Why is there a double standard between VA Hospitals?

Hello Invisible Reader.  Finally, I'm going in to have my second (right) shoulder repaired.  I can't begin to tell you how happy I am.  My right shoulder has been service connected since I retired in 1994.  I've been complaining about it for years.  The last couple years both shoulders have gotten very bad.  I've lost range of motion in both of them and they've been extremely painful.  It hasn't helped that my left knee buckles whenever it feels like it and my shoulders almost always take the brunt of my falls.

I had my left shoulder repaired in January of this year.  The diagnosis of both shoulders is bilateral adhesive capsulitis.  In English that translates to "frozen shoulders".  The VA didn't do my surgery.  I was outsourced (The VA Calls this "Fee Basis") to the Florida Orthopedic Institute (FOI) and my surgeon, Dr. Frankle did an amazing job.  I was back on my feet, so to speak, in a matter of weeks after surgery.  There was no physical therapy after surgery.  He sent me home with a Continuous Passive Motion (CPM) chair and starting the evening of my surgery, I spent one hour, three times a day in that chair for about 6 weeks.  My left shoulder is almost completely healed now.  I have almost no pain and just about complete range of motion.  There is still some soreness but any surgical procedure takes time to heal and that was expected.

Now it's time to repair my right shoulder.  There is no question that the VA is going to send me back to FOI and Dr. Frankle.  I'm scheduled for pre-operative stuff on May 11th and surgery on the 13th. 

I'm giving you this information because I want you to know how easy I have it here in Tampa, Invisible Reader.  Others I know don't have it so easy.  There is a huge double standard in the way Veterans are cared for around the Country and I don't know why that is.  I don't know what to do about it.  I have a dear friend who is suffering because of it.

I know a woman who has the same condition as I do.  I don't want to say the name of the VA Hospital where she gets treatment because they know her name well there.  She's been battling this particular VA Hospital for more years than she cares to count.  She is in a lot of pain, Invisible Reader.  Pain that I understand well.  Pain that I can relate to.  In addition to having a frozen shoulder, she also has bone spurs in her shoulder.  When she went to Orthopedics, the doctor prescribed physical therapy for her.  Even the physical therapist agreed with my friend that having a bone spur would only aggravate her condition further.  Needless to say, armed with this information, my friend won't go to physical therapy.  Would you do physical therapy if you knew that it was going to hurt you more?  Would you do physical therapy if it was going to cause more harm than good?  Of course you wouldn't, Invisible Reader.  You're more intelligent than that.

My friend went back to her doctor and asked for a second opinion.  As Veterans, we're entitled to that.  At least I believed that until I heard back from my friend.  Any time I've asked for a second opinion at the Tampa VA, I've gotten it.  It doesn't work that way at her VA Hospital though.  She was denied.  She tried to use the normal channels to get help.  She went to the patient advocate.  Denied.  She went to the hospital director.  Denied. She tried the VAOIG and was denied.  They told her medical issues were out of their jurisdiction.  Say what?

To add insult to injury, after a particularly heated conversation with the patient advocate this morning, two police officers showed up at my friends door.  They told her they'd gotten a phone call from the VA Hospital with a report that my friend was suicidal.  Suicidal???  She was angry, not suicidal.  The police whisked her off to a civilian hospital.  The staff at the civilian hospital couldn't believe she was even brought in there and they released her within an hours time.  Suicidal or just a pissed off patient advocate getting even because my friend interrupted her break?  That's right.  It was the patient advocate who called the police.  My friend was able to confirm that.

I've made my friends story much shorter and more simple than it really is.  This has been going on for a very long time.  Things I find so simple to do at the Tampa VA are a huge struggle for her at the VA Hospital where she receives treatment.  I will say, without giving away her location, that she's in the same State as my friend Jane, the transgender Veteran, who fought such a long battle for treatment. What does that tell you?


I ask you this, Invisible Reader.  Why is it so easy for me to get my shoulders treated by an outside source?  Why are they telling my friend, with the very same problem, that she can't see an outside provider, can't get a second opinion, and has to spend ONE YEAR in pain before they will even consider surgery?  Her doctors solution was to offer her stronger pain medications but she doesn't want those.  She doesn't want to become a legal drug addict like I am and I don't blame her.  Who wants to be a morphine addict?  But why should she have to spend a year in agonizing pain?  Why can't she get the same things at her VA Hospital that I get from mine?  Why is there such a double standard between VA hospitals?  She's a 100% disabled, service connected Veteran.  She should get anything she needs.  I'm only at 80%.  The first shoulder of mine they operated on wasn't service connected yet they got me in for surgery as quickly as they could.  And I'll say this again .. they outsourced me to a civilian facility.  I asked for a second opinion and I got it, no questions asked.

I did try the traditional treatments first, Invisible Reader.  I tried the steroid injections in my shoulders.  I went back a couple of times to the VA and had them done.  My friend has tried them, too.  I tried physical therapy but it hurt me more than it helped me and when I had my first visit with Dr Frankle he stopped the physical therapy immediately.  He believes that anything that causes more pain when you're injured is not helpful.  This is from an award winning surgeon, so believe it, Invisible Reader. 

So here we are, two Veterans with the same problem, "Frozen Shoulder".  I'm being well taken care of by the Tampa VA.  In nine days I'm going in for surgery to correct my second shoulder and then hopefully I'll be done with surgery's for a while.  In the mean time, my friend over in another State has the same issue that I have and is being treated like a second class citizen.  No one wants to help her and she in excruciating pain each and every day.  I say again .... WHY THE DOUBLE STANDARD of treatment between VA Hospitals?  Why isn't she getting treated the same way that I'm getting treated?  Why is she having to fight for something that is so easy for me to get at the Tampa VA Hospital?  We're two Veterans with the same problem using the same health care system.  Why the double standard???

Think about that for a while, Invisible Reader.  I'd love to hear your thoughts on this.  I'd love to hear your experiences on this topic.  Please send them directly to me at wendigoodman1958@gmail.com and put "DOUBLE STANDARD" in your subject line.

Until the next time .....

VIETNAM VET PRAISES MICHIGAN'S MEDICAL MARIJUANA LAW -- "I did it because I am on all these narcotics through the VA. The narcotics tear your liver up ... " - VA Watchdog dot Org - 02-08-2010

Hello Invisible Reader! 

Be sure you read the article that the title of this blog hyperlinks to.  It's an important article published in VA Watchdog dot Org and my blog today is based on that article. 

Picture this. You wake up every morning. You grab a bottle of water, head to the bathroom and pick up your pill box. It's a seven-day pill box broken into four times for each day.  That's right.  You take so many pills every day that the only way to keep track of them all is to organize them in a pill box.  Bleary eyed, you open up that mornings "section". Disgusted, you empty the 10 or so pills into your hand.  You take meds for pain, meds for depression, meds for your stomach because all the meds you are taking for pain are eating up your stomach, laxatives and stool softeners because your narcotics have you so blocked you go days without a bowel movement and vitamins because you've lost 60+ pounds in the last year and your doctor is concerned about the weight loss.  You don't eat because the pain you are in all the time has killed your appetite.  Do you recognize this person?  Is it you?  Do you repeat this ritual two, three or four times time a day?  Barely awake, you take your pills and pray the pain will subside enough for you to move around a little.  Already still groggy from sleep, your medications make you even more groggy.  You have errands to run?  Out of the question unless you have someone to drive you.  The morphine, assorted pain pills and depression meds have seen to that.

Too tired to do much else thanks to all the pain and depression meds, you sit at home.  You watch television or you browse the internet.  You can't sit at your PC for too long because your legs begin to swell and ache.  You notice it's been 4 or 5 hours since your last dose of pain meds.  Back to the  pill box for your second dose of the day.  More pain meds,  More morphine.  Time for a nap.  When I wake up maybe I won't hurt so much.

I slept too long.  I wake up stiff and sore.  My hands and arms are numb.  Pills won't help this.  I have to "shake" this off.  I get on the computer and hope that I can work out some of this stiffness.  The pain meds just make me groggy and do little to help and soon it will be time to take my next dose.  I take more pills than the second dose because included in the third dose of the day are all my stomach meds and I have to take them so that I can try to eat.  If I wait to long to take my third dose I'm in too much pain and lose my appetite completely.  My partner cooks dinner.  Sometimes, if I've taken my meds on time and I've napped during the middle of the day, I can eat.  Not much, I have very little appetite, but I can get some food down without choking on it.

I get back on the computer for a few hours.  I have responsibilities to people online. Commitments I'm obligated to and no matter how tired I am and/or how much pain I'm in I went into these obligations freely and willingly knowing how much of my time they would take and I am bound and determined to meet these obligations. I enjoy the work I do online.  It keeps my mind off my own troubles, allows me to block out my own pain and depression.  Most of all, it allows me to help other Veterans whose problems are far more serious than my own.  I've learned a lot this past year about filing disability claims; both social security disability and VA disability, and I enjoy sharing what I've learned.  I'm not kidding myself.  I have a long way to go before I can really be effective, but in the meantime I do what I can.

A few hours of that and it's time for my final, fourth, dose of meds of the day.  The last dose will knock me out.  Two pain pills and an anti-anxiety pill -- two of them.  I need the anxiety meds at night.  If my partner touches me when I sleep I wake up frightened and unaware of my surroundings.  I wake up in the middle of a panic attack not knowing where I am, who I'm with, what I'm doing.  I'm terrified and my heart is pounding out of my chest.  I'm fighting to get out of my bed and away from my partner as she attempts to assure me that I'm safe, that I'm home, I my own bed and everything is okay.  I hear the words she is saying to me but I don't comprehend them and I fight to get away from her and out of our bed.  I'm usually in such a panic to get out of the bed that I often hurt myself getting out of bed.  I lock myself in the bathroom, smoke a few cigarettes until I'm calmed down enough to g ack to bad and when the panic settle down and my heart stops racing, I go back to bed.

So why am I telling you this Invisible Reader?  You have to be asking yourself this.  Did you read this article that preceded my  narrative?  Medical marijuana.  It's the wave of the future, Invisible Readers.  Believe me, if I had my druthers, I'd much rather smoke medical marijuana than take all the pain medication that I do.  I can't smoke it because according to the narcotics agreement I signed with the VA Pain Management Clinic I've agreed to submit to random drug testing one a month.  If I test hot for anything other than a therapeutic level of opiates I won't get my monthly supply of morphine.  I don't relish the thought of going off my morphine cold turkey.  On the other hand, if I could get my hands on some medical marijuana I suspect I could go off a lot of the crap the VA doctors have me on.

Medical

I have a buddy in New Mexico.  He's an OIF Veteran, 100% service connected for PTSD.  All the meds the VA Doctors prescribed him failed to help him.  Somehow he got hooked up with a group that promotes medical marijuana for the treatment of PTSD.  My friend is like a different man now.  California allows the use of Medical Marijuana..  Michigan allows it.  New Mexico allows it.  The VA doesn't recognize it because it's a federal agency and possession of marijuana is still a federal crime.  

Let's assume I can smoke marijuana for the first couple of days after my drug test.    Let's assume I've done that.  Let's assume that it only take a couple of hits off a joint and I'm totally pain free.  I'm not high.  I'm not groggy.  I'm just totally pain free.  Why wouldn't I want to smoke that instead of taking all the meds that I take each day?  Those prescription meds are making me sick.  Those prescription meds are wearing me out.  Those prescription meds are causing me to lose weight.  Those prescription meds are causing other health problems.   Eventually, the VA will have to increase my VA Disability Payments to include those secondary conditions caused by those medications provided a can make a case for it ... which I'm sure I can do.

How about it VA.  How about getting with the program and passing out some medical marijuana to us?

Invisible Reader, what are your thoughts?  I'd love to hear them.  Tell them to your congressman or anyone who will listen to you.  Me, I'm just one Veteran in cyberspace with no influence.  I'm just someone who is curious to hear what the rest of you, also in my same boat, are thinking.

Until the next time......

Paper Waste. VA Tree Killers. More random thoughts.

Today I received 6 postcards from the VA Hospital. Count them. Six. They were reminder postcards for the appointments that I have coming up over the next two weeks. One of the postcards was for a new appointment. I got a letter in the mail yesterday regarding this "new appointment" in the PMR General Clinic. It took two days of phone calls to figure out what that appointment was for.

First of all, why does the VA Hospital feel the need to send you no less than three reminders for each appointment? I have stacks and stacks of reminders letters and postcards piled on my desk. Each time I get one, I open it up and compare it to what's written in my planner. The VA likes surprises. They will cancel your appointment and reschedule it. Then you'll get several postcards telling you your appointment has been canceled. You'll get several postcards and maybe a letter or two with instructions for the new appointment. Half the time they use such obscure abbreviations that I have to call the VA Hospital to find out what clinic the appointment is in.

Let's not forget those automated phone calls! Those come three days before your appointment. You know the calls. That automated voice reminding you that "The Patient born on December 18th, 1958 has two appointments on" ... But they don't tell you what the appointments are for. Wouldn't that be the time to tell you what clinic you are scheduled to go to in case you didn't get the mound of paperwork they sent you?

There must be an easier, more efficient way to do things. The VA is spending shitloads of money on paper reminders and automated systems to remind us multiple times of our appointments. Is it working? What is the no show rate? Where are the statistics? Is it overkill? Can that money be better spent somewhere else in the hospital? Perhaps they can use it to hire more doctors and reduce the waiting times for us. I know I'd love to cut my waiting time back.

Speaking of waiting times...

You go the the VA Hospital and you check in 20 minutes in advance like they tell you to do. You're there on time. The nurse calls you in for triage. No patient privacy there. You share a room with another Veteran while the nurse asks you personal questions about your health, gets your weight, blood pressure, temperature. Then you go back to the waiting room. So aptly named. The sign says, "If you have not been seen 20 minutes past your appointment time, please tell the clerk at the desk." You learn that it's not worth your time to tell the clerk. The clerk will tell you "doctor is behind in appointments today." I've waited as long as two hours to be seen. By the end of that two hours, I'm in so much pain from sitting, I can hardly move.

I get up and walk back to the doctors office when my name is finally called. The doctor tells me what I've heard before. "We don't know what is causing your pain. Here is a script for more pain meds. We're going to treat you symptomatically. I don't want to to be treated symptomatically. I want answers.

My PCP physician sent me back to the pain clinic because my monthly drug tests are coming back "abnormal." My urine is full of opiates as it should be. The Ph is normal. But my urine is "diluted." It has been for the last 3 months. That would suggest that I'm pouring water into my urine before I turn it in for the drug screen. I have offered to let them monitor me when I piss into the bottle. I have told them to take a sterile sample from me. Not one doctor has thought to look into the fact that something else might be going on. I have diluted urine, no appetite and I've lost almost 40 pounds in the last 3 or 4 months. Isn't it time to start looking into a medical reason for diluted urine? Isn't it time to stop pointing fingers and stop accusing me of ... of what? I have the appropriate amount of opiates in my system, my ph is normal. It stands to reason there is an underlying medical condition going on. I drink a ton of water every day. I must drink 8 or so bottles of water, if not more. Of course my urine is going to be diluted. Stop the finger pointing, Doctor, and get to the real reason for the diluted urine.

Until the next time.