In the months after checking out of Walter Reed Army Medical Center, he found himself easily frustrated and, his wife said, perpetually angry. Envisioning threats in grocery stores and shopping malls, he stopped leaving his house and started drinking heavily. His marriage was near collapse when, in a fit of alcohol-fueled despair, he drove his car into a brick wall, emerging so dazed that he thought he was back in Iraq.

“with a physical injury — three months, six months, whatever — your cuts will heal,” he said. but post-traumatic stress “is more difficult because people don’t see it.”

Like Mr. Pennington, many veterans injured in combat are finding that their invisible psychological and neurological wounds are proving more debilitating than their obvious physical ones.

About 1,700 American service members have lost limbs in Iraq and Afghanistan, most in roadside bombings that seared skin, shattered bones and damaged internal organs as well. Most of those troops also came home with traumatic brain injuries and post-traumatic stress disorder, which in many cases were not recognized for months.

While advances in prosthetics have made it possible for many lower-limb amputees to regain full mobility, the track record for overcoming brain injuries and chronic P.T.S.D. — both capable of altering personality and hampering mental functioning — is more spotty, experts acknowledge.

“I think the limiting factor for these people going back to their lives is not having lost a limb,” said Dr. Douglas Cooper, a neuropsychologist at Brooke Army Medical Center in San Antonio. “The P.T.S.D. symptoms and post-concussive symptoms are the ones that seem to get in the way.”

For Mr. Pennington, medications seemed to worsen his depression and therapy did not ease his anxiety. He seemed headed for divorce, isolation and perhaps alcoholism. And there his story might have ended, a case study on the intransigence of war’s psychological scars. but it did not end there.

In 2009, an unexpected opportunity landed in his e-mail inbox: a casting call, forwarded by a friend in Nashville, from an undergraduate filmmaker looking for someone to play a combat veteran who had lost a leg, had post-traumatic stress disorder and lived in Maine.

This is my life, Mr. Pennington thought.

So on a lark, Mr. Pennington — whose last appearance on stage was in middle school and who had become nervous in crowds and, indeed, avoided most human contact — decided that fixing his life depended on performing before a camera.

“I thought acting would be so out of the normal that it would force me to deal with things,” he recalled. “I wanted my life back.”

The struggle by wounded veterans like Mr. Pennington to reclaim their lives is the unfolding next chapter in America’s wars in Iraq and Afghanistan. Since 2001, 46,000 American service members have been injured in combat, perhaps a third or more seriously. Those veterans now face years of rehabilitation at a cost of billions of dollars annually.

In the coming weeks, The New York Times will profile a few of those veterans. Their cases say much about the critical importance of high-quality health care and loving families. but as with Mr. Pennington, they also underscore the individuality of recovery, where the most effective therapies are often discovered by the veterans themselves.

Mr. Pennington, 28, grew up in central Maine and Fort Worth, Tex., toggling across the continent between divorced parents. He was a talkative boy who loved the outdoors and was good in school, but bad at keeping the jobs that helped support him after he said he had problems with his alcoholic father. When he turned 17, he joined the Army.

He fell in love with the life immediately. His first deployment to Afghanistan in 2002 with the XVIII Airborne Corps was uneventful, so he volunteered to go to Iraq almost as soon as he returned home. He lost a dear friend during that tour, but it did little to sour him on the adventure of war. He raised his hand a third time.

On that third deployment, to Iraq in 2006, he was driving the lead Humvee in a convoy through the insurgent-friendly city of Samarra when a powerful bomb exploded beneath the engine. Through fire and thick smoke, he managed to maneuver the vehicle out of danger with a push from a truck behind.

But when he went to slam on the brakes, he realized his left foot was gone, taken off by shrapnel that had penetrated the bottom of the truck.

His rehabilitation at Walter Reed Army Medical Center in Washington went relatively smoothly, fueled by his hatred of wheelchairs. He was discharged from the Army and returned to Maine in just a year. And there his problems really began.

Perhaps it was leaving the secure cocoon of Walter Reed. perhaps it was living in a rural town, far from Army buddies. perhaps it was his battles with the Veterans Affairs bureaucracy over benefits. perhaps it was the long menu of medications his doctors prescribed: narcotics to ease his pain, antipsychotics to control his moods, sleep aids to tame his nightmares.

Whatever the cause, he grew more irritable, anxious and depressed, symptoms of post-traumatic stress disorder. After he crashed his car into the wall, he told his wife, Marjorie, “I can’t do it anymore.”

With the help of a nonprofit group, the couple moved to Houston in 2008, where he found the care at the veterans health center more to his liking. Doctors there got him off most of his medications, started treating him for traumatic brain injury for the first time and expanded his P.T.S.D. therapy. He felt he was getting better.

But in 2009, Ms. Pennington’s brother committed suicide and the couple returned to Maine to help care for her nephew. Mr. Pennington again fell into a deep funk. He imagined people everywhere judging him, for having killed Iraqis, for being a “crazy veteran.” He spent more of each day in front of the television, afraid to leave home.

Around that time, Nicholas Brennan was looking for actors for his senior project at New York University, a film about a wounded veteran struggling with the transition to civilian life. a casting call sent across a veterans’ e-mail network got about a dozen responses, mainly from soldiers who had lost legs or from out-of-work actors. but the last one, from Mr. Pennington, seemed the most poignant.

“I was injured in 2006,” Mr. Pennington wrote. “it resulted in a personality change for the far worse.”

Mr. Brennan, who was also from Maine, visited Mr. Pennington and was struck by the similarities between the real soldier and his lead character, a Marine named Connor. both had worked in boat repair shops, both loved to fish, both struggled with life in small-town Maine.

“it was pretty clear from the first few minutes I met him,” Mr. Brennan recalled, “that he would be a perfect partner on this project.”

At first, Mr. Pennington simply hoped that acting would force him out of his shell. but as he inhabited the role, he found himself not just identifying with Connor, but also realizing things about his P.T.S.D.

In the final scene of the 15-minute film, titled “a Marine’s Guide to Fishing,” Connor sits on a pier at sunset, his prosthetic by his side, decompressing after a violent flashback in front of his co-workers. His boss, a Vietnam veteran, counsels him to take his time, but leaves with a gentle warning: “You stay out here too long, you’ll never get back.”

“that rang right home to me,” Mr. Pennington said in his Texas twang. “I said, ‘well, dang, that’s what I’m doing.’ ”

After the film was finished last spring, Mr. Brennan and Mr. Pennington showed it publicly for the first time in Portland. Mr. Pennington says he was terrified about speaking before an audience, but afterward people came up looking for advice about relatives struggling with P.T.S.D. His ability to help them was deeply satisfying.

The two men decided to create a Web site to distribute the film and offer their services as speakers. they have done about a dozen such engagements, including one at the Veterans Affairs Health Care Center in Augusta, where Mr. Pennington receives his care and has, at times, clashed with bureaucrats and doctors.

For Mr. Pennington, the public engagements have been a form of exposure therapy, pushing him to articulate bad memories and buried feelings that he had avoided before. The experience has also motivated him to return to therapy himself, making him realize, he said, that “this P.T.S.D. is really getting the best of me.”

Experts say that public speaking alone is not a solution for the symptoms of P.T.S.D. but it can be therapeutic, helping people articulate their emotions and give meaning to their experiences.

“it gives people some authority over what happened to them,” said Dr. Matthew J. Friedman, director of the Veterans Affairs National Center for P.T.S.D. in New Hampshire.

Recently, the Penningtons, who live with their five dogs in a bungalow on a grassy knoll overlooking Dexter, renewed their wedding vows. He spends his days chain-smoking Marlboros, riding a mountain bike for exercise and studying books on acting. He is considering joining a local theater group and doing stints as a regular guest on a radio station owned by the author Stephen King.

He still wakes each morning hating his carbon-fiber leg, which gives him cysts under the skin of his stump. but it is a part of him now. His relationship with P.T.S.D. is more complicated.

He is learning, he says, to talk about his darker memories of war, including the time he nearly killed an Iraqi family that had driven through a checkpoint. The family lived, he says, only because his gun jammed, and the event has haunted him since.

He is also learning how to talk about killing. it has not been easy, he says, because he still feels ashamed when acquaintances blithely ask how many Iraqis he killed. His solution has been to answer bluntly and without explanation: 18.

But the best thing, he says, is that he has become more confident about offering advice to other veterans.

During a recent trip to Augusta for a checkup, Mr. Pennington was approached by an older veteran, who pushed himself in a small cart. a former submariner with a bushy white beard, the man had diabetes, and doctors wanted to remove one of his legs. He nervously asked about what lay ahead.

Balancing gracefully on his good leg, Mr. Pennington removed his prosthetic and described the various annoyances the silicone sleeve could cause. then he put it back on and smiled.

“It’s not so bad,” he said. “if this was my only problem, I’d be doing great.”

It depends on the STD

years…some people never get symptoms…if u think u have an std, u should go get checked out asap!

Some don't have any noticeable symptoms that would prompt a visit to the doctor. that is why they spread so rapidly. People are carrying them without even knowing it!!

Um I heard for the rest of your lifetime. its hard to tell on women.

forever, in fact with some you may never see actually symptoms of them

depends on what std.. syphilis in the latent stage can have no symptoms for a year but can be "silently" damaging your internal organs, if you think you have a std you should get checked out.

you could go years without symptoms

Some symptoms don't ever show, just see the doctor to be sure.

years if not treated you can carry it indefinatly but sooner or later you will get symptoms. Men can be carriers and never get symptoms us women are the lucky ones to notice and get both parties treated

3.2 seconds,

soon, the STD will travel to your brain, causing to you to see random penis' flying around your head. and then, your brain will think you want to give them blow jobs, and you will walk around town, pretending to suck a cock where ever you go,

Indefinite. Chlamydia displays no particular symptoms.

you can have "dormant" hiv cells for up to 10 years without symptoms.
Same with aids. other things such as gonnheria and syliphis can take up to two weeks and herpes and crabs few days after the incident. The best thing for you to do is get tested immediately hiv testing is free and you dont have to have parental permission. other test cost around 20-50 dollars.

You could have syphilis undetected for decades once the rash has gone from the 'secondary' stage. Aids can sit in your body untreated for a dozen years without showing symptoms. Gonorrhea can infect a woman and show no symptoms.

there are no fact on limitation on any STD….most people are living with STD's and just don't know it …i have a friend who has been passing STD test for Chlamydia for a while but just found out he really does have it and had been giving it 2 lots of people for a while without knowing

Pleural mesothelioma is the commonest type of mesothelioma. Mesothelioma is a rare form of cancer that attacks the mesothelial cells in the mesothelium, the tissue that forms the membranous lining of the body’s major internal organs and cavities.

Pleural mesothelioma develops when the cancer affects the pleura {the membranous lining of the lungs}.this form of cancer is commonest in the UK, followed by South Africa, then Australia, then USA, then Eastern Europe.

The pleura has two layers which gives support and protection to the lungs and chest cavity:

-The outer layer, or parietal layer, lines the entire chest cavity and the diaphragm.

-The inner layer or the visceral layer which applies directly over the lungs.

Pleural mesothelioma can start from any of these two layers then spread to the other layer. Exposure to asbestos has been strongly linked to the development of this type of cancer. the toxic fibers get trapped in the spaces between the mesothelial cells of the pleura.

The asbestos fibers trapped in the body cause cancerous cells to multiply and divide haphazardly without control. these results in the thickening of the pleural membrane and mesothelial cells, leading to fluid build up in the pleura {pleural effusion}. this accumulated fluid will gradually start pressing on the lungs and the respiratory system leading abnormal and difficult breathing.

These developments eventually form the basis of most of the symptoms of pleural mesothelioma. these symptoms include:

A} Persistent dry or raspy cough

B} Haemoptysis, the coughing up of blood in the sputum

C} Difficulty in swallowing {dysphagia}

D} Difficulty in breathing, labored breathing known as dyspnoea

E} Pleurisy, pain in the chest during breathing

F} Development of lumps under the skin of the chest wall

G} Night sweats or fever

H} Unexplained weight loss

Just like in other forms of mesothelioma, the symptoms of pleural mesothelioma show up many years after the initial exposure to asbestos and these symptoms are not specific to pleural mesothelioma, they also occur in some other less serious lung diseases like pneumonia and influenza.

All these factors make the diagnosis of pleura mesothelioma very difficult.

Once there is a strong clinical suspicion of pleural mesothelioma, diagnosis is then confirmed by imaging tests such as x-rays, CT scan, to confirm the location of the cancer. the patient is also subjected to fluid and tissue analysis known as biopsy to confirm the type of cancer involved.

Newly developed drugs and detection techniques have improved the outlook for patients with pleural mesothelioma.

In general there are three main modes of treatment: a} Surgery b} Chemotherapy c} Radiotherapy. most patients receive a combination of two or more of the different modes of treatment.

The earlier the cancer is detected, the better the prognosis and the wider the range of treatment options. when the tumor is detected early, curative surgery is done to remove the cancer, this is followed by chemotherapy or and radiotherapy to kill off any remnant cancerous cells. Curative surgeries is only carried out in patients that have good general state of health and whose cancers have not spread beyond localized sections of the lungs.

The level of progression of the tumor is classified in terms of the stage of the cancer. the stages range from stage 1 to stage 4 depending on the level of spread of the tumor.

Stage 1 and Stage 2 pleural mesothelioma have better prognosis and better treatment options.

The latter stages of the cancer, namely stage 3 and stage 4 are mostly limited to palliative modes of treatment to improve the quality of life and not their prognosis. these palliative treatments include the draining of excessive fluids in the pleural spaces and surgical removal of tumors to relieve pressure on the lungs.

According to current studies, approximately 10% of all pleural mesothelioma patients will survive for three to five years after diagnosis and 5% will survive for 5 years and above.

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