Few commercials move you as this one submitted by members Paul and Leigh. Someone who feels he has the stoic control of his emotions may still feel the lump and remember the moment when he/she arrived back from being in harm’s way.
Check this one out. http://beerpulse.com/2014/07/guinness-fourth-of-july-inspired-empty-chair-ad-airs-during-world-cups-halftime-video/
This may atone for burning down the White House in 1814.
I have been approached many times and asked to “coach” someone on how they can better present themselves at a PTSD C&P exam. I even have several widgets on my site for info on PTSD exams and so forth. It is not to instruct Vets on how to cheat but to give them an idea of what they are getting into. Maple Syrup Frank sent me a link to this article and it struck a silent chord in my memory I thought I might share with all of you.
I know about PTSD. I did two years in a war zone and some of it entailed violence. It took me several years after I returned home to achieve what I call the ‘new, revised normal”. One thing that never left me was a desire to cover my six o’clock. Another was being armed all the time. I wasn’t ‘coached” on this. I’ve never applied for VA benefits in this area. It was merely a byproduct of my environment. It does lessen with time but never goes away. Wild and crazy dreams are the only residuals that afflict me other than Hueys and O-1s going over or loud bangs. Cupcake has been kicked, clobbered and almost pushed out of bed numerous times over the years in an attempt to escape from something I don’t recall in my waking moments.
Which brings us to all of those described in the article who suffered irreparable trauma from breaking their leg on the way to the chow hall at Lackland AFB in Basic Training. I’ve worked with a fellow who was stationed in Bahrain (a noncombatant country) and nowhere near the combat zones of Aftstan and Iraq. He sought to file for bent brain and was striving to milk me for something-anything- he could use to hang his hat on to get VA comp. The problem was he was far more sane than me. I could also hear that plaint in the timber of his voice that implies a less than truthful analysis of his affliction. Face it. Some of you will always aspire to feel you were in danger and will manufacture the requisite emotions to convince yourselves and others. I see it frequently. The mind is an interesting playground of emotions and some can sway your vision of reality to fit your desires.
This creates a contretemps of sorts between those legitimately afflicted and those wannabes who see the pot of gold at the end of the VA rainbow. Some of you are very well acquainted with the fears of combat. If you’ve ever had 7.62 rounds zip past your ear or a B-40 whoosh into a nearby jeep and go off, you can identify with wanting to know where ‘they’ are and keep your body oriented to the direction of the danger. Conversely, if you are thousands of miles away in Bahrain, it cannot be said that your demise is ‘imminent’ or assured. And then we have the Major Sexual Trauma victims of assault. These folks are the ones most disadvantaged by the process as they often do not seek help for the assault- especially if it’s male on male. Women Vets were equally unlikely to do anything about it in decades past as it only caused more harm and abuse. This post is not meant to address that facet of PTSD so don’t think I am marginalizing any of you. I speak today of real combat-associated PTSD. Since the number of support troops to actual combat troops is 85% to 15%, by rights the number afflicted should be much smaller as it was in Vietnam. Granted, PTSD as an affliction was not devised until 1980, but it has many other names from conflicts past. Shell shock, the Thousand Yard Stare, the uncontrollable shakes from unmitigated fear to name just a few.
I can remember sitting on a stack of body bags eating lunch one day at Lima Site Betty. We were waiting for an Air America Helio Courier to pick us up and the glad bags were in the shade. It seemed the natural place to sit out of the sun. The Pathet Lao inhabiting the bags were by now having their spiritual meals with the Phee (Laotian for spirits) in the next world and could care less. By rights, according to the DSM- IV I should be horribly afflicted with guilt for sitting on the dead Tahann (soldiers) but I’m not. Does this mean I’m inured to mental anguish? I’m sure a head shrinker would have a field day with this and try to pigeonhole it into some suppressed emotion due to explode in X number of years. Sorry. No sale. I remember it vividly and it didn’t give me erectile dysfunction for life. It stunk to high Heavens. We used to carry a little jar of Vick’s Vaporub and put a spot of it under our noses to mask the smell. If you didn’t have that, a small bandana of parachute silk and a dip into JP-4 or AVGAS would do the trick, too. The mind has a special device that blocks a lot of this out in times of stress in most of us. We take a cue from those around us and whether they are quaking in their boots, too. No one aspires to be the rock of Jello in an emergent situation so many squelch that fear of injury or death and press on.
What is it that sets some of us apart? Why is my rubber band in my noggin more resilient that that of, say, Bruce Almighty down in Georgia. Could it be the sum of the mental insults combined over time? Bruce did four tours back to back- from 1968 to 1972- a large portion of it in a dustoff chopper as a combat medic. Contrary to popular belief, that big red crosshair with a white background did not give him immunity from ground fire. If anything, it was an improved aimpoint in the smoke and haze of battle. Add in the brainf___K of bullets hitting all around you out in the open in a hot LZ and no way to defend yourself. That is the essence of bent brain. It’s the reality of the very real probability that the Golden BB is going to find you eventually. In time, it turns into a fatalistic approach to life. Why burn both ends of the candle when you can break it in two and light four ends at once? I’ve been there and done that. I don’t need to ask others about it.
Compare that to more recent Vets who ran convoy up the highway from Baghdad to Mosul. The threat of violence was tantamount to actual harm in these instances (IEDs) but it fades in comparison to five minutes of Hell or actually being hit and wounded. Seeing a fellow airman or soldier get dusted can be a predicate for bent brain but it only mobilized me to become more violent and vindictive-not fearful for my life. Somehow, over time, that emotion subsided and was replaced with sadness- and lastly- closure or something similar that ameliorates the ache.
Thus all of you who felt you were in danger, regardless of how far or near your service to the ‘front’ was, can understand that some of us who served in Southeast Asia look at those of later wars and ask what all the theatrics are about. The constant worry that bad things might have happened can never be the predicate for a lifetime of bent brain. Everyone who serves in combat brings away a different perspective of the horror. Those who didn’t often try to conjure up an alternate reality of “But what if I had been hurt? We were 80 klics from the fighting and we always were on DEFCON 2 so we could have been legitimately impacted. The fact that we weren’t does not lessen the fear of imminent bodily harm.” Alternate realities are all well and fine but they are a compendium of nothing more than “might have”, “could have”- or less. To me, a CIB or a CAR are the predicate for opening a discussion about PTSD. A Purple Heart can also be a valid conversation starter on this subject. Merely possessing an “I was there medal” somehow does not evoke the sympathy of those who were doing the shooting.
My answer to the “almost” argument isn’t simple. PTSD is something that makes your eyes get wet merely thinking about an event 40 years ago. It’s a storm inside your mind that never abates-that just subsides for periods of time. With luck, it relinquishes it’s grip eventually and let’s you resume a semblance of your earlier life. To me, PTSD is not a disease but an affliction akin to Tinnitus. You feel it, you live it and you live with it. No one else can see or hear it. But primarily, with PTSD, you had a stressor that was valid. One that jumps up and bites you on the ass at 3 AM-for eternity like a Groundhog Day movie. Try stuffing the intestines back into a friend as you light up a Marlboro Red for him and tell him it’s just a minor flesh wound. Circle a downed aircraft in Indian Country with no other air assets other than a S&W Model 19 and a CAR 15 and try to run off a well-armed cadre of Pathet Lao determined to kill your friends on the ground. That, ladies and gentlemen Vets, is the predicate for a lifelong echo of PTSD in the noggin. Why I was not irreparably impacted will always make me wonder for life. I eat no drugs to modify my persona. I wouldn’t even if they were prescribed. Granted, I am one person who legitimately should be afflicted but am not. Why, then, the plethora of those now claiming far less exposure and far more deleterious effects that preclude employment? Does the new generation of warrior being turned out by the Army have some inherent mental defect that arises about the time they separate? What separates these two generations of Warriors?
After reading the article, I cannot say that I am convinced every Vet applying for PTSD actually suffers it. Admittedly, everyone has a point where the rubber band breaks. And then there is the flip side of the coin-all the Major Mental Disorders (MDDs) such as schizophrenia, bipolar disease, depression, anxiety, et cetera. None of those can be blamed on combat or the diagnosis would be PTSD. An interesting contretemps. But that is the subject for another day.
You can bet VA will only become more selective in the future on this subject. Be prepared.
This just in from Fort Fumble, Colorado. VA is actually talking about spanking their employees and even threatening to wash their mouths out with soap. Why, they may even go so far as to put a negative performance review in the personnel file and recommend remedial training by Human Resources facilitators to help them work through their time-challenged scheduling quandary. And sadly, yes… that perennial VA Bonus every year is gone. So long to the annual vacation at Lake Winnipesaukee.
What everyone may not find entertaining is that someone innocently inserted a requirement to reinstitute the bonuses again poste haste but keep them down at $325 Million dollars instead of their historic high in 2008 at $360 million dollars. If you really dig in and read line by line (and I have not) I am told by reputable sources who have that it solves nothing now. It merely begins anew the circus of years and decades before. Try to find a trail of fired administrators of VISNs. Search for all the heads on a platter who will not be getting the 20 years and the golden parachute. Find those that have benefited by deceiving us into believing they were putting up good numbers based on what they were told by the little people.. Ask them politely to refund the VA bonuses they took. Deduct them every month until repaid if they decline to. You know. Just like VA does to you and me if they accidentally pay us too much and we fail to catch it. If these higher-ups try to weasel out and quit, file a lien on their bank accounts and freeze the suckers. The savings from that simple step alone will refuel the VA’s treasury with hundreds of millions of dollars.
Now let’s add in the delay for trying to get faster medical care. Imagine what it feels like to hit the 1-800-827-1000 Oracle at Delphi Line at 1000 hrs. EDT and be told (after waiting 45 minutes) that you have to get a letter from the VA Secretary showing you’ve waited over 45 days/ >40 miles away. Do you know how long it takes to do anything at the VA? What part of Fort Fumble did you misunderstand? Murphy’s 7th Law-You can’t get there from here- is the operative phrase. Of course, Murph’s First Law is immutable-No good deed goes unpunished. In their haste to get to Happy Hour at Harry’s Bar and Grill, they missed the niggling little fact that the VA is inept and unable to steer their personnel into new waters in the near term. The mere idea that a Vet contends he has waited more than 45 days first has to be investigated and verified. That alone takes thirty days by itself. It is then evaluated by Google map apps at VA to discern if a Vet used back country two-lane roads, whether it could possibly be shorter. Forget the fact that he’ll have to leave three hours earlier if he obeys the 35 mph speed limit and doesn’t run any red lights.
We had this problem with the ACA. It was voted on before it was written in indelible ink. Representative Miller, in his haste to appease everyone and no one (and get out of town for vacation), has opted to stand behind the worst abortion of VA changes to come around in all of the former centuries combined. Nothing is cured. Vets cannot wake up tomorrow after the President signs it and proceed apace with their pacemakers to a Heart Doc near them. It merely sets in motion another Perpetual Government Motion Machine that impedes and defeats logic. Firing stupid, inept leadership will be so minutely defined such that no one will be able to be fired. The phrase “It blew me away. We just heard about the ________ coverup in the news this morning. Right here under our noses all that time and we were unaware of it. Boggles the mind, it does.” will become status quo for a legitimate excuse. We didn’t know. We’re in the same boat you are. We just heard. Yeah, they were our guys but they sure didn’t get these hare-brained ideas from anyone around here. I know it looks bad seeing’s how we got those bonuses but it’s a phenomenal coincidence.
Spin to determine blame.
Let’s review this. Fast and Furious? We weren’t in the loop. IRS? We didn’t have any oversight. Benghazi? Our intelligence was faulty. Wait. It was an anti-Islamic Utube video. VA? Wow. They lied to Shinseki. He was clueless. So were we. These folks at VACO aren’t entirely paralyzed from the neck up. They can see which way the Cliff Notes excuse book is going. You can logically assume it was a right wing conspiracy initiated by Bush and Cheney to deprive Vets when VA gets done spinning it. A janitor in Phoenix will be fired for throwing evidence away unwittingly. Several mid-level schedulers around the country will be sacrificed but none will have to return a bonus because they never got one. VAOIG will continue to visit VAROs and VAMCs coincidentally located in the south near really well-kept-up golf courses. The VA’s HR bigwigs will organize a few Meet and Greets with a token ice sculpture and wine/cheese themes. New York is ideal. They can get lost in the shuffle and go unnoticed.
VA knows very well where each and every one of you is if you are in their system. They can tell via the travel pay computers exactly to the tenth of a mile whether you exceed the 40 mile limit. Remember also, any VA clinic is a broad definition. Having a CBOC near you is sometimes as useless as male nursing pigs in an emergent situation. If you are discovered to have cheated by a tenth of a mile or shaving a few days to make it look like you were over 45 days, well, it’ll cost you. VA will refuse to pay and you get stuck appealing that one for about 5 years if you want to get your money back without interest. We’ve been there and done that one.
Where I guess I get the heebie jeebies is to think if all this tomfoolery and purposeful misconstruing of the facts is going on in the VAMCs across our vegetabled plain, what has Mother Superior Hickey done to inspect the framework of the VBA for cockroaches? If she is still in denial and thinks knocking a million claims out the door by August is some kind of Guinness Book record, she needs to take the pulse of the score up at the CAVC. The Office of General Counsel is batting about 35% accuracy and suffers greatly from poor BVA jurisprudence and the dreaded VLJ Hanging Judges. Nevertheless, at each new appearance on the Hill, she regurgitates the same lies and statistics by rote-“86% accuracy of all decisions (with that number constantly going up); with FDCs, the adjudication rates are often less than 189 days and 2015 will be even better.” Things like this are often spoken just before aforementioned party pulls the ejection handle and departs at the end of the month. Thus they can be quoted, strongly suspected of authoring the ruse, but not blamed.
VA is on what many consider the cusp of a new day. Great things are portended again. A bright future dawns with a brave new Captain of Industry at the Helm. We shall see. I predict sixty more years of winter. VA has always been a political dumping ground. Do a congressman a favor and bingo! Your kid with the freshly-minted Bachelors in Haircombing 401 from Mt. Altoona Jr. Community College has a place to hang his sheepskin for life. Nothing will change. The reins of power may or may not change in 2016, but don’t hope for change at the VA regardless of who prevails.
P.S. Oh, and I forgot this vignette. You’ll love it. Oh, those other years up to 2010? Well, sheesh. Why didn’t you say you wanted them. Now we have to go back to the dungeon beneath 810 Vermont Ave. NW and dredge those up. It’ll be a couple of years because we haven’t gotten around to electronically digitizing them.
Once again, we delve into the intricacies of just what it takes to invoke the dreaded word “Reverse”- the ultimate bitchslap to a Veterans Law Judge (VLJ). Equally embarrassing is the fact that the Office of General Counsel (OGC 027) has been hoodwinked into going along with this. I prefer ‘inveigled’ as it implies the RO examiners, the RO RVSRs, and all the industrious little elves who fashion decisions out of whole cloth at the ROs were studious and dutiful in their investigation/decision of our claims. Additionally, all the staff attorney/future Acting VLJs and the actual judge himself who signed off on this travesty of justice have to have been equally hornswoggled or complicit in a ‘prearranged’ denial with a rat’s ass chance of ever winning.
I’m sorry but this one goes over the top for stupidity on VA’s ‘independent medical examination’ or IME meter. The purported rationale for the remand to readjudicate this with an eye towards a genuine, independent assessment of Mr. Issa J. Traore is that the BVA VLJ failed to get ‘substantial compliance’ with the remand order and thus committed a Colvin violation or what we in DickandJanespeak call “busted for impersonating a medical doctor”-or any kind of doctor for that matter. That includes, in no particular order, psychiatrists/psychologists, chiropractic doctors, naturopathic doctors (Wiccans excluded), medical doctors and the VA dentists. The idea is to look professional when you arrive with the hanging rope. Having a good denial nexus that covers all the bases and explains it in plain English is paramount. Having the proper credentials to opine with is even more so.
At the bottom of this decision, fortuitously pointed out to us by Judge Greenberg and his merry band of sleuths, is footnote² at the bottom of page three. The footnote annotates the phrase:
Prefacing this phrase above is the predicate for the term ‘separately’ at the bottom of page 2. Read this one carefully.
So, various VA examiners, specialists all, replete in the knowledge of their respective fields of expertise, all opined over a very short period of time in August 2012 that Issa J. was not Totally Disabled due to Individual Unemployment (TDIU) but rather upper body-challenged for doing lifting over his head. Concurrently, another specialist, a psychiatrist probably, has inveighed and postulated that Issa is good to go on the Major Depressive Disorder thing and should be capable of holding down one of those “Earn $12,000.00 a day AT HOME in your Spare Time, Dude!” jobs. The Heart Doctor put him on the treadmill for the 5-minute/50,000 foot stress test – and he passed. And lastly, the Podiatrist or orthopedist did an in-depth analysis of foot and ankle issues and gave him a clean Bill of Health for his new computer vocation. Or did they?
Minimal interaction with others and a steady income stream. A marriage made in Heaven. No heavy lifting, either. TDIU denied. Back to work, Issa.
Padewan you are, yessssssssss. Back up and reattach the boat to the dock, Gilligan. Our erstwhile friend footnote ² has this to say:
Ruh-oh, Rorge. Can this mean that our multi-talented VA examiner Monica has even more initials after her name and is merely too polite and well brought up to brag by divulging them all? Well, not exactly. The BSN is explained here Basically, it’s a RN who went for a Bachelor’s in Nursing. Boy, howdy. They must teach a shit ton of subjects there at the BSN community college. The amazing thing is that Nurse Rupp RN, BSN, can upstage a true medical doctor and her opinion is given added weight if she has had the pleasure of perusing Mr. Traore’s c-file. Just like that. Such are the prerogatives of the exalted VA Examiner-Poobah. This happens about 800 times a day across the fruited plain.
After reading extensively on why Nurse Rupp has the particular combination of letters after her moniker, the answer is simple. Monica did this on the fly. Monica was on a low budget. She did the Licensed Practical Nurse (LPN) to RN bridge program on line and then jumped into work and eventually took the BSN on line. Her actual hands-on experience in a medical environment is virtually nil but her value to the VA is immeasurable. Chances are the VA paid for her BSN or a big chunk of it. Thirty pieces of silver? Priceless. For all else there’s a VA bonus.
Judge Greenberg, the FNG at the CAVC, is far too polite and well-schooled to call the VA out on this so he subtly footnotes it, and relegates it to the bottom just to let VA know he spotted it. Sharp-eyed law dogs should zero in on this like a gaggle of setters on point. The reason is simple. Our good friend the much-vaunted Presumption Of Regularity (POR) in all things medical is at stake. Every C&P, every doctor’s finding, every VA examiner’s reasoned explanation is a finding of fact. This one footnote implies VA has used gross chicanery and misfeasance to accomplish what they were unable to do via legal, independent venues.
Once you overturn the Presumption, there can be no more assumptions, presumptions or consumption of VA propriety. The whole legal concept that VA is pure as the driven snow abruptly melts and reveals a dirty parking lot full of potholes. We see this at the Phoenix VAMC and about 190 other VAMCs/CBOCs etc. Much like the credibility presumption we cling to in a claim, once it is proven you are a card-carrying bigot from VA who cheated on a C&P exam and screwed over the poor Vet, every action-indeed, every facet of the decisional process -is not just suspect, but incredible. Incredible like RVSR aliens with big eyes and gray skin. Incredible like a gigantic conspiracy by the worm people to take over the land east of Nod. As incredible as a systemic VA conspiracy to cook the books at VA medical facilities nationwide in pursuit of lucrative VA bonuses for ‘fixing the appointments backlog’.
VA avoids this like the plague. Nobody wants to be revealed as being devoid of credibility. Either you are an honest, pro-Vet, stand up agency or… or what? You’re a den of liars and thieves? Mostly, nobody at VA wants to disturb, cast aspersions on or negate the POR. It is Sacred Writ. ‘Tis far better a rater who would grant the claim on remand now to avoid dismemberment or a rending asunder of the sacred holding. I’m sure that’s part of the password and secret handshake they use at VA. Although I’m not allowed to reveal my sources, I will confirm the Rater guy I got this from in Seattle has really big, bugged out eyes but it was dark and he was wearing a trenchcoat and what appeared to be gray slacks. And that’s all I’m gonna say about that.
The smart money in Reno is 10-1 on Issa driving a new 2016 Lexus and the VA’s POR remaining intact like a virgin’s hymen. The VLJ will be instructed to get the vapors and suddenly realize he is not House, MD. Issa will get his full ride and the P&T from the AMC to keep it away from those boorish RO chuckleheads. It’ll also take about another year or two for the attorney to get his EAJA funds just to be mean and spiteful.
Vets should note the rainmaker on this was Robert V. Chisholm. He’s in the Yellow pages and he didn’t just arrive on the SS Mayflower last night. He’s very well respected in the Veterans Community.
Veteran John Perrat helps weed the corn
July has been berry berry good to us. Raspberries are over and the blackberries have begun. The zucchini is running amok and the string beans are all but done. The corn is over seven feet high. We have Paul and Leigh Burch to thank for all the largesse. Silver Queen seems to like western Washington just fine.
Here’s a compendium of July.
Black Beauty zucchini
Liberty apples
beans and Purple Kohlrabi
First tomato came in yesterday morning-an Alaska Fancy
Gewurztraminer grapes
incredible peach results this year
My Sovaldi minder contacted me this afternoon and told me I was getting:
1) More Anemic
2) My creatinine levels were dropping precipitously so my kidneys are not happy campers.
3) My Anti-nuclear Antibodies test (ANA) indicated my autoimmune Hepatitis component was climbing.
4) My IgG globulin level was going up indicating the White blood cells were massacring a lot of something nasty.
I had to disinterestedly ask “You didn’t happen to get the viral load test back yet, did you?” She indicated no and then corrected herself. “Oh. Here it is. It just came back a little bit ago. It says twelve copies which is virtually disease-free. By a month from now it will probably be zero. The doctor also says to reduce your Ribavirin amount again by one tablet a day and eat two in the morning and just one in the evening. So that’s a total of three a day. Do you want me to mail out that dosage note to you or can you remember it, sir?”
Twelve copies. Down from 857,000 two months ago. An amazing drug. Expensive at $168,000.00 dollars? Yes. The cost of long-term medical and a transplant? $552,000.00 conservatively. Pay now or pay later. Gez. I wonder how the VA OGC is going to take this? Priceless.
After six weeks of negotiation, and four days before recess, it appears as if we will be soon be seeing details of the new veterans’ bill. This provision as reported in the Washington Post, gets a thumbs up from me:
According to a draft summary of the measure provided by House aides, Congress would give eligible military veterans a “Veterans Choice Card” and allow them to seek health care outside the VA medical system from Medicare-eligible providers, other federally qualified health centers or facilities operated by the Defense Department or federal Indian Health Service centers….
Veterans eligible to seek care outside the system would need to be enrolled by Aug. 1, or enroll for VA care within five years of ending their military service in Afghanistan and Iraq, according to the draft agreement. A veteran could leave the VA system if they’re unable to receive an appointment within 14 days — the current VA wait-time goal, or if they live more than 40 miles from a VA facility.
Kiedove update (Tuesday noon): To read Sander’s website updates from Monday night scroll down for the bill summary and bill. This summary says a 30-day wait period for non-VA care which is different from what the WP reported earlier. The conference committee report gives more information. This gives more information about the 40-mile rule which has some exceptions. C-span has video.
We’ll have to stayed tuned to see what was decided. Check it out- Update.
Editor’s note. Be prepared to see the VA definition of a mile revamped to measure 10,560 feet from it’s current 5,280 feet. Either that or the new metric will measure it directly as the crow flies. In fact, if you had an F-15, you’d be there by now.
The VA tests veterans with, or without HCV, for creatinine levels:
Three GFRs, less than 60, in a three month period, may indicate kidney disease and further testing will be needed.
Remember when I-never mind. I just want you to know I was wrong. I projected all fifty states would eventually be caught up in this deceptive business of screwing us Vets over. The POGO votes are not all counted yet so maybe the rest (15) will turn green too. I have no doubt. Those VA computer viruses are lethal.
Today “almost” viral-free Randy from the mile-high stoner city of Denver sends us this important “Well, not exactly.” article that we are coming to associate with the VA medical community. Hepatologists from our favorite AO laboratory at the National Institutes of Health (NIH) are beginning to retreat from earlier ebullient claims and throw out decoy flares to distract us from the fact that SVR-even SVR after six months or a year- does not mean “true” SVR. It merely means the HCV is lying dormant again as it usually does-hiding in this or that organ. Or, it is a reinfection. Or….”‘It’s Baaaaaaaack!” and no one knows why but make sure you notify your local Health Department so they can publish your name (again) in the ‘recently diagnosed with STDs’ BOLO newspaper release.
Randy and I discussed this yesterday afternoon. He’s using the VA pharmacy and they disburse their Sovaldi in 14-pill, two-week increments so you won’t go out and resell it on the black market. Same for the Ribavirin. No, fellow Veterans. We won’t descend into an orgy of laughter and guffaws over this. Their logic is already well into the Twilight Zone. I merely mention this because they (VA) seem to also have trouble counting. Again, hold the Captain Obvious award. I’m not referring to scheduling practices in Phoenix. I’m referring to much smaller numbers emanating from their laboratory sleuthing.
Randy called to announce his recent reduction in perceived bugs per-square-inch of blood. Seems the stoned folks down at the lab need the services of the Sesame Street Count as they are unable to venture past the number of fingers and toes born with. Their initial number two humans and one extra hand (forty five) but after a quicky do-over, they discovered it was actually two guys and seven fingers (twenty seven). 45-27= 18. 18 is not a rounding error. 18 is not close as in horseshoes, M-26s and Claymores. In science land, 18 is a gaping chasm. Apparently at the VA, it’s no big deal. Au contraire, ma cher. To us hoping for the Holy Grail of SVR, being off by 18 bugs is the difference of getting stung again inside a supposedly screened-in environment after a heapin’ helpin’ of OFF bug repellent.
Randy and I, being HCV rocket scientists with big long strings of impressive-looking capitalized letters after our names, opined that it may be impossible to scare all them critters out in such short order. Have you ever gone grouse hunting and flushed a covey out off the edge of a forest? There’s always that one bird who hesitates and the dogs almost run over him after you’ve flushed them and shot. Only then does he make his presence known. And much like the reemergence of HCV, it scares the living shit out of you. We theorized that these rogue grouse viral cells can hide out in your organs. Hell, we know they love our livers. They’re like little PACMAN critters running around munching it up. Endemic evidence over time has revealed their presence in our brains and even the thyroid gland. Considering the x rays of my kidneys look like the Shenandoah Caves’ stalactites, I’d say they hang around there on spring break as well.
When the Practitioners of Medicine read the blood results from the lab, they are looking at the number floating in free liquid (your blood). If you’re running around with a Franchi SPAS 12 gauge and a 20-round drum magazine full of Sovaldi buckshot hosing these viruses, it stands to reason a few could hole up in the recesses of the body to avoid the slaughter. They’re smart enough to mutate ever so slightly to disguise themselves from your white blood cells so it is plausible. After 44 years with HBV, then HCV and now AIH, nothing would surprise me. One thing is certain. It’s freaking out the scientists enough that they’re actually thinking about trying to get to the bottom of it. As usual, the immediate panacea is: Take protein pill. Put helmet on; use protection when having sex, do not share toothbrushes/razors/coke straws and avoid intravenous drug use. Yo, Gendarmes. Round up the usual suspects tout de suite.
I feel like I’m in the right place at the right time for once in my life. Mark went down from one million to 15 BSI (bugs per square inch) after four weeks and then bingo at six. Randy went from 2 million copies to 27, assuming we trust that latest VA estimate for the last four weeks. Next week I find out my initial number as well. I was starting from a lower number of 448,000 BSI. My autoimmune disorder manufactures a lot of white blood cells (WBC) which ‘hunt’ for viruses. Unfortunately, their aim is less than perfect and they incur collateral damage when they miss and hit the liver. I’m glad I’m using a civilian lab. They rarely call back and say the bugcounter doomoflotchie wasn’t calibrated correctly.
Medical science re HCV is in such flux now that the Grand Poohbahs of the Art cannot even present a unified front on how to attack it. I hear several schools of thought coming from different sources that queers me to the idea any of them even knows what they are about. One school of thought from the pharmacy who supplies me is “Do they still have you on the Ribavirin?” Remember, this is the beginning of the second month-not three or four later. If the pill salesman is amazed you’re still on it, it implies some of us are not. It also means they’re partially amazed you made it to the phone and answered it coherently before it went onto the answering machine.
Next, I am becoming anemic. Not just a little anemic but a lot. The monogram on Ribavirin says “May cause anemia”. My Sovaldi minder (Mariah) at the doctor’s office called last Friday and said “Hmmmmm. Seems your getting a leettle anemic. I wonder what’s causing that? Let’s try something here. I want you to take one less Ribavirin a day henceforth. That would be four tablets instead of five a day. Can you remember that or should I send you a letter?” Wowser. Where did you park the ambulance, Dr. House?
Add in that they are perfectly aware, or should I couch it in VA terms and say “They are in constructive possession”, of the knowledge I get a phlebotomy of 800 ml (one pint) every month which, the last time I checked, is the speediest way short of slitting your wrists to attain perfect anemia. No one has suggested I refrain so I didn’t. I almost can’t wait to see the horrified looks next week over the realization that my Red Blood Cells (RBC) are going to be in the subbasement. Screw it. I want the BSI in the cellar. We have the technology to increase the RBC. That’s the very least of my worries right now. Besides, it gives me a bodacious buzz when I tie my shoelaces and stand up. It’s like a 30-second LSD trip where everything takes on that paisley look with a pink tint. Relax. It’s an anemia thing. You wouldn’t understand.
Today’s blog is brought to you by the numbers 2 and 7. In VAspeak, that’s all your fingers and toes, your four appendages and your ears and nose. Do not employ the bilateral factor when adding or this won’t work. Do not round up or down, either.
+
asknod
Bethanie Spangenberg
kcraveiro
robinhoodesqvetsatty
Wesley McCauley
Veterans Claims Help 