TRAVERSE CITY -- After she suffered a devastating back injury while on active duty in Iraq in 2004, Maggie Pezzullo was told she needed surgery to fuse four of her lower vertebrae together.

Her other option, she was told then, was to take pain meds and check back in a year. The local VA clinic in Traverse City told her if she wanted to have further tests, she would have to travel to Saginaw -- the location of the closest VA hospital -- to see a doctor.

Maurice Cole served with Gen. Patton's Third Army in World War II and was injured at the Battle of the Bulge. He suffered severe and permanently debilitating frostbite in his feet and hands and was left with chronic back pain. He's legally blind and deals with neuropathy -- damage to peripheral nerves through lack of circulation, chemical imbalance, trauma or other factors. He's in pain every second of every day, unless he's taking a pain pill.

"I was told that if I needed to see a doctor about my neuropathy, I'd have to meet a van at the VFW post at 4 a.m. to take me to Ann Arbor," said Cole, 82, who has since learned his neuropathy may be caused by diabetes and treatable locally. "I'm legally blind. How am I going to get to the post? They said I'd have to figure it out. That's just not right."

Two generations. Two wars. Same story.

Many veterans in northern Michigan cannot get the medical services they need in their local communities, and they're frustrated, broken and angry.

While local VA clinics offer primary care and laboratory services like blood draws, veterans have to travel long distances to receive treatment for more chronic or serious injuries. They also often face a mountain of paperwork, hoops to jump through and long waits at clinics inundated with soldiers coming home from the Iraq war.

Nearly 29,000 troops have been wounded in action in the war, compared to 3,175 killed, according to Dec. 27 U.S. Department of Defense figures. About 13,000 have been unable to return to duty, many of them because of injuries and ailments like amputations, traumatic brain injuries and the mental and emotional shock of combat.

A class-action lawsuit was filed in July against departing Veterans Affairs Secretary Jim Nicholson, his agency and other governmental plaintiffs by veterans of the Iraq and Afghanistan wars. They say they didn't receive the medical care to which they were entitled for post-traumatic stress disorder. The lawsuit came amid intense political and public scrutiny of the VA and Pentagon following reports of shoddy outpatient care of injured soldiers at Walter Reed Army Medical Center and elsewhere.

Pezzullo, 23 and caring for 2-year-old twins, was quick to note that she wasn't casting blame on any individual in the VA when she was interviewed a few months ago; she just wanted the system to change to make it easier on veterans.

"Injured veterans should not have to travel halfway across the state to get the services they need," she said. "This really needs to change."

Carrie Seward, public affairs officer for Michigan's Veteran's Administration, agreed that in many instances, veterans have to travel to their nearest VA hospital for care. There are five in Michigan, with Saginaw's Aleda E. Lutz VA Medical Center being the closest to Traverse City.

"Northern Michigan has not had a veteran's hospital in the past, which means that many veterans must travel a long distance to get care," she said. "It would take an act of Congress to change that fact, and when or if funding comes through for that change, we would welcome it."

But she said many veterans can be served by outpatient and community-based outreach clinics located in more than a dozen communities. In northern Michigan, clinics in Traverse City, Oscoda and Gaylord served 28,000 veterans in 2006, which translated to 200,000 visits.

"The numbers are increasing as a result of the current war," she said. "It may be time for a change. I know the local clinics are doing the best they can with the funds they have."

Cole said that over the years -- and several changes in administrative leadership at the regional office -- he has had to endure a nightmare of paperwork and red tape to get his pension and benefits from the Veteran's Administration. Though he finally began receiving a small pension in 1974, it's far less than it should be, he said, adding that his case is being appealed.

"For years, they told me I couldn't get services, because they lost my records in a fire down South," he said. "Finally, I got someone to help me, and I'm now receiving a small pension, but I still am so angry by how far I have to travel to get medical help. Something needs to change. The system is not working."

Seward said that an American Veterans Service Officer is at each clinic once a week, and that volunteers help transport veterans to their downstate services.

"Many times we don't have enough volunteers to get the veterans where they need to go, which is a problem," she said.

She also acknowledges that the VA system can be fraught with forms, waiting and phone calls.

"Our system is underfunded. I think we do an excellent job with what we have, and Michigan's VA hospitals are getting very high marks for service, but we have a lot of needs out there," she said.

Now it looks as if some of those needs are finally being addressed. Even before James Peake was sworn in as Secretary of Veterans Affairs on Dec. 20, now-Principal Deputy Under Secretary for Health Gerald Cross told a House Committee on Veterans' Affairs in April that the department is moving toward a comprehensive plan with initiatives to address rural veterans' issues.

Among those initiatives: establishing an Office of Rural Health to focus attention on issues of veterans who reside in rural areas; expanding telehealth and telemedicine programs to bring health care providers to patients rather than the other way around; establishing more Community Based Outreach Clinics to increase access to care; and utilizing fee-based service with private health care providers.

In northern Michigan, Seward said the VA is in negotiations to add 3,200 square feet to its 6,700-square-foot Gaylord clinic. The expansion would allow the clinic to take care of more patients, implement home-based nursing and dietitian-provided primary care, and increase mental health services.

"The goal is that ... the building process should be completed by March of 2008," she said.

Two new Community Based Outreach Clinics also are expected to be implemented this year in Alpena and Clare.

Record-Eagle staff writer Marta Hepler Drahos contributed to this story.

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