Member Dennis (Pop Smoke) sends us this vignette on the VA. It comes as no surprise that VHA and their medical arm, VAMCs, tend to shovel opioids down our throats in an effort to pacify, drug and otherwise keep us sated so we do not complain. Drugged Vets are Happy Vets ought to be their catchphrase. All this is about to change.
Speaking from a personal standpoint, for years I have been prescribed pain relievers for my back. Upon entering the VA system, they simply added it to my list and continued to prescribe it to me. It came in the mail unsolicited. After exiting the hospital for my one year, all-expenses paid vacation by VA, they continued to blindly mail me copious quantities.
After three years this ceased suddenly and I was required to come in and be examined in September. There, to the horror of the nurses, it was noted that I had been on these for five, long years with little or no supervision. As an aside, I must describe the 1000 yard stare I got from Dr. Rose Sessoms, my latest Personal Care Physician (PCP). Without casting racial aspersions, Rose is a mid-sixties, African American who does not wear a wedding ring. Her sudden appearance at the VA this late in life as a general practitioner speaks volumes and engenders untold new questions about her recent change in employment. When I went in for the scheduled appointment, the good doctor asked me why I was there. In a good-humored rejoinder, I rhetorically bounced it back and said ” I don’t know. T’was you who summoned me.” Levity with a doctor is to be avoided, apparently. At the VA, it is ill-advised. This forced her to actually look in the computer to determine why I was there. She sucked her lips in and said “Oh, dear. You’ve been on pain meds for aeons!” Nothing escapes the steel trap minds of these astute doctors. Nothing.
I was immediately put on the Group W bench, issued a Blood pressure machine and told to be prepared for “change”. In the next week, I was assigned to a Pain Conference 90 miles away for an initial intake and three Kumbaya group encounters (in succeeding weeks) with others similarly situated- in December. We were going to explore new techniques to conquer pain as if simply forbidding it to inhabit my body would solve the problem. I’m envisioning acupuncture and Yoga. Maybe healing crystal stones with a side of Rev. Sun Myung Moon’s Nam-E-O-Oringay-Keo chants.
I called up the pain conference coordinator and explained my particular circumstances. “Rhan” signaled that this wasn’t what his Hugs for Vets group was designed to do. It was for FNGs-newbies, if you will. Newer Iraq and Afghanistani Vets with recent, chronic pain issues was his venue. He also asked if five years on some heavy duty drugs had not led to some “addiction issues”. Steel traps indeed, and he isn’t even a doctor.
So what do my wondering eyes behold than an official policy position coming out concerning this. After a brief teté a teté with Dr. Sessoms and my patient advocate, I pulled out the “I’m not an idiot. I advocate for Vets. I’m fully aware of my VHA rights concerning my health decisions”. Next, she announced via secure messaging to me that from a longitudinal review of my records I was double-dipping- i.e getting prescription drugs via civilian doctors in addition to my VA prescriptions. Nothing could be further from the truth. VA has given me wheelbarrows full of pain meds. I sure didn’t need to go doctor shopping the way they were shoveling them out the door. Besides, VA’s pills are free. Why pay?
Member Mark, who, shall we say is conspiracy oriented, very wisely pointed out something I had overlooked. This is all the ammo they need to declare you an addict, uncooperative and in need of fiduciary supervision. Addicts don’t think clearly and make bad decisions. Besides, they’re belligerent and liable to harm small, fuzzy animals-with guns. Reluctantly, I quickly assured my patient advocate that all was fine in Mudville and I wished to close out my complaint. Happy, happy, happy.
I went on MyhealtheVet a week later and looked at the good doctor’s assessment of our “disagreement”. As the process is decidedly one-sided, it was recorded that I was a raging junkie and demanding even heavier hardcore drugs. The double-dipping allegation was prominent as well. Here is what was missing from the HealtheVet records. The head pain poohbah of the Seattle VHA, who incidentally is not even a doctor or exalted PA-C, has decided, in concert with Dr. Sessoms, to begin weaning me off all narcotic drugs and starting over with a bare bones assessment sans my drug delirium. None of this is of record or visible unless you obtain your VISTA records from the Release of Information portal. I guess they think we are incapable of doing a little sleuthing on our own. I was of the understanding that MyhealtheVet was all-inclusive records wise. What use would it be to you if only part of your records were associated with your file?
Being of above average intelligence and only too aware of VA’s proclivities, I have opted out of the VA’s pain management system. I haven’t been addicted to anything since shortly after escaping their clutches in May of 2010. I can tell you it was more difficult that giving up red meat but not as hard as quitting cigarettes. When the pain did become unbearable, I could always fall back on their pills. Henceforth, I will rely on Obama and Medicare for these needs. I doubt Social Security will appoint a fiduciary and I can’t wait for the next missive from my PCP inquiring as to how it is I have not requested a refill to quench the thirst of my addiction.
This is going to become humorous. VA is all about control. They thrive on dictating the terms of your care. Normal doctors are inquisitive and attempt to work with you. VA informs you of the parameters of the vertical and the horizontal. If you agree to submit, you’re in. Any deviation from the “program” is grounds for abrogating the agreement. How they will deal with me when I refuse to answer their medical queries and play by their acupuncture rules is going to be an interesting dance.
We all know how frustrating it is when we send in a request for a c-file and VA ignores us for a year or two. Imagine asking a Vet to report for a medical assessment of his/her addiction with the threat of cutting them off from their precious supply and s/he refuses to respond? How aggravating. With no fulcrum, they lack any lever to enforce compliance. It appears the shoe is on the other foot and is an uncomfortable fit-or will be soon when I fail to report for my group therapy in December.
On the other hand, this just may be part and parcel of the new drug program at the VAMCs. Insult the Vets. Lie about their habits. Cut them off and see how the chips fall with the new Obamacare model. It could be that this will shift healthcare in a different direction. It’s not inconceivable that it is nothing more than a blatant attempt to shift 100% disabled Vets (read deadwood) out of VA care and into Medicaid/Medicare. I, for one, won’t be crushed at that outcome. Remember, they tried four times to kill me with little success. I’m lucky that I do have Medicare as a fallback position. And now for the kicker. The food’s better and the nurses are far more polite in civilian hospitals. You don’t have to wait four months for a MRI or beg for medications. If you have an emergent situation, you don’t have to call and get permission/assurances that VA will pay the meat wagon bill or any incidentals at an emergency room. And lastly, they don’t go behind your back and stealthily plot to sabotage your treatment. Put your cursor on the picture below and click for magnification.