Archive for January 2016

Warrior Connection – 01.31.16

Sunday, January 31st, 2016
the January 31 edition is a discussion on the proposed  National Desert Storm Memorial!
National Desert Storm War Memorial

Your support is needed TODAY! The National Capital Memorial Advisory Commission meets tomorrow, Thursday, January 28, 2016 to discuss the location in Washington D.C. for the memorial. We need you, and everyone you know, to write an e-mail to the Commission asking them to pick the best possible location for the National Desert Storm War Memorial in the Area I region of the capital. This is the area where the other war memorials have been placed.

This correspondence is absolutely vital in helping us secure the most appropriate site for our memorial. We have to show that the American people demand our memorial is given the same honored place near other war memorials. Spread the word and share this effort!

Statements and correspondence should be e-mailed to today!

Scott Stump, CEO NDSWM
Dear Mr. May,
I want to voice my enthusiastic support for the construction of the National Desert Storm War Memorial in Washington D.C. Operation Desert Storm was a very significant event in our country's modern history. We liberated the country of Kuwait while restoring the belief in the dominance of the U.S. Armed Forces and American power. The over 300 Americans who made the ultimate sacrifice should never be forgotten. 

I would also like to strongly encourage you and all of the other members of NCMAC to allow the memorial to be constructed in close proximity to the other war memorials in an Area I location. By doing this, you will allow the Desert Storm War Memorial to take it's rightful place of honor for generations to come and for our living veterans, survivors and their families to honor their memories.

Thank you for your consideration and for the work that you do!

{your name here}
{your address}
{city, state, zip}

Warrior Connection – 01.24.16

Sunday, January 24th, 2016

The January 24 edition of Warrior Connection was first in a series on the 25th anniversary of desert storm and discussion of medical research- treatment programs for ill vets to enroll in. 

Warrior Connection – 01.17.16

Sunday, January 17th, 2016

The January 17 edition of Warrior Connection was a discussion on the still troubled VA Choice program and enduring medical care problems that elude fixing.

Bradley Kieffer of Healthnet provided this comment in response to our requests for on air discussion:

Media Statement Health Net Federal Services is proud to serve our nation’s veterans, and we are committed to providing timely access to medical care in the 37 states where we administer the Veterans Choice program. Veterans Choice was created in 2014 to better meet the health care needs or our nation’s veterans by allowing them to see community providers when the U.S. Department of Veterans Affairs is unable to see them timely or conveniently. By late 2014, Health Net was scheduling 34,000 medical appointments and fielding more than 230,000 phone calls monthly in support of the Veterans Choice program. We recently opened a service center in Tampa, Florida, to assist veterans in obtaining their needed care. Many of these associates are veterans themselves. To date, we have hired and are currently training over 200 associates. In the future we hope to hire up to 500 associates for this office. Developing a complex and consistent new program like Veterans Choice is a team effort, and Health Net is working closely with Congress, the Department of Veterans Affairs, health care providers and many others to provide veterans with the appropriate, coordinated and convenient care they have earned for their service to a grateful nation. - January 11, 2016.

Veterans Choice Program

Access health care closer to home

For Providers

Providers interested in participating must establish a contract with one of the contractors, Health Net Federal, or TriWest Healthcare Alliance. Providers do not need to join PC3 to participate in the Choice Program.

Providers must:

  • Accept Medicare rates.
  • Meet all Medicare Conditions of Participation and Conditions for Coverage.
  • Be in compliance with all applicable federal and state regulatory requirements.
  • Have a full, current, and unrestricted license in the state where the service(s) are delivered.
  • Have same or similar credentials as VA staff.
  • Submit a copy of the medical records to the contractor for medical care and services provided to Veterans for inclusion in the VA electronic record.

Providers listed on the Centers for Medicare and Medicaid Services (CMS) exclusionary list are prohibited from participating.

How to participate:

To determine which of the two contractors you should contact (Health Net or TriWest) based on your geographic location click here.

  1. All Patient – Centered Community Care (PC3) providers are automatically eligible to participate in the Choice Program.
  2. Contact the appropriate contractor using the information listed below.
    Contact Information for Health Net:

o    Hours: 6:00am — 7:00pm EST Monday through Friday, excluding federal holidays

o    Provider Customer Service Phone Number: 1-866-606-8198

o    Email:

o    Website:

Contact Information for TriWest:

o    Hours: 8:00am — 10:00pm EST, Monday through Friday, excluding federal holidays

o    Provider Services Contracting: 1-866-284-3743

o    Email:

o    Website:

  1. Complete the process to establish a contract or provider agreement with the appropriate contractor, which will allow you to see Veterans seeking care through the choice program.

Are you an Academic Affiliate Partner of the Department of Veterans Affairs? 
Click here for more specific information.

To learn more about Military Culture Training for Community Providers click here.

Veterans Choice Program

Access health care closer to home

What is the Choice Program?

If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your existing VA health care, or any other VA benefit.

30 Days:

A Veteran is told by his/her local VA medical facility that they will not be able to schedule an appointment for care either:

  • Within 30 days of the date the Veteran’s physician determines he/she needs to be seen; or

  • Within 30 days of the date the Veteran wishes to be seen if there is no specific date from his/her physician.


40 Miles:

Travel Burdens

  • The Veteran resides in a location other than Guam, American Samoa, or the Republic of the Philippines and needs to travel by air, boat, or ferry to the VA medical facility closest to his/her home.

  • The Veteran faces an unusual or excessive burden traveling to a VA medical facility based on geographic challenges, environmental factors, or a medical condition. Staff at the Veteran’s local VA medical facility will work with him/her to determine if he/she is eligible for any of these reasons.

  • The Veteran’s specific health care needs, including the nature and frequency of the care needed, warrants participation in the program. Staff at the Veteran’s local VA medical facility will work with him/her to determine if he/she is eligible for any of these reasons.

  • The Veteran resides in a State or a United States Territory without a full-service VA medical facility that provides hospital care, emergency services and surgical care having a surgical complexity of standard, and resides more than 20 miles from such a VA facility.

NOTE: This criterion applies to Veterans residing in Alaska, Hawaii, New Hampshire, Guam, American Samoa, Commonwealth of the Northern Mariana Islands and the U.S. Virgin Islands. Also note that some Veterans in New Hampshire reside within 20 miles of White River Junction VAMC and are therefore not eligible for the Choice Program.


Travel Burdens:

The Veteran resides in a location other than Guam, American Samoa, or the Republic of the Philippines and needs to travel by air, boat, or ferry to the VA medical facility closest to his/her home.

The Veteran faces an unusual or excessive burden traveling to a VA medical facility based on geographic challenges, environmental factors, or a medical condition. Staff at the Veteran’s local VA medical facility will work with him/her to determine if he/she is eligible for any of these reasons.

The Veteran resides in a State or a United States Territory without a full-service VA medical facility that provides hospital care, emergency services and surgical care having a surgical complexity of standard, and resides more than 20 miles from such a VA facility.

NOTE: This criterion applies to Veterans residing in Alaska, Hawaii, New Hampshire, Guam, American Samoa, Commonwealth of the Northern Mariana Islands and the U.S. Virgin Islands. Also note that some Veterans in New Hampshire reside within 20 miles of White River Junction VAMC and are therefore not eligible for the Choice Program.

To learn more about the unusual or excessive burden criteria, click here.


Am I Eligible?

If you are already enrolled in VA health care, you may be able to receive care within your community, instead of waiting for a VA appointment or traveling to a VA facility.

You are eligible if any of these situations apply to you:

Check Your Eligibility

If you’d like to talk to someone, call 1-866-606-8198.

How do I Sign Up?

To get started, you’ll need to pick a health care physician, gather some information and give us a call. We will work with you to ensure you are approved for care in your community.

  1. Step 1: Check if you are eligible.
  2. Step 2: Explore which doctors are participating in your area.
  3. Step 3: Make sure you have information on hand about any other health insurance coverage you may have.
  4. Step 4:

Scheduling an Appointment:

If you are a Distance- eligible Veteran call 1-866-606-8198 to confirm eligibility and ensure the care needed is covered by VA. When you call, you will be asked for:

o    Your first and last name

o    Your full address

o    The name of your preferred community physician. Unfortunately, not all physicians will be eligible to participate so if your preferred physician is not available, we will recommend other physicians in your area.

If you are a Wait List- eligible Veteran, you will receive a phone call from a VA partner (a non-VA phone number) to help set up your appointment. When you receive this call you will be asked for:

o    Your first and last name

o    Your full address

o    Your date of birth

o    The last 4 digits of your social security number

If you’d like to talk to someone, call 1-866-606-8198 or live chat with one of our representatives today.

Additional Program Information

  • The Choice Program does not impact your existing VA health care or any other VA benefit.
  • If you did not receive a Choice Card or if you cannot find your card, please call 1-866-606-8198 to learn more about eligibility for the Veterans Choice Program.
  • If you are satisfied with your wait time at a VA facility and wish to continue waiting for VA care, there is nothing you need to do at this time.
  • Care in the community is only covered by VA for medical needs which have been approved by your VA physician. We can happily schedule an appointment for other medical needs, but we can only cover the cost of care related to your VA-approved health needs.
  • The Veteran Choice Program is part of the Veterans Access, Choice, and Accountability Act of 2014 (VACAA). To learn more about VACAA click here.

Warrior Connection – 01.10.16

Sunday, January 10th, 2016

The January  10, 2016  edition of Warrior Connection was a discussion on gun safety / use and also crime control based on


Doug Rokke, Ph.D.

Major, US Army, retired

January 2015

   The Christmas tree lights shined brightly matching every color in the rainbow with beautiful ornaments hung from the trees branches and an Angel perched on high atop the tree. The bright red tree cloth around the base of the green tree contrasted with the multitude of Christmas gifts wrapped in glorious paper arrayed around the tree’s base. While clothes, tools, toys, and household items are always found, the magical almost mystical gift boys and girls from 7 to 97 look forward to each Christmas is the new Christmas gun either a rifle, shotgun, or handgun. The new gun may be a kit such as a black-powder Kentucky rifle or pistol that you need to assemble or it may be a fully assembled operational gun.  Today we might add a crossbow or other archery equipment to that so sought after list of cherished items. Although the excitement of hoping for the unknown magical gift that may or may not be beneath the tree because of recent legal requirements is history it does not diminish the excitement of opening that package to find a treasured gun. I believe that each of us can remember when our father or mother or grandpa or grandma gave us our first gun at Christmas and the thrill that had us beaming like the brightest star in the heavens. As we opened the box and ran our fingers over our gift the tingling spread from our fingers to our toes and we hoped for good weather to go try out of new gun. So what do I do next?  Each of us has asked that question with a gleam in our eye. Although, we might want to go outside immediately, load the gun, find at a tin can or other target, and shoot away there are prudent steps to take before we hear the loud report “music in our ears” of the new Christmas gun upon pulling the trigger.

Step 1: Read the manual from cover to cover and make sure you understand all characteristics of your new gun. It is also a good idea to learn all about the ballistics of each type of ammunition for your new gun.  For more ballistics information and calculations please refer to the “ballistics calculator” at (, ammo manufacturers publications, and of course the annual “GUN DIGEST”.

Step 2:  Give your new gun a complete cleaning. That means learning how to and actually taking your gun apart and putting it back together at what is called in the military “field stripping” level. Some new guns are shipped with protective lubricants that must be removed.

Step 3. Without any ammunition any place around you or in the gun practice operating the gun until it becomes ingrained second nature. This should include dry firing with appropriate aides such as a snap cap- plastic. We want to know how each gun functions and how each trigger reacts or functions.  Practice putting the safety on and off. Practice clearing or make sure you know how to clear malfunctions. Practice sight picture acquisition with your gun for different shooting positions.

Step 4. Identify and obtain the correct ammunition for you new gun. Make sure it is good usable ammunition not old crusty junk left around in your stash. Collect and try on all necessary safety equipment for eye and hearing protection.

Step 5. The moment has arrived. You are ready for music in your ears.  Find a safe range location to shoot and set up your target ensuring safety at all times. Now you need to make sure your sights are set for your needs. Basic settings can be made prior to actually firing your gun but sighting in requires time and careful effort.  While most guns are shipped at mechanical zero or approximately on target each person’s sighting needs vary.  I suggest that you get a large piece of cardboard and put an 8” x 11” piece of paper with a target- a large black marker spot - in the center of the piece of paper and then center that piece of paper on the cardboard. Some rifle – scope combinations are shipped bore-sighted that means both the axis of the rifle bore and scopes bore are aligned but it does not mean it is sighted in. It will take effort and multiple shots using the same technique to get your new gun sighted in “for you”. Once sighted in it should remain sighted in “for your” own specific needs. Please remember each person must sight in the gun for their own use. 

Step 6. Put the gun safety on.

Step 6. Load your gun. It is best to only load one of two rounds to begin with rather than a full quantity possible for your gun’s design.

Step 7. Get into proper shooting position.

Step 8. Obtain proper sight picture. Ensure the range is safe.

Step 9. Turn off the safety. Pull the trigger. Enjoy the music in your ears.

Step 10. Clean you gun and store it safely until next time! 

The almost magical feelings associated with each new Christmas gun do not subside with age nor with how many guns are found beneath the Christmas tree but please remember to follow the steps essential to safely enjoy your new prized possession remain inviolate for all eternity. Now that you have your new Christmas “toy” it is imperative that you obtain proper instruction from qualified instructors with lots of practice. MERRY CHRISTMAS, HAPPY NEW YEAR, AND ENJOY YOUR NEW CHRISTMAS GUN UNTIL THE SAME THRILL HAPPENS ONCE MORE THROUGHOUT YOUR LIFETIME.

Gizmos and Accuracy

Dr. Doug Rokke

    Every rifleman and riflewoman seeks to excel. Consequently they may consider installation of all types of gizmos to improve their shooting ability or the capability of their rifle or handgun to place a bullet in the exact place they aim for.  Today, adjustable butt stocks, forearms, handles, grips, fixed and adjustable open iron sights, glow in the dark fixed sights, battery operated optics, conventional glass optics (scopes), lasers, tactical lights, sticks, tripods, bipods, fixed rests, recoil pads, and slings can be purchased and installed on your rifle or shotgun.  Some of these gizmos are also available for handguns.  Besides physical modification of any gun, different types of bullets and gunpowder “propellant” combinations may be chosen and used to improve ballistic properties.  The costs for each of these gizmos or various bullets /gunpowder/cartridges varies but they can significantly increase the basic purchase price, gizmo price, and operational cost of any gun that a rifleman/riflewoman shoots.  

Some add-ons such as various fixed sights or optics such as a scope can help you improve your aim by helping you see the aiming point or target better through magnification or simple optics such as a peep sight.  However, just because you can see the target better does not mean that your accuracy will improve.  “Red dot or green dot” optics allow you to put a optical image on your target but the minutes of angle (moa) or area that the dot covers may not improve pinpoint accuracy, especially as the range or distance to the target increases.  Laser sights can provide you a visible spot, but the moa or width of the laser dot highlighting your exact point of aim on the target increases as the distance to the target increases. Lasers also have a limited operational range and are affected by bright light conditions.  This means that the visible laser dot will be wider or maybe not even visible as the distance to the target increases or the sun shines thus affecting actual bullet placement.  Please note that for self defense purposes when you paint a target with a laser dot your psychological advantage is incredible.  Although visibility of a laser dot on the target may help you designate an exact aiming point, basic principles of marksmanship must still be followed. 

Adjustable or modified stocks may help the rifle or shotgun fit better to your physique.  This improves your ability to hold the gun the same way each and every time that you pull the trigger therefore maintaining consistent sight alignment.  Grips that are designed or fitted for your hand size will also allow you to hold the handgun better and thus improve stability and sighting in on the target. Although grips and specialized stocks improve the fit of the rifle, shotgun, or handgun to your specific physique, your accuracy will only improve if basic principles are implemented.  Recoil pads fall under the fit and comfort concept with their primary goal of reducing felt recoil or shoulder impact.   According to Sir Issac Newton “for every forward force these is an equal and opposite backward force”.  Therefore the purpose for installing a recoil pad is to reduce the effects of this backward force.  Your shoulder will feel better after numerous shots if you use a recoil pad. Therefore, you can improve your ability to hold your gun tightly against your shoulder improving accuracy.  A properly fitted and used sling improves stability.  Consequently you can decrease the diameter of any shot group and improve overall accuracy but only if you adhere to basic marksmanship principles.  

Bipods, tripods, sticks, and rests are all valuable tools that can improve your overall stability.  Heavy rifles and even some heavy handguns can affect you ability to hold them in precisely the same way each and every time without them wavering around like flag in a breeze unless you have adequate hand, arm, and shoulder strength. Sadly, some of us do not have the required strength and if we did it has decreased with increasing age and the onset of health problems.

    The relatively new addition or use of tactical lights poses several challenges. First, the additional weight of a light just like a laser will affect overall balance and thus stability. Although the target may be more visible – illuminated under low light conditions, the now extremely visible light source at your body makes you a perfect target.  The bright light may also interfere with your own night vision.  Obviously target visibility can help you place your sights on the target but at what cost?  Lights actually decrease overall balance or stability and thus may decrease accuracy.  The added weight when a tactical light or laser is attached to the barrel or grip of a handgun can have a dramatic effect on your ability to shoot that handgun with consistent accuracy because they increase the need for increased hand, arm, and shoulder strength.  

The selection of specific bullets, cases, and gunpowder, especially if you do your own reloading, can improve the consistency of a round performance through optimization of bullet aerodynamics by selecting a desired ballistic coefficient as a function of bullet shape, bullet mass (weight), and muzzle velocity. However, individual marksmanship ability still is the deciding factor for improving overall personal accuracy as a rifleman / riflewoman. Please remember that a bullet only goes exactly where it is aimed for at the precise moment it exits the muzzle but with the influence of muzzle velocity, drift, and drop. The Winchester ballistics calculator on the web site ( can help you understand how any bullet performs under varying conditions but accuracy still depends primarily on individual marksmanship ability. 

Thus with all of different types gizmos that are available that can help you improve stability of your rifle or handgun, sighting in, and visibility of your target; cost factors and how well you want or need to shoot should be factored in as you select any of the gizmos for purchase and installation your rifle, shotgun, or handgun.  But it all comes down to the basics.  Do you know how to use your rifle or handgun as designed?  Can you consistently apply the basics principles of marksmanship?

 While some individuals can master these skills on their own it is preferable to complete a rifle/shotgun/handgun safety and marksmanship training course with qualified instructors.  Guns Save Lives instructors conduct numerous courses throughout the year (  In conclusion, each rifleman / riflewoman needs practice, practice, and more practice in a safe controlled environment to improve and maintain accuracy no matter what rifle, shotgun, or handgun they shoot and what gizmos they have installed.  But in the end shooting is simply always about having fun and the wonderful friendships each of us can develop and maintain with others who enjoy shooting.  This weekend go buy a box of ammunition then  shoot up a bunch of tin cans, punch holes in paper targets, or pulverize some clay birds with your friends or family members at a range or other safe area using any gun you have available. THAT IS ENJOYMENT!  

Practical Ballistics for Self-Defense

Doug Rokke

          The decision to use any rifle, handgun, or shotgun for self-defense entails legal justification according to state law and the selection of ammunition that will ensure that you win the gunfight. Just as old saying goes “you don’t bring a knife to a gun fight” you should select ammunition that will immediately end any gunfight that you are in. That means knocking the person or vicious animal down and out with the first or second shot. This is commonly referred to as “stopping power”.

          The two primary physics concepts associated with ballistics are kinetic energy “K.E.” and momentum “p”. The laws of physics require that energy and momentum conserved. That means that for protection we should select ammunition that deposits all of it’s energy/momentum into the target but that still has enough kinetic energy or momentum for penetration and to ensure the knock down-kill.  Both kinetic energy and momentum are a function of bullet mass (grains) and velocity where:

K.E. = “1/ 2” x “mass” x “velocity squared”

“p” = “mass” x “velocity”

Another important factor is “expansion” or how much the bullet deforms upon penetration to create a mortal wound channel as it transfers all or part of it’s kinetic energy and momentum into the target. Ideally any bullet would enter the target (penetration), fully expand, and transfer all of its energy into the target and thus stop before exiting out the other side.  That is why a 12 gauge shotgun with slug, double “0” buck, or even #4 shot is so effective at close range and the obvious first choice for self –defense.  The wound channel is huge and usually mortal because virtually all of the shotgun shot’s or slug’s energy is transferred into the target over a large entrance diameter thus immediately ending the gunfight because the slug or pellets rarely penetrate all the way through the target.

However, for many reasons the handgun will be the weapon that is used in most self-defense situations- gunfights. Today, self-defense handgun ammo includes: .25 auto, .32 auto, 9 mm, .38 special,  .357 magnum, .40 S & W, .44 magnum, .45 auto, and .45 colt.  Gunfights with a handgun will occur within 25’ so we need to look at muzzle energy and even more effectively muzzle momentum and bullet expansion.   Ideally we want to select a large caliber “heavy mass” bullet, with excellent expansion, and enough muzzle velocity to ensure penetration through clothing.  High velocity, small diameter, and low mass bullets tend to zip right through targets at close range with minimal stopping power and create too much risk to bystanders.  Thus the stopping power of a .45 auto/colt or .44 magnum is far better than for a .38 or 9 mm with a .357 magnum in between. As we select ammo please remember that any bullet less than 100 grains when combined with possible powder loads just does not provide the necessary energy required for a probable one or two shot kill.  However, no matter what handgun and bullet caliber you select you must practice, practice, and practice after going through a certified qualification course to teach you the fundamentals.  GSL instructors conduct numerous courses throughout the year (  Spraying rounds from large capacity magazines is simply too dangerous, inadvisable, rarely stops a gunfight, and is probably on shaky legal grounds too. Simply, if we face a situation where escape is impossible and the “perp” is ready, willing, able, and intent on killing us or our loved one then we want to end the gunfight immediately- hopefully with the first or second shot.

          The selection of rifle ammo follows the same rational except ranges may be greater. Therefore, we need to look at muzzle velocity, kinetic energy, bullet mass, and expansion at ranges from up close to 100 yards or 200 yards.  However, please realize that the legal justification for self-defense gunfights at long at ranges is questionable at best but may me required for vicious animals.  Popular rifle ammo such as the .223 or 5.56 mm with low mass bullets less than 100 grains that while having a flat trajectory loose energy rapidly and usually pass right through the target with minimal energy transfer.  That is why the readily available and dependable .30 caliber rifle ammo such as the .30-06,  .308, and .30-30 are the practical choice and are found in reliable rifles. For more ballistics information and calculations please refer to the “ballistics calculator” at (, ammo manufacturers publications, and of course the annual “GUN DIGEST”.  In conclusion as you select a weapon(s) and matching ammo for self-defense it is important to remember the sole purpose when legally justified is to immediately end the gunfight with minimal number of rounds expended, minimal risk to bystanders, and mortal wounds to the target. 


As the discussion regarding gun violence and crime control increases I suggest a very simple effective route to hopefully make a difference. We need to enact a new and very clear law at both state and federal levels such as follows that will be enforced for juveniles and adults. In other words any crime involving the use of guns automatically makes it an adult court issue.

  1. Upon conviction for carrying a gun or any firearm of any type during the commission of any crime the individual shall be sentenced to 20 years in prison without parole or probation.
  2. Upon conviction for carrying and firing a gun or any firearm of any type during the commission of any crime the individual shall be sentenced to natural life in prison without parole or probation.
  3. Upon conviction for carrying and firing a gun or any firearm of any type during the commission of any crime and wounding or killing any individual the convicted individual shall be sentenced to public execution.

Given gun laws and gun control do not work and are ineffective at preventing crime then it does not make sense to punish those who never violate the law or to limit second amendment liberties. Therefore, we must simply end the violence by punishing those to choose to cause us harm. PLEASE JOIN ME AS AN ADVOCATE FOR THIS. IF YOU DO NOT SUPPORT PUNISHMENT OF THIS TYPE FOR CONVICTED CRIMINALS PLEASE TELL ME WHY.

I thought I joined the military and went to war and became disabled in defense of our constitution and all or our precious freedoms under the bill of rights. I thought all members of congress took an oath as I DID to defend and support the constitution of the United States and that includes all of our precious freedoms listed under the bill of rights especially the 2nd amendment given that the 2nd amendment is our only insurance to sustain our entire constitution. NOW I LEARN THAT THOSE WHO ARE TASKED BY ELECTION TO SUSTAIN AND ENUSRE WE HAVE ALL OF OUR RIGHTS LISTED IN OUR CONSTITUTION WANT TO OBLIERATE IT. I thought that in our nation we only punish those who are convicted of crimes and not those who want to sustain our precious freedoms and possess a tool- a gun- under the legal right to do so. . I did not know the President, members of congress, or members of state or local governments could pick and choose which freedoms to defend and allow us to exercise. I also thought the Supreme Court has ruled that the 2nd Amendment is an individual right that can not be suspended!

Thank you,

Dr. Doug Rokke

Warrior Connection – 01.03.16

Sunday, January 3rd, 2016

The January 3 warrior Connection was a discussion  between Dr. Doug Rokke and Bonnie Rokke Tinnes, RN,  about anemia and then we read some short stories about life in northern Minnesota at Christmas time.

Vitamin B12 deficiency can be sneaky, harmful

POSTED JANUARY 10, 2013, 10:03 AM , UPDATED SEPTEMBER 09, 2015, 3:13 PM

Patrick J. Skerrett, Former Executive Editor, Harvard Health

What harm can having too little of a vitamin do? Consider this: Over the course of two months, a 62-year-old man developed numbness and a “pins and needles” sensation in his hands, had trouble walking, experienced severe joint pain, began turning yellow, and became progressively short of breath. The cause was lack of vitamin B12 in his bloodstream, according to a case report from Harvard-affiliated Massachusetts General Hospital published in The New England Journal of Medicine. It could have been worse—a severe vitamin B12 deficiency can lead to deep depression, paranoia and delusions, memory loss, incontinence, loss of taste and smell, and more.

The human body needs vitamin B12 to make red blood cells, nerves, DNA, and carry out other functions. The average adult should get 2.4 micrograms a day. Like most vitamins, B12 can’t be made by the body . Instead, it must be gotten from food or supplements.

And therein lies the problem: Some people don’t consume enough vitamin B12 to meet their needs, while others can’t absorb enough, no matter how much they take in. As a result, vitamin B12 deficiency is relatively common, especially among older people. The National Health and Nutrition Examination Survey estimated that 3.2% of adults over age 50 have a seriously low B12level, and up to 20% may have a borderline deficiency.

Are you at risk?

There are many causes for vitamin B12 deficiency. Surprisingly, two of them are practices often undertaken to improve health: a vegetarian diet and weight-loss surgery.

Plants don’t make vitamin B12. The only foods that deliver it are meat, eggs, poultry, dairy products, and other foods from animals. Strict vegetarians and vegans are at high risk for developing a B12 deficiency if they don’t eat grains that have been fortified with the vitamin or take a vitamin supplement. People who have stomach stapling or other form of weight-loss surgery are also more likely to be low in vitamin B12 because the operation interferes with the body’s ability to extract vitamin B12 from food.

Conditions that interfere with food absorption, such celiac or Crohn’s disease, can cause B12trouble. So can the use of commonly prescribed heartburn drugs, which reduce acid production in the stomach (acid is needed to absorb vitamin B12). The condition is more likely to occur in older people due to the cutback in stomach acid production that often occurs with aging.

Recognizing a B12 deficiency

Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can also come on relatively quickly. Given the array of symptoms it can cause, the condition can be overlooked or confused with something else. Symptoms may include:

  • strange sensations, numbness, or tingling in the hands, legs, or feet
  • difficulty walking (staggering, balance problems)
  • anemia
  • a swollen, inflamed tongue
  • yellowed skin (jaundice)
  • difficulty thinking and reasoning (cognitive difficulties), or memory loss
  • paranoia or hallucinations
  • weakness
  • fatigue

While an experienced physician may be able to detect a vitamin B12 deficiency with a good interview and physical exam, a blood test is needed to confirm the condition.

Early detection and treatment is important. “If left untreated, the deficiency can cause severe neurologic problems and blood diseases,” says Dr. Bruce Bistrian, chief of clinical nutrition at Harvard-affiliated Beth Israel Deaconess Medical Center.

B proactive

It’s a good idea to ask your doctor about having your B12 level checked if you:

  • are over 50 years old
  • take a proton-pump inhibitor (such as Nexium or Prevacid) or H2 blocker (such as Pepcid or Zantac)
  • take metformin (a diabetes drug)
  • are a strict vegetarian
  • have had weight-loss surgery or have a condition that interferes with the absorption of food

A serious vitamin B12 deficiency can be corrected two ways: weekly shots of vitamin B12 or daily high-dose B12 pills. A mild B12 deficiency can be corrected with a standard multivitamin.

In many people, a vitamin B12 deficiency can be prevented. If you are a strict vegetarian or vegan, it’s important to eat breads, cereals, or other grains that have been fortified with vitamin B12, or take a daily supplement. A standard multivitamin delivers 6 micrograms, more than enough to cover the average body’s daily need.

If you are over age 50, the Institute of Medicine recommends that you get extra B12 from a supplement, since you may not be able to absorb enough of the vitamin through foods. A standard multivitamin should do the trick.

Not a cure

The Internet is full of articles lauding the use of vitamin B12 to prevent Alzheimer’s disease, heart disease, and other chronic conditions or reverse infertility, fatigue, eczema, and a long list of other health problems. Most are based on poor or faulty evidence.

Take Alzheimier’s disease as an example. “Although there is a relationship between low vitamin B12 levels and cognitive decline, clinical studies—including those involving people with Alzheimer’s disease—have not shown improvement in cognitive function, even doses of the vitamin as high as 1000 micrograms,” says Dr. Bistrian.

For now, it’s best to get enough vitamin B12 to prevent a deficiency, and not look to it as a remedy for what ails you.