Helping Homeland Security Agents

Posted on January 27, 2012 by asknod

While hiking down along the border this morning, I saw a Muslim extremist fall into the Rio Grande River . He was struggling to stay afloat because of all the guns and bombs he was carrying. Along with him was a Mexican who was also struggling to stay afloat because of the large backpack of drugs that was strapped to his back. If they didn’t get help, they’d surely drown. Being a responsible Texan and abiding by the law to help those in distress, I informed the El Paso County Sheriff ‘s Office and Homeland Security. It is now 4 PM, both have drowned, and neither authority has responded. I’m starting to think I wasted two stamps.

Makes me proud to be an American knowing guys like this can get over the animus of a terrorist or drug smuggler and worry about their well-being.

Posted in Humor, Uncategorized | Tagged , | Leave a comment

Hunting and Poll Taxes

Posted on January 26, 2012 by asknod

Seem incongruous? How, you ask yourself, can I conjoin two such disparate concepts into one diatribe considering one went out with whites only water fountains? Pull up some grass and have a seat as my daddy used to say.

I was born and raised in the south and by rights should be a dyed in the wool racist. The fact that I am not is due to my father. He wasn’t born there and thus was not imbued with all the hate and ill feelings associated with the aftermath of the War of Northern Aggression. Having said that, I will point out that the animus was palpable in everyone and everything there. One of my early memories (1956) was going to the movies in Albany, Georgia to see Cinderella. Dad was stationed at Turner AFB and was the 31st  Wing Commander. The theatre  was on Main Street and, as was the practice then, there was a water fountain there.  The sign above it said “Whites only”. Albany is hot most days. I asked my mother why that was. She dissembled and said it was simply the way things were. No long dissertation on the Civil War and emancipation. No diatribe that these southern Neanderthals were remnants from the stone age of common sense. Nothing.

Dad was the 4th Wing Commander in Goldsboro, N.C. in 1962 at Seymour Johnson AFB. He stopped by the Sheriff’s office to pick up a key to some acreage we dove hunted on. The Sheriff owned it and let us use it. It was fun going to the jail. If I’d been misbehaving, the sheriff would take me back to the lockup and show me my future fate if I didn’t eat my brussels sprouts.

One September afternoon we arrived and an older black man was there sitting across from the Sheriff. He winked at my dad, which I thought was weird, and said he’d be with us in a minute. What happened next was indelibly printed on my mind for life. I had no idea what the significance was but knew it was a watershed moment.

The black denizen was there to pay his poll tax and prove he was literate. This would entitle him to vote in the upcoming  Presidential election. The Sheriff told him to hold up on the tax money and asked him to read a newspaper he had pulled out of his top desk drawer. ” Here, Denny. Read this. What does it say?”  The newspaper was printed in Chinese characters or possibly Japanese. I wasn’t educated enough then to know the difference, but I knew something wrong was happening.

Denny said ” Well, Sheriff. I’ll tell you what that says. It says I ain’t gonna be votin’ in this election is what it says. I’se might sorry I bothered you folks today.” The Sheriff allowed as Denny was welcome there any old time, and if he somehow became literate in Chinese some day, well, he’d be eligible to vote then. On the way to hunt, I asked my father why you needed to be literate in Chinese to vote. My dad proceeded to enlighten me on southern politics in general and racism in particular. He said we were fortunate that it had been banned in the military and that some day it would be the norm everywhere. This was food for thought on the order of a 10 course dinner to me.

Martin Luther King had not spoken his famous line about how the content of your character far outweighed the color of your skin yet. As a matter of course, blacks would continue to be effectively discriminated against for many more years. I was 11 years old then and had no inkling there was a color line, even though there were no black students in my school. I knew that they often got out of line ahead of us at the local Piggly Wiggley Supermarket on the rare occasions my mother shopped off base. It seemed they had forgotten something and had to leave the line to go get it.  It didn’t dawn on me that it was a perennial response every time we shopped locally.

When I was 17,  my father was  stationed in Sumter, S.C. at Shaw AFB. By now I knew there were “rules” and blacks crossed them at the risk of whites’ approbation-or worse. One of my friends’ dad owned a gas station/liquor store off base. This was a good friend to have, too, I might add. That’s where we got our  94 proof Orange Julius pints on Friday nights for the drive-in. They employed a black man to pump gas and clean the store. We were leaving and heading into town one evening and the young man was walking on the side of the road in the same direction. I pulled over and we offered him a ride. He was absolutely and completely terrified of the idea. We finally induced him into riding in the back back of the old Ford station wagon in the seat that faced backwards. As we drove I happened to look in the rear view and discovered he was slumped down out of sight in the seat. We dropped him off several hundred yards before his street because he didn’t want his folks to think he was “uppity”. That was a concept I hadn’t even considered.

I don’t live in the south anymore, but go back to visit with relatives fairly regularly-or did before I became ill. The same thing happens to this day in the Northern Neck of  Virginia. A young black lady stepped out of line at the five and dime when I went in to get something. She looked in her basket and fretted that she must be absent-minded to have forgotten whatever it was. The white shopkeeper gave her that  patronizing smile and nod of approval for her “politeness” in letting a white person go first.  Bad habits die hard…

Posted in All about Veterans, General Messages, Uncategorized | Tagged | 3 Comments

BIANNUAL HEPATOLOGY VISIT

Posted on January 25, 2012 by asknod

VA PACT

Employing the latest Patient-Aligned Care Team (PACT) model, I attended my first hepatology appointment  Monday. I could see no apparent difference other than the two ladies who greeted me at the Blue team check-in desk. They sat and did nothing while I waited for several minutes and finally one looked over at the other and then at me. Only then did I get the magic “Next?” I guess they were playing Not it! and seeing who would blink first. And yes- I did turn off my invisibility-cloaking device before I walked in.

My appointment was for 0800 so I reasoned that it was the first of the day. No one else was even in the waiting room. Nevertheless, I still had to do penance for 30 minutes. Everyone knows this. We are asked to arrive 15 minutes early. I refuse to play that game any more. If I had, I could have sat there for 45 minutes.

Finally my ARNP came out and invited me back. This is part of the new “hands on program”. The doctor or poohbah you are seeing personally fetches you. That was the high point of the visit. Everything went downhill from there. Irene (name changed to protect incompetence) has decided I need a new liver biopsy. The last one is 3 years old and apparently out of date. VA wants to know if the HCV is winning or the autoimmune hepatitis is ahead. Who cares? They can’t do anything about it because I’m 1) not a candidate for IFN Tx and 2) not a candidate for a new liver. Irene asked me “Well, jez. Don’t you even want to know? Aren’t you just a little bit concerned? My answers were “No” and “No” respectively.

Having little or no medical training, but being well-versed in the art of internet parsing for knowledge, I countered with the usual. “Do an Anti-Nuclear Antibodies test and and an Anti-Smooth Muscle antibodies test, honey. Also an alphafetoprotein test or whatever its called. This will tell you if the AIH  has highjacked the liver. A viral load test will also tell as much if those numbers are elevated. Also run the normal LFTs and IgA, IgG, and IgM test to see if the cryoglobulinemia is up.  As for another biopsy, I have no interest in getting a new shelf life sticker. It won’t change anything.” Her rejoinder was icy. “Mr. Nod, this could advance medical science on autoimmune disorders”. My parting shot was equally cold. “Fine. If you get there before the cremation, ask them to put the liver in one of those styrofoam doomoflotchies to go. Check with the wife on that, though. You guys pissed her off when you almost killed me in 09”. She’s not the biggest fan of VA medicine anymore.

The last time I saw Irene in August, I couldn’t even get her to run a viral load to check out the AIH. Now she wants to irritate what’s left of the liverbox with a core needle biopsy. Huh? Three quarters of it is non-functional and they want to scramble another egg in there? I’m on Coumadin blood thinner because they gave me a heart attack for Halloween 09. I have no desire to be taken off that to do the biopsy.

The last straw was the admonition that if the AIH was in the active mode, she wanted to put me on Imuran again. That’s also known as Azothiaprine-aka cancer causing. This would just throw a new monkey wrench in on top of the other lethal medical processes at work. When I  indicated that I had no desire to add cancer to my problem list, she reluctantly acknowledged  that maybe it wasn’t a good idea. PCT is almost a guarantee of Hepatocellular Carcinoma in conjunction with HCV. She’s not an MD, but would like to opine as one. She also tells me the doctor who supervises me looks over all this. I’ve never met this phantom doctor. I’m too polite to call bullshit on her.

Since Irene refused my request for phlebotomies for my PCT in August, I didn’t bother to enlighten her and explain that I’d sought out my old PCT doctor and got him to write the scrip. I’ve been getting them for 6 months now and the hematocrit is finally going down. Irene probably thinks its due to Immaculate Intervention.

Anyone using the VA as their primary medical provider should start studying medicine-and soon. You’ll  live longer. This may not be the norm at all VAMCs , but it is cause for concern. VA loves to experiment on us. I know that from experience. They do things that may harm us to see if it “fixes” things or simply makes them worse. I would make an analogy to pulling the wings off of flies to see if it impairs their aerial capabilities. VA’s take is “Well, you don’t know that ahead of time without trying it, smartypants. After all, I’m the doctor here and I have more experience.”  I went into the VAMC in 09 for a  surgery that turned into 3 more. What no one noticed was that they left me on the prednisone they were treating me with for the AIH. They took me off the Imuran, but left the other in place. The nurses dutifully administered dose after dose every day for a year. I was so toasted on Dilaudid I didn’t notice. When I escaped in 2010, someone did notice and I was surreptitiously weaned off it with not another word said. This is why my staples and stitches kept falling apart and caused the peritonitis.  After the fourth surgery (to correct the “medical misadventure” in the third one). the surgeon said “Well, duh! Here’s your problem. The prednisone was weakening the fabric of your tissue. Everyone knows that.” This would be the same surgeon who did the first, third and fourth surgeries.

Do not let VA play doctor on you. Remember the childhood game “Operation”? It has new resonance where this is concerned. I will give Irene credit for one thing. She didn’t try to put me on the new Vertex IFN treatment this time. I think she read her old notes on it and bit her tongue in time.

One last thing. Does anyone think it odd that a person trying to ascertain your health would wait until you arrive to then order lab tests?  I do. I built houses for 35 years and like to work from a position of knowledge and strength. I liken this to building with no blueprints. PACT? Physicians Absolutely Confused and Tactless…

 

Posted in All about Veterans, General Messages, HCV Health, Uncategorized | Tagged , , , , , , | 6 Comments

Dupont Spinners

Posted on January 24, 2012 by asknod

When I first arrived at Udorn Thani Royal Thai Air base in May 1970, my chaperone Ron (NLN) introduced me into how to make extra money. Nobody kept track of M-26s.  Why would you? Hand grenades were a dime a dozen and we sure weren’t paying for them.

Ron was an entrepreneur of the first order and naturally found a way to make money off anything. He was the squadron scrounger-a modern day Radar O’Reilly. He was the squadron orderly and knew where all the bodies were buried.  He collected the styrofoam containers for MK-82s and sold them to the local fishermen for disposable boats. For you who are not bomb aficionados,  an Mk-82 was an iron bomb of several different sizes, the most common a 500 or 750 lb. version. They were shipped in huge styrofoam wraparounds with the two pieces conforming to the shape of the bomb. Naturally they were hollowed out in a perfect curve and would support a small-statured oriental. They were supposed to be returned to the port at Sattahip for reuse. “Supposed to” is the inoperable verb here.

Enter the M-26. They were made by  E.I. Dupont Nemours and Company of Wilmington, Delaware fame. They’ve been making hand grenades for several wars and are getting quite proficient in it. Ron was quite a fisherman and had used dynamite down in Alabama as any lazy fisherman has. He called the M-26 a Dupont spinner, named after his favorite Mepps spinner. We caught a Baht bus up  to Nong Khai which was the border crossing into Laos. This is the Mighty Mea Kong River like our Mississippi. We were graciously greeted with many bows and the hand grenades were fondled and pointed to.  The local Buddist priest was called out to drive the Phee (ghosts) away from the boats and the hand grenades. This cost 10 cents per boat and the same for hand grenades.

Ron argued the price with them because he’s a natural Milo Minderbinder. We arrived at 2,000 Baht ($20.00 U.S.) per person and a minimum of 6 hand grenades per person. They provided a “boat” and tied ours to theirs. Out we went.

When a fish experiences the detonation underwater, their flotation bladder decompresses and they tend to do the chicken. They generally float to the surface and the fishermen scoop them up in nets before they recover. Twelve hand grenades nets an inordinately large amount of fish. We accomplished this in 3 hours and were rewarded with a liter of ice cold Singha beer each and several skewers of  roasted water buffalo. MMMM.Water buffalo are harvested where they keel over and die from old age, so you can imagine how tough that was. Soom tam from raw papayas with Kow neo sticky rice was included.  Desert was cow neo sakaiya (I don’t even want to know what it was). A good time was had by all and we did this on succeeding Sundays until someone blew the whistle.

Turning large quantities of Baht or MPC into greenbacks was the trick. I’ll save that for another story.

Posted in From the footlocker, General Messages, Humor, Uncategorized | Tagged | Leave a comment

BVA– THE VETERAN IS COMPETENT TO REPORT HIS DRUG HISTORY

Posted on January 24, 2012 by asknod

FROM FORT FUMBLE

 IN RENO

The last laugh has to be on Mr. Cronk and Dr. Snood. This is what happens when you set your febrile mind free to extrapolate all the myriad ways you can use pot and hash. Of course, IVDU immediately comes to mind and thus is born a drug addict from an occasional toker. Here, it backfired as the Vet is a credible witness and didn’t prevaricate. His story never waivered one bit and VA was forced to admit-through lack of evidence- that this ever happened. VA’s “fig newton” offense is  thus unmasked and the Vet wins.

The Veteran is competent to report his drug history.  
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).  
Moreover, the Veteran is credible in his reports. The
record reflects no clear first person statement that
he used IV drugs.  Where that allegation is made, it 
is done second hand, where another party has interpreted 
either a statement or a record.  The Veteran has offered
a reasonable explanation of the confusion, and the fact
that only one doctor has specified use of IV drugs raises
serious doubts as to the accuracy of the allegation. 
While the Veteran has used drugs in the past, such is 
limited to the smoking of marijuana and hash; there is no
credible and competent evidence of intravenous or 
intranasal (or any other) use of other drugs such as 
cocaine or heroin.

A good win just wouldn’t be complete without our erstwhile Doctor friend:

Dr. B. Cecil, associated with a hepatitis C treatment 
center, reviewed the Veteran's service records and current 
treatment records, and opined that the currently diagnosed
 hepatitis C and associated liver damage was related to 
service.  He noted that the Veteran had "no history of 
drug abuse or transfusion," and felt that the extent of 
current liver disease was "very suggestive" of a 1979 
infection.  Dr. Cecil also noted additional risk factors, 
including air gun injections, shared razors, and blood 
exposure during football games.

http://www.va.gov/vetapp11/Files4/1132255.txt

E.I. Dupont Nemours- when you care enough to serve the very best.
Posted in BvA Decisions, BvA HCV decisions, Nexus Information, Tips and Tricks | Tagged , , , , , , , | Leave a comment

BVA– NEW FORMAT ON CLAIMS?

Posted on January 24, 2012 by asknod

FROM THE BRANCH DAVIDIAN

RO CAPITOL IN TEXAS

OUR MOTTO?

BURN FIRST AND ASK

QUESTIONS LATER

 

Strolling through all the new releases of BVA decisions allows for little nuggets of info to be picked up. Here, I spotted a subtle new wrinkle to go with our new HCV medical form:

The record reveals that the Veteran submitted a claim of 
entitlement to service connection for hepatitis C.  As 
will be discussed further below, the medical evidence of 
record reflects that the Veteran was diagnosed with 
infectious hepatitis during service, and a January 2003
 letter from the Carter Blood Care Center reflects that 
the Veteran tested positive for hepatitis B core 
antibodies.  See a January 2003 letter from Carter Blood Care
 Center.  Concerning the Veteran's in-service diagnosis of 
hepatitis, the Board points out that hepatitis C was not 
diagnosed, nor could it have been, during the Veteran's 
service since hepatitis C was not specifically 
denominated as such until the 1980's.  Further, the 
United States Court of Appeals for Veterans Claims 
(the Court) has held in Clemons v. Shinseki, 23 Vet.
 App. 1 (2009), that when a claimant makes a claim,
 he is seeking service connection for symptoms 
regardless of how those symptoms are diagnosed or labeled.  
In light of above, the Board has recharacterized the 
issue as entitlement to service connection for a hepatic 
disorder.

I like this one, too. Vet loses job. Vet tells VA in Claim. VA “construes” it to mean he wants to file for TDIU. Vet has a 0% or No% rating so he isn’t qualified to receive this. VA knows that so why did they do it?

In an September 2007 statement, the Veteran asserted that 
he was "dismissed" from his job because of "medical 
reason."  See the Veteran's September 2007 statement.  
It appears that the RO construed this statement as a 
claim for TDIU.  See Roberson v. Principi, 251 F.3d 
1378, 1384 (Fed. Cir. 2001) (VA to "determine all 
potential claims raised by the evidence, applying all 
relevant laws and regulations").  Indeed, in a letter 
from the RO dated in November 2007, the RO notified the 
Veteran of the laws and regulations relating to TDIU 
claims and provided him a VA Form 21-8940 (Veteran's 
Application for Increased Compensation Based on Individual
 Unemployability) to complete.  Servello v. Derwinski, 
3 Vet. App. 196, 198-200 (1992).  However, it does not 
appear that the Veteran completed and/or submitted the 
VA Form 21-8940, and the RO did not adjudicate the Veteran's 
TDIU claim.

Even money says that if he did apply, they may have slapped him with a fraudulent claim! We’ll never know.

This old boy will live to fight another day.

http://www.va.gov/vetapp11/Files4/1132924.txt

Posted in BvA Decisions, BvA HCV decisions, Tips and Tricks | Tagged , , , , , , , , | 2 Comments

BVA– NO DIC FOR WIDOW

Posted on January 24, 2012 by asknod

FROM THE HORSE-TRADING

RO CAPITOL OF THE WORLD

I don’t know which is more painful – the idea of the BVA VLJ having to sign this decision or the widow conned into chasing this chimera with no hope of winning.

 I take no pleasure in bashing the VA. I find it unavailing and I’d be out of a blog if they ever started performing up to their own ideals. I commiserate with this poor widow that she will never attain DIC, but it simply wasn’t possible given the medical evidence that Mr. Bourbon was the guilty party. When you live that close to a man, I think you’d be able to discern a pattern of ETOH abuse over 30 or 40 years. To ignore it and mount a legal assault on VA for benefits is either the height of hypocracy or… the product of some extremely poor legal advice.

Were you or I to have consulted with a VA-approved attorney, he would have  asked VA  for the same file (the C-file) that contained all this nefarious information about our Resurrected Brother’s alcoholic liver. He would then have ascertained the futility of the endeavour and communicated as much to the widow. She, with this valuable knowledge, would apply for a pension if it paid more that SSI.

What happened is best described as tragic. Somehow, or some way, this poor widow woman was induced into filing a rainbow chase claim. The American Legion SO, were he properly trained, could have avoided this too. Somewhere along the line someone had to convince her this was the correct and lucrative path and perfectly legitimate. Assuming her age to be 78-82, she didn’t hatch this on her own. Perhaps she had a greedy daughter or son in law. It still should have stopped at the VSO for a long discussion of how they were going to win it.

Springing all this evidence into court and embarrassing his spouse is unprofessional. Nevertheless, this is what we see day in and day out. Blame it on the Vet if you must but don’t compound it with interest by dragging the widow through the mud. Due diligence would have revealed the predicate for the denial and the futility of an appeal.

http://www.va.gov/vetapp11/Files4/1133916.txt

From the footlocker:

Posted in BvA Decisions, BvA HCV decisions, From the footlocker | Tagged , , , , , , | Leave a comment

BVA–40 YEARS TO SC

Posted on January 24, 2012 by asknod

FROM THE MAPLE SYRUP

RO IN VERMONT

Imagine filing shortly after service for Hep because you came down with it a week after you got out. You know the dentist is responsible but VA treats you like a dolt and denies. Being young, dumb and underrepresented (by VSO), you are induced not to appeal.

Insert thirty years and then discover it has gotten worse and changed flavors. That’s what our Vet has discovered. To add insult to injury he went through two, count them, two DRO reviews with no luck. Finally the BVA adds it all up and comes to the right conclusion. Gee, the Vet wasn’t lying and there may be some substance to his contentions. VA calls them contentions because that’s how they view them. The theory can also be called “Guilty until proven innocent”.

The Vet has finally prevailed by amassing so much evidence that even  reasonable minds could only come to the conclusion it occurred in service. What  is disturbing is that the DRO couldn’t do this. After all, they are the best of the best at the RO and the senior raters. The refusal to grant in 2009 just proves the futility of trying to get anything out of these bozos once they throw the gauntlet down. Moving the claim to D.C. is prudent in the long run. Your decision will occur a year sooner and most with any legs will win.

The Veteran wisely collected “buddy letters” from all his friends and relatives to document this. His filing in 1972 although unappealed, was  more ammunition in his favor. He presented this well and was lucky the VA’s “nexus” was in his favor. It’s risky business to allow them to do this, but here it paid off.

http://www.va.gov/vetapp11/Files4/1134287.txt

Note the tail number starts with an “O”. That’s not a zero. The O designation (Obsolete) was the AF and the government’s way of taking the aircraft “off the books and transferring it to places it wasn’t supposed to be or to organizations who were not governmental. Even the military has rules. This one still has it’s AF insignia on it before transfer to the RLAF in 1968. These brand new Cessna 170Es  (O-1 E) were declared obsolete as soon as they were “born” and accepted by the AF.

Posted in BvA Decisions, BvA HCV decisions, Tips and Tricks | Tagged , , , , , , , , | 1 Comment

BVA–DM2= HCV

Posted on January 24, 2012 by asknod

Here is something Vets can take to the bank. Peel off the studies on HCV and DM2 and insert them into your claims. Then proceed to get it in nexus format. This is proof positive that HCV equal DM2. VA has denied this for years but this puts paid to the story. Read it closely and look up the studies to print and include in your claims. This is an instance where the evidence is overwhelmingly in your favor. The Vet wins on his hypertension claim as well even though it was far more tenuous.

In contrast, the file contains positive nexus opinion 
of September 2011, offered by a practicing hepatologist.  
The doctor cited numerous medical studies and provided 
additional medical information, but determined that he 
could not conclusively say that HCV was the proximate 
cause of the Veteran's diabetes.  He further observed that
 based on the preponderance of (specifically cited) evidence 
linking both HCV and cirrhosis with diabetes, it was his 
expert opinion that it was more likely than not that HCV 
and cirrhosis were either causally related to or chronically 
aggravated the Veteran's diabetes.


The Court has held that a medical article or treatise "can  
provide important support when combined with an opinion of 
a medical professional" if the medical article or treatise 
evidence discusses generic relationships with a degree of 
certainty such that, under the facts of a specific case, 
there is at least "plausible causality" based upon 
objective facts rather than on an unsubstantiated lay 
medical opinion.  Mattern v. West, 12 Vet. App. 222, 228 
(1999); see also Sacks v. West, 11 Vet. App. 314 (1998) 
and Wallin v. West, 11 Vet. App. 509 (1998).  Here, the 
studies cited by the hepatologist assisted him in 
providing a positive and adequately supported medical 
opinion in 2011.

The BVA has been good to us this year and even more so in this last quarter. Realization that something is amiss should be evident by now. If we have appealed 20,000+ denials of HCV at the ROs, how many were filed, lost and unappealed? Frightening to think. Using the 28% figure, I would assume somewhere in excess of 100,000 of us filed in 2010-2011.

We are rapidly becoming dinosaurs in this fight, so it behooves us to fight all the harder to win. With the BVA more inclined to actually read the appeal and use elementary logic, chances of a win go up daily.

http://www.va.gov/vetapp11/Files4/1138429.txt

Posted in BvA Decisions, BvA HCV decisions, HCV Health, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , , , | 1 Comment

BVA–ABSENT RISK FACTORS= JETGUNS

Posted on January 23, 2012 by asknod

Its nice to see these decisions as they are entirely too rare. Here, there simply isn’t any other risk. Try as they might, VA cannot hang this guy out to dry. I wonder if they are finally coming to rue the day they said it was biologically plausible…

http://www.va.gov/vetapp11/Files4/1140321.txt

I’m sure the AMLEG guys got this fellow’s photo on the wall in the trophy room. It’s probably the first HCV one, too.

Posted in BvA Decisions, BvA HCV decisions, Jetgun BvA Decisions, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , | Leave a comment