Ways the VA Healthcare Program is Hurting Local Veterans

            Prior to moving to the Durango, Colorado area, I had been enrolled in what is called the Choice Program, which provides military veterans, as well as their dependents, to obtain care from community resources that are not provided through the VA system. This is the system I used to receive services such as rheumatology, gastroenterology, and dermatology. For the most part, this system helped to provide me with the resources I require to tend to my health needs. Sure, the physicians and specialists could have just as well been military doctors, as I received the same quality of care from them...and that is not saying much, considering my previous experience with military doctors, but I digress.

            When I had my initial appointment with my new primary care provider, I was told something that just came across as blatantly wrong. See, my doctor told me that my only options to see these types of specialists would be to drive nearly 4 hours each way to the large VA facility in Albuquerque, which is insane to suggest, or not see any specialists. Sure, they have a courtesy shuttle van that takes patients to the larger facility, but you must plan your day around the appointments of others, so you would either leave early, or must stay late, depending on the schedule for that day. The other option just was not feasible either, as I have a family history of colon and bone cancer, as well as having been diagnosed with a myriad of chronic pain conditions.

I live at a Level E on a daily basis, just for reference

            You know the saying “if it sounds too good to be true, it probably is?” Well, that is applicable to my situation, but rather replace “good” with “wrong” and you see where I am going with this, right? Well, when I met with the social worker at my local VA clinic, she repeated the same incorrect information regarding the Choice Program. She told me that, while there are services in town, such as support groups, there is little in the way of community resources that address symptoms. I can’t really go to a support group for my colonoscopy or endoscopy now, can I?

            My social worker also told me that I am my own advocate for my health, which is a phrase that she might be wishing she didn’t say. See, I thought that the information I was provided by not just one, but two medical professionals at my local VA clinic, sounded incorrect. Just in case though, I called the Choice Program directly, and boy, am I glad. The representative that I spoke with was just as befuddled by what I was told as I was when I heard it. It helped to put my mind at ease, knowing that I was correct about this program, as well as the fact that I would (hopefully) be able to see a provider here in the community, as my symptoms have increased since my last visit to the shoddy rheumatologist who reprimanded me for crying out in pain when he took a biopsy from my thigh at 5:30 in the morning, before I was fully numb. But again, I digress and that, along with the other numerous experiences I have had with military health officials and those covered by the Choice Program.

            So, here is my conundrum. Yes, I am my strongest advocate for both my mental and physical health. The soonest they could schedule me with a mental health professional (to address my depression, anxiety, PTSD, and MST) is the end of February, and even then, it would be only via tele-health. That falls outside of the 30 days or 30-mile rule that applies to the Choice Program (maybe not the distance, but certainly the time-frame). In the past, I have conveniently fallen through the VA health cracks, as it had taken me 18 months to even get an appointment with a rheumatologist, as the original request somehow got lost. I know that I am in the right and have a whole organization and website that provides me with the answers to help to support my position. I know that I am most likely not the only veteran in the area who has been fed this lie. However, I may be the only one to raise a little hell over the incorrect information that could have potentially affected the lives of a significant number of veterans living in the area.

            I have been known to let my emotions get the best of me, particularly when I know that I am in the right. This isn’t just relegated to my health, but also where we used to live, I have been physically threatened when I spoke up for the poor treatment of the dogs I would witness running in the street. As if it were my fault that I recognized this behavior as wrong and dangerous. I am not kidding. I wish I were. So, I need to come up with a game plan of sorts, as I know that I need to go into the clinic and let them know that they are wrong, that I qualify to see community providers that honor the Choice Program in the area. I know that other veterans have experienced this same type of treatment. The sooner the better, but, dude, I am not looking forward to it. I just need to keep my cool, and remember why I am doing this...for the health of not only myself, but the countless veterans who have received the same misinformation. Sadly, I know that this not only applies to my local clinic, but the Portland, Oregon one too, as that is who contacted me to set up my appointment for the tele-health mental health sessions...I was told that since they can provide me with the tele-health services, then I don’t qualify for community care. Well, that is not true either.

Rhubarb Applesauce: The VA Choice Program

Imagine the following scenario and assess what you would do in the situation…

“I’d love to make some homemade applesauce. I think I will go down to the fruit stand to pick up some apples” you say to your dog as you head out the door to the fruit stand. After making your way into town, the green grocer greeted you with a warm and friendly “Good morning! What can I get for you today?”

“I need some apples, so I can make some applesauce. Homemade always tastes better and there’s often fewer ingredients too.”

“Gee, I am so sorry. We have some lovely bananas, but we’re all out of apples. Can I interest you in some rhubarb?”

“No, I don’t think those will do, as I am making applesauce.”

“What about some pomegranates? They are chock packed with nutrition.”

“No, I am sorry, but those won’t work either. I really need apples.”

“Well, you can drive four hours south and I think they might have some apples for you. You could try that.”

“Thanks for the idea, but I am not sure that it will be worth the travel.”

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Okay, after you have read that scenario, what are your thoughts towards the fruit stand employee? What would you do in that situation? Maybe change your mind and not make applesauce after all? What if all of the stores within a 30-mile radius were also sold out of apples? Would you make the trek?

            In the example scenario, it outlines something I learned today from my visit with a social worker at my local VA outpatient clinic. See, there is this program called Choice, which is supposed to be a safety net for veterans if they need care, specialized or routine. In my previous clinic location, I was placed on community care via the Choice program for dermatology, rheumatology, and gastroenterology. Since the clinic where I received care in the past did not have these specialists on hand, this system worked for me, for the most part.

However, at my new clinic location, I was told that if you are within a 30-mile radius of a VA health clinic, the veteran would not be eligible for the Choice program. I even inquired if this would still be the same answer if the clinic did not have certain specialists on hand, such as a rheumatologist, gastroenterologist, or dermatologist. Sadly, I was informed that it would still apply. Seriously. If I want to receive care from these specialists, I will have to drive nearly 4 hours (each way, so 8 hours round-trip). With my hips seizing up after sitting in a car for less than an hour, it does not look like I will be receiving any care from these types of specialists. I have been diagnosed with fibromyalgia and irritable bowel syndrome, along with a familial history of colon and bone cancers. This system is broken.

What would you do in this situation?

A Pain in my Arse

An occasional sharp pain leads to a constant feeling of despair, as the anxiety of not knowing if the next step will be painless or send you into a realm of pain that you never knew existed. Trying to put mind over matter lasted only so long, as the facade began to tarnish and crack. There is no denying or hiding the cringes that accompany the unseen pain; each step is a weary endeavor, with a time bomb flashing in your peripheral vision. It would almost be easier if it was a broken bone, as it is a visible injury. However, much like the mental illness battles, the hidden ones often hurt more.

Having had tried to “walk off” two herniated discs about a decade ago, I am not one to quickly admit defeat or even admit that I am human. Being a dedicated follower to the motto “Toughen Up, Buttercup,” I tried to pick myself up and dust myself off. But this time I couldn’t. This pain was different than the disc injury, as there were no tingling limbs, but rather just a sharp pain and achiness. I tried to heal myself through the use of PiYo (a mix of Pilates and yoga) and herbal supplements. Sure, most people would say, “Why don’t you just go to the doctors if you are in that much pain?” Well, it’s because as a freelance writer and graduate student (with the latter now on hold due to my injury, as it is hard to sit down and concentrate for long periods of time) and don’t have health insurance. I would have qualified for Medicare due to my low income status, but the lovely governor Rick Perry decided not to expand the program. However, due to my loving (and persistent) boyfriend, I started the process of obtaining my medical care through the Veterans Administration, as I earned the status of disabled veteran due to my 30% disability rating that I incurred over the course of my 12 years of active duty.

It took about three month to navigate the system, as my application for coverage was sent to the wrong address, then when I called to follow up about two months after I sent it off, I was transferred to the publications office (perhaps this is an example of why so many are disenchanted with the VA). I called back and was able to reach a very helpful woman (Betty) who told me that I could email her a copy of my application and DD-214 and she would help me to get the ball rolling. Two weeks after I sent Betty the paperwork, I called back to check on my status once again, and lo and behold, I was in the system and could finally obtain medical services! Yay! I was told that I should go to the local VA clinic and make an appointment. I grabbed my wallet and keys, then off to the VA I went. Well, it appears that all of the doctors have quit working at that location...which was built this year. Sure, they have some doctors from other locations filling in, but there are no doctors assigned and I was not able to make an appointment at that time, but they would call me when there was an opening. That wasn’t going to cut it though.

The next day the pain was still bad (I had been living in a 6/10 -7/10 of pain on a regular basis, with 25/10 on occasion) and I wasn’t sure that I could hold on until the local clinic had an opening. I called the larger clinic, which was about 70 miles away, to at least try to make an appointment. I called the number and was stuck in voice prompt hell and then when I called back and told the operator that I was trying to make an appointment, she transferred me to someone’s voicemail (just another reason to be disenfranchised with the system). Well, due to my untrustworthy nature of voice mail, I decided to get in the car and drive that 140 miles round trip...to at least make an appointment. I am glad I made that decision though, as they told me to go to the VA Urgent Care (which is in the same building) and I was seen, got a shot in the ass, and even got a few x-rays done.

Upon examination of the x-rated pictures (hey, it’s pictures of my innards), it was discovered that I have some narrowing and compression of some of my discs, a little curvature of my spine to the right (my spine is a Republican? Crap) as well as a few bone spurs in at least one of my vertebrae. So, at least there is something wrong and it’s not all in my head. They gave me a few prescriptions and made a few appointments for me at the local clinic that is closer to where I live, including a lab appointment. It has been a good five years since I have had any blood work done or even seen a doctor other than the one I saw when I was a student at Oregon State University for my Mirena (I highly recommend it, btw).

The doctor I saw at the Urgent Care clinic told me that if the medications don’t work, that I would need an MRI. Well, it looks like that will be in my future, as the pills I got do diddly squat. As it is, I am taking one of each (a pain pill and a muscle relaxer) and a Doan’s pill every couple of hours. He told me that the muscle relaxer should be taken at night, as it would knock me out. Well, that is not the case either. Even taking this concoction, it hurts to: walk, stand, stand up from a seated position, sit, roll over in bed, get out of bed, pull my pants up, and just about anything and everything else. However, the annoying thing is that the pain is not constant or consistent, which contributes to the anxiety and muscle stress due to the constant unknowing, bracing myself for the possibility of pain.

I may have to go back to the clinic that is further away, as the pain is getting worse, as before it went away a bit as my back loosened up a little, but that is not the case anymore. The anxiety is challenging, and so is the depression that accompanies the fact that I know what my body has been capable of in the past: I have completed two Tough Mudders, enjoyed MMA training, kickboxing, Insanity programs, lifting heavy things, and when I moved to Texas, I loaded the truck myself, alone. Feeling like a shell of who I was before is hard, and even more so since I have used workouts as a form of therapy, and now I am not able to do such things. So, until I am able to resume my normal activities, I need to find other outlets, such as writing, reading, and trying to take care of myself so I can come back stronger than ever.