Updates . . .

Yes, yesterday was Veteran’s Day. I know that I have posted something about it every year for several years, but yesterday I did something more personal.

You see, I found a limited series on Netflix called “Medal of Honor” – which should be self-explanatory. I spent most of my waking hours yesterday watching that series, and saluting my brothers in uniform who rose to the occasion to deserve the highest military honor the USA ever awards. As one relative of a Medal of Honor recipient said in the show, “You want to think you’d do what they did, but you can never know for sure until you’re in that situation.” I was particularly impressed by the Medal of Honor recipients who have children or grandchildren who chose to enter the military service too.

I can only hope that Netflix will continue the series. All of those stories deserve to be told.

Additionally – I’m only about a week away from my first visit with the local General Surgery clinic where I’m supposed to get my abdominal hernia repaired. I do have one concern – that in the paperwork they sent me they wanted to know about alternative insurance. The Veteran’s Administration referred me to their clinic. I should need no additional insurance. If they are not willing to perform this procedure without some extra assurance of payment, I might have to decline. There is no way I’m going to sign anything that makes me, and by proxy my wife, obligated to pay for a procedure the VA sent me to them to receive.

Qualified Success . . . . ?

I’ve written several times before about how I’ve been frustrated by my attempts to get the US Veteran’s Administration Health System to help me by fixing a hernia that runs vertically down the center of my front abdomen.

Yesterday, I had my annual physical with the VA. The night before, my wife and I talked (again!) about my plans for the visit, and I told her that if my doctor still wouldn’t listen to me about why I need to get my hernia repaired, I wanted to ask for a new doctor. She suggested that, should it come to that, I should ask to speak with the Patient Advocate, which I agreed would be a sound strategy.

So, I arrived yesterday on time, got all of my blood work drawn up, and sat waiting for the visit with my doctor. Much to my pleasure, the doctor I’ve seen the last few times has retired. I had a new doctor – or to be more precise, a Physician’s Assistant.

We went through the usual song-and-dance about my “high cholesterol” and her concern about my negligible cigarette use (I smoke, less than 2 packs per week, and sometimes only 3-4 cigarettes per day). Then she asked if there was anything specific that she could help me with, and I told her that I was still interested (because I’d talked to her predecessor about it a few times) in getting the hernia repaired.

Up to that point, she’d been mostly focused on typing my responses into the computer. When I mentioned the hernia, her head snapped around, and she exclaimed, “You have a hernia? Where?” So I leaned back slightly and lifted my shirt to show her. Her eyes became the size of saucers, and her jaw hit the floor. After uttering a very uncharacteristic epithet, she again faced her computer and exclaimed that she could get a surgical consult for this right away – AND asked me if I had a local hospital I’d prefer to have the procedure done at.

So, it isn’t fixed yet. And there is no certainty about how the billing will wash out. But, there is progress, and I’m hopeful for the first time in years that the hernia will finally be repaired.

MyHealthEVet.com . . . .

that is the address for the official interface online between veterans and those who provide health care to veterans, in the USA.

There is just one problem.  It doesn’t work, at least 50% of the time.

For example, I recently contacted my primary care doctor through the MyHealthEVet.com site, about a (potentially minor) health concern, and got a reply back asking about my access to online video conferencing technology.  I responded that I do not use any online service of that nature, and do not trust them to be secure, and the reply was ANOTHER REQUEST for my contact information via the preferred video conferencing services the VA wanted to use to conduct an interview.

I realize that the Covid-19 crisis has placed a huge strain on health care providers, worldwide, and is still continuing to do so.  However, for them to place the burden of compromise on MY shoulders to be able to continue to provide services that they are LEGALLY required to deliver is beyond the scope of acceptability.   Either you can deliver the services you should through the interface already provided, or you need to update the interface.  It is not MY problem, and I will not bend my comfort zone to accommodate your problems!

Dealing with the Veteran’s Administration again . . .

I am currently trying, once again, to deal with the Veteran’s Administration (VA), to get my left femur replaced.  At this point in time, I have been trying for 38 years to get this problem fixed.

In all of that time, the standard response of the VA has been “the problem is not yet severe enough for us to justify the expense or risk of performing the procedure.”  What that means is, because the procedure would probably need to be repeated in 20 years, they are unwilling to do the corrective surgery before I am old enough to only qualify for it one time.

So, because I became disabled so young (aged 18), I have spent 38 years waiting for the chance to resume anything even remotely resembling a normal life – even though it would only require ONE surgery to deliver that option to me.

My new primary care doctor, at the VA Health clinic in Joplin, was willing to order a new MRI to evaluate the situation, and that has been scheduled for later this month.  However, based on the report of the preliminary X-rays before the MRI, I am not expecting them to agree to the procedure at this time.

IMHO, this is a completely upside down evaluation.  The VA is looking at how many times the procedure may need to be done throughout my lifetime – and what I am concerned about is my quality of life for however long I have left.  The last 38 years have been what should have been some of the most productive years of my life – and of them I’ve spent 28 years doing minimum wage labor, and the last 10 years I’ve been unemployable.  All of this despite the undeniable fact that nobody knows for sure when I will die – whether by an accident, illness, or natural causes.  Let’s not forget, it all started with a bone tumor, and that caused a permanent impairment to my immune system.

If the VA tells me later this month that they are still not willing to replace my femur, my wife is considering adding me to her medical insurance, just to attempt to get the surgery done.  I think that is still a long shot, but we’ll look at it.  If it isn’t viable, I’m considering whether it is time to consider a new body.  Continuing the downward spiral is certainly not going to be viable for very long, and since I do believe in a form of reincarnation, it is worth thinking about.

Exposed a lie . . .

Yesterday was a very long, but ultimately worthwhile, day for us.  It was my first visit to the new VA Health clinic in Joplin.

Of course, being a new facility, it looked nice.  In fact, it’s so new that the installed TV’s weren’t hooked up to any programming, yet.  LOL! To me, that was actually a good thing – we didn’t have to sit through hours of TV commercials while waiting for my appointments.

Anyway, the new care team I’m working with is AMAZING!  Every member of the team is either a veteran, or directly connected to a veteran.  They all expressed that they want to treat every veteran the way they’d want their family to be treated.

A direct result of that was exposing a lie told by my previous care doctor.  The previous one had told me, many times, that the Imitrex he was giving me was the ONLY prescription for Imitrex he could write.  10mg tablets, 9 tablets per 90 days, no automatic refills.  Yesterday’s visit with the new doc was RUSHED – his nurse said the doc usually wants to spend 2-3 hours working with a new patient on the first visit (I got 15 minutes because of a scheduling glitch) – yet he heard my complaint about the Imitrex and had no qualms about writing a new prescription for Imitrex at 50mg, 18 tablets per MONTH, with auto refill.

I think, in the long term, this is going to be a better experience, with another positive change scheduled to happen in June.  That change will come from Congress, so we’ll see how it works.

Veteran’s Hospitals have a math problem . . .

Ok, first let me acknowledge that I DO understand that there are health issues to be concerned with.  Still – this goes way beyond health, into absurdity.

The specific problem I’m talking about is with the prescriptions for Imitrex that I’ve been getting.  Ever since I started getting it – they have only sent me 18 pills at a time, and limited me to one refill every 3 months.  About 2 weeks ago, I sent them a secure message asking for another refill.  So far, they have only given me 25mg tablets, but I know it is available in dosages as high as 100mg, so I asked if I could get either a higher dose, or more pills, or both, since I keep running out.

They replied that they limit the number of pills they send because they don’t want me to exceed the 200mg maximum dosage per day.  So, here is where they have a math problem.

They only send me 18 pills every 3 months.  It takes 8 25mg pills to REACH 200mg for a day.  Each of my migraines lasts 3-4 days, and I usually have about 3 migraines every month.  I run out of pills if – ONLY on days I have a migraine – I only take 1 pill each day.

To actually risk excessive dosage, I’d first have to have enough pills to TAKE an excessive dosage – because running out is a MISERABLE option.  So, 8 pills per day for 9 days a month for 3 months.  The ABSOLUTE minimum number of pills I need for a 3 month prescription is 216, IF I was taking 200mg per migraine day.  Some months I’d need as many as 336 at that dosage level.  Still, even at the minimum – the actual prescriptions they have given me have fallen short by almost 200 pills every 3 months.

And the fools wonder why I haven’t gotten enough help from their treatment protocol to be able to return to work.

Health update . . .

You want to know something?  If it weren’t for the migraines and arthritis, I’d probably live forever with this body.

That’s only partially a joke.

Today I had my annual physical at the VA health clinic I’ve been going to for nearly 10 years.  They drew a fasting blood lab first, and then I went to see my primary care doctor.  He got the results of the blood work while we were talking.

EVERYTHING – Yes, everything, was within “normal limits” except for my cholesterol numbers, which have been elevated since the first time I was ever tested.

When the team nurse tested my blood pressure, she had to do it twice.  The first time it was 128/94 – which I would have accepted.  But, she said she got distracted talking to another nurse, and she and I had discussed the logistics of the VA moving the clinic to another town (which is supposed to happen late next year), so she wanted to do it again.  The second test was 120/87.

Keep in mind – I’m now 54 years old, and take no medication for blood pressure control.

But, when I saw the doctor, he didn’t like the numbers because he said the second one was too high.  So, he tested it himself.

And the numbers HE got were 110/80.

For the first time since he met me, he didn’t even bother asking me to take medicine for my cholesterol.  When he pulled up the blood test results, he did say that it was still high, but when my wife asked him how it compared with last year he acknowledged that the LDL was down 50 points from last year.  So he just told me to keep doing what I’ve been doing, and dropped it.

Keeping it real . . .

I have a confession to make; I have a bad habit.  When I get a new idea, I get so enthusiastic about it that I tend to forget that it might not work out like I want.  For example, when I first started seriously thinking about the femur replacement, I was so thrilled about being able to do serious exercise again that I didn’t stop to realize all the other things going on that won’t be fixed by that surgery.  So, to put my feet back on the ground, I thought I should make a list:

arthritis and bursitis in shoulder

bratwurst sized hernia along the center of my abs

migraine headaches

bad teeth (seriously, I should just get them all pulled and get full top/bottom dentures)

This does not mean that I shouldn’t get the femur replaced – in fact, I am still trying to move forward with the VA about it.  At this point, though, I don’t even know for sure the VA will agree that I should get it, so optimism is premature.  I just want to be realistic about how much my life will change once it’s done.  Yes, I will be able to do more weight lifting and eventually work back into distance running, but I’ll still be curled up in a dark room 1/3rd of each month on average, and I won’t be exercising my abs at all (except indirectly).

Veteran’s Choice and other updates . . .

Veteran’s Choice:

I finally found out the precise process for going through Veteran’s Choice to get any health care.  First, you have to qualify (which I do, they even re-issued the card for me).  Then you have to get your VA Health System primary care doctor to authorize use of Veteran’s Choice for every visit.  Then you get to actually go to the local physician to get taken care of.

In the case of my possibly getting a hip/femur replacement, it means that I have to go to my VA PC doc, he’ll order x-rays, and then put a consult request into the VA computer system for me to be seen by the nearest orthopedics clinic – Fayetteville.  Then Fayetteville looks over the x-rays and visits with me about my situation.  IF they agree that I should have the procedure, then AND ONLY THEN will I get to see if there are any local surgeons who work with Veteran’s Choice – and that doesn’t even start dealing with the physical therapy after the surgery.

Double the doctor visits; double the x-rays, potentially double the wait time for treatment – and this is supposed to be BETTER care?  I don’t think so!  I was so upset by this revelation that I called my dad – and asked him to call his neighbor and good friend: US SENATOR JERRY MORAN to voice my complaint.  He (dad) said he could do that today.

RANDOM STUFF:

We’re in the process of finding a new home for the black leather, overstuffed, love seat we’ve had in our living room for the last 15 years.  We still like it, and it’s not in bad shape (for sharing a home with indoor cats), but we need the space for the weight bench that I got to prepare for if I get the hip/femur surgery.

I’ve been doing some research, and determined that the hip replacement and the femur replacement are almost the same surgery.  The difference would be that to replace the entire femur should actually be less time in the surgery, because they don’t have to cut the femur with a bone saw and screw on the metal replacement.  But it will leave a larger scar.  Oh well, to get full range of motion and weight-bearing capability back, I think I can live with the scar.

The weight bench has a leg curl/leg extension attachment, so that I can start with low weight and insanely high reps to condition the muscles before the surgery.  Then, after the physical therapist gives me the all-clear, I’ll start working up to heavier weight and get these legs back into the condition they were in before the tumor – at least in theory.

The new weight bench was delivered by FEDEX this morning.

Oh, and in the middle of all the other stuff going on this morning – I got a knock on the front door.  When I answered it was one of the city employees who worked on the new sidewalk through our front yard.  He said that the city “came into some money” specifically allocated for shade trees over the new sidewalk, and he wanted to know if we were interested in getting a couple.  I laughed – I was just on the Arbor Day Society’s website yesterday looking at what we might do along that same idea!  Now all I have to do is go out and put some tomato stakes in the yard to mark where the shade trees should be put and the city will do the rest, within the next week!  WIN!