THE EXAMINER

Volume 19, No. 7 July 2011C

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism since 1993”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail atcomplaint@jointcomission.org

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in May -- 12,000Appointment No Shows in May -- 852

More good news for our patients in May... the downward trendin no shows for appointments is still trending down. For May itwas 6.6 percent. We still have to keep trending down so we canmeet or even exceed our goal of 5 percent. Help us to help youincrease your access to health care... you deserve the best!

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

Former Hospital Corps Force Master Chief Lou Green, left, andHN Thomas Hess, the youngest Hospital Corpsman at the HospitalCorps Birthday Ball, team up to cut the birthday cake. Hess worksin the Multi-Service Ward of the Robert E. Bush Naval Hospital.

Happy Birthday Corpsmen! Navy Surgeon GeneralDiscusses Advancementsin TBI Treatments

From Navy Medicine Public Affairs

SAN FRANCISCO, Calif. (NNS) -- The top medical officer for theU.S. Navy and Marine Corps discussed military medical researchadvancements in the areas of traumatic brain injury and post traumat-ic stress at the 8th Annual World Congress on Brain, Spinal CordMapping and Image Guided Therapy, June 8.

The annual medical conference is a multi-disciplinary forumdesigned to facilitate cross-disciplinary sharing of technological andmedical advances and scientific discovery. The attendees are a mix-ture of neurosurgeons, radiologists, neurologists, psychiatrists, reha-bilitation medicine, cardiologists, pulmonologists, bioethicists, policymakers, government officials, engineers, physicists, graphic designers,allied healthcare professionals, healthcare executives, students, post-docs., residents and fellows.

During his keynote address, Navy Surgeon General Vice Adm.Adam M. Robinson Jr, stated that military medical advancementscoupled with enhanced medical training and trauma experience duringten years of war have led to a 97 percent survival rate for coalitioncasualties; the lowest mortality rate amongst trauma victims comingout of any war in history.

“When Sailors and Marines in the fight are hurt, we apply all of ourtraining and resources to provide rapid evacuation and care, and thisis done in partnership with our sister services,” said Robinson. “If awarrior can arrive with life in him or her, there is a good chance wecan keep them alive. This is a huge advancement since the days ofVietnam and even Desert Storm.”

Due to the nature of wounds in Iraq and Afghanistan, Robinsonmade Traumatic Brain Injury and psychological health treatment histop research priority to best support both operational forces andhome-based families during his tenure as Navy Surgeon General andChief of the Navy Bureau of Medicine and Surgery.

“Our focused research has yielded tremendous results in combatcasualty care in mild to severe TBI and post traumatic stress, as wellas areas like wound management, wound repair and reconstruction,extremity and internal hemorrhage control and phantom limb pain inamputees,” said Robinson.

Robinson told the audience that a key element of healing woundedwarriors in body, mind, and spirit starts with care near the point ofinjury such as the Navy’s Concussion Restoration Care Center locatedat Camp Leatherneck, Kandahar Afghanistan, the first of its kindfacility that brings concussion specialists to the front lines. Accordingto Robinson, most Sailors and Marines in the fight who are beingtreated at Camp Leatherneck suffer from mild TBI or concussions

Continued on page 7

Warning: exposure tothe sun’s ultraviolet(UV) rays can damage

your skin. At 93 million milesaway we sometimes don’t real-ize how dangerous the sun canbe as far as skin damage thatcan lead to cancer and damageto our eyes that can lead tocataracts.

Each year, approximately onemillion skin cancers are detectedin the U.S. Reducing yourexposure to the sun’s UV rayscan decrease your risk of skincancer.

Want to know how you canprotect your skin and eyes whilestill having fun outdoors?

Here are some tips to help pro-tect you and your family fromthe damaging rays of the sun.

Avoiding the sun during themidday hours provides the bestdefense against skin cancer.However, if you can’t avoid themidday sun, remember thatchoosing shade, hats, sunscreen,etc can protect your skin.

Use sunscreen everywhere -not just to the pool or beach.Use a sunscreen with a sun pro-tection factor (SPF) of at least15, generously apply it 30 min-utes before going outdoors andreapply it frequently throughoutthe day, especially after swim-ming or exercise. A couple ofgeneral tips: avoid sunscreensprays, pumps and powdersbecause the chemicals in themcan be inhaled, and chooseproducts that use the mineralszinc or titanium as their activeingredient because they’re themost stable.

Don’t be misled by the veryhigh SPF numbers found onsome sunscreens as it can giveyou a false sense of safety in thesun and causing you to reapplyless frequently or stay in the sunfor longer periods.

Never put sunscreen on babiesunder six months old as it canbe absorbed through their skin.

The best way to protect yourbaby is to keep them out of thesun completely by keeping themin the shade, wearing hats andbaby size sun glasses to protecttheir delicate eyes.

Read the label before using

any sunscreen to be sure thereare no toxic chemicals in themsuch as PABA, retinyl palmitateor oxybenzone as these chemi-cals have been found to be haz-ardous. Oxybenzone is anendocrine disrupter (a chemicalthat can upset the hormone bal-ance in your body) and retinylpalmitate is a form of topicalvitamin A that some animalstudies suggest may be linked toan increased risk of skin cancer.PABA has also been linked toincreasing your risk of skin can-cer.

The research group“Environmental WorkingGroup” has compiled a sun-screen safety guide that explainswhich sunscreens have toxicchemicals in them and whichsunscreens perform the best.That report can be found athttp://breakingnews.ewg.org/2011sunscreen/.

Here are more tips to help pre-vent skin cancer. Seek Shade...Whenever possible, avoid themidday sun when UV rays arethe strongest and do the mostdamage. When you’re outdoors,look for trees, beach umbrellasor tents as good sources ofshade.

Use Your Head and wear aHat... Up to 80 percent of skincancers occur on the head andneck, so wearing a wide-brimmed hat is a great way toshade your face, ears, scalp, andneck from the sun’s rays. A hatwith a four-inch brim providesthe most protection. If youchoose a baseball cap, also use asunscreen with an SPF of atleast 15 to protect your exposedears and neck.

Cover up with clothing... Ashirt, beach cover-up, or pantswith a tight weave are all goodchoices for cover. A typical T-

shirt usually has an SPF that ismuch lower than the recom-mended SPF 15 so you will stillneed sunscreen and shade whenpossible.

Wear sunglasses...Don’t forgetto protect your eyes from harm-ful UV rays. Sunglasses protectthe tender skin around your eyesand reduce the risk of develop-ing cataracts. Look for sunglass-es that block both UVA andUVB rays. Also, try wrap-around lenses, which keep UVrays from sneaking in at thesides.

Remember that the damageyou do to your skin and eyes asa young person never goesaway. That tan or sunburn yougot as a young person is directlylinked to your risk of skin can-cer as you get old. Protect your-self now and save yourself thepain of skin cancer later in life.

2 -- The Examiner -- July 2011

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Cynthia Gantt, NC, USN

Command Master ChiefHMCM (SW/FMF) Rodney Ruth, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: dan.barber@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

Summer Is Here -- Protect Yourself From The SunBy Martha Hunt, MA CAMFHealth Promotion and WellnessRobert E. Bush Naval Hospital

Thinking of Quitting?...This New TRICARE Benefit Could Help

By Shari Lopatin and Diane MayerTriWest Healthcare Alliance

Have you ever thought of quitting smoking, but just didn’t feelready...yet? Or perhaps, you want to quit, but don’t knowwhere to start.

After all, kicking that habit isn’t exactly easy.That’s why TRICARE now offers a new counseling benefit for

smoking cessation. You don’t need to have a smoking-related illnessto use the benefit. You just need to receive the counseling from aTRICARE-authorized provider who's properly licensed or certifiedfor this type of counseling.

The only restriction is this: the smoking cessation counseling benefitis not available for Medicare-eligible beneficiaries.

Need a reason to seek more information? Try this: According to theAmerican Lung Association, your lungs will start growing healthieralmost immediately after quitting.

Check out any of these resources for more on the counseling bene-fit, or for help to quit smoking:

* TriWest’s tobacco cessation page: www.triwest.com/tobacco * TriWest Tobacco Quitline: 1-866-244-6870* TRICARE Tobacco Free: www.tricare.mil/tobaccofree * DoD-sponsored website: www.ucanquit2.org * Center for Disease Control and Prevention: www.smokefree.gov

Editor’ s Note: You can also contact the Robert E. Bush’s HealthPromotions coordinator, Martha Hunt, to help you kick the habit oftobacco... Call 760-830-2814.

By Martha Hunt, MA CAMFHealth Promotion and WellnessRobert E. Bush Naval Hospital

Summer is the season fortravelling to visit friendsand family, who may own-

pets that you and your familymay not know.

Summer is also the seasonwhen some families decide tobring a new puppy into theirhome as part of their family.When visiting family andfriends, here are some tips tohelp prevent an unfortunate dogbite. Most dog bites are theresult of the person not under-standing some basic ‘dog eti-

quette’ and acting according towhat the dog is capable ofunderstanding.

Remember, when a dog bites aperson, both the victim and thedog suffer from the conse-quences.

Never approach a dog you donot know or who you have notseen in a long time as it maytake a while for the dog toremember you.

Always approach the owner ofthe dog first, so that the dogsees that you are friendly andnot an immediate threat to them.If the owner is not present, thendo not approach the dog at allunless you have been visitingfor a few days and the dog has

gotten used to you. Never approach a dog that is

eating, sleeping or caring forpuppies. They will may be pro-tective and might bite.

If you or a family member areapproached by a strange dog,then let the dog sniff you. Standstill and keep your hands toyour sides. Never make directeye contact with a strange dogas they will see this as aggres-sive behavior on your part andmay bite in response.

Teach your kids never to runand scream around a strangedog. This will bring out thedog’s attack or herding instinctsand could end up with yourchild being injured. Also, teach

your kids to always ask theowner of the dog if they maypet the dog, rather than justreaching for it. The dog will seethe motion as a threat and mayreact by immediately biting.

If you are attacked by a dog,it’s best to try to feed the dogyour jacket, book, purse, or any-thing else that can serve as abarrier between you and thedog. If you are pushed to theground, it’s best to curl into aball and protect your face andears with your hands.

Remember, don’t scream or tryto run, this will only excite thedog further and make the bitingworse.

Now, if you have decided tobring a new dog into your homethis summer, there are ways thatyou can raise your new familymember to be more social andless likely to bite someone theymay see as a threat.

Start with socializing your dogas early as possible to otherdogs as well as to other humans.Introduce them safely to newpeople, places and animals sothat way they will be able to tellwho is friend and who is foeand act less aggressively.

Also, they will be less nervousand frightened if they are usedto other people and dogs aroundthem and less likely to grow upto be a fear biter.

The next step is to teach yourdog what behavior is allowedand what is not. Take your dogto obedience training yourself --rather than have someone elsetrain your dog for you -- so thatyou and your whole family learnto work as a team. This wayyour dog understands what you

expect of them and not what thetrainer expects.

Play responsibly with yourdog. Do not teach them aggres-sive behavior in play. Playing attug or teasing them is teachingthem to be aggressive.

Play should be fun and safeand should not teach the dogaggression to anyone. The dogwill not be able to tell who isfriend and who is not if youmake fun time aggressive. Justlike kids, dogs learn from youand if you teach them aggres-sion, they will respond aggres-sively.

If you don’t know how yourfluffy bundle of joy will react ina new situation, like visitingfamily or friends, then keep himaway from strangers until he canbe introduced safely.

Remember, if you socializehim to new people and places,he’s much more likely to be lessstressed and less aggressive inthese situations.

Spaying or neutering your petalso helps to reduce aggressivebehavior in dogs as it reducestheir desire to roam. Spayed orneutered dogs are 3 times lesslikely to bite than are intactdogs.

Finally, make sure that youhave your pet's vaccinations upto date. If a dog bite does occur,you will need to provide all ofthe proper vaccinations andlicensing documents to theauthorities. Be a responsible petowner. Your dog can be a lov-ing, protective member of thefamily if both of you have theproper training.

The Examiner -- July 2011-- 3

Atlas2X3

Critter de jour...While Watching out for Dangerous Desert Denizens you also need Dog Bite Safety Awareness

By Sharon FosterTRICARE Management Activity

When beneficiariesretire from activeduty, they may have

big plans for how they are goingto spend their time. Along withchoices about where to live andtheir next great adventure, theymust make choices about theirhealth care.

Understanding these choiceswill help beneficiaries and theirfamilies make the best healthcare decisions.

“While active duty servicemembers must use TRICAREPrime or Prime Remote, retireeswho are not eligible forMedicare may be eligible forTRICARE Prime or chooseTRICARE Standard or Extra,”said Kathleen Larkin, director,Health Plan Policy Division ofHealth Affairs, TRICAREManagement Activity.

“Each program has advantagespertaining to cost, location andconvenience,” she added.

If space is available, retireescan continue care in a militarytreatment facility (MTF) with aprimary care manager, throughTRICARE Prime. This requiresre-enrolling and paying annualfees of $230 for an individualand $460 for a family.

If beneficiaries choose toenroll in TRICARE Prime at anMTF, they will receive carebased on the same access-to-care standards as all other Prime

beneficiaries.TRICARE Standard or Extra

may be the best option if aretiree moves to a location thatis not near an MTF or wherePrime is not offered. TRICAREStandard is a flexible, affordableplan that gives retirees and theireligible family members agreater choice of providers, noenrollment fees, waiver of costshares for most preventivehealth care services and thesame low catastrophic cap asTRICARE Prime.

TRICARE Extra offers evenlower out-of-pocket expense ifretirees use network providers.Although there is no enrollmentfee for TRICARE Standard andExtra, a deductible of $150 forindividuals and $300 for a fami-ly must be met before cost-shar-ing begins.

Under TRICARE Standard andExtra, retirees retain the sameaccess to pharmacy benefitsthrough a local MTF or TRI-CARE Pharmacy HomeDelivery.

To learn more about HomeDelivery, go to:www.tricare.mil/homedelivery.

Retirees also have the optionto use the TRICARE retail phar-macy network and can purchasedental coverage through theTRICARE Retiree DentalProgram (TRDP). More infor-mation on TRDP can be foundhere: www.trdp.org.

In addition to TRICAREretiree health care benefits, cer-tain medical and pharmacy ben-

efits may also be available toretirees from the Department ofVeterans Affairs. Go towww.va.gov/health/default.aspfor more information.

The TRICARE OverseasProgram (TOP) Standard optionis available to retirees planningto live outside the United States.They and their family must meeta deductible before cost-sharingbegins and generally file theirown claims for reimbursementfor covered health services.TRICARE also has additionalcountry-specific requirementsfor care received in thePhilippines.

Retirees should alwaysremember to update the DefenseEnrollment Eligibility ReportingSystem (DEERS) with any newpersonal information, includinga new address. The websiteaddress for DEERS iswww.dmdc.osd.mil/appj/dwp/index.jsp. Automatic coverage byTRICARE Standard and Extraor TOP Standard occurs afterretirement as long as DEERSinformation is current.

TRICARE recommends bene-ficiaries consider all availablechoices before retiring. It is bestto plan well in advance toensure a smooth transition.Beneficiaries can learn moreabout retiree health care optionsat their local TRICARE ServiceCenter. Other TRICARE contactinformation and beneficiaryassistance locations can befound at www.tricare.mil/con-tactus.

TRICARE Does Not Retire When You Do

4 -- The Examiner -- July 2011

Super Stars...

CSCS Gener Cunanan,Material Management, isfrocked to his current rank ofSenior Chief.

HM3 James Abelar, MaterialInfant Nursing Dept., receivesa Letter of Commendation.

Mr. Vincent Aldaz, CombinedFood Operations Dept.,receives the Individual SafetyAward for 2010.

CS2 Robert Dalton, CombinedFood Services Department isfrocked to his current rank as aPetty Officer Second Class.

HM3 Patrick Coke, PatientAdministration Department isfrocked to his current rank asa Third Class Petty Officer.

HM3 Courtney Marsh, MentalHealth Clinic, is frocked to hercurrent rank as a Third ClassPetty Officer.

Lt.j.g. Gretchen Roseen, a Nurse Corps Officer assigned to thePediatrics Clinic takes the oath at her promotion ceremony toLieutenant.

CS3 Edwin Abad, CombinedFood Operations, is frocked tohis current rank of Third ClassPetty Officer.

HM3 Brendon Gordon, MainOperating Room is frocked tohis current rank as a ThirdClass Petty Officer.

HM3 Jason Dyrhaug, MilitaryReadiness Clinic is frocked tohis current rank as a PettyOfficer Third Class.

CS2 Giam Magpayo, CombinedFood Services receives a Navyand Marine CorpsAchievement Medal.

Lt.j.g. Shelly Griffith,Environmental Health Officerin the Preventive MedicineDept. takes the oath during herrecent promotion ceremony toLieutenant.

HM3 Vincent Petsch, OB/GYNClinic, is frocked to his currentrank of Third Class PettyOfficer.

HM3 Valentin Diaconu,Manpower, was frocked to hiscurrent rank at the HospitalCorps Birthday Ball.

The Examiner -- July 2011 -- 5

IT2 Matthew Colvard,Information ManagementDepartment, receives a FlagLetter of Commendation for hiswork while assigned to the USSMount Whitney (LCC/JCC 20)

Lt.j.g. Mary Redden, Maternal Infant Nursing Department, left,and Lt.j.g. Christopher Redden, Mental Health Department, takethe oath at their recent promotion ceremony to Lieutenant. Bothare Nurse Corps Officers.

Lt.j.g. Charles Kinard, NurseCorps Officer in theEmergency MedicineDepartment receives a Navyand Marine CorpsCommendation Medal.

HM2 Abner Ocampo,Pharmacy, is promoted to hiscurrent rank of Second ClassPetty Officer, and he is awardedhis first Good Conduct Medal.

HM3 Ricky Galan, StaffEducation and TrainingDepartment, receives a Navyand Marine Corps AchievementMedal for his work whileassigned to HeadquartersBattery, 3rd Battalion, 11thMarine Regiment as TrainingPetty Officer and BatteryCorpsman.

HM1 Eduardo Pamatz, left,Radiology, is awarded theMilitary Outstanding VolunteerService Medal.

Lt. Cmdr. Junewai Reoma, asurgeon assigned to the hospi-tal’s General Surgery Dept.receives a Navy and MarineCorps Achievement Medal forhis work at the hospital.

HMC Thomas Tennison,Medical Services, receives aGold Star in lieu of his secondNavy and Marine CorpsCommendation Medal.

HM3 Derrick Roberts, right,Mental Health Dept. receives

his first Good Conduct Medal.

HM3 Ryan Schuck, left,Emergency Medicine Dept. isfrocked to his current rank ofThird Class Petty Officer.

Continued on page 8

VIP2X4

Full Color

By Dan BarberPublic Affairs OfficerRobert E. Bush Naval Hospital

Just in case you haven’tnoticed, we are in the sum-mer season here... and I’m

sure that you’ve heard thiswarning before... but it is worthrepeating because it is importantto pay attention to your environ-ment to prevent heat stroke.

The Heat Condition FlagWarning System, determined bythe Wet Bulb GlobeTemperature Index (WBGT)reading, on the Combat Centeris set up to help you determineyour safe daily outdoor activi-ties in the summer months. TheRobert E. Bush Naval Hospitalalso constantly monitors the‘Mainside’ WBGT in real time

making it available on the hos-pital’s internet athttps://www.med.navy.mil/sites/nhtp/Pages/FlagCondition.aspx

The WBGT index consists of acombination of readings from

thermometers, providing tem-peratures for dry, humid andradiant heat. These three tem-peratures are combined in astandard formula providing amore accurate reading of heat

stress intensity, known as theWBGT Index.

Safety concerns with heat andphysical training are very real,especially in a desert environ-ment. Dehydration is a constant

threat when exercising in theheat. Thirst occurs too late to bea good indicator of excessivewater loss from the body. Whenyou are engaged in a lot ofintense phyiscal activity during

the warm summer months, besure to weigh yourself regularly.

There is no specific tempera-ture beyond which you shouldnot exercise. People havebecome heat casualties even in

subfreezing temperaturesbecause they were overdressed.Any circumstances that causeyour body’s heat production toexceed its capability to cool offwill often result in heat stress.

To alert Combat Center mem-bers of hazardous heat condi-tions, the following flags areflown to indicate readings andcontrol physical activity:

Green Flag -- WBGT IndexTemperatures range from 80-84.9 -- Unrestricted physicalactivity may be carried out.

Yellow Flag -- WBGT IndexTemperatures range from 85-87.9 -- Physical activity shouldbe limited to those people whohave been exercising in similarheat for a minimum of 10 daysor more.

Red Flag -- WBGT IndexTemperatures range from 88-89.9 -- Physical activity isadvised only for members whohave been working out in simi-

lar heat conditions for a periodof 12 weeks for more.

Black Flag -- WBGT IndexTemperatures range 90 andabove -- Vigorous outdoor exer-cise, regardless of conditioningor heat acclimatization, is notadvisable.

Combat Center membersshould be advised to note theflag, which is indicated on thehospital’s web site before begin-ning outdoor workouts on Mainside in the summer months. ForCamp Wilson and Ranges,check with Marine WingSupport Squadron -- 374(MWSS-374) Weather Office at830-7809, as geographic loca-tions on the base cause theWBGT Index to vary.

Although you do not have achoice about the characteristicsof work clothing or gear, do notuse a vapor barrier (rubber) suitas an aide for weight reductionwhile exercising. Exercising in arubberized suit may result insevere dehydration and elevateyour core body temperature.Wearing these suits also will nothelp you with your weightreduction program since thedecrease in weight is due to avery temporary loss of fluid, notfat loss. If you are required towear NBC gear or body armoryou should add 10 points to theWBGT Index to determine yourtraining activities.

For more information on theWBGT Index call the Hospital’sPreventive MedicineDepartment at 830-2029.

By Shari LopatinTriWest Healthcare Alliance

“For the first time inour history, Americanchildren may face a

shorter expected lifespan thantheir parents.”

That quote, taken directly fromthe Partnership for a HealthierAmericaís website, explains theessence of a growing obesityproblem across the U.S. Thepartnership...which is headed byFirst Lady MichelleObama...says that obesity rateshave tripled in the past 30 years.

Obese and overweight childrenare more likely to suffer aca-demic, social and financial bur-dens throughout life. So, whatcan you do, to prevent this fromhappening to your children?

Together CountsTriWest Healthcare Alliance,

the company which administersTRICARE in 21 western states,believes that together, we canmake a difference. That’s whyTriWest joined forces withTogether Counts, a nationwideprogram that inspires active andhealthy living. As part ofTogether Counts, we challenge

you:* Eat at least ONE healthy

meal each week.* Do at least ONE family

activity each week.

That’s it-- Just one... It can beas simple as cooking dinnertogether, then going for a walk.Or if you have kids, let themchoose a fun activity. A picnicand a game of Frisbee at thepark? A barbeque followed by afew hours in the pool?

Because, what it all boilsdown to is, we are a nation thatneeds to move again.

What causes obesity?According to the Centers for

Disease Control and Prevention(CDC), obesity now affects 17percent of all U.S. kids andteenagers.

The CDC listed these as themost common causes of obesity:

* Energy imbalance. Thismeans eating too many caloriesand not getting enough physicalactivity to burn them off.

* Genetics, which also affectsmetabolism (how fast onedigests food), behavior (stayingup late and sleeping in), envi-ronment (nowhere and no timeto exercise), culture, and socioe-

conomic status.* One’s behaviors and envi-

ronment play the largest roles incausing obesity. These also rep-resent the best areas for preven-tion and treatment.

Want more information?It’s easy to find... Learn more

about Together Counts, and howyou can help, by visitingwww.TogetherCounts.com.

Find more healthy living tipson TriWest’s Healthy LivingPortal, atwww.triwest.com/HealthyLiving

6 -- The Examiner -- July 2011

Sub Offer3X3

Meals and Moves: Together Counts!

The Heat of the Summer is Here... Again

...Safety concerns with heat and physical training are very real, especiallyin a desert environment. Dehydration is a constant threat when exercisingin the heat. Thirst occurs too late to be a good indicator of excessive waterloss from the body...

from IED blasts. Since opening, the center has

seen hundreds of personnel andthe Navy has since expanded itscapability to include first everNavy Neurologist assigned toKandahar to help support thismission. The Center at CampLeatherneck is also a full spec-trum center providing occupa-tional and physical therapy,acupuncture, sports medicineand psychoeducation.

“We are benefitting greatlyfrom having this in-theater sup-port to immediately diagnoseand treat concussions or mildTBI,” said Robinson.

Robinson highlighted the con-tributions of medical researchand research and stated thatNavy Medicine would not beable to accomplish its missionwithout a vibrant research anddevelopment community that issupported by and works in part-nership with both of its militarysister services, as well as theprivate sector, non-profits andacademia.

The United States Navy has along history of medical research.Dating back to 1853, when theU.S. Congress created the firstNaval Medical Research facilityin Brooklyn, New York. Navy

Medicine has 10 medicalresearch laboratories located inthe U.S. and overseas, focusingon programs as wide ranging aspopulation based medicine andepidemiology, aviation, subma-rine, directed energy, toxicology,emerging infectious diseaseevaluations, combat casualtycare, diving medicine and manymore areas.

“Many of our wounded war-riors are walking, talking, andleading productive lives todaybecause of the research andmedical advancements we haveworked on together, and becauseof our transition/reintegration

and resiliency programs wehave created for them and theirfamilies,” said Robinson. “Theworld class care we providetoday is a direct result of therazor sharp focus we haveplaced on translational researchadvancements for our woundedwarriors.”

The Navy's Surgeon Generalalso shared his views on thelong-term care that will be need-ed for many wounded veteransand emphasized the Navy’scommitment to work withnumerous partners to ensurethey receive enduring care.

“Make no mistake, the chal-lenge of healing and caring for

these men and women, in body,mind, and spirit is a long-termone that will last the better partof this century as the youngwounded warriors of todaymature into tomorrow's agingheroes,” said Robinson.

Robinson oversees a globalhealthcare network of 63,000Navy Medical personnel aroundthe world who provide highquality health care to more thanone million eligible beneficiar-ies. Navy Medicine personneldeploy with Sailors and Marinesworldwide, providing criticalmission support aboard ship, inthe air, under the sea and on thebattlefield.

The Examiner -- July 2011 -- 7

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Advancements in TBI Treatments...Continued from page 1

Going Paperless Raises $85,000 for Military FamiliesPHOENIX (June 6, 2011) Making the simple

switch to electronic statements means military fam-ilies throughout the country will receive thousandsin additional funding to help during a future timeof need.

Through TriWest Healthcare Alliance’s “GoGreen and Give” campaign, more than $85,000was raised to help four national military charitiesin their mission of supporting military families.

All told, more than 17,000 TRICARE WestRegion households participated in the three-montheffort.

Go Green, TriWest Gives GreenFor each of the 17,000 households that chose to

Go Green and receive healthcare statements elec-tronically, TriWest agreed to donate $5 to one offour military charities:

* Armed Services YMCA (ASYMCA) * Operation Homefront* Tragedy Assistance Program for Survivors

(TAPS)* USO“It’s great to know that by simply choosing

paperless options, our customers were able to helpthese four outstanding organizations...and ultimate-ly, provide support to the men, women and chil-dren who do so much for our country,” saidTriWest President and CEO David J. McIntyre, Jr.

Clearing the ClutterTRICARE West Region beneficiaries can contin-

ue opting in for paperless healthcare communica-tions, such as referral and authorization letters,claims and explanation of benefits statements, byvisiting www.triwest.com/GoGreen.

By Linwood Outlaw IIITRICARE Management Activity

For beneficiaries with specificmental or physical disabilities,TRICARE's Extended CareHealth Option (ECHO) providesbenefits, including financialassistance that is not availablethrough the basic TRICAREprogram.

ECHO does not replace bene-fits from other TRICARE pro-grams; it simply offers supple-mental benefits, such as possiblecoverage for assistive services,durable equipment, transporta-tion, special education, in-homemedical services and in-homerespite care services.

ECHO is available to activeduty family members, includingfamily members of NationalGuard and Reserve membersactivated for more than 30 days;family members eligible forcontinued TRICARE coverage

through the TransitionalAssistance ManagementProgram; children or spouses offormer service members whowere victims of physical oremotional abuse and familymembers of deceased activeduty sponsors during the periodthey are in transitional survivorstatus.

Children may remain eligiblefor ECHO benefits with noadditional premium beyond theusual TRICARE eligibility agelimit (21 or 23 if enrolled in col-lege full time) as long as thesponsor remains on active duty,the child is incapable of self-support because of a mental orphysical incapacity that occursbefore reaching the age limitand the sponsor is responsiblefor more than one-half thechild’s support.

Qualifying conditions forECHO include moderate orsevere mental retardation, a seri-ous physical disability and a

physical or psychological condi-tion that causes the beneficiaryto be homebound.

Under the ECHO plan, activeduty sponsors are responsiblefor paying a cost share deter-mined by their pay grade andseparate from cost shares associ-ated with other TRICARE pro-grams. Regardless of the num-ber of dependents registered inthe ECHO, the sponsor paysonly one cost share for benefitsused in a calendar month. Themaximum TRICARE cost sharefor all ECHO benefits com-bined, excluding ECHO homehealth care benefits, is $36,000per fiscal year. Comprehensiveservices offered through theECHO home health care benefit,which provides assistance tobeneficiaries who are home-bound and generally need morethan 28 hours of home-basedmedical services each week,have their own separate reim-bursement rates.

TRICARE ECHO Helps Families with Special Needs

8 -- The Examiner -- July 2011

Huck Fin4X4702

Super Stars...Continued from page 5

HM3 Michael Wall, MaternalInfant Nursing Dept., isfrocked to his current rank as aThird Class Petty Officer.

HM1 Jeremy Walton, MaterialManagement, receives his forthGood Conduct Medal.

HM3 Zachary Zanone, Multi-Service Ward, is frocked to hiscurrent rank as a Third ClassPetty Officer.

HN Henry Bueno, AdultMedical Care Clinic is the BlueJacket of the Quarter for theperiod from Jan. 1 throughMar. 31.

Ubaldo ‘Dave’ Llanos,Command Suite, has beenselected as the Junior Civilianof the Quarter for the periodfrom Jan. 1 though Mar. 31.

HM3 Jason Mitchell,Manpower, has been named theJunior Sailor of the Quarterfor the period from Jan. 1though Mar. 31.

HM1 Timothy Nacinopa,Laboratory has been selectedas the Senior Sailor of theQuarter for the period fromJan 1 through Mar. 31.

Therese Weseman, TRICAREOperations Dept., is named asthe Senior Civilian of theQuarter for the period fromJan. 1 through Mar. 31.

Lt. Cmdr. Joseph Gomez,Department Head at the AdultMedical Care Clinic was select-ed as the Officer of the Quarterfor the period from Jan 1.through Mar. 31.

Lt. Leah Williamson, receives aNavy and Marine CorpsCommendation Medal for herwork while assigned to theNaval Hospital’s MedicalServices Directorate as a busi-ness manager.

HM2 Steven Diaz, EmergencyMedicine Dept., was frocked tohis current rank at theHospital Corps Birthday Ball.