Welcome to Veterans Radio.
I am Jim Fossone.
I'm the officer of the deck today.
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Two interesting segments today for veterans and their friends and family.
First up, and I don't know that we've ever really had a discussion on this on Veterans
Radio, is about the VA dental benefits that are available and VA dental insurance which
is available to every veteran.
So kind of an interesting topic.
And second, we're going to talk about veterans and their exposure, I guess, prevalence to
Parkinson's disease with a veteran and the Parkinson's Association.
Probably something you ought to listen in and learn about.
Hopefully, you'll never have to worry about it.
But then again, so listen in.
We want to welcome to Veterans Radio today the Assistant Undersecretary for Health for
Dentistry, Dr. Christine Lamar.
Dr. Lamar, welcome to Veterans Radio.
Thank you.
Thank you so much for inviting me.
I'm really excited to talk to you today.
Well, we're really looking forward to getting some information out to our veterans about
the VA's dental policies and those benefits.
But let me set this up a little bit.
You completed your general practice residency at the VA Long Beach Health Care System in
California in 1998.
In 2002, you became Chief of Dental Services.
You've also served at VISN 22 as the lead dentist for seven years and the Office of
Dentistry Infection Control Consultant for six years.
You were appointed the Director of Operations in the Office of Dentistry for 2021 and the
Acting Undersecretary in 2023.
So you have a long history with the VA and you're an active member of the American Dental
Association and a fellow in the International College of Dentists.
And we're going to ask you some questions about some ADA information later.
But you bring a real focus on dental health care with veterans.
How did that become of such an interest to yours?
And tell us a little bit about your career.
Yeah, great.
Thank you for asking.
So I first started off, my first love was to work with communities.
Prior to coming to the VA, I ran a Ryan White clinic, which was a dental clinic for individuals
with HIV and AIDS.
And kind of fell in love with that sector of the community outreach.
And I had always, I loved my residency.
I did it at the VA.
And when an opportunity opened up, I looked into it and I thought, this is the perfect
place for me.
My grandfather was a World War II, 100% service connected veteran, my father's a Vietnam veteran.
So I always felt like I've been a caretaker, so to speak, of veterans throughout my life.
We often find when we ask that question that back in the family history somewhere, there
are family members who have been veterans.
And certainly, both your father and your grandfather obviously had an impact on your
career choices, I think.
Yeah, no, definitely with my grandfather, especially with him being a 100% service
connected veteran, he got all his care through the VA and he even lived in a veteran community
in Florida.
And I used to spend my summers down there.
My parents, we were in Michigan and my parents would, I know kind of the opposite right of
a snowbird, but I would go down to Florida for the summer and spend it with my grandparents
down there in Florida.
Thank you.
Let's turn to veteran dental care because I think a lot of people struggle with understanding
how one qualifies for this benefit.
You shed some light?
Yeah, absolutely.
And that's probably the most common question we get, right, is who's eligible for VA dental
care?
And this question most often refers to VA provided dental care.
In order to qualify for the VA provided dental care, a veteran would need to meet certain
criteria set by law.
And some veterans may have a limited eligibility and others are eligible for what we call comprehensive
dental benefits.
I actually have a, I'm going to go into it a little bit for you, but I actually have
a fact sheet that I can send you.
If you have a website, we could put up for folks to look at as well to help with this.
Oh, absolutely.
Yeah, I'll give it to you later and we'll put that up on veteransradio.org as well as
the social media pages.
Okay, perfect.
Thank you.
So for comprehensive dental benefits, there's about four categories a veteran would need
to, or criteria, excuse me, a veteran would need to meet to go into that.
One is they would need to have a service connected, compensable, dental disability or condition,
be a former POW, have a non-compensable dental condition or disability resulting from combat
wounds or service trauma.
Or, and this is our most common category that we see in our clinics, is they have a service
connected disability rated at 100% or unemployable and paid at the 100% rate due to their service
connected conditions.
So if I have what's commonly known as TDIU, which gets me rated at 100%, that would be
that fourth category?
Yes, yes.
And then we do have some limited categories of care.
So I'll give you one example of that.
For a veteran who's been recently discharged from the military, they would become eligible
for one-time dental care if at the time of discharge, they did not have all of their
dental treatment completed by the military and that was notated on their DD 214.
These categories are pretty clear.
I don't know why they're not so well known.
As you explore this issue as the Assistant Undersecretary for Health for Dentistry, why
doesn't the message get out more, do you think?
You know, that's a great question and something we absolutely are pondering as well.
And it's just a lack of awareness.
And so I think that folks are not really sure, dental's kind of that area of the hospital
that maybe they're not as familiar with and they are not just aware of that.
You know, sometimes people have their own dental insurance and so they think, oh, well,
I have a dental insurance, I can't use the VA dental.
Well, that's actually not true.
You can use your own insurance and you can use the VA dental benefit, but we want every
veteran to use all of their earned benefits, especially their dental benefit.
Absolutely.
They earned them through their service and they shouldn't be shy about using them.
I saw in some research that VA provides medical care for about 9 million veterans, but only
about 1.8 million are eligible for dental care and only about 40% of those who are eligible
actually use the care.
So there's a big gap between those who are entitled to and those who actually use the
care.
One of the questions I guess I'd have, and this seems awfully naive on my part, but does
every VA hospital have access to a dental clinic?
So every hospital except for one has a dental service associated with it.
So when I say that, what I mean is, you know, you might have a hospital in a location and
then in the CBOC, they have dental clinic or it could be in the hospital, but we do have
dentistry associated with every hospital except for one in the country.
And so the dental services might be provided, you mentioned a CBOC, which is a community
based outreach clinic.
So it might be in the clinics versus in the hospitals.
Is that what you're saying?
It could be.
Absolutely.
We have many, many in the hospital, but you know, depending on the region and the access
and where the veterans live, we do have them in different locations.
Now I saw a report from some researchers at the American Institute of Dental Public Health
and CareQuest Institute.
I don't even know who all those people are, but they say that veterans have a higher rate
of dental problems than the civilian population, including issues with tooth decay and gum
disease.
Does that sort of track what you have found in your role as assistant undersecretary for
health for dentistry?
We have.
We do see.
I'll be honest, I haven't looked at the literature exactly what you're referencing, but we do
see our veterans have a high rate of periodontal disease and dental carries.
I think though, when you look at some factors, such as the age of the population we're treating
and other things, it might be closer to the norm with that.
But we definitely make sure we're focusing because we know that is very important to
our veterans.
So there's a couple of things we really look at.
We have some quality indicators in place to make sure we're getting patients in for
recalls.
We have fluoride interventions and all these different preventive things that we focus
on because we do want to make sure that their oral health is optimized.
Yeah, I think there's general recognition nowadays that your oral health does relate
to your overall physical health, doesn't it?
Yes.
Absolutely.
So oral health is part of whole health and we've had some articles out there that absolutely
do not necessarily it's cause and effect, but it can have different, you know, we know
it can affect those chronic diseases.
So what services, Dr. Lamar, are actually available?
Is it just cavities and pungent teeth or is it cleanings and x-rays?
I mean, when we talk about available dental services, broaden that out for us a little
bit.
Yeah.
So we offer the full gamut of dental services outside of maybe a couple of things and I'll
get into those as well, but we offer everything from exams and x-rays, fillings, all the way
up to implants.
So we have a full gamut of services.
I think what is maybe sometimes difficult to understand about the VA versus just going
into your private dentist is that we don't have a list of things that it says you can
have these things.
We create a customized treatment plan for every veteran that comes in.
That's a big difference because in the private sector, it's what is your insurance allow
and we'll do this?
Exactly.
And that's where we focus on what is going to get you to the optimized oral health.
So that is our focus and sometimes we might say, this is what we are going to do today.
Let's get your oral health up to that and then let's move on to that next step and see
what we can do then.
But we sometimes take a, we really take a long-range approach where our focus is on,
let's get you up to that optimized oral health with this customized treatment plan.
So as somebody who's not a big fan of dentists and who's had root canals and crowns, I assume
your treatment services include those sorts of things and maybe even dentures?
Yes, absolutely.
We include crowns, partials, dentures, root canals.
You name it, we have all of those things and we even have in some of those areas, we have
residency programs teaching people how to become specialists in some of those arenas.
So we definitely provide all of those services.
I'll go back because I realize I didn't mention the couple of things that we don't do.
We don't do dentistry purely for cosmetic purposes and then orthodontia is not something
we offer unless you need orthodontia as a result of a CERNUS trauma condition.
Certainly, yeah.
One of the challenge, I'll come to the challenge in a minute, but you mentioned residency and
I always like to take a minute to remind people and I assume it's true in your area because
you did your residency, general practice residency at VA Long Beach.
I think people forget how much training the VA does.
Can you, and this is medical doctors and nurses and PAs and everybody else, I never thought
about the training, the teaching it does in the area of dentistry.
Can you elaborate on that a little bit?
Yeah, we have incredible training programs.
We have general dentistry residencies, we have specialty residencies in the VA.
We even have dental hygiene, we even have some dental assisting programs that come in
to our clinics.
What's great about this is it becomes our program where people get to know about the
VA and then they want to come work for the VA.
When I go and post for positions, I've got folks who've come into my service who know
already about the veterans and our mission and want to be part of that.
I have to say when I was the chief, I think almost all of my dental staff had done a residency
at a VA.
No, that's excellent.
Again, I think one of the great, unsung stories to the general public is how much the VA does
in research and training and that's a benefit to the whole community, not just the community
of veterans.
Let me ask about the challenge though.
I suspect like many VA services, there may be challenges about staffing and having enough
personnel and budget to meet the need.
Can you talk about the challenges?
Yeah, absolutely.
So last year, VA dental clinics, we provided 5.5 million procedures to more than 560,000
veterans and that still didn't meet all of our need.
In addition to that, we spent $1 billion in the community because we needed to make sure
our veterans had access to care for the mission act.
I'm sure you're familiar with the mission act.
Those standards apply to dentistry.
Okay, I was going to ask that.
That's good to know.
Yeah.
So for example, when I talked about veterans in Vermont, we're not just letting veterans
in Vermont go without dental care.
We still serve them through community care and that would be one area where you would
see that.
So if we can't provide that care in-house, we will provide that care in the community
or if that veteran meets that drive time standard as well.
So that's the challenge.
So the originally going back to your question, our challenge is, I would say our challenge
is more having space, having dental treatment rooms is really the challenge we're facing
right now to get all of our eligible veterans in, especially in where we're seeing these
areas of the country with large growth.
And that is a very complicated question because it takes congressional dollars to build out
all those rooms and add all that equipment before you can even get to the personnel issues,
isn't it?
Right.
Exactly.
You know, that's exactly right.
You have to have that space to treat that veteran and then we're doing, you know, bringing
in folks.
I have to say because of those training programs we have and things like that, we've done fairly
well with being able to recruit dentists.
The area right now, and this is true not just in VA but across all of dentistry.
The American Dental Association has spoke about it, but we're seeing a nationwide shortage
of dental assistants and dental hygienists.
Help the uneducated out like myself.
What's the difference between an assistant and a hygienist?
Sure, absolutely.
So a dental assistant is that person who you usually see helping the dentist when you're
getting your treatment.
The dental hygienist is the person you see when you go in for your cleanings.
And those would be, you know, every six months when you go in for those cleanings in your
dental office.
Usually you see a dental hygienist.
Right, right.
So let me go on to another area that may become a challenge and there's been some articles
written on because of the 2022 promise to address Comprehensive Toxic Act, better known
as the PACT Act, that we're going to see a lot more veterans qualifying for dental benefits.
Is that something you're thinking about now in the office there?
Oh, absolutely.
We have absolutely, that's one of the areas, the strengths of our office is Dr. Trap who
I think you read about in that ADA article you mentioned at the beginning.
We have a dental resource model that is a data-driven model along with geospatial information
that looks at and predicts where our veterans be, where do we need to build our clinics
for that.
In addition to that, we are looking at, one of the wonderful things the PACT Act did was
give us these different authorities to expand.
And so we've gone into agreements with, or lease agreements with the Department of Defense.
We're seeing more and more joint DOD VA clinics.
We're looking at leases in private, a dental office that maybe is vacant.
Can we lease that space and use it as well as traditional expansion.
So all of those things are being put into place.
Well, that's one of the things that I think, again, the VA does a pretty good job of it,
which is trying to think ahead about where is this going, what do I need to be doing,
I meaning VA, what does VA need to be doing to address these future set of complexities.
There is another benefit I wanted to talk about with you and that is the VA Dental Insurance
Program.
I'm sure that if I had 100 veterans in the room now, okay, I'll say one of them might
have ever heard of this.
I'm not even sure if one has.
Can you talk to us about this?
Yes, absolutely.
So the VA Dental Insurance Program, if a veteran does not qualify for VA dental care, or maybe
they only get limited care and they're enrolled in VA healthcare, they have the option to
enroll in a Veterans Affairs Dental Insurance Program.
And what that is that's administered by Delta Dental and MetLife, and you can, it's similar
to what I as a VA employee can choose for my own personal dental insurance.
And you can, there's different programs, different levels, different geography.
So for example, you can do a veteran only program plan with maybe, you know, it gives
you your traditional cleaning exams, and then would cover maybe some work at 50% for maybe
$20 a month.
And it also can offer extensive programs where it covers more extensive procedures, maybe
those root canals and crowns you were talking about.
And you can also sign up with a veteran and spouse, and that could maybe be about $60
a month for that more extensive plan, depending of course on your geographic location, it
varies.
And this is available because I have my veteran status.
I don't have to be a member of a union or part of this company or that company.
I can sign up for this because I'm a veteran.
That's correct, but you do have to be enrolled in VA healthcare.
Yes, absolutely.
We remind everybody that even if you aren't entitled to healthcare under any of these
various circumstances, you should still be enrolled in VA healthcare for the, when that
day comes that maybe you need it.
So we...
Exactly.
I have this argument with my father.
And that's one of the great things that PACTAC did was I actually got him to sign up for
VA healthcare when the PACTAC came out and I used, you know, look at during COVID, he
could have access to different services.
The VA was at the forefront of offering if he'd been in part of healthcare.
Signed up.
And as I say, the dental benefits aren't really widely known and the dental healthcare insurance.
Boy, that was a first for me.
Before we close up here, I want to give you the chance to cover anything that I've not
mentioned where you go, well, people don't know about this either.
That's why he can't ask.
What did I not cover that you think I want to get out to the wider veteran audience?
Yeah.
No, thank you for doing that.
You know, I think that VA dentistry is, I mean, we're here for the veterans oral health.
That's why we're here.
And our providers, we have a dental patient satisfaction survey.
And people who come in and see our dental providers are nine times out of 10 most of the time,
they're rating our providers in the care they received very highly.
And that's very important to us.
And like you said, you're not a huge fan of the dentist.
The best way to make sure you don't have to come in is through prevention.
Absolutely.
Yeah.
Even though you don't want to see us, see us before you have to.
Absolutely.
And we want to thank Dr. Christine Lamar, assistant under secretary for health for dentistry at
the VA for coming in and talking to us today to spread the word about the services that
are available, the amazing work that the dentists do both in terms of training and research,
and help get the word out on something that maybe people didn't know about, which is the
VA dental insurance program.
Dr. Lamar, thank you for your time today.
Thank you for inviting me on and letting me get the word out to veterans about VA dentistry.
Okay, let's admit it.
You didn't know anything about VA dental before you heard this program.
That's why we do veterans radio.
We want to get information out to our veterans, to their friends and family about benefits
that veterans have already earned because of their service.
And really the wide range of things that may be available from the VA that gosh, you just
didn't even know we're there and may make your life a lot easier.
And as I said during the discussion, I had never heard of VA dental insurance.
So even that, that you have access, your family has access to an insurance program, government
designed for dental insurance because you're a veteran.
Pretty cool stuff and I'd encourage people to look into that if that's an item that they're
missing from their healthcare portfolio.
So stick around, we're going to have a few words from our sponsors.
And then we're going to have a discussion about really a dreadful disease Parkinson's
disease.
But again, one of those things that you have to know about, you have to know how it relates
to veterans and maybe your service and how there are services, there are national providers
available to ease this process.
I actually just this week had an opportunity to mention this, you know, to a family that's
struggling with a recent diagnosis.
So listen in.
veterans affairs.
If you have a VA claim denied by the Board of Veterans Appeals, contact Legal Help for
Veterans at 1-800-693-4800.
They're experts in handling cases before the U.S. Court of Appeals for Veterans Claims.
Their number again, 1-800-693-4800.
So sing a little of the songs of the Vietnam War Prozent was during the unter Long Island
and sleeping there.
So we're doing a little shout out and love to the West Point to the Army.
This is football season and us guys in the water whether you be Navy, Coast Guard, NOAA,
Merchant Marine, you know we got to look to the Navy football team to represent but let's
face it this year it's Army.
Armies whooped out everybody they continue the season I think they got the Commander's
Cup well in hand but enjoy football while it lasts it is November and soon we'll be
I guess moving over to hockey but we got a month or two here of playoffs it ought to
be fun but that's why we did the Army song and now we're going to talk with folks on
this as I say really horrible disease Parkinson's but there is hope and there is support.
We want to welcome to Veterans Radio today a couple of gentlemen we're going to talk
about Parkinson's disease and its involvement in relationship with veterans in your service
we're going to talk to Mark Kelm.
Mark welcome to Veterans Radio.
Well thank you very much Jim.
Mark we'll talk about his military service here shortly but we also have on the line
John Lair who's the CEO of the Parkinson's Foundation.
John welcome to Veterans Radio.
Thank you so much Jim it's a pleasure to be here.
Mark let's start with you a nice kid like you from Minnesota you joined the Army Reserves
in 1989 you serve on active duty for a few years you spend some time in the National
Guard you held a role as a military chaplain.
Flesh that out a little bit tell us some more about your military service.
Sure from 1989 until 1996 I was enlisted guy I served in the 205th Arctic Light Infantry
in the Army Reserves and then transferred over to the 34th Infantry Division with the
Minnesota Army National Guard in 1996 I was commissioned in Osir a second lieutenant and
I served in the New York Army National Guard and had active duty time on after that so
it's kind of a career that went from 1989 to 2006 and I loved almost every moment of
it.
Oh yeah nobody believes it if you say you loved 100% because we all had those situations
like what the heck did I volunteer for?
Exactly but proud to serve and actually found a lot of the people who served along with
me are some of my lifelong friends that I know I could call up at any moment and they'd
be here for me and they certainly have during my trials and tribulations living with young
onset Parkinson's disease.
Well let's start there a little bit too because that's what we're focusing on is explain to
people what the Parkinson's disease is about.
Yeah so Parkinson's disease can be caused either by genetics or environmental factors
or a combination of both.
It actually is the cells within your basal ganglia that create dopamine are dying or
collapsing in on themselves and so when you don't have dopamine it's like a car engine
that doesn't have oil.
It's going to seize up.
When it seizes up it causes certain symptoms.
Some of the cardinal symptoms of Parkinson's is the tremor that you might find often you'll
see it in someone's hand visibly it could be in their leg.
They could have an internal tremor.
You'll notice slowness of movement, rigidity within your muscles, balance can become an
issue with people with Parkinson's.
So there's a constellation of things that Parkinson's can have and not everyone has
all of the symptoms.
Some people have worsening of their tremor.
Other people their tremor is well controlled with levodopa, the medicine that we take but
their balance isn't helped.
So you never really know exactly how it's going to affect you compared to everyone else.
And John let me bring you in on this.
Maybe you want to expand a little bit about the longevity of this disease process and
what folks experience over time.
Yeah, so I'll just say Parkinson's disease affects 1 million Americans and we have a
new study that shows that each year 90,000 individuals are nearly diagnosed with the
disease which is a 50% increase over prior estimates.
What we always say about Parkinson's is it is primarily a disease of aging.
That is the number one risk factor for Parkinson's is age.
So the older you get the greater the likelihood that you may develop Parkinson's.
But again it's a relatively rare disease, not a rare disease but relatively rare disease.
And as I said people will develop it say in their early 60s and may live a full and long
life.
They may have a fairly benign course of disease.
Some people have a much more aggressive course of disease and may not live as long as you
would hope.
And then about 4 to 5% of people are classified as young onset Parkinson's disease.
Those are people who are diagnosed before the age of 50.
For people with young onset Parkinson's we see them living fairly for many, many years.
But we say at the Parkinson's Foundation and you'll hear this throughout the community
that no two people will have the same course of disease.
It's a very idiosyncratic disease.
So somebody with a lot of symptoms and a lot of restrictions on their lives may be living
next door to somebody who's living relatively without a lot of complications from Parkinson's.
But it is a tough disease.
It's progressive.
It's degenerative.
Every day is going to be a little bit, maybe not measurable but a little bit harder than
the day before.
I think most folks have some understanding of it.
They've probably seen Michael J. Fox on TV talking about the disease and the work that
he does in this area and the fundraising and volunteer work.
One of the things that you've done, Mark, is sort of taken your experience as you've
now gotten out of the military and had to stop working full time because of Parkinson's
and you've really put that energy into volunteering in the Parkinson's community.
Tell us some about your work in that space.
Yeah, for me, living with early onset or young onset Parkinson's disease has encouraged
me to say I don't want to stop living.
I want to get off the bench and be in the game.
And so I started in annual Parkinson's Awareness Day at Target Field in partnership with the
Minnesota Twins.
I've organized events such as Trivia Fundraiser Night to raise funds for the Minneapolis Space
Struthers Parkinson's Center, which is the center of excellence for the Parkinson's
Foundation.
I've got the American Legion heavily involved here, Chesterburg American Legion in Golden
Valley, Minnesota, to raise funds for Parkinson's as well.
I've taken on the role of National Chair of the Parkinson's Foundation, People at the
Parkinson's Council, which ensures that the perspective of people living with Parkinson's
is integrated into the Foundation's programs, development and priority settings.
I volunteer on the U.S. Department of Defense's Congressionally Directed Medical Research
Program.
Parkinson's Research Program is a consumer advocate participating in the evaluation of
research applications.
And I also participate in Moving Day Twin Cities.
And my youngest daughter took over for my oldest daughter serving on the Twin Cities
Chapter Board for Moving Day.
Let's make a little more connection here between veteran status and service and the possibility
of Parkinson's.
I've read that there's about 110,000 veterans with Parkinson's disease who received care
through the VA hospital.
And there is such a connection and a kind of empirical studies that the VA recognizes
Parkinson's disease as a presumptive illness from exposure to Agent Orange and other herbicides
that one gets exposed to during military service.
And you're on DOD committees.
Talk to us about what veterans ought to be thinking about as it relates to, did I get
exposed to, is Parkinson's related and why that's important.
Sure.
As you mentioned for our Vietnam era veterans who experienced Agent Orange, 50% of the active
ingredient Agent Orange is a chemical known as 2,4-D, which, amongst causing things like
cancer, it also can cause Parkinson's later on in life.
And that's something that became presumptive.
So if you have Parkinson's, you served in country in Vietnam, you can end up having
a service connection between the two and get the help that you need from the VA.
I'm one of 110,000 veterans who works with the VA on healthcare, and they've done a great
job for me and for my family.
It's not just the Vietnam era though with Agent Orange, it's also Desert Storm people,
people in training in the military who received traumatic brain injuries during their service.
If you have in your medical history a TBI that was considered moderate or above, you
actually can be service connected with your Parkinson's disease if you have that diagnosis.
Chemical exposures go way beyond Agent Orange in Vietnam.
We know with Iraq and Afghanistan that the burn pits that were there, we're seeing Parkinson's
come out from troops who were living nearby or working in and through those burn pits.
And so there's different ways that the military community can end up having experiences
such as traumatic brain injuries from IEDs during training incidents, during combat,
along with chemical exposure that is seeing a rise amongst the veteran community compared
to the civilian community.
And so we're trying to raise awareness saying, hey, if you have any of these cardinal symptoms
of Parkinson's, go in and get checked out.
And it's important because the things key, medical science and VA's understanding of
the things keep evolving, just like they've, they said, okay, well, we used Agent Orange
in Vietnam.
Okay, we'll admit we used it in Korea.
The PACDAC now says, oh yeah, well, we used it in Thailand and Guam and there's some places
in the US.
So there's sort of an evolving exposure opportunities.
You might have known you were exposed, although they don't recognize it yet or they're just
beginning to recognize it.
So this is not something that you just say, well, they said, no, so I walk away.
And it's important, isn't it, because it gives the veteran and may give them disability
benefits, but more importantly also gives you some healthcare benefits that take a lot
of pressure off the family, I suppose.
Absolutely, Jim.
You know, from the military training, we're taught, never give up, never surrender, adapt
and overcome, right?
And so even if the VA says no, it doesn't mean you need to quit.
We now know like Camp Lejeune, the drinking water in Camp Lejeune.
Excellent point, yeah.
Yeah, right.
So those troops who served now over 30 days, 30 days and over in Camp Lejeune and we're
drinking the water and they have Parkinson's disease diagnosis can be service connected
now where for decades, the VA said no, now there's a service connection that's going
to be automatic for them.
And so even if you've been head no, don't give up the fight.
Well, the other thing, and I'll jump back over to in a moment here to John, but Mark,
one of the things you and I were talking about before we got started was that, you know,
a private medical physician is going to look at a veteran a certain way whereas a VA doctor
who knows what you went through is going to look at you a little bit different and you've
kind of experienced that, I suspect.
Absolutely.
You know, there is a difference.
A lot of times civilian doctors and neurologists don't even ask us about our military experience.
It's not in the forefront of their mind when they're thinking of what the diagnosis might
be.
There currently isn't a test that's widespread that's used right now to detect Parkinson's.
It's really the neurologist looking at you and excluding everything else first.
So we really want to make sure that if you serve in the military, you had chemical exposure,
you had traumatic brain injuries, that you make sure you say something to your doctor
because they can start connecting the dots then.
And the VA doctors within neurology, some of them the best, I work with Scott Lewis
out of the Minneapolis VA, he is absolutely outstanding where he does take the time to
read through a person's military file, your 201 file, to find out what experiences you
had and what that could do in relation to your health.
John isn't one of the frustrating things for patients and Mark just referenced it.
So they exclude everything else that you must have Parkinson's.
Talk to us about how that diagnosis comes about and what resources does the Parkinson's
Foundation have for those who might be thinking, I don't know if I'm asking the right questions
here.
Yeah, it's a really great question.
So one of the biggest challenges in the Parkinson's space is that a diagnosis of Parkinson's
is done clinically.
I have type 2 diabetes and you can get a blood test and an A1C test to say, look, your blood
sugar is too high, whether it's on a daily basis or over a longer term period.
But in Parkinson's there is no clear and widely used biomarker.
So clinical diagnosis happens when you go in, you start to suspect yourself of having
something that's not quite right.
So you go in often to your primary care physician and they start to look at you and if they
see the resting tremor or they see some challenges with your gait or your stability or your walking,
then they'll probably refer you to a neurologist who will make the clinical diagnosis.
One of the interesting breakthroughs that's happening right now is there are, we're in
the hunt for good biomarkers and about a year ago there was a study that came out that
said you could see alpha-synuclein aggregation in spinal fluid.
So alpha-synuclein, Mark was talking earlier about what Parkinson's is within the basal
ganglia.
But essentially what happens is you get this aggregation of alpha-synuclein which kills
off your dopamine neurons.
And so if you can find that aggregation in spinal fluid early on, that means you could
be diagnosed much earlier and get on a treatment regimen earlier, start exercising and doing
all the things that you need to do to take care of yourself.
But more recently there's a study that's come out showing that you can find alpha-synuclein
aggregation in skin biopsies, a much less demanding way to get biomarkers than a spinal
tap for sure.
So there's a lot of progress being made on including the diagnosis of Parkinson's disease
and essentially setting the clock backward a little bit or forward whatever the right
way to do it is so that you can get diagnosed earlier with more definitiveness.
Hey, John Laird, who's the CEO of the Parkinson's Foundation.
If people want to find more about what the foundation has available in terms of resources,
where would they go?
Yeah, the best place to go is to our website which is Parkinson.org.
I can tell you, Jim, we're pleased to report within the last week that we had 7 million
unique visits to our website this year, which is a record for us.
And that means a lot of people are going to our website multiple times to get the information
they need.
But we also have a helpline which is 800-4, the number 4, P, as in Parkinson's, D, disease,
info, INFO.
So that's 800-4-PD-INFO.
And so our helpline is staffed by medical professionals who are experts in Parkinson's
care and we field about 25,000 calls a year.
A lot of times people are just asking, what is Parkinson's?
Where might I get treatment?
What are these signs or symptoms about?
A lot of referrals.
But our people will be on the phone with people for maybe as short as a minute, but as long
as an hour or so.
So that's another resource for people.
And if a military veteran calls in, John and says, hey, I was in the service, is that
something your folks are attuned to?
Absolutely.
And as we mentioned at the top of the call, there are 110,000 individuals in the United
States who are veterans who live with Parkinson's disease.
That's 10% of the overall population.
So we offer a lot of things.
We have a whole guide, Frequently Asked Questions Guide, which is specifically developed for
people with, for veterans living with Parkinson's disease.
We also offer a Veterans and PD webinar series.
So it covers all topics that are important to veterans around planning for the future,
general exposure, managing mental health issues.
And as I said, we have our website which says General Information and then our Helpline.
They can get much more specific.
And those people on our Helpline, they speak to a lot of veterans and they are very good
at addressing veteran issues.
Well as we know, it's not just the patient, it's the whole family that has to address
these issues.
Mark, you're particularly lucky in your faith and in your family.
Your wife in particular, you want to talk a little bit about the importance of those
issues?
Absolutely.
I happen to have three kids, a 22-year-old, a 20-year-old, and a 16-year-old, a wife of
23 years.
And I've been absolutely blessed by that.
They are my support network that helps me live well with Parkinson's.
A lot of times people, when they find out that I have Parkinson's, will say, I'm sorry.
And I'm like, nothing to be sorry for.
I'm living well with Parkinson's.
Getting the diagnosis for me was not a death sentence.
It was information.
It was information about what was going wrong with my body and how I could work with the
Parkinson's Foundation to learn to live the best quality of life that I can.
And also for my family to understand how they can support me better in living a quality
life.
And one of the things I want to tie back to veterans and why, if you're a veteran or
a family member or friend, you want to think about this connection, if your Parkinson's
is connected to your military service, the VA has a lot of programs for caregivers as
well.
And I don't know if you've used any of those yet, Mark, or if you've had to go ahead and
talk a little bit about the support that VA gives to its caregivers.
Yeah, so the caregivers themselves have classes where they meet together once a month.
My wife has been part of this.
Part of it is just a social time, right?
For spouses and partners, significant others, caregivers in our life, there's even children
who are caregivers who will end up logging on.
And half time is spent socializing, supporting one another.
And the other half of the time is getting information.
They'll have doctors speak, physical therapists, occupational therapists, speech therapists,
each giving information to caregivers to help them better understand what's happening
during the progression of the disease and how they can assist their loved one.
For veterans, the Parkinson's Foundation also has a specific spot on our website that you
can go to and get great information.
As our CEO, John Laird, said, go to Parkinson.org, T-A-R-K-I-N-S-O-N, dot, O-R-G, and then add
slash veterans, Parkinson.org slash veterans, V-E-T-E-R-A-N-S.
And there's an amazing amount of resources there to help the veteran community.
Well, I mentioned this too in setting up this interview with John Laird, CEO of Parkinson's
Foundation and Army and National Guard veteran, Mark Kilm, that I have some family involvement
here, and actually I'm kind of dedicating this interview to my uncle John Roy, who is
an Air Force veteran, because he was a caregiver for probably 30 years to my aunt Joanne, who
had Parkinson's and ultimately succumbed to it last year.
You don't die from Parkinson's, you die from all the other stuff that kind of goes along
with it.
And I think it's important that we get out and have these kind of discussions, and people
aren't either super afraid of the disease or think, as Mark you mentioned, it's not
a death sentence, you just have to, I think I like your language, you have to learn to
live well with the disease, and I think that's the great spirit and the fighting spirit that
I'd expect somebody from the Army to give me.
Any final words here, Mark?
Don't be afraid to ask for support.
I've asked for and received support from my friends, family, medical team, and faith community.
You don't have to do this alone, you're not a one man Army.
John, any final words for our veteran radio listeners?
Yeah, well just first to thank you, Jim, for putting a spotlight on veterans who are living
with Parkinson's disease, and to thank Mark Kilm, who also serves as our chair of our
Parkinson's Policy Advisory Council, and does an outstanding job on that, keeps us well
advised on all the issues related to living with this disease.
We're really grateful for the opportunity, and just to thank all the veterans who served,
and then all the veterans who unfortunately have come down with this difficult disease.
We're here to help in any way we possibly can.
Well, I want to thank both of you for helping get this information out, and again we had
kind of adjust schedules, and I really appreciate everybody being available.
Thank you.
Thank you, Jim.
Appreciate it.
As I said at the outset, these are stories you're not else.
You didn't hear about VA dental care anywhere else, and this relationship between military
service in Parkinson's, and then what life is like with Parkinson's, and what resources
are available.
That's what we do on Veterans Radio.
We bring you stories that we know you should hear.
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So it's really a combination of things that we do to try to keep people informed.
And as I say, you can't do this without the listeners.
So if you have questions, send them in to dale at veteransradio.org or Jim at veteransradio.org.
If you have benefit questions, what's VA doing, maybe some questions about what the military
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We're trying to answer all of those in a way that helps get the information out to others.
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It is a process that takes a lot of time, it's a labor of love by all of us.
And we often have what I would consider cutting edge discussions, maybe before it hits the
general press.
You certainly see that in many of our conversations with thought leaders.
It hasn't quite yet made it to the general press and then it finally breaks its way through.
We have stories on PFAS contamination that is a good example of that or what happened
to those who went to K2 in Uzbekistan as part of the Afghan war.
So listen in, you'll be ahead of the curve, you'll know more of what's going on than others.
And we really appreciate you listening in.
We're going to go out with the Marine Corps song in light of their upcoming birthday here
on November 10th, created in 1775.
Music
From the halls of Montezuma to the shores of Refori
And our country's battle on the land and on the sea.
First you fight for right and freedom,
And to keep our honor clean.
We are proud to claim the title of United States Marine.
And we are proud to claim the title of United States Marine.
We are proud to claim the title of United States Marine.