Adaptive Treatment for Wounded, Ill, and Injured Sailors and Marines

By Helen Metzger, Health and Wellness Department Head at Naval Medical Center San Diego, and Health Promotion and Wellness Department at Navy and Marine Corps Public Health Center

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At NMCSD, we provide robust programs covering disciplines such as recreational therapy, kinesiology, nutrition, exercise physiology, and psychological well-being.
I’ve learned there is no one-size-fits-all approach to treatment for WII service members. Everyone is different so the key is to find what will encourage an individual.

I became a true believer in wellness after joining the Health and Wellness Department at Naval Medical Center San Diego (NMCSD) and am now committed to increasing awareness of how to maximize your quality of life through healthy lifestyles and self-care.

At NMCSD, we provide robust programs covering disciplines such as recreational therapy, kinesiology, nutrition, exercise physiology, and psychological well-being. Our wounded, ill, and injured (WII) Wellness programs are beneficial not only to those wounded in battle but those with non-combat illnesses such as cancer or injuries sustained in vehicle crashes which represent a large part of the WII population.

Along the way, I’ve learned there is no one-size-fits-all approach to treatment for WII service members. Everyone is different so the key is to find what will encourage an individual. Initially, our WII Wellness Program was focused on fitness; however, we came to realize that each service member has a spectrum of needs that vary during their treatment here. Each week, our multi-disciplinary team of licensed practitioners review cases and determine which programs to prioritize based on the service member’s needs and abilities for that month. To supplement our approach, we began coordinating with other organizations to expand our services.

Since their inception, we have collaborated with the Warrior Athlete Reconditioning Program (WARP) and the Military Adaptive Sports Program (MASP) to provide fitness activities and competitive events.

Since their inception, we have collaborated with the Warrior Athlete Reconditioning Program (WARP) and the Military Adaptive Sports Program (MASP) to provide fitness activities and competitive events. The sense of belonging that service members gain from participating in the wheelchair basketball team with those who understand their experience is amazing and fosters an important reintegration with the military community. We also support the Challenged Athletes Foundation’s (CAF) Operation Rebound program that provides unparalleled opportunities for service members to pursue active, athletic lifestyles by offering access to funding for equipment and training and competition expenses, Military Medical Center Physical Training (MMCPT), and sports clinics.

For the MMCPT, the CAF works closely with our staff to provide opportunities for physical training that is in compliance with discrete rehabilitation programs and applicable military regulations. For a sports activity, we both coordinate with lifeguards at Del Mar Beach to host surf clinics that provide benefits such as relieving pain from focused activity rather than medication, focusing on the use of existing limbs to perform skills and improve balance, and gaining a sense of community as they partake in activities they thought could not be a part of their lives. It may not even be surfing but instead experiencing the beach environment that leads to socialization or increased activity participation. It’s not simply mechanics; it’s body and mind.

We also work with Resounding Joy to provide music therapy services, which patients have stated are one of the primary support resources that kept them motivated to continue treatment. We provide an Iyengar adaptive yoga program which modifies traditional yoga postures for those coping with chronic illness or injury. Additionally, the San Diego Zoo offers dedicated access times and special events for our service members to enjoy with their families without having to face or maneuver through large crowds. To help their longer term reintegration, we coordinate with Navy Medicine’s Reintegrate, Educate, and Advance Combatants in Health Care (REACH) program for which the ultimate goal is to hire these individuals into Navy Medicine. We currently have 65 personnel enrolled in the REACH program in San Diego.

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For health care providers serving this population, I encourage you to engage the patient early and treat not only the illness or condition but, the person undergoing the treatment. Be attuned to what the service members need and learn about the services that are beneficial for this population

Even with the war draw down, the need remains among the WII population for these unique yet relevant services often not available elsewhere. To note, “military community” is especially important due to the strong connection, and with that resilience. I recommend that all Health Promotion and Wellness personnel keep an open mind to coordinating with organizations of mutual interest. Our collaborations with WARP, MASP, CAF, REACH, and non-profit organizations have been invaluable and so much a part of our program that there is no distinction between them and our staff. Truly a one-stop shop.

For health care providers serving this population, I encourage you to engage the patient early and treat not only the illness or condition but, the person undergoing the treatment. Be attuned to what the service members need and learn about the services that are beneficial for this population. Visit the Navy and Marine Corps Public Health Center’s Health Promotion and Wellness page for WII-specific health and wellness resources. If the patient has restricted ability to exercise, focus on eating well, supporting tobacco cessation, and interacting with others to combat depression. Keep encouraging the service member throughout their treatment and offer mentoring opportunities with peers who are further along in their rehabilitation, who can truly understand their experience and help motivate them. Above all, as their health care provider, it’s important to remain flexible and adapt to the unique, changing needs of each service member in your care.