Season 2 Episode 3 – Aiding vision-impaired Veterans through experience: Iowa City VA VIST Coordinator Keith Queen

In this episode of the Vets First Podcast, Dr. Levi Sowers and Brandon Rea are joined by Neil Andrews for a collaborative interview.

Niel Andrews is the executive editor and science journalist for the Migraine Science Collaborative, which serves as an online platform dedicated to a wide array of migraine-related research in pursuit of their mission statement, “To accelerate research advances in migraine and headache diseases.” Andrews explains how they aim to bridge the gap between complex scientific findings and a wider audience, ensuring that their content is accessible and informative for both experts and non-experts alike.

With a twist on our usual format, Neil Andrews conducts the first half of the interview and questions our hosts on the origins of the Vets First Podcast, which was created with a similar goal in communicating complex scientific issues to veterans and to better understand the issues they face. Levi and Brandon reflect on their interactions with veterans and the strength and resiliency of dealing with unseen diseases like migraines. Our hosts explain how, in contrast to other areas of pain research, migraine research has seen continued innovations. Despite this, they emphasize the need for more scientists dedicated to the field.

In the second half of the interview, Brandon and Levi question Neil Andrews about his life as a science journalist and the challenges faced by the Migraine Science Collaborative. Having shared similar experiences in their pursuits of communicating research, the trio discusses the difficulties in conveying intricate scientific methodologies and techniques to non-specialists but emphasizes the importance of making these studies more accessible and understandable.

Overall, the episode offers a look into the complexities of migraine research, the challenges of communicating basic science, and the collaborative efforts aimed at advancing understanding and treatment for individuals affected by migraines.

 In this episode of the Vets First Podcast, hosts Dr. Levi Sowers and Brandon Rea interview Dr. Eric Singman, a neuro-ophthalmologist working at the Department of Defense Vision Center of Excellence in Baltimore, Maryland. He has been working with Veterans and active-duty military for 20 years. Prior to his position at the VA, Dr. Singman spent most of his academic career in the greater New York City area, obtaining his MD and PhD with a focus on vision problems associated with optic nerve damage from brain injury. 

During this episode, Dr. Singman discusses his clinical role at the VA and explains how he directly works with patients suffering from brain injury induced vision problems. He touches on topics like using stem cells to regenerate affected areas of the nervous system and utilizing different colored NoIR sunglasses to allow visually impaired patients to be more comfortable. He then explains at length about the importance of choosing the right color and how it relates to the optic nerve and its circuitries in the brain. 

Later in the episode, Dr. Singman elaborates on injury induced by impacts and talks about what happens physiologically, particularly with the optic nerve. He differentiates the effects on the nerve among blunt, ballistic, and blast injury, and discusses how protection may play a role in vision health depending on the injury. Then, Dr. Singman talks about the potential for brain tissue to have regenerative properties like other organs in the body such as the kidneys and the liver. Lastly, he talks about the social and economic impact of brain injury in Veterans, how he builds a network of physicians and caretakers for his patients to ensure correct treatment, and how traumatic brain injury is likely the key player for many other diseases and disorders outside of the brain injury itself. 

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss. 

In this episode Dr. Levi Sowers and Brandon Rea interview returning guest Dr. Randy Kardon. Dr. Kardon is a neuro ophthalmologist at the Iowa City VA Healthcare System and the University of Iowa in Iowa City who has had federal funding for over 30 years. This episode focuses on diabetic neuropathy and diabetic retinopathy. Diabetes affects many different types of body tissues, including the eye. With minimal invasiveness, the eye can be studied and provide information about how diabetes damages other tissues. Additionally, the eye can allow doctors to detect diabetes far earlier than other tissues with high resolution scans on the cells in the eyes. Early detection and management of diabetes can help minimize health effects of the disease and can prevent blindness. Control of blood sugar is the most important aspect to help prevent blindness with diabetes. Dr. Kardon explains how diabetes affects the eye and can lead to vision loss, as well as other effects on the body and available treatments. He explains that there are tiny blood vessels in the eye that are lined with endothelial cells. In diabetes these endothelial cells are damaged by the byproducts of high blood sugar and cause the tiny blood vessels to leak fluid into the tissue. When fluid gets into the tissue layers it disrupts the tissues' ability to function. This, however, can be managed with treatment. After the vessels begin leaking, the eye releases growth factors to allow new blood vessels to grow. Unfortunately, these vessels are weaker and begin to leak even more, and this is what leads to severe blindness in patients. Though there are treatments for the second stage of blood vessel leaks, when the leakage is too severe there is little that can be done. Dr. Kardon also talks about the different types of diabetes and how each type affects vision in patients.

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss. 

In this episode Dr. Levi Sowers and Brandon Rea interview Dr. Lina Kubli. Dr. Kubli is the RR&D Scientific Program Manager for Sensory Systems/Communication Disorders. Dr. Kubli was born in India and lived there until age 7 before moving the United States and settling in Maryland. She attended college at the University of Maryland initially majoring in Biochemistry, then switching to Hearing and Speech. In this time, Dr Kubli learned that she wanted to not only participate in clinical work but also interact with people while staying within research. She continued her education with earning her Master's in Audiology from the University of Maryland and worked with Veterans at Walter Reed National Military Medical Center (WRNMMC) as a Research Scientist and served as a Subject Matter Expert on Central Auditory Processing disorders and Traumatic Brain Injury. Initially reluctant to leave such an engaging research project, the director of the clinic encouraged Dr. Kubli to find a PhD program that could accommodate her schedule. She was able to find this balance at Gallaudet University, where she earned her PhD in Audiology. Dr. Kubli served on the Executive Committee of the Medical Staff as Chair for the Patient and Family Centered Care Steering Committee at Walter Reed National Military Medical Center.

Together with Levi and Brandon, Dr. Kubli explains what it means to be a Scientific Program Manager and how she oversees the program within the Rehabilitation Research and Development Service. She evaluates a broad range of funding applications for research that include vision, hearing, balance, communication, and more. Additionally, she recruits individuals with expertise to best evaluate the funding applications. Many of the panel members are from outside of the VA to ensure that the most knowledgeable reviewers help navigate a project being implemented in the VA. Dr. Kubli shares about all the work that goes into supporting important research for the benefit of Veterans.

Warning before the podcast, this episode contains graphic content of an Iraqi Veteran’s experiences and may be difficult to hear for some listeners. 
 
 In this episode of the Vets First Podcast, Dr. Levi Sowers and Brandon Rea interview Veteran Tim Hornick. Tim Hornick is a post 9/11 Army Captain who served from 2002 to 2011 in Operation Iraqi Freedom. He earned his Master's in Social Work and began working for the Western Blind Rehab Center. Tim grew up in the south side of Chicago and joined the military while applying for colleges to study nursing through the ROTC. However, he decided to not go the nursing route, enlisted at 22, and was stationed in South Korea. In this episode Tim tells his story of when he was deployed to Iraq in 2004. On November 11, 2004, while supporting the Iraqi national guard Tim was shot through the left temple, narrowly missing his helmet, and the bullet exited the right eye where he ultimately lost his sight. The bullet missed the brain but tore through nerves causing him to lose his sight. Tim talks about his journey after the accident and speaks on the mental process that allowed him, years later, to be able to laugh about the trauma and grow. Tim shares that over the years he has become happier and learned from his condition. While he still misses parts of his old life, he does not dwell on the past and has turned his experience into a way to help others grow from similar situations, highlighted by his term “transilience”. The VA has started to move forward with Ocular Trauma and Blind Disability Excellence Centers that allow Veterans with vision loss to find others with similar conditions. At the time of this recording, Tim Hornick was working within the VA’s Western Blind Rehab Center as the admissions coordinator. Now Tim has moved into a new position with the Blinded Veterans Association as their Director of Special Initiatives. He oversees the development of the Vet Tech program which focuses on assistive technology through support groups and podcasts and CARE review.

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with mobility, communication, and living with vision loss. 

In this episode of the Vets First Podcast, hosts Dr. Levi Sowers and Brandon Rea interview Loretta Phillips, an Army Veteran from Lancaster, South Carolina. Loretta suffers from visual impairment due to complications from diabetes that progressed due to depression and post-traumatic stress disorder. During this conversation, Loretta talks about the patient perspective of dealing with visual loss as a Veteran and shares her journey in getting treatment for her developing issues. 

Loretta joined the Army in 1989, where she spent most of her time in Germany amid the Cold War conflict. She obtained the rank of Sergeant in less than three years and served seven in total. After she came back to the United States, she had a daughter. However, four months later, she experienced vision loss during work. Throughout the episode, Loretta describes her diagnosis and the troubles she overcame to get treatment, having to resort to civilian doctors over government health workers at the time. Then, she describes an instance where she almost lost sight completely and how treatment for it damaged her eyes and consequently her eyesight. 

Later in the episode, Loretta talks about what life is like with loss of sight and, more specifically, how the Blind Rehabilitation Center with the VA, helped her learn the skills to survive and live with vision loss. Then, she talks about joining the Blind Veterans Association and gives advice to Veterans experiencing visual loss. She encourages Veterans to reach out to the visual programs and discusses how it can be difficult accepting loss of vision. Finally, she talks about both the mental and physical sides of vision impairment and the importance of research for vision loss. 

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss. 

In this episode of the Vets First Podcast Dr. Levi Sowers and Brandon Rea interview Elizabeth Holmes. Elizabeth “Liz” Holmes is the Blinded Veterans Association National Secretary and is part of the Georgia regional group. She is an Army Veteran and during her career she attended both basic and advanced ordinance courses and airborne school. Liz was born and raised in the south side of Chicago about 15 minutes from Indiana. She went to DePaul University and didn’t initially have plans to join the military. However, seeing that the ROTC program there did not have any women and knowing she could do anything a man could, Liz decided to join the ROTC program in 1975 and received her training at Fort Riley, Kansas. Following college, she joined the service as a reserve officer and then went on active duty for 11 years where she traveled all over the states, Korea, and Germany. Liz served from 1976 to 1987, where in 1976 she was commissioned to be a Second Lieutenant in the ordinant specialty. Following her military service, Liz worked in the United States Postal Service serving in a variety of different ways until retirement in 2014 due to vision loss because of glaucoma. She had never noticed a change in her vision until she went to an eye exam where her glaucoma was diagnosed. Liz had surgery on her left eye but continued to experience issues. She began seeing a specialist that worked to save her right eye’s vision. Liz was referred to the VA for further care and joined other programs to help navigate life with vision loss. While in blind rehabilitation in Birmingham, Alabama, Liz joined the Blinded Veterans Association and became an active member. She shares about her experiences in the military, vision loss with glaucoma, and her involvement in the Blinded Veterans Association.

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss. 

In this episode of the Vets First Podcast, hosts Dr. Levi Sowers and Brandon Rea interview Dr. Steven Fliesler, a SUNY Distinguished Professor at the University of Buffalo and a career scientist at the VA in Buffalo, New York. Dr. Fliesler holds positions as an endowed Chair of Ophthalmology and Director of Research in the Department of Ophthalmology.

Dr. Fliesler was born and raised in New York and moved to California at the age of 15. He attended the College of San Mateo, the University of California in San Diego, and the University of California Berkeley during his undergraduate education and later obtained his PhD in Biochemistry at Rice University. During his time at Rice, his professor in neurobiology needed someone, particularly a chemist, to give a lecture about the chemistry of vision. This led Dr. Fliesler to an opportunity at the Baylor College of Medicine, where he did a postdoctoral fellowship in the Department of Ophthalmology. From there, he has distinguished himself in research and teaching within the vision field and has since been interested in research towards helping Veterans with mild traumatic brain injury (TBI). 

Throughout this episode, Dr. Fliesler discusses how he started researching TBI and why it interests him. First, he talks about what inspired him to enter blast injury research and highlights his collaboration with one of his colleagues. He then talks about utilizing animal models to better understand visual abnormalities found in trauma patients at the VA and converses about the methodology he used to quantify the visual effects of TBI, both behaviorally and physiologically. 

Later, Dr. Fliesler further describes his exploration into blast research with a professor at the University of Buffalo. He comments on the effects of auditory blasts that cause trauma in mice and how that affects visual function. Then, he discusses the various mechanisms that causes visual deficits and how it is important to understand in the context of TBI in order to rescue visual impairments. Finally, he hypothesizes on how the human body reacts to TBI. 

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss. 

In this episode of the Vets First Podcast, hosts Dr. Levi Sowers and Brandon Rea interview Dr. Laura Peters. Dr. Peters currently works as a licensed counselling psychologist at the VA Blind Rehabilitation Center in Palo Alto, California. Originally from California, Dr. Peters completed her graduate degree in counseling psychology at University of Utah. She began working with the VA during a practicum in which she focused on geriatric psychology, the psychology of aging, and worked at an outpatient mental health program in Salt Lake City, Utah. Eventually, she found her way to Palo Alto, California where she currently lives. 

Dr. Peters goes on to discuss her path to her current career at the Blind Rehabilitation Center and her role in helping visually impaired Veterans as a licensed counselling psychologist. She further discusses the diverse causes and symptoms of vision loss that impact Veterans, and the general population. Dr. Peters talks more in-depth on the prevalence of age-related vision loss and how Veterans learn to adapt with sudden or progressive blindness. Levi, Brandon, and Dr. Peters examine the impact of both physical and mental aspects of vision loss on Veterans’ daily activities, and several tools that assist individuals with varied spectrums of visual impairment.  

Dr. Peters discusses the benefits of using a whole-person approach in treatment of vision impaired Veterans. She further highlights the inter-professional collaboration between counsellors, social workers, physicians, and other healthcare professionals when a Veteran seeks care within the Blind Rehabilitation Center. Lastly, Brandon, Levi, and Dr. Peters briefly discuss recent research around visual loss and Veterans, as well as Veteran testimonials regarding Blind Rehabilitation Centers. As Dr. Peters mentions in this episode, there are a total of thirteen VA Blind Rehabilitation Centers as well as several non-VA facilities throughout the United States that a Veteran can access if experiencing vision loss.

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here.

In this episode of the Vets First Podcast, hosts Dr. Levi Sowers and Brandon Rea interview Dr. Thomas Zampieri. Dr. Zampieri currently serves on multiple Department of Defense grant review panels and has been appointed to the VA National Research Advisory Council, which is a Congressional mandated council to advise research at the VA. He is also the past president of the Blinded Veterans Association and he’s a former Army Veteran who served during the Vietnam era as an Army medic. In this episode, Dr. Zampieri talks about his career as a physician assistant and as a Veteran suffering from retinitis pigmentosa, a genetic degenerative disease that breaks down cells in the retina over time.

Dr. Zampieri started his career early on as an emergency medical technician in rural New Hampshire and Vermont, which led him directly to the Army as a field medic and as a physician assistant. He talks about how the gradual visual loss affected his work and how it ultimately forced him to stop medical practice and leave the VA. He then discusses his perseverance with loss of vision and how he found the motivation to obtain a PhD in Political Science at the age of 47. 

Later in the episode, Dr. Zampieri narrates his journey back to the VA through the Blinded Veterans Association as the Director of Government Relations to represent blind Veterans. From there, he obtained many other VA positions and discussed his appreciation for helping Veterans. He elaborates about his efforts towards advocating for more funding in research to assist degenerative eye conditions, particularly vision dysfunction from traumatic brain injury (TBI). Then, Dr. Zampieri communicates about the struggles many Veterans go through with TBI. Finally, he talks about one of his unique meetings with a recently blinded Veteran and demonstrated how you can still live your life well with vision loss. 

If you are a Veteran or you know a Veteran needing help with visual loss, contact the Visual Impairment Services Team coordinator at your nearest VA medical center or contact the Blind Rehabilitation Service Program by phone which can be found here. There are 13 Blind Rehabilitation Centers around the country, which can help with things like mobility, communication, and living with vision loss.