Jeff Adams knows why his legs swell and sometimes split open, and why his urine contains uranium.
A tank round containing depleted uranium hit his armored personnel carrier during the waning hours of the Persian Gulf War. The 46-year-old Springfield resident still carries 10 pieces of shrapnel in his right leg.
But why his other joints ache, why he’s always tired, why he sweats excessively and why he wakes up at night to throw up is still just a frustrating guess.
Of the 700,000 veterans who served during the 1991 war, Adams is among the 250,000 who suffer from Gulf War illness, the mysterious condition that puzzles researchers and has now been reported by veterans of the more current wars in Iraq and Afghanistan.
“I believe we were exposed to something,” Adams said.
A paper published recently in a medical journal agrees with his assessment, and one of its authors told the Springfield News-Sun it’s a game-changer in identifying the cause of the illness.
However, a new report sponsored by the Department of Veterans Affairs isn’t as sure, stating not only that the cause of Gulf War illness will likely never be determined, but there’s also no single therapy to treat it.
While agreeing that Gulf War illness — which also has a new name, chronic multisymptom illness — “is a serious condition that imposes an enormous burden of suffering on our nation’s veterans,” the Institute of Medicine in its Jan. 23 report for the VA also noted that chronic, unexplained symptoms affect one-fourth of the general U.S. population.
Even service members who served more recently in Iraq and Afghanistan, the report revealed, have reported similar symptoms to veterans of the 1991 Gulf War, including headaches, fatigue and chronic pain.
The uncertainty of the new government report seems to be in contrast to the paper published in December in the journal Neuroepidemiology by Dr. Robert W. Haley and James J. Tuite.
Haley and Tuite assert that when coalition jets bombed Iraq’s chemical weapons facilities the nights of Jan. 18 to 19, 1991, it released a cloud of sarin nerve gas was carried south by high-level winds before settling on U.S. troops like Adams in Saudi Arabia.
“The evidence is now much stronger for sarin than for other chemicals,” said Haley, an epidemiologist at the University of Texas Southwestern Medical Center in Dallas.
Haley’s first published study on Gulf War illness, in 1997, pointed to a cocktail of chemicals as the cause of the sometimes debilitating fatigue, muscle pain, gastrointestinal problems and memory issues experienced by up to 35 percent of the war’s veterans.
The Institute of Medicine concluded in 2010 there’s not enough evidence to establish a relationship between the illness and any specific toxin or drug, alone or in combination.
Haley said other chemicals may still play a part in the illness, including pesticides and pyridostigmine bromide, the anti-nerve agent medication taken by Adams and his fellow soldiers.
Haley believes the illness to be a neurological condition, noting animal studies showing that repetitive exposure to sarin will produce permanent brain changes.
Many, however, still regard Gulf War illness as a psychological condition, a belief Haley and veterans like Adams reject.
“Stress doesn’t cause brain damage,” Haley said. “Twenty-five percent of those guys came back ill. When did stress ever do that?”
Haley’s new evidence reveals that low-level sarin could very well be the illness’ accelerant. It’s also possible sarin acted alone, he said.
“Without sarin, I don’t think we would’ve had a problem,” he said.
Paul Sullivan, a Gulf War veteran with the advocacy group Veterans for Common Sense, called the fallout of sarin the world’s biggest friendly fire mishap. He also called Haley’s findings important, and that they should prompt Congress and the VA to reassess why veterans are sick.
“There’s a Department of Defense propaganda myth that the Gulf War was quick, clean and cheap,” Sullivan said. “The facts show otherwise.”
The Pentagon has long discounted the prospect of a traveling plume of nerve agents, noting an absence of chemical casualties around the bombed sites and incompatible surface winds.
“Because there were no casualties around the sites, they really dismissed it, and they’re still dismissing it,” Haley said.
The Department of Defense isn’t swayed by Haley’s new findings.
“The sarin gas cloud claims were investigated many years ago,” Cynthia O. Smith, a Pentagon spokeswoman, wrote in an email. “In 1997, the Presidential Advisory Committee on Gulf War Veterans’ Illnesses found them to be not viable. The Senate Veterans Affairs Committee did the same in 2000.”
Sullivan, in turn, remains skeptical of the Pentagon.
“They’re entitled to believe in unicorns and fairies, but facts are facts,” he said. “At one time, the Department of Defense said it was safe to be around nuclear bomb blasts. The Department of Defense at one time said Agent Orange was safe.”
According to Haley, who analyzed meteorological and intelligence data for his paper, officials previously didn’t consider that the chemical plumes at Muthanna and Fallujah could have risen so high in the stable nighttime sky that they would become susceptible to supergeostrophic winds, which carried the fallout such a long distance in a single night.
Any potential fallout, officials previously concluded, would have traveled at ground level — which it would have, Haley said, had the bombings happened during the day.
“They missed this entire phenomenon,” he said.
Once over U.S. troop positions, it stalled.
“That stuff hung around for about a week,” Haley added. “It just hung over the guys.”
The way the plume traveled closely parallels the transit of radioactive fallout from the nighttime explosion at the Chernobyl nuclear reactor in 1986, Haley said, which traveled more than 600 miles overnight before being detected in Sweden.
Nerve-agent alarms did, in fact, sound at troop positions in Saudi Arabia, according to the paper, but later were dismissed as false positives.
According to Haley, the new measure of exposure for Gulf War illness should be whether veterans heard nerve-agent alarms. Adams remembers hearing them sound at least a couple of times.
To Adams — who called in air strikes during the war as a forward observer for the Army’s 2nd Armored Division — it now makes sense.
“We’re the ones who heard our sirens go off,” Adams said. “I don’t believe it’s psychological. It’s that no one wants to admit to anything.”
He remains curious to know what’s behind his many unexplained symptoms, which have only gotten worse with age.
“I know everyone I was with is very curious,” he said.
Adams has so far chosen to manage Gulf War illness on his own. He’s already on enough medication the way it is, he reasons.
“I just deal with the sweating and change my shirt a couple of times a day if I have to,” he said.
He also has never applied to the VA for disability compensation in regards to Gulf War illness.
“He has a tough front anyway,” his wife, Karen Adams, observed. “If you want to find out anything about him, you have to ask. You don’t see it. He wouldn’t tell you if something hurts.”
But, it’s clear to her that he has far too many problems for a man only in his 40s.
“He’s young to be having all these aches and pains,” she said.
Jeff Adams, who works as the area’s veterans representative for the Ohio Department of Job and Family Services, faces an even more grim prospect that he still could lose his legs.
“If they do have to take them off,” he explained, “I’ve accepted it already.”
Early in the morning of Feb. 26, 1991, during a firefight with Saddam Hussein’s elite Republican Guard in southern Iraq, Adams’ Bradley Fighting Vehicle was accidentally targeted from more than a mile away by a friendly M1A1 Abrams.
He knew of friendly fire, but, “I never thought it’d happen to me.”
It took Adams six months to walk again. The soldier riding next to him died.
“It happened. I try not to think about it too much,” Adams explained two decades later. “I don’t watch many war movies.”
“Loud noises make me jumpy,” he added.
As a result of his injuries, Adams suffers from venous insufficiency, an impairment in the flow of blood that can cause skin ulcers. His left leg, he said, is turning black and blue from the knee down.
The right leg is now starting to spot.
“I would hate to switch places with him,” Karen Adams said. “I wouldn’t wish that on anybody.”
He’s also decided not to father any additional children since coming home for fear the uranium in his body will cause birth defects.
“I didn’t want to take the chance,” he said.
Together with the intestinal problems of Gulf War illness, Adams acknowledges he’s not the man he was before the war.
“It takes effort for me to get out and do work around the house,” he said.
While still the source of debate, Haley said Gulf War illness is starting to become more clarified.
“Treatment is the next frontier of this disease,” he said. “I can’t tell you how many veterans have said to me, ‘I don’t want benefits. I want the VA doctors to make me well.’ ”
However, without a defined set of symptoms, the VA should continue to individualize care, the Jan. 23 Institute of Medicine report stated. Afflicted veterans may benefit from antidepressants and cognitive behavioral therapy, the report stated, and the VA should fund and conduct studies into acupuncture, St. John’s wort and aerobic exercise, among other treatments.
Regardless, Gulf War illness is not getting the attention it needs, Haley said.
“Funding for it pretty much dried up,” he said.
He said his findings underscore the need in particular for more research into how to guard against chemical weapons. Sarin, he said, is widespread throughout the world.
“This is the poor man’s weapon of mass destruction,” he said. “A lot of countries have these things. We need to have new technologies for protecting our troops from this.”
The Persian Gulf War: A look back
• Began when Iraq invaded Kuwait on Aug. 2, 1990, with 100,000 troops.
• The war, Operation Desert Storm, started on Jan. 17, 1991, with a U.S.-led air campaign.
• Ground offensive began on Feb. 24, 1991, and lasted 100 hours before a cease-fire was declared.
• A total of 383 U.S. service members died, including 148 from hostile fire.
• Of the war’s 700,000 veterans, one-third suffer from unexplained health problems, including fatigue, joint and muscle pain, gastrointestinal issues and memory problems.