FDCH Congressional Testimony, November 3,
1999<br><br>November 3, 1999, Wednesday<br><br>SECTION: CAPITOL HILL
HEARING TESTIMONY<br><br>CLAUDIA S. MILLER, MD SENATE
COMMERCE, SCIENCE AND TRANSPORTATION<br>MANUFACTURING AND
COMPETITIVENESS MACHINE TOOL INDUSTRY<br><br><br>Committee on
Veterans' Affairs Subcommittee on Benefits . United States
House of Representatives Invited Testimony by Claudia
S. Miller, M. D., M.<br>S. Environmental and
Occupational Medicine Department of Family Practice October
26, 1999.<br><br>I have been asked to explain how
physicians who see sick Gulf War veterans can observe the
same or similar symptoms and interpret them as
either<br>undiagnosed illness or diagnosed illness. Even when doctors
apply monikers to these patients' illnesses, like
depression, migraine headaches, asthma, irritable bowel or
fibromyalgia, these monikers do not explain why
these<br>veterans are sick. Most have symptoms involving several
organ systems simultaneously. For them there is no
unifying diagnosis offered, no etiology specified, and no
disease process clarified. In truth, all of these
veterans<br>are undiagnosed because what we are dealing with is
an entirely new mechanism of disease not covered by
standard medical diagnoses one which<br>presents itself
symptomatically as different conditions to different specialists.
<br><br>The rheumatologist observing diffuse muscle pain
diagnoses myalgias. <br><br>The neurologist hearing head
pain and nausea diagnoses migraine headaches.
<br><br>The pulmonologist finding airway reactivity diagnoses
asthma. <br><br>The psychiatrist seeing chronic malaise
diagnoses depression. <br><br>The gastroenterologist noting
GI complaints diagnoses irritable bowel
syndrome.<br><br>Some private practitioners diagnose multiple chemical
sensitivity, or MCS, which is not a diagnosis in itself, but
rather just another manifestation of the underlying
disease process. So what is at the core of this myriad
of<br>symptoms that has come to be called "Gulf War Syndrome?"
What is the underlying disease process? The key is in
the new-onset intolerances these people share. Over
the past six years, I have served as a consultant to
the<br>VA's referral center for Gulf War veterans in Houston.
The vast majority of the veterans there reported
multiple new intolerances since the War. Among the first
59 patients, 78% reported new onset chemical
intolerances; 40% experienced adverse reactions to medications;
78% described new food intolerances; 66% reported
that even a can of beer made them feel ill; 25 percent
became ill after drinking caffeinated beverages; and 74
percent of smokers felt sick if they smoked an extra
cigarette or borrowed someone<br>else's stronger brand.
More than half reported new intolerances in all three
categories -- chemical inhalants, foods, and drugs or
food/drug<br>combinations. One mechanic said that before the Gulf War his
idea of the perfect perfume was WD-40. Since the war,
WD-40 and a host of other<br>chemicals make him feel
ill. Many veterans no longer fill their own gas tanks
because the gasoline vapors make them "spacy" or sick.
Some won't drive because they become disoriented in
traffic and they fear causing an accident.