Monday, June 04, 2007
Possible connection is subject of studies, legislation
By Laura Ungar
Bob Wolz blamed dehydration and the blazing sun for his mysterious blackouts during the first Gulf War.
But he had no idea what to think when his left arm and leg got weaker and thinner than his right limbs. The problems continued after he returned home, and last year, two years after retiring from the military, doctors diagnosed Wolz with multiple sclerosis -- which the Army veteran now considers a lingering wound from his first tour of duty.
"I was exposed to something," he said.
Wolz, of Rineyville, Ky., is among a growing number of Gulf War veterans who have developed the chronic neurological disease, suggesting a possible connection to toxic substances or other environmental triggers during wartime.
That possible link, hinted at in a couple of past studies, is the subject of new research, funding efforts and legislation. A Georgetown University doctor who identified more than 5,000 service-connected MS cases is now looking specifically at veterans of the Gulf War in 1991.
The National Multiple Sclerosis Society is pushing for $15 million in research funding for the Department of Defense. And a bill before Congress would help veterans with MS get disability benefits more easily.
Backing up such efforts is a study published in 2005 showing that MS among Kuwaitis more than doubled between 1993 and 2000.
So far, there are no firm statistics on the number of Gulf War veterans with MS. But Julie Mock of Washington state, president of an advocacy group called Veterans of Modern Warfare, said she knows of at least 600 nationwide and gets calls and e-mails from new sufferers every day.
"People are coming out of the woodwork," said Mock, a 40-year-old Gulf War veteran with MS.
Wolz, 42, is not surprised that other soldiers who served in the Gulf struggle with the illness. Looking back, he recalls several possible triggers, from anthrax vaccinations to chemical exposure. He was a decontamination specialist with a chemical unit, and was in Kuwait when the Iraqi oil wells burned, turning the sky so black he couldn't tell whether it was night or day.
Experts said studying veterans like Wolz could have wide implications for the 400,000 Americans with MS, which has no known cause. Dr. John Richert of the MS society echoed others, saying that finding an environmental trigger "would break new ground," pointing the way toward better treatments or even a cure.
MS takes its toll
On a recent morning, Wolz sat at the edge of the examining table at the Louisville Veterans Affairs Medical Center as Dr. Manjari Motaparthi checked the strength and feeling on both sides of his body.
She asked him to follow her finger with his eyes, lightly touched his cheeks, then pressed on his left leg and noted, "It's a little bit weak here."
"It hasn't gotten better," he told her. "It hasn't gotten worse, either … well, maybe a little bit."
Over the years, MS has taken its toll. In addition to losing muscle tissue, Wolz can't stand the heat, is prone to falls and has memory problems that he copes with by writing notes to himself.
Wolz said he hasn't had trouble getting military benefits for his disability, as some vets have. But getting diagnosed wasn't easy, he said. None of the doctors he visited at military bases and in war zones found any serious problems.
Then, after Wolz retired from the Army in 2004, his family doctor in Elizabethtown told him he might have suffered a small stroke. He was referred to a physical therapist at the VA, who disagreed and suggested more tests.
A scan confirmed MS, which occurs when a fatty tissue that helps nerve fibers conduct electrical impulses -- called myelin -- is lost. Wolz had the most common type, relapsing-remitting, which is characterized by flare-ups and recoveries.
The main treatment, giving himself shots of interferon beta-1 three times a week, has proved difficult. "It took 45 minutes before I could even do it the first time," said Wolz, who is now working as a military analyst. "I do not like needles."
Dr. Stephen Kirzinger, medical director of the University of Louisville's MS Care Center program, said he is intrigued by the research exploring the connection between MS and the Gulf War, since he has treated several veterans at his local clinics.
MS is thought to be an autoimmune disease related at least partly to genetics, and is more common among women and people who spent their mid-teenage years in northern climates. While researchers have long suspected a trigger, they have mostly considered infectious agents such as viruses.
But the Georgetown study, led by Dr. Mitchell T. Wallin and published in the Annals of Neurology in 2003, said the higher-than-normal MS rates found among veterans who served from 1960 to 1994 "strongly imply a primary environmental factor in the cause or precipitation of this disease."
Other studies, which looked more generally at the collection of problems dubbed "Gulf War Syndrome," mention the possible dangers of oil-well smoke, vaccines and sarin from the destruction of weapons. Army Times reported last month that researchers at Boston University have all but determined exposure to sarin gas in 1991 is the cause of Gulf War Syndrome.
Mock said she thinks scientists will find a link because the anecdotal evidence is undeniable. Among a detachment of 60 people who served with her in southern Iraq, she said, "there were three of us within 100 feet of each other" who now have MS.
Benefits and research
As research continues, so do efforts to help these veterans.
U.S. Sen. Patty Murray, D-Wash., reintroduced a bill in March to help them qualify for VA disability benefits. The legislation would remove a seven-year limit veterans now face for connecting their MS to military service after an honorable discharge. The bill would also ensure the condition is presumed to be caused by military service if diagnosed later.
Congress is also expected to decide by August about giving the Defense Department the $15 million in federal research funding. Shawn O'Neail, associate vice president of federal government relations for the MS society, said the money would go to the department's Congressionally Directed Medical Research Programs, which would distribute it using a peer-reviewed application process "with a preference given to combat service" studies.
"It's definitely something that needs to be researched further," O'Neail said. "Whatever the benefits of the research are, they could be applied to everyone with MS."
Meanwhile, Wolz continues his personal battle. Motaparthi called his prognosis "favorable" and said he may be able to keep the disease at current levels if the injections continue working.
Nothing is assured, however; half the people with his type of MS go on to develop another type in which the disease steadily gets worse.
Wolz's wife, Linda, said although her husband is dealing well with the disease, it has changed family dynamics. Their children are gentler toward her husband, she said, more like parents.
"I get worried when he's here alone," said daughter Bianca, 16. "I don't want him to fall."
Wolz tries not to dwell on the possibility that he may someday need a wheelchair to get around safely, or that MS will compromise his future.
"If I focus on that, I can't focus on fighting it," he said. "I have too many things I want to do in life."
Reporter Laura Ungar can be reached at (502) 582-7190.