General sees Sanford Chip as more help for veterans’ health

Robert Bray is concerned about what veterans have been exposed to while serving

Sanford Health

Veterans who have served have gone through a lot. Their work in the service can be physically exhausting, mentally demanding and emotionally draining — often in nasty conditions. And sometimes, their health pays the price.

Maj. Gen. Robert Bray, who has retired from the U.S. Army National Guard, is well aware of this. Part of his job was monitoring the health effects soldiers experienced from their deployments, from back pain to environmental hazards to suicide. His concern also gets personal — he, his son and his daughter-in-law all have served in Iraq, among other sites.

Now Bray sees his Sanford Health primary care doctor every year, along with a pulmonologist to keep an eye on his lungs.

“One of my tours in Iraq, I was in a dust storm, just real fine particles of dust,” he said. “That gets in your lungs and affects your breathing.”

Recently, in addition to his regular checkups, Bray took another step to clarify his health picture. He received the results from his Sanford Chip test, which is offered at no cost to U.S. veterans who are patients of Sanford Health. The results from the blood draw may help identify how your body responds to certain medications based on your distinct genetic make-up, as well as reveal an increased risk of some genetic diseases.

His enthusiasm for the potential of this test to help veterans’ health signals how much he cares about those he served with and guided.

Evolving career(s)

Bray spent nearly three decades in parallel careers with the Sioux Falls (South Dakota) Fire Department and the South Dakota National Guard. He rose in the ranks of both until 1998, when he retired from the Fire Department.

At that point, Bray developed a civil support team for the state of South Dakota to prepare a response to chemical, biological, nuclear and radiological events. He became the field artillery brigade commander for the National Guard in Sioux Falls, leading the team through exercises across the globe. He helped in the transition from cannon artillery to rocket artillery, which earned him some national recognition.

After 9/11, Bray moved to Fort Sill, Oklahoma, for several years to fill an artillery position there and received a promotion to brigadier general. He once again traveled the globe as he trained U.S. Army active and Guard artillery units.

“That was an exciting time but a challenging time as well, as during that time frame we were experiencing a pretty significant number of casualties,” Bray remembered.

Eventually, he learned about a job opening in Rhode Island as the senior officer of the state’s National Guard. The post sought someone with a background in emergency management. To his surprise, Bray received the job offer a month after he interviewed. Soon after, the new adjutant general of Rhode Island had his first meeting at the Pentagon.

Soldiers’ back problems

It was during his leadership of the Rhode Island National Guard, from 2006 until he retired in 2011, that Bray really focused on health problems that soldiers and airmen were experiencing. A variety of units mobilized and deployed during that time, from infantry and Special Forces to engineer and airlift.

One area of concern that Bray worked on with teams and physicians was back injuries. When the deputy chief of staff of the Army complained about the number of back injuries, Bray said they had to educate him about the weight of gear.

“When you’re in Iraq or Afghanistan,” Bray said, “every soldier is wearing about 75 pounds of body armor with their ammunition, their weapon, their medical kit, their CamelBak water bag, helmet, goggles, their boots and knee pads. All of that is weight on that soldier that causes stress or back pain.”

So he helped look for ways to prevent back injuries, including adjustments in equipment. For example, Bray said, they switched from the once commonly used M16 rifle to the lighter-weight M4 rifle.

Suicide and burn pit concerns

He also became involved in suicide prevention among soldiers.

“In my organization alone, at one period of time in two months from December through January of 2010, four of my soldiers committed suicide. So we were really concerned about why did that happen? How can we prevent that?” Bray said.

“Working closely with all of our medical teams, we worked on programs that helped prevent the kind of physical and emotional challenges that come with military service — in particular at the time of war.”

Bray also has been concerned about the number of soldiers with environmental exposures such as burn pits. Companies under his command were part of efforts to destroy materials, including munitions of Saddam Hussein, through burn pits, where smoke could contain toxins. Diesel exhaust is another common exposure in all branches of the military. Artillery units are exposed to propellant gases in rocket systems. Soldiers may be exposed to depleted uranium as projectiles containing the substance pierce an object, or as tank armor that contains it is pierced.

“All of those are having an impact on the physiology of our soldiers, sailors, airmen, Marines, Coast Guardsmen,” Bray said. Counted among those, besides himself, are his son in Special Forces and his daughter-in-law, a Black Hawk pilot who was part of the initial invasion of Iraq.

“They had all those kinds of exposures. So for me, that physiology was really important. So when I found out about the Sanford Chip program, I was really interested,” Bray said.

“That ability to know what medications may work better, but then even more importantly that hereditary piece, is one of those great benefits that technology now provides for us.”

Medication review

The Sanford Chip tests certain classes of drugs that can be affected by a person’s genetics to see which medications may provide the most benefit with the least amount of side effects.

Bray, who now lives in Sioux Falls, went over the results at a recent physical with his pulmonologist, Dr. Ashraf Elshami. The review suggested that the medications he is currently taking are working best for him. However, if the test showed that Bray wouldn’t react well to a certain drug, his doctor could have decided to adjust the dosage or try a different medication.

Bray recommends the Sanford Chip test for any veterans, even service members at the beginning of their careers.

“The world has changed,” Bray said. “Our Department of Defense is mobilizing and deploying on a pretty regular basis since 9/11. … Having that baseline, I think, will be a great advantage for future medication needs they might have.”

Through the years, Bray and his doctor had to experiment to find the right medication to treat his high cholesterol.

“Had this maybe been available to me 20 years ago when my cholesterol issue was first identified, I might not have had to go through all of those different kinds of medications to get where I’m at now, where it is actually helping me control that cholesterol,” Bray said.

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Posted In Genetics, Innovations, Pulmonology, Veterans

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