VA examiners should ask patients about their multi-dose vial HCV risk exposure to meet today’s best practices and standards of care

doc chartSoon private physicians must make basic improvements in their practices. If they deliver haphazard care, they can face penalties.  If they follow evidence-based practices, they can be rewarded. Therefore, professional medical associations are creating learning modules, called Practice in Improvement, or PIMs.  The Hepatitis C Chart Questions was published by the American Board of Internal Medicine (2011). Some kind soul uploaded it online (read in full screen).  

#54 Question Text:  Identification of Risk Factors/Transmission Mode

Docs should ask about exposure to  #3  Unsafe therapeutic injections (e.g. cross-contamination from reused needles or syringes, multiple-use medication vials)?

Boot camp jet-injector vaccinations have multi-dose vials so the answer is yes.  It’s not too late to update your medical records in writing for your private physician, VA doc, C & P examiner ect..,because this is an authoritative source.  It’s not “internet junk” as the BVA likes to call submissions.

I’ve had a tough time getting the slides into a printable format but try this: hcv multi-dose vial presentation pdf .

Powerpoint slides for download: HCV Questions Presentation in ppt format. No Office? Download the free Microsoft Powerpoint Viewer and open it within the program after installation.

Posted in Guest authors, HCV Health, HCV Risks (documented), Jetgun Claims evidence | Tagged , , , , , , , , , , , , , | 1 Comment

Will your VA Medical Center’s quality-of-care data be posted on Medicare’s site soon?

West Haven VAIt appears as if medical consumers will be able to see how VA hospitals stack up against each other and private hospitals in their region on Medicare’s Hospital Compare web tool in the future.

Background 

“In November 2001, HHS announced the Quality Initiative to assure quality health care for all Americans through accountability and public disclosure. The Initiative is intended to (a) empower consumers with quality of care information to make more informed decisions about their health care, and (b) encourage providers and clinicians to improve the quality of health care.”

I’ve emailed Medicare to find out why the VA’s data has been “suppressed for one or more quarters by CMS” according to footnotes.  Will update this post when I hear back. In the meantime, many private hospitals have selected data online now.  (You can also compare physicians, nursing homes, home health and dialysis providers too.)

Posted in Guest authors, VA Health Care, VA Medical Mysteries Explained, vA news | Tagged , , , , , , , , , | 1 Comment

VETERAN’S SPONGEBOB TOMBSTONE REMOVED

c5aa8b6080d1dc23400f6a7067006f8eI spotted this in the AM papers and it crushed me for many reasons. Kimberly Walker had one big love in life-Spongebob. She carried this to the grave after her murder by a fellow soldier in Colorado earlier this year on-of all days- Valentine’s. It gives a whole new meaning to a Saint Valentine’s day massacre.

After a vetting by cemetery personnel, her family’s request to have her interred with her signature Spongebob Squarepants headstone was approved. Suddenly, months later, the same cemetery hierarchy revoked their approval and summarily removed the headstone as well as a similar one planned for her twin sister who still serves in the Navy.

This is a classic example of political correctness run amuck. Obviously some tortured soul who came to mourn his or her relative was incensed that anyone (alive or dead) would inject humor into death and try to uplift fellow mourners’ depression. Hell, I’m just upset that someone planted the flag before I got there. If they’d let me have a Yosemite Sam headstone in  ANC, I’d be in high cotton.

All I can take away from this is that some who are on this side of the grass are a humorless cadre or that the cemetery folks in Ohio have absolutely no respect for Veterans. If we can’t take something of ourselves to our ultimate resting spot without raising the ire of those who dictate Groupthink, then perhaps fighting for America’s freedom is a hollow concept and an unworthy endeavour.

My heart goes out to her sister and family. No amount of apology, excuses and remuneration will ever make this one right. The appropriate response would be remorse, sackcloth/ashes on the forehead and rescinding the order posthaste. A prompt return of the icon is in order and to have it reinstalled promptly. I’d give them a bye on full military honors for the reinterment.

This last summer, my wife and I journeyed back to the Hugfest 2013 celebration held at Magnet, Indiana. I had the honor of now knowing where a pilot and friend was buried and made plans to visit his grave site in Winchester, Indiana. We made one error of judgement. We arrived on a Sunday and there was no one available to direct us to his burial site at Fountain Lawn Cemetery. After scrambling for several hours, we finally found the groundskeeper who aided us and located it. In the intervening two or so hours, we scoured thousands of headstones in the cemetery looking futilely for his. During this search, I came across a grieving mother who was sitting on a lawn chair “visiting” her  son who had recently perished in Afghanistan. She had his Teddy Bear and a pack of his favorite smokes in front of his headstone. When she discovered what Cupcake and I were looking for, she abruptly dropped her Sunday morning plans and began earnestly searching with us. While this has no direct comparison to what the grieving Walker family is going through, it amply demonstrates the closeness all Veterans families feel for each other and the common bond we share.

This is why I plucked this from the news to share with you. We are an elite 7% of America. It is a club closed to most if they choose not to join it early in life. One cannot put it on the Bucket List to do before one passes. It can not be added to a calendar to do during a summer vacation. It’s not like going back to college and getting that degree you put on hold in 1975. Once the boat sails, it’s gone. All the well-meaning soliloquies later on in life about “You know I came this close to signing up for the Army in 80 but there were more pressing issues I had to address.”, ring hollow.

Kimberly Walker stands tall because she had what I call “Veteran’s humor”-that irrepressible desire to express herself without worries of how others might perceive her. That her family saw fit to fulfill her wishes, and indeed, her sister following suit with a similar headstone, is testimony to why we are unique. The irreverent actions of the cemetery personnel to circumvent her and her family’s wishes is egregious beyond words. To perpetrate this abomination on a Veterans is beyond words.

Hugfest 2013 Indiana 024

Posted in Inspirational Veterans | Tagged , , , , , , , , , , , | 1 Comment

New: North Dakota updates Hepatitis C (HCV) outbreak to 28 infections

nd

Bad HCV trouble in ND

These news stories are so discouraging.  The new HCV cluster in ND may be another possible healthcare associated infection.  A Minot nursing home investigation is being studied according to one report.

State Updates Info on Hepatitis C Outbreak

BISMARCK, ND – On October 17, 2013, the North Dakota Department of Health received confirmation from the Centers for Disease Control and Prevention (CDC) that testing had been completed on blood samples from additional individuals in the hepatitis C outbreak investigation in Ward County. The CDC has confirmed that 21 additional cases are related to the seven cases that had previously been identified, bringing the total number of related cases to 28. In addition, as the investigation progresses more people will likely be tested. 

According to Tracy Miller, State Epidemiologist with the North Dakota Department of Health, the state is receiving assistance in this investigation from the Centers for Disease Control and Prevention. CDC personnel are in Minot to assist state investigators. As this investigation proceeds, the Department of Health will continue to provide updates to the public as to the course of the investigation.

I’m sure we’ll be hearing more about this in the weeks ahead as further test results are revealed.  In 2010, North Dakota had a population of  672,591.  Some airman reading this may have been on duty at Minot Air Force Base.

“There were 48 cases of chronic hepatitis B, zero cases of acute hepatitis B, zero cases of acute hepatitis A and 543 cases of hepatitis C reported in North Dakota in 2011.”

The Twitter account is here: https://twitter.com/NDDOH

Posted in Guest authors, HCV Health, HCV Risks (documented), Medical News | Tagged , , , , , , , , , , , , , , | Leave a comment

IF YOU CAN’T BE / AT THE ANC…

googletrek011382296151Member Frank of maple syrup fame sends us this vignette. What a wonderful way to enjoy the National Cemetery if you find yourself on the other side of the country. Lucky me. I have a spot all picked out there by virtue of my father having been interred there, too. It’s about the only benefit I’ve ever received by riding on someone else’s coattails. What the hey. I suppose I get to be planked there by virtue of it being my birthplace, too, but it’s nice to have insurance. One of these days they’re going to put up the ugly sign that says “No Mo’ Vacancy”. 

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VA’s Medical Foster Homes (MFH) Program

VET_D_20100412103449

WSJ photo WWII vet in
MFH

Losing one’s independence due to disability is costly in many ways.  No one wants to end up in a nursing home and eating poor quality food.  The idea of living with strangers seems unpleasant but many aged are alone in this world when they need more help. Caregiving is hard work. But the pay is decent if caring for the maximum allowed 3 vets.  It should attract good people to this private-public partnership.

The VA can pay for nursing home care for service-connected disabilities or partially for Medical Foster Homes.  This 2010 Wall Street Journal article, is favorable for reasons the title makes clear:  Happier Vets, Lower Costs

The home is one of hundreds across the country that take in veterans who can’t care for themselves, but don’t want to live in an institution. The vets pay the foster family’s expenses, while the VA covers the costs of regular visits from health-care providers, such as nurses, therapists and dietitians. The result is dramatically lower costs—the VA pays just about $52 a day for patients in foster homes, compared with an average of $469 for those in nursing homes.

Slides from Denver put the VA’s cost at around $1,500 per month including health visits.  Priorty 1A vets are used in the cost estimates towards the end.   I would keep an open mind about this option in case one can no longer age in one’s own home and you want to pay for a private room.  (Some vets share a room and use the VA’s telehealth services–NYT.)

VSO’s often get involved.  Here is the American Legions fact sheet.  The DAV estimates taxpayer savings of 1 million dollars every 12 days.  With such huge savings to the taxpayers, I’m sure this program will continue to expand to all 50 states.

The Official VA Handbook 1141.02  is here.

 

Posted in Guest authors, VA Health Care, VA Medical Mysteries Explained | Tagged , , , , , , , , , | Leave a comment

BVA–THIRD QUARTER DECISIONS ARE UP

safe_imageThe third quarter release of BVA decisions are out as of this morning. Someone must be working overtime. We had hoped to see them by August 30th but we all know that the BVA is backed up and constipated just as badly as the rest of it’s parent VBA organization. 

Hopefully, those of you who study HCV decisions will spot some daisies that have import with jetgun claims. I, for one, will be perusing them heavily for that alone. Onward through the Fog.

download

Posted in BvA Decisions, BvA HCV decisions, Jetgun BvA Decisions, Jetgun Claims evidence | Tagged , , , , , , , , , , , , | Leave a comment

SUNDAY FUNNYFACE PAGE

564080_10151920125960700_500815409_nSpotted on Deb Zuckewise’ Face page this morning. I love it. Seems we’re just “in the news” these days on GMO Initiative 522 , left-handed tobacco and anything else the somnolent drive-by media can pick up on that doesn’t require getting out of the news van for. One thing is evident. Vets are gradually becoming a dinner table conversation topic in more and more households. This is one reason why I still enjoy the newspaper. It isn’t filled with the breathless, vapid, monosyllabic chatter of verbally challenged newsies. 

Posted in FACE HUMOR | Tagged , , , , , , , , | 2 Comments

$47,000 mechanical bull for Utah National Guard?

AMVETS National Exec­u­tive Direc­tor Stew­art Hickey was ticked off.

While the Depart­ment of Defense has money to call 350,000 employ­ees back to work, and buy a $47,000 mechan­i­cal bull, they don’t have the fund­ing for our fallen fam­i­lies…. This is such a trav­esty that I am barely able to remain civil when I think about it.

bull

Me ride bull. Me cool.

Can this be true? Yup!  From the GSA (see left menu):

Sept. 4--The National Guard – Utah requires the following items, Brand Name or Equal, to the following:

LI 001: We are seeking purchase Mechanical Bull Sales bull which needs to be durable & low maintenance. Seeking brand name or equal see attached specifications.

Oct. 7 (Day 7 of shutdown)–Contract Award Dollar Amount: $47,174.00

MECHANICAL BULL SALES, INC [DUNS: 782182203],220 Region Court,State College PA 16801

Oct. 10 (after publicity) Cancelled. 

This was an Army contract. Someone’s fury made a difference–for now.

Posted in Complaints Department, Guest authors | Tagged , , , , , , , , , , , , , | 2 Comments

The big GI bill carrot, student veterans, and the shutdown

carrot

Congress to post 9/11 vets
We promise you can go to college after Iraq/AF.

Who are these veterans? Student Veterans of America (SVA) have a few facts up on their website.  They note that 47% have families, 85% are older than 25, and 27% are female.  My DS (dear son) is in the first two statistics and he is one of thousands who receives post 9/11 GI bill benefits. Because the GI bill hotline was shut down, SVA and VFW stepped up and answered student veterans’ questions via email.  The message for student vets was not good:

VA Secretary Eric Shinseki confirmed this week that living stipends and other benefit payments for nearly one million currently-enrolled student-veterans could be cut off if Congress fails to resolve the government shutdown by Nov. 1.

Wounded Warriers pledged 20 million dollars, or $500 each to about 40,000 veterans who would miss their Nov. 1 payment.  With the shutdown ended, they are reallocating this money back to their programs.

When these young people joined the military, they faced getting beheaded and other atrocities in the middle east. To have certain Congressman vote to abruptly end the program they really need and value-a college education–and a financial stipend rug out from under them, mid-term, is deeply shameful to me. The Washington Post’s infographs “Faces of the Fallen” is a poignant reminder that  6,735 U.S. service members have died in Operation Iraqi Freedom and Operation Enduring Freedom.  The Army and Marines lost the most of America’s finest. God bless them all.

The GI Facebook page is back up, “We’re back!”

https://twitter.com/VAVetBenefits

Posted in Guest authors, Gulf War Issues, Veterans Law, VR&E | Tagged , , , , , , , , , , , , , | 6 Comments