air Force at 650-493-5000, ext. 22558. n screening and assessment, health veteran Patricia Teran-Matthews, VASNHCS Welcomes Doctor Cipollina The VA Sierra Nevada not come at a more appropriate Manager. Health Care System time. The remodel will include “In the brief Women’s Health Program a separate Women’s Health time that Dr. is pleased to introduce Clinic, with two exam rooms and Cipollina has Dr. Carmela Cipollina, a private waiting area for our been on board, Women’s Health, women veterans. The remodel I’ve received Ambulatory Care. Dr. should be complete by the end of rave reviews Cipollina is our full-time 2008 or the beginning of 2009. from our women Women’s Health GYN veterans who’ve “Here at VASNHCS, we can Dr. Carmela provider. been seen in our now say we have a truly Cipollina, Women’s Women’s Health With our upcoming comprehensive Women’s Health Health, Ambulatory Clinic.” n

sierra nevada Primary Care remodel, Program,” said Denise C. Haynes, Care, VASNHCS her arrival could Women Veterans Program

4 Veterans’ health matters VAPIHCS’s new CT Scan The VA Pacific Islands to create images of the body. Health Care System (VA This technology can create more PIHCS) recently dedicated detailed images in a shorter a new 64-slice Computed amount of time. The CT scanner Tomography (CT) scan, the is a large donut-shaped X-ray newest generation in CT machine that takes X-ray images scan technology. It has the at many different angles around the central part of the body being ability to do cardiac studies the body. In each of these images examined. When these levels are and angiograms without the body is seen as an X-ray further added together, a three- the need to hospitalize slice, which is recorded digitally. dimensional picture of an organ patients for arterial Imagine the body as a loaf of or body structure can be obtained. catheter placements. The bread and you are looking at one That picture can then be rotated pacific islands 64 “slices” refer to the end of the loaf. As you remove and viewed from all different number of images that are each slice of bread, you can see angles. VAPIHCS’s new CT Scan gathered at one time. Original CT the entire surface of that slice is only one of two located in the scanners used only one detector from the crust to the center. The Hawaiian Islands, and is another to gather information, modern body is seen on CT scan slices in example of how we provide the scanners use multiple detectors a similar fashion from the skin to best health care anywhere for our Pacific Islands veterans. n New Services Available at VANCHCS Two new health A cochlear implant is an electronic for VANCHCS patients is at the opportunities are currently device that overcomes damage San Francisco VA Medical Center. available to our patients. to the inner ear hair cells by Age-related macular degeneration One is our recently providing electrical stimulation is the leading cause of vision loss approved capability of to the remaining auditory nerve in the United States for people identifying and providing fibers. Veterans who have been over 60 years old. An NIH clinical implanted with this device are care for cochlear implant trial is studying 4,000 patients those whose hearing loss is of such patients, and the second nationwide by looking at the severity that they do not benefit is the opportunity for effects of vitamins and nutritional from hearing aids. patients diagnosed with supplements on the eye. age-related macular Pre-implant evaluations to identify VANCHCS is the only VA degeneration to take part candidates are available at the northern california facility in the country included in a unique research project Outpatient Clinics at Redding, in this research trial. Interested sponsored by the National Chico, Martinez and McClellan patients may contact Dr. Linda J. Institutes of Health (NIH). Park. The closest Surgical Center Margulies at 925-372-2600. n Centralized Check-In Services Now Available Veterans can now sign in these changes. There has been for their outpatient clinic a 50 percent reduction in returned appointments using the appointment reminders due to new centralized check- wrong addresses on file. in counter located at the The centralized check-in process main entrance of the is used for most appointments, but Medical Center. This new not all. Patients who arrive for service allows veterans and has a private office for various procedures, like laboratory, the convenience of one updates on personal financial X-rays and EKGs, are not required check-in location for all information. During the check- to do so. Some clinics, like mental

central california their appointments, to in process, veterans can update health and the emergency room, get information about addresses, telephone numbers, are also excluded. The new check- scheduling and to update their health insurance coverage, and in process is quick and easy and personal information, all in changes to annual earnings. The the friendly check-in staff is one stop. opportunity to update a veteran’s eager to enhance each veteran’s The new space is designed administrative records has been appointment with courtesy and for handicap accessibility extremely convenient and helpful a smile. n to those who need to make

www.visn21.med.va.gov 5 A Laughing Matter: High School Sweethearts eorge and Edith had They walked in and asked George: “Hearing aids, denture been high school the pharmacist: “Are you the supplies and reading glasses?” G sweethearts 50 years owner?” “Yes sir, I am,” he said. Pharmacist: “Yes.” ago, but had gone their “How can I help you?” separate ways after graduation. George: “What about eye George: “Do you sell heart Then, two years ago, their drops, sleeping pills, Geritol, medications?” paths crossed again, and Preparation-H and Ex-Lax?” they began seeing each other Pharmacist: “Of course.” Pharmacist: “Absolutely.” regularly. With age 70 just George: “What about around the corner, they decided George: “You sell wheelchairs, medications for rheumatism, they might as well spend the walkers and canes?” osteoporosis and arthritis?” rest of their lives together. Pharmacist: “Yes, indeed. But Pharmacist: “All kinds.” Excited about their decision to why all these questions?” George: “How about support marry, they went for a stroll George smiled, glanced shyly to discuss the wedding and hose, waterproof furniture pads at Edith and replied, “We’ve what plans needed to be made. and Depends?” decided to get married and we’d Finding themselves in front of Pharmacist: “Yes, sir.” like to use your store as our a drugstore. George said, “Let’s Bridal Registry.” n go in. I have an idea.”

E P F Q Q Y E H I I C H A Y R U N D D T B M B W U J Z C Z Q E C M I N F M E F D T U Q J V I O Q V F O L K X Q K P H F M U B J O Z M A w G M C B P N V Z I E L H O Y Z Z A Z K I D G B J E C P G T L U U C w P B R A B I R L D U P R L N O G N R D Z R N Z D R P T T J I T P Y K F S M U H I I D P H E A D M I R A T I O N w K E H Y T X V B A J D I C E F C X A N I F M R C V R Y R Q O U D Q G L Q O L U R A Z C Z I I L N M V E Q R T E R E I S M V Y E F Q R E V S I P K W A Q P I I H N S M U F E H R V S R R T K A M U C V M O I I D E A D F J R w B E G L I L D V W H V I N X R C R R I L Y E Y S O U C F T D V S E U S S I Q N M G H G P Q N F D J M E E R M K w P F U L R Z F O L R E D I V O R P N B J P P R I D E T U R D R K V L F T Y C D U E Y P J N Q U T S E L T C P S O Q Y B E I V G B X M Z

o ADMIRATION o IMPROVING o PRIDE o RESILIENCE o BENEFITS o ISSUES o PROGRAMS o SERVICES

W ORD SEARCH o CONTRIBUTIONS o MILITARY o PROVIDER o TRAUMA o IMPORTANCE o OUTREACH o RECOVERY o WOMEN

6 Veterans’ health matters Resilience: A Tribute Duty, Honor, By Joel Schmidt, Ph.D. Psychology Internship Training Director, VANCHCS Country listen to unpredictable ways of giving people for back some meaning to their I a living. lives. For example, there was As a psychologist a veteran whose most powerful in VA, I hear therapeutic experience was about some of the helping his grandmother keep worst experiences her small business running. This humans have to cause gave him a reason to care, bear. I’ve sat face-to-face with a someone to emotionally connect Bataan Death March survivor, with and ultimately a reason or an airman shot down over get up in the morning. Germany, a Marine who was at This might sound like naive the Chosin Reservoir, veterans optimism when, in fact, treatment from every region of Vietnam, is often long and hard. Not every medics and infantry soldiers from story has a happy ending. Some Afghanistan and Iraq. days when I go home my head I’ve spoken with people who hurts. I feel sad, or worried, or have faced unthinkable abuse angry, or ineffective. On those in childhood, others who’ve been days, I have to appeal to my assaulted and brutalized by own strategies for self-care, pick their own comrades, and parents myself back up, and keep going. who’ve had to attend their own I went to school to learn about children’s funerals. people, and how to help them get I’ve gained a surprising Duty, Honor, Country – these three words, made belief from famous by General Douglas MacArthur during his hearing address to the 1962 West Point graduating class, about so were the inspiration for these posters, designed by much agony: Jon-Nolan Paresa, Visual Information Officer at the I believe VA Northern California Health Care System. in the power of human resilience. I’m better. Instead, it’s often the very continually inspired by the ability people I’ve spent my career trying of the emotionally wounded to help who remind me how to to pick themselves up and care for myself. I keep a catalogue keep going after enduring the of them in my head, and I try most traumatic circumstances to use this list as a road map, imaginable. an inspiration, and a reminder of what human resilience can Operation Iraqi Freedom achieve. Veterans describe to me the constant hell of unpredictable I make it a point to compliment IED attacks and invisible snipers. the people who sit in my office By the time they get home, many on their strength and ingenuity. can’t drive on the freeway, or But the truth is, I don’t think be in the same room with old many of them realize the depth friends. One vet described it as of my admiration. Sitting with being locked in an emotional cage, these people every day allows between numbness and rage. me to hope that I might also find strength to face future Emerging from this terrible adversities. This solid sense of backdrop, many Operation hope is a gift, and it’s my humble Iraqi Freedom Veterans have desire to share it with the next surprised me with their person who sits with me. n drive to recover, and their

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