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Dr. (Col) Randolph Modlin, a cardiologist and chief of medicine at Landstuhl Regional Medical Center, examines Spc. George Vianelli, a soldier from the 82nd Airborne Divison, 2nd Brigade, 325th Airborne Infantry Regiment, on Friday.
Dr. (Col) Randolph Modlin, a cardiologist and chief of medicine at Landstuhl Regional Medical Center, examines Spc. George Vianelli, a soldier from the 82nd Airborne Divison, 2nd Brigade, 325th Airborne Infantry Regiment, on Friday. (By Ben Bloker / S&S)

While doctors at Landstuhl Regional Medical Center in Germany have treated more than 37,000 patients from the wars in Iraq and Afghanistan, only about 20 percent of those were seen for combat-related wounds, officials say.

Troops and civilians from the combat zones, including Americans and patients from 41 other nations, have sought treatment at the U.S. Army hospital for ailments including heart problems, back injuries, kidney stones, respiratory illnesses, gynecological issues and dermatological complications, officials said.

“When you’ve got more than 140,000 people in any one place, you have to expect diseases and injuries that have to be evaluated and treated,” said Dr. Randolph Modlin, an Army colonel and chief of cardiology at Landstuhl.

More than half of the noncombat patients flown to Landstuhl from the combat zones arrive for treatment for chest pain and possible heart problems, though not all diagnoses are cardiac-related, Modlin said.

One reason they seek treatment at Landstuhl is there no cardiologist in theater, though a cardiologist at times rotates through the U.S. medical treatment facility in Kuwait, he said.

“In my opinion, it would be cost effective to have a cardiologist downrange, since chest pain is the number one [complication],” he said.

But a cardiologist alone wouldn’t solve all the problems because the combat support hospitals also lack the high-tech diagnostic or treatment equipment that cardiac patients need, Modlin added.

As of Jan. 25, the number of patients treated from Iraq and Afghanistan stood at 37,362, hospital spokeswoman Marie Shaw said. Of those, 6,808 were battle injuries from Iraq, and 519 were battle injuries from Afghanistan.

From the early days of the wars, the number of inpatients and outpatients flown to Germany from Iraq, Afghanistan or surrounding areas has decreased.

One reason is that downrange military treatment facilities either augmented or improved the medical services provided, said both Modlin and 1st Lt. Justin Kocher, a spokesman for the 28th Combat Support Hospital in Baghdad.

Troops today can be treated in Baghdad for problems ranging from breathing difficulties to stomach ailments, broken bones, rashes, eye or ear diseases, and gynecological needs, Kocher said.

They don’t have to spend so much time traveling for medical care and can return to their units quicker, he said.

In fiscal 2003, Landstuhl logged its highest monthly averages of inpatients and out-patients brought in for treatment — 237 inpatients and 781 out-patients, Shaw said.

In fiscal 2004, the averages were 253 inpatients, 586 out-patients. In fiscal 2005, the averages dropped to 246 inpatients, 539 out-patients, she said. In fiscal 2006, the averages were 242 inpatients and 452 out-patients.

A major medical challenge has been the high number of reservists and National Guardsmen activated for the war, Modlin said, a population who tends to be older and less prepared physically for the rigors of combat. Following cardiac complaints, back pain is the second most common noncombat injury Landstuhl doctors see.

“The war has changed the mission at Landstuhl dramatically,” Modlin said. “The size of staff has grown … and we’ve rotated reservists in and out of the hospital.

“Before the war, six patients in the [intensive care unit] meant we were busy,” he said. “Now, we have 10 to 15 patients on a regular basis."

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