Army doctors use detective work, teamwork, technology to protect health of force
February 5, 2014
By David Vergun
WASHINGTON (Army News Service, Feb. 5, 2014) -- Army doctors diagnose and successfully treat a host of potentially lethal diseases in Soldiers and family members on a routine basis, without much fanfare.
Maj. Andrew D. Mosier, an Army radiologist, said it's all in a day's work. But he also said the cause of a malady isn't always readily apparent and sometimes it takes some skillful sleuthing to discover its identity -- an especially important part of a radiologist's job.
Mosier's efforts as an Army doctor payoff twofold. First, they can save a Soldier's life. And second, they help the Army maintain a ready, healthy, fighting force.
By using technology to bring medical teams together from around the world, and putting minds from multiple medical disciplines on solving a problem, Army medical professionals are able to protect the health of the Army community.
Last year at Ireland Army Community Hospital, Fort Knox, Ky., for instance, Mosier said he detected a small, malignant cancer in a female Soldier's breast just prior to her scheduled one-year deployment.
"Had she not had this screening mammogram, she would have been overseas with a cancer progressing in size without knowing it," he said. "Instead, after my biopsy proving breast cancer, she was able to have it resected, with follow-on chemotherapy and radiation."
After her follow-up treatment, Mosier said, the Soldier chose to catch back up with her deployed unit.
"I am a firm believer that the health of our Soldiers begins at home," he said. "If a Soldier's family is well taken care of, then they can firmly focus on their mission."
Mosier's belief that taking care of families is part of taking care of Soldiers recently hit home when he looked into the chest pains experienced by Lt. Col. Brian Borek, of Army Human Resources Command. Borek is Mosier's cousin.
In early 2013, Borek started experiencing chest pains during physical training. He said this was unusual because he's been keeping physically fit ever since joining the Army in 1985.
He said he went to a clinic and the physician assistant who saw him thought he might be experiencing gastroesophageal reflux disease, or GERD, a non-cardiac chest pain that does not result in heart disease or a heart attack, Mosier said.
But despite receiving medication for GERD, had said the pain persisted. In April, he called his cousin, the Army doctor.
Mosier said he became concerned because he knew that Borek's family has a history of heart disease. Mosier and his wife, Susan, got permission to examine Borek's medical records. Susan, currently a civilian pediatrician, is a former Army brigade surgeon.
After looking at his records, Mosier worked with Borek's primary care provider to get him a cardiolite stress test. The test assesses the heart for areas where blood flow may not be present or adequate.
The radiologist who administered the test told Mosier that the test came back positive, with a 99 percent blockage of Borek's left anterior descending artery, the largest coronary artery that supplies blood to the left side of the heart.
Mosier said the test showed that some 50 percent of the blood flow that should have been flowing to Borek's heart muscle wasn't getting there.
Mosier added that "the left side of the heart is the most important because it is responsible for pumping blood to the rest of the body. Blockage of this artery is called a 'widow maker' and it can kill instantly if left untreated. Brian's was fortunately discovered just in time."
Borek was immediately rushed to the nearest cardiac center from Fort Bragg, N.C., where he was then stationed. There, he underwent a cardiac catheterization and stent placement to open the largest artery in his heart, Mosier said.
"Had this been unsuccessful, he could have needed an open chest cardiac bypass," Mosier said.
"Brian will continue his recovery for six to nine months after the stent placement as restored blood flow returns to the stunned heart muscle," Mosier continued. "He's already experienced an immediate boost in energy, an immediate decrease in fatigue and resolution of his chest pain."
Mosier said he takes just a small measure of credit for returning Borek back to good health -- he's now doing physical training with his unit. Mosier said that Army medicine is like an infantry squad where each Soldier has an important role to play and each must rely on others in the squad.
Mosier said he credits the Army's centralized database, which allowed him to access Borek's medical records at Fort Bragg, from Fort Knox, where Mosier was practicing medicine at the time. And finally, he credits TRICARE with smoothly and efficiently getting Borek's cardiolite stress test within 24 hours of reviewing his medical records.
And finally, Mosier praises the good collegial relationships between military hospitals and surrounding civilian hospitals. In Borek's case, "without that relationship it wouldn't have been possible to arrange for the urgent same-day cardiac catheterization with stent placement."
In essence, Mosier said Soldiers and their family members can be confident that the teams that make up Army medicine will be there for them should the need arise.
Currently, Mosier is on a fellowship at the Cleveland Clinic Foundation, practicing and studying breast radiology, mammograms, ultrasounds and magnetic resonance imaging, as well as biopsies. He has also co-authored a book with Dai Kohara, "Osteopathic Medicine Recall." Mosier said the book was written to help medical students quickly and easily grasp the fundamentals of osteopathic medicine.
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