Cryoglobulinemia and HCV

Posted on November 13, 2011 by asknod

Cryoglobulinemia is a big word. My spell checker refuses to recognize it no matter how many times I add it to the dictionary. Such is life. I don’t know how many are afflicted with this disease but it seems to travel with HCV as frequently as PCT does.

Cryo, if you will permit me to abbreviate or shorten it, is a disease where the body seems to accumulate large amounts of Gamma globulin proteins that coagulate in the blood at lower temperatures. If you have ever suffered from this, the immediate effect is aching hands and feet in cold weather. The repair order is to get warm in a hurry. This causes even more pain until the protein doomoflotchies liquify like the butter you pour on your popcorn.

http://en.wikipedia.org/wiki/Cryoglobulinemia

As you can see, there are three distinct flavors of this from the Wikkie link. HCV sufferers seem to get the one with the high IgG version. This link calls it Type II or III, but I have seen them numbered differently depending on where the article was written  (i.e. England, Israel, etc.). While everyone has slightly different symptoms, the one I mentioned is the hallmark. Others sometimes complain of symptoms as far ranging as achy joints which is usually an indicator of Rheumatoid Arthritis or Fibromyalgia. When this is a factor, you will usually see a component of autoimmune disorder evidenced by a high Anti-nuclear antibody  (ANA) test and an elevated RA factor in the blood.

More than one member has asked me if I experience some (or all) of these symptoms. Yes and no. When I tried out for the Interferon audition in 2007, all hell broke loose. This was due in no small part to my underlying autoimmune disfunction. I didn’t have the panoply of diseases then that later showed up. Interferon is like throwing 100 gallons  130 octane Avgas on a  well-developed house fire. It takes it up several notches. If you suffer from any of the run of the mill autoimmune disorders such as Sjogren’s, Crohn’s, RA, UC or the like, Interferon will be your worst enemy. Chances are if you don’t have Cryo yet, you will after starting treatment. Some can tolerate the harsh effects of the IFN treatment for a while, but ultimately it will ramp up the immune system to attack everything in your body, including your liver. This is called autoimmune hepatitis and will accelerate the HCV disease process exponentially. You will see viral load counts higher than any of your previous best. I jumped from 27,000 to 8.5 million in less than seven months and it took several years to get it back down. All that from just one dose of the rat piss. ANA tests are measured like the doubling cube in a backgammon game-i.e. 2,4,8,16,32,64, 128 etc. They start at 1:40 and proceed up the same exponential ladder. Hence the next is 1:80 followed by 1:160 and so on. I hit 1:2510 and I was one sick doggie. There is probably no way to describe how you feel so I won’t try.

The testing process for Cryo is very unique. You have to go to a hospital with a laboratory for this. They heat up a test tube to keep your blood warm and keep the vial in a bath of heated water while they prepare the sample for testing. My tests revealed a reading of 3910 micrograms per whatever  which is way up there. I suspect normal is more like 40. You’ll know if its elevated if you go outside when its less than 50 degrees. Your hands generally turn white because no blood can enter the extremities. When you reenter a warm, heated area the agony is indescribable. The pain subsides gradually as the cryoglobins dissolve or liquify.

While I can’t swear to it medically, the high IgG rate seems to provoke cognitive issues. It may be a brain fart or simply old age, but it seems worse when the levels are running high. The good news is phlebotomies. They tend to reduce this to a manageable level where the symptoms are not so pronounced.  Talking your doctor into a regular phlebotomy regimen is going to be a challenge. There is actually nothing deleterious about it, but you have to remember that doctors in the 17th, 18th and even the 19th centuries regularly engaged in the practice of bloodletting and using leeches. We’ve come a long way- perhaps too far. Doctors are so staid in their ways , they look at this as quackery from the dark ages and refuse to entertain it. Nevertheless, there seems to be some correlation between the two.

Absent a really good automobile accident with a resultant high loss of blood requiring a transfusion, you will never get to experience a reduction in IgG. Discussing this with doctors is recommended , but arm yourselves with the facts before you go in. Most gastrodocs are not well-versed in hepatology unless they opt to specialize in it. Don’t get me wrong. They go through the normal classes in med school touching on the ill effects of hepatitis on the liver, but mostly with the more common HAV and HBV scenarios. HCV is usually referred to specialists in that specific area of expertise.

Hepatologists are a unique breed. They all have that cattle drive mentality towards the different treatment protocols involving the menu of IFN and Ribavirin. With the addition of  Telepravir and Bocepravir to the appetizer list, they simply have more options. They rarely think outside the box and look at other procedures that may have a beneficial effect on your well-being. This phlebotomy thing would never have arisen absent my PCT. The resultant beneficial effects from it also would never have surfaced unless I had a baseline of horrible health to measure it against. The difference in how I feel is definitely a night and day proposition.

If you have HCV and haven’t been tested for the IgA, IgG and IgM group of globulins, you might politely ask your doctor where he got his diploma. I would point out that you do not necessarily have to have an autoimmune disorder to have this nor have gone through Ifn therapy. Some only need the risk of HCV to provoke this animal.

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AMERICORPS FOR VETS

Posted on November 12, 2011 by asknod

This morning’s paper held this nugget. Allow me to do my Evelyn Wood speed reading trick and summarize this in a few short sentences from the pound of newsprint and ink. Apparently in a photo opportunity for Veterans, the Public Lands  Commissioner of Washington State  has started a program exclusively for Vets. In an amazing coincidence, this program was inaugurated just yesterday and incidentally happened to correspond with (taa-daa) Veterans Day!  Mr. Goldmark, who probably gets a six figure salary, has hired six (count them) young Vets to do landscaping along a river in Tacoma. He feels this is a “good fit” for Vets coming back from a war zone like Iraq or Afghanistan. It allows them to commune with nature,  enjoy a low stress environment, gives them solitude if needed and makes them feel empowered because they are working. Win-win situation, right?

Back up, Gilligan. Untie the ropes first. Ryan P. is a 27 year old who was a former E-4 who recently finished an 18 month tour in Iraq. As an E-4, Ryan was waking up every morning to $25, 531.00 a year tax free in a war zone (if they still consider Iraq to be one). He is now working for AmeriCorps for minimum wage. In the enlightened Utopia of Washington (state), the going rate is currently $8.67 which is higher than the federal minimum of $7.25. The $1.32/hour difference is the Grief Tax visited on private enterprise here to “level the playing field” for the poor man.This will yield our new landscape technician $69.36 a day for $346.80 a week. This translates out to $18,037.60 before Uncle Harry and Aunt Nancy take out a little for this and that. Oh, and let’s not forget the Social Security contribution which is mandatory. Ryan is going to be “income challenged” as they say for a while. In fact, if Ryan is married with children, his wife is going to need a job to help supplement this financial shortfall. The need for ensuing Day care will make more inroads in their income but will reduce unemployment by creating day care jobs. Once again, this is a win-win for everyone.

This new cadre of six intrepid Veterans “is fueled by a $150,00.00 grant from the U.S. Fish and Wildlife Service.” While I have no objection to seeing my tax dollars used as a “create-a-job ” slush fund, I would like to see the monies spent on the actual Vets. Do the chuckleheads at the FWS think we can’t multiply $18,037.60 by 6 and come up with $108,225.60? So, are we to believe we are left with administrative costs of $41,774.40 to administer to six guys? As an E-4, I would think Ryan was a capable Corporal and squad leader. As squads consist of 10 men rather than six, it would seem we could up Ryan’s pay to his former $25,531.00 and save a bundle. Ryan gets pay commensurate with his abilities and only has to supervise five more. We could up the number to ten and save even more. The $41.7K  saved could go towards hiring 2 more Vets. Whoa, Pilgrim. Totally new concept. Saving money and hiring people. It would never work.

Photo Ops are expensive. I bet they cost more for overtime wages on Veterans Day:

“A motivated work force is going to be fundamentally important to the success of Puget Sound.” Goldmark said. 

The veterans joining Puget SoundCorps fit the bill, said Department of Veterans Affairs Director John Lee.“These are men and women who are dependable and know how to survive and work in the elements,” he said. “They don’t need a lot of training”.

In the months ahead, look for Puget SoundCorps crews to be assigned throughout the Puget Sound watershed, restoring wetlands, removing barriers in salmon-bearing streams, and eliminated (sic) bulkheads and creosote pilings from the shoreline., Ecology Director Ted Sturdevant said.

Well, I’m surprised that with no less than three talking heads they got away with only $41.7 K evaporating. One will notice that I computed these Veteran’s jobs as being a 52 week proposition based on a salaried wage. The article only mentions them being employed “in the months ahead.” Ruh-oh, Rorge! Gee. What is it, Astro?  More bad economic news for the Fantastic 6? Ruh-huh!

I won’t bore you with the details, but are any here old enough to remember the meltdown in 1974-80ish? Gas lines? Even-odd? Make-work jobs? Jimmy Carter wearing a sweater in the Casa Blanca and his Civilian Conservation Corps? The poor hired to insulate old hot water tanks and pipes and staple clear Visqueen over windows to conserve energy? Do I sense history being reinvented here or is it just my imagination? I foresee a whole new army of Vets coming soon bearing 6 foot ladders and armed with energy efficient, curly Q, mercury-filled  fluorescent light bulbs to a home near you soon. We are going to lick this problem even if we go bankrupt trying.  You can take that to the bank, assuming they haven’t all failed by then.

America cannot get back up on her feet with government jobs. Jobs that support the government are a product of private enterprise. Taking your tax dollars and hiring Vets is an admirable idea, but unsustainable. Taking your tax dollars, hiring Vets and then hiring 3 talking bobbleheads to explain that they’re landscaping for $130 K a pop is the problem. Too many chiefs and not enough Indians…

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The Bonus Army and OWS

Posted on November 12, 2011 by asknod

Few people who are alive today, and certainly no Veterans from the first World War, can attest to what transpired on July 28th, 1932.  Some of of our most illustrious leaders from the coming world war in 1939 were employed to route a crowd of 10,000 or so veterans and their families from their encampment on the banks of the Potomac. I speak of Generals MacArther, Eisenhower and Patton. How one can attack one’s own brethren and sleep at night will escape me forever.

 http://www.eyewitnesstohistory.com/snprelief4.htm

Some media types have had the temerity to compare this event to the recent Occupy Wall Street movement. I ask the reader what could be more asinine. The two movements have absolutely nothing in common. The Veterans in 1932 were simply asking for remuneration for their service earlier than the promised 1945 redemption date. Knowing the deleterious effects of inflation first hand, these brave souls were asking for their promised stipend sooner due to economic doldrums suspiciously similar to what we now are encountering in the marketplace. I’m sure there are numerous Vets reading this who have finally won a long-standing dispute with the VA and been given a rump settlement that does not compensate for the loss in dollar value nor pay interest for the  years the claim was held hostage.  To those souls I can only offer condolences. This is the system we endure. Our government is renowned for its penurious proclivities so it should come as no surprise.

This in no way compares to what transpired in 1932. Tens of thousands of  WW1 Vets were granted $1.25 for every day served overseas and $1.00 a day for stateside service in 1924 by a grateful nation.  The catch was that this munificence would not become due and payable for another twenty-one years (1945). One does not need the acumen of a John Maynard Keynes to figure out this was a ploy to gain time and pay in inflated dollars. You can almost see the future fingerprints of what the government is currently up to with Social Security here. Nothing has changed in 88 years, has it?

Which brings us to 2011 and the newest Bonus Army. This eclectic bunch of protesters has very little in common with our 1932 crew. Some of those arrested have listed addresses in parts of upscale New York which do not comport with what we could consider the 99 percentile. I admire them for coming out on weekends and standing with their downtrodden fellow humans even if they are not economically depressed or unemployed. What might be overlooked in this rush to judgement are the very large numbers of Veterans now being attracted to this as it builds. The obvious difference is that their  jobs plight has resonance. They are not asking for another 99 weeks of unemployment or some nebulous amount of money simply because Joe Goldman Sachs has more of of it than they do.

Veterans are arriving on our shores in ever increasing numbers as the wars on terror subside and we decrease our military budget. We will soon have a rump army as we did in the post-Vietnam era with no ability to project power abroad, but that is an argument for another day. Unemployment is becoming endemic among these troops as they separate from service. The government, through its inaction and apathy, have compounded the problem with interest. When left with no ability to attain gainful employment,  these brave men and women are doing what their forebears of 1932 resorted to- voicing their displeasure with the status quo. The fact that their OWS demonstrators make odd bedfellows should not detract from their cause. The two have nothing in common other than a shared voice at the inequity of what is afoot in America today. Don’t blame the millionaires. Blame your government for its wastefulness. Better yet, America. Look in the mirror.

America is on the cusp of a new era. We have partied hearty. We have burned the candle not at both ends, but rather have broken it in the middle and lit all four ends simultaneously. Every budget cut proposed is met with another expense such that no meaningful savings and austerity can ever accrue. We have finally arrived at what can best be described as the Beatle’s song- I, me, me, mine. Take from him and give it to me.  The government’s rejoinder seems to be- Here’s one for you, nineteen for me. What is lost in the shuffle is the compact we, as Veterans, have always been enticed with in order to serve America. The promise of meaningful future employment gained by learning a trade in the service, medical care in the event of injury and most importantly, compensation for those injuries should we manage to survive them have been the paramount reasons for many of us to heed the call to arms. Others, like me, just liked the smell of cordite and the thrill of victory. Eau d’ gunpowder is a powerful aphrodisiac to the young. However, our government’s habit of waging war without considering the collateral damage to Vets is coming back to haunt them as it did in 1932 and post-Vietnam. The piper must be paid.  No more can we sweep this under the carpet because the carpet’s beginning to resemble the Rocky mountains.

So now we Americans find ourselves at a crossroads. Our promise to our warriors is beginning to ring hollow and they suspect as much. Consider the conundrum of the Emperor becoming chilly and discovering suddenly that he is naked. Many is the Vet who has returned to seek his former job as the law dictates he is entitled.  The civilian who took his place feels equally disenfranchised when asked to relinquish it. Employers are using all manner of subterfuge to get around this impediment. Once again, the Vet loses and the government looks the other way. The parallels to the Bonus Army are numerous and bode poorly for these returning warriors.  The new reality is starting to make itself apparent. Blame is apportioned to many, but a coherent solution remains elusive. I, me, me, mine.

A redux of 1932 may not be avoidable. Sometimes we have to have a distasteful display of what life without civilized discourse looks like to bring us to the bargaining table. The demonstrations during the Vietnam war were a prime example of how America voiced its displeasure with the direction government was taking. The Kent State massacre, like the uprooting of the Bonus Army, became a rallying cry for justice in 1970. It was narrowly focused on one goal-something the OWS movement lacks.

Now is not the time to be ushered to the back of the bus to sit with the Rosa Parks of the movement and patiently await our turn at the microphone. Veterans should become the vanguard of this and politely ask the OWS riffraff  to move to the back of that proverbial bus and wait their turn in line. Veterans have been marginalized for decades and have politely acquiesced to the prevailing political winds for their meager reward. Sometimes you have to piss on the fire and call in the dogs as my daddy used to say.  I expect that time is now before we are asked to sacrifice for the good of America and wait yet again “until things get better”. We arrived at this impasse figuratively in 1932- far earlier than  the 99ers. I submit that we have legitimately earned the right to be at the head of this line.

Somewhere in the intervening years since the Gettysburg address, the phrase “For he who shall have borne the battle, his widow and his orphan child ” has lost it’s ability to move Congress to do what is unarguably their duty to the Veteran. Granting us one day a year and paying us lip service with a mindless  “Thank you for your service” doesn’t cut it with me either. It may make you feel all warm and fuzzy inside. It may even make you swell your chest in pride. Unfortunately, “Thank you for your service” doesn’t give these Veterans what they need- namely, a job. Happy Veterans Day to all but is it truly a happy one?

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PHLEBOTOMIES AND HCV?

Posted on November 10, 2011 by asknod

I went in for my monthly phlebotomy today. I do this to reduce the iron in my system from the Porphyria Cutanea Tarda. I was wondering in an earlier post about why it seems I’ve suddenly slowed my rush towards cirrhosis and the inevitable HCC. I passed on some interesting links to this about Coumadin usage as a blood thinner and its beneficial effect on the liver in an earlier post this week.

I think the phlebotomies I’ve been receiving since November 1992 might have something to do with it as well. Think about this. I  have had over 160 phlebotomies since then and each represents 800 milliliters or approximately 1 pint each.  According to the American Red Cross, it takes the human body 57 days to regenerate one pint .The average human body contains about 10 pints. There are 8 pints to a gallon and 160 pints equals 20 gallons. That, my friend, is a shitton of blood to pour down the drain. Each time I suspect it removes a lot of HCV virus in addition to the iron I’m trying to decrease. It makes sense my viral count would be lower afterwards.

Our good friends at Hepatitis Central supplied me with this tidbit:

http://www.hepatitis-central.com/hcv/iron/effect.html

Who would have thunk it? I have to say I was doing this once every three weeks to get it down in the beginning in 92, but once a week? That would have to be hitching a ride on the anemia express. I have an upcoming  Liver Function Test coming up in 10 days at the VAMC. I happen to know from my civilian doctor that it was 300 on the 16th of October. It will be interesting to see if it goes down.

My VA-appointed “hepatologist”,  Nurse Eileen H., is a real-life Nurse Ratched. She refused my last request for a viral load count (VLC) when I was really feeling punky in July. Most heppers don’t realize this , but if you have AIH and it’s really cooking in you, your VLC will shoot way up. Mine usually is about 28 K and my personal best is 8.4 million after one dose of IFX.. It goes up and down and was 200K recently. This tells me it may be up to its old tricks and busy eating my liver like PACMAN. I conned my new VA PCP into running it for me several weeks later. Eileen will undoubtedly be pissed off and frown a lot but it’s my life, not hers. She’s not even an MD- just a lowly ARNP. It will be interesting to see if the AST/ALT decrease with this latest phlebotomy.  Here’s another little trick I use. I qualify for medicare now so I play them off against the VA and use both to keep track of what’s going on. My old PCT doctor would write a prescription for phlebotomies for my dog if I asked him to. He used me in a 1994 AMA article about PCT and the relationship to HCV, HBV,  and the rainbow herbicides by Dow. Anytime I ask, he cuts me a new one. It’s not like it’s an Oxycontin scrip, now is it? There can’t be many who are into bloodletting a la George Washington.

Trust the Israelis to find this one out:

http://munstermom.tripod.com/phlebs.htm  Look down to the third article and click on Beneficial effect of phlebotomies on HCV.

I guess in retrospect I really lucked out eating a lot of Agent Orange and having the VA give me a heart attack, huh? I may be plowing new ground in the Coumadin/ phlebotomy pasture for all I know. If I’m still kicking in 10 years, I’ll be sure to tell everyone my theory. It may become standard protocol for non-responders if they don’t find something sooner. Stranger things have happened. What the hey? It sure can’t hurt having a few less Hepbugs and a pound of iron running round my veins.

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CMOH winner Ed Freeman

Posted on November 10, 2011 by asknod

  I received this today from a friend who was not a Veteran. His father, who was, sent it to him today . If Robert McNamara had let us run the war from Saigon instead of D.C., there’s a high probability we could have won this. Telling us where we could shoot, when we could shoot and what, when and how much ordnance we could drop is what cooked our goose.

You’re a 19 year old kid.  

 

You’re  critically wounded and dying in

 

the jungle somewhere in  the Central Highlands of Viet Nam ..  

 

It’s  November 11, 1967.    

LZ  (landing zone) X-ray.  

 

 

   

Your  unit is outnumbered 8-1 and the enemy fire is so intense from 100 yards away, that  your CO (commanding officer) has ordered  the MedEvac helicopters to stop  coming  in.  

 

You’re  lying there, listening to the enemy machine guns and you know  you’re not getting out.  

 

Your  family is half way around the world, 12,000 miles away, and  you’ll never see them again.  

 

As  the world starts to fade in and out, you know this is the  day.  

 

Then  – over the machine gun noise – you faintly hear that sound  of a helicopter.  

 

You  look up to see a Huey coming in. But.. It doesn’t seem real  because no MedEvac markings are on it. 

 

Captain  Ed Freeman is coming in for you.  

 

He’s  not MedEvac so it’s not his job, but he heard the radio call  and decided he’s flying his Huey down into the machine gun fire  anyway.  

 

 

 

Even  after the MedEvacs were ordered not to come.  He’s  coming anyway.

 

And  he drops it in and sits there in the machine gun fire, as  they load 3 of you at a time on board. 

 

Then  he  flies you up and out through the gunfire to the  doctors and nurses and safety. 

 

And,  he kept coming  back !! 13 more  times!!  

Until  all  the wounded were out. No one knew until the  mission was over that the Captain had been hit 4 times in  the legs and left arm.  

He  took 29 of you and your buddies out that day. Some would not  have made it without the Captain and his Huey.  

 

Medal  of  Honor Recipient, Captain Ed Freeman,  United  States   Air Force, died last Wednesday at the age of 70, in Boise ,  Idaho  

 

May  God Bless and Rest His Soul.  

 

I  bet you didn’t hear about this hero’s   passing,   but we’ve sure seen a whole bunch    about  Lindsay Lohan, Tiger Woods and the bickering  of congress over Health Reform.  

 

Medal of Honor  Winner Captain Ed Freeman  

   

 

Shame  on the American media !!!  

 

Now…  YOU pass this along to YOUR

 

mailing list. Honor this  real American.   

 

Please.  

 

 

 

 

 

 

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Jay Claire Warner–1916-1989–An American Veteran

Posted on November 9, 2011 by asknod

In years past, I have looked for some uplifting story around Veterans Day about a unique Vet who stood head and shoulders above his peers. With the current wars in SWA, there are many who qualify for this. What I lack is an intimate knowledge of their military history to write about. This year I opted for anybody’s Vet-one who wasn’t unique. I think my Uncle Jay qualifies.My father did 35 years and made a career out of it, but Jay epitomized the regular, blue collar enlisted man with all the accompanying warts.

Jay graduated early from school at 16 in 1932 and found himself jobless along with most of America at that time.  A falling out with my step grandfather pushed him out of the house and on his own. He naturally signed up for the US Army with grandpa’s blessing and a permission slip when he reached 17. Jay rapidly rose through the ranks to Sergeant and was busted back down to Private just as quickly for drinking incidents in Hawaii in 36 and 38.  He gradually made his way back up and was looking good in the neighborhood in the Philippines by 1940. He caught the silver BB (a through and through in his ankle) and was captured by the Japanese on the Bataan Peninsula in April of 1942. He did the 97 kilometre Bataan Fun Run to Camp O’ Donnell and became a prisoner of war for the next three years. He told me they had to drink each other’s urine in order to survive. His ankle healed poorly after the march for lack of any medical treatment. He escaped twice and was beaten so severely that the scars remained with him for life. His back looked like a Rand McNally road map. The Japanese knocked all his teeth out with rifle butts.  Nowadays we have a hard time conceiving of that hard life. Read this to get an idea:

http://en.wikipedia.org/wiki/Bataan_Death_March

Jay and his fellow POWs were liberated in January of  1945. He weighed 87 lbs. and  stood 6′ 2″. He was brought back to the States and recovered at Letterman Hospital in San Francisco for 18 months. He and his fellow prisoners were in such bad shape they couldn’t be shown to reporters. After several years of rehabilitation, the VA opted to amputate his right leg above the ankle due to the severe damage from the GSW.  Jay set sail on his post-Army adventure in 1948 with his new prosthesis.

The VA had various names for PTSD back then. Battle fatigue and shell-shock were the most common. Jay was rightfully given 100% P&T and he proceeded to cut a swath across the Wild West. Our family is part Ute Indian from Colorado. The lineage is from my biological (half Ute) paternal grandfather- June Claire Warner. This would explain why Jay had such a problem ingesting alcohol. June didn’t fair any better. He and his 3 brothers were caught robbing a Union Pacific Train near Montrose, Colorado in 1919 and were given a Texas necktie party on the spot by the Pinkerton detectives that caught them.

Jay Claire traveled extensively with circuses and the like. He’d settle down for a while, get married, piss off the new bride and head out again. I can remember as a child hearing the phone ring in the middle of the night and my father talking to him and asking him to call at a reasonable hour. He was polite but firm with Jay. I know Dad loved him, but Jay’s lifestyle was utterly alien to him. We all know that there is someone just dying to hear from us at 2 AM after a night of  hard partying. I’ve done it, too. It’s the Ute gene. My father was the only one who seemed to dodge this disease.

Jay sought me out several years after I came home from my adventures in Southeast Asia. I lived in Seattle and he had finally married a VA nurse and settled down in Cottage Grove, Oregon. He and Jackie came up and introduced themselves to my family in 1977 when my daughter was born. Jay had settled down quite a bit and given up drinking and burning down the world by then.  That was one of the prenuptial clauses Jackie insisted on.

After finding Jay, we spent lots of time with him during holidays. They had a large old ranch house out in the country and we could poach deer any old time in the apple orchard out back. As both of us were creatures of war, we occasionally talked of this. He showed me his scars and told me of his POW travails. He told me of the day in 1944 when they chopped off two fingers and almost beat him to death when he was recaptured after an escape. He actually laughed about it and said he was made of tougher material than them.  He never shared this with anyone-not even my dad or Jackie. Up to that point I had no idea anyone could treat their fellow man so harshly. It was a fact up in Laos during my time there that if we got shot down it was good night, Irene. Every one of the pilots that augured in while I was there were listed as KIA-BNR. I heard that one Air America pilot was repatriated after the war, but none of our AF pilots. The Pathet Lao had a No deposit- No return policy. Jay indicated life wasn’t much better for him as a POW. His body was testimony to that, but from his every day demeanor, you would never guess it.

I had the pleasure of Uncle Jay’s company until he passed from a combination of war ills in 1989. He lived long enough to see my son born. He must have come down with every disease you can think of and received no medicine to combat it during his POW tenure. He was a pragmatist about it all and the only ill effect from his service was the inability to be around anyone of Asian descent. I hardly blame him, but it was uncomfortable at times when he went into Bi-Mart in Cottage Grove and  went Postal if he saw any.

Jay never had any children. Jackie took me aside and explained the day after the funeral. The Japanese had amputated more than just two fingers that day in 1944. Jay never divulged that to me and I can understand why. Losing one’s manhood, even in war, is a horrible thing to contemplate- let alone share with another.

Thus ends the tale of a run of the mill Vet. He didn’t wait for the draft. He took his punishments in stride and went up and down the enlisted ladder regularly like a pianist on his keyboard . He didn’t discuss his military past with anyone and he didn’t hang his medals on the wall. He didn’t belong to the VFW or AMLEG. He didn’t attend Veterans Day parades. In a word, he was the quintessential American. He came, he saw and he served. He didn’t ask for special consideration and shunned the limelight.

This is why America is great. It was built on the backs of unassuming men like Jay Claire Warner, SSGT. US Army 1932-1945 who didn’t think his life story was any more remarkable than yours or mine. His love for America knew no bounds.  We receive recognition for our contribution to freedom one day a year.  I expect that was one day too many for Uncle Jay.

Happy Veterans Day to all of you who value a concept (freedom) more than your own well being. You’re crazy. You know that, right?

P.S. As an aside, I would note that Warner was my father’s and Jay’s surname at birth. As was the habit in the 30’s, they were informally adopted by my step grandfather without any paperwork and assumed his name. Until the VA grants my claims, I will remain anonymous or Buckwheat, whichever you prefer. I answer to most anything, but don’t call me Late for Dinner.

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FED. CIR–HAMER V. SHINSEKI (he’s baaack!)

Posted on November 8, 2011 by asknod

downloadIt’s always interesting to follow the progress (or nonprogress) of a claim as it wends its way up the legal ladder. As the BVA is rather secretive and does not divulge the name, rank, airspeed and tail number of the Vet, we only pick up on these as they go by at the Court. I happened to spot Mr. Hamer back in the news again today. Apparently the gentleman, still under the expert tutelage of Mr. Kenneth Carpenter, has opted to take it up a notch and pursue his argument before a panel of the Federal Circuit.

This should be interesting. I posted a writeup of Mr. Hamer’s excellent adventures in claims back in October, 2010 and his subsequent mishap when the BVA inadvertently granted the very thing he wished- a CUE of his 1985 rating.

http://www.uscourts.cavc.gov/documents/Hamer_07-3181_published_opinion_July_27.pdf

When they did this, it freed them up to use what we call the Fenderson or staged rating technique wherein  you are rated retroactively based on the available medical and work history info the VA has access to. Technically they are not allowed to hire private dicks and put surveillance on your home. Hell, they don’t have to. They have their own jack-booted thugs at their beck and call. Of course, if you’re on TDIU and working, that’s a different story altogether. That’s cheating. One is the antithesis of the other. One simply cannot be “Totally Disabled Due to Individual Unemployability” if he is working. Or can he? There’s one small wrinkle here. The VA’s actions caused him to seek work to eat. He obtained what can best be described as “sheltered employment” as a Service officer of a VSO. This was still no excuse as we saw at the Court.

When Mr. Hamer won his CUE claim they Fendersoned his ass and scalped him of his TDIU during that period he was working (1989 to 2000) and then re-TDIU’d him. Apparently this rating technique did not sit well with the gentleman. Yesterday he and his esteemed mouthpiece went to the Fed. Cir. and pleaded his case before them.

You can listen to the hearing (audio only) by visiting :

http://veteranslawlibrary.com/files/Fed_Cir_Audio/2011/Hamer_2011-7033.mp3

Mr. Carpenter has cogently and ably made his case and it isn’t all that tortured or convoluted. He simply points out that a CUE claim is clearly defined as a restoration of one’s existing claim rather than a new, initial award that can then be Federsonated. Always remember, Fenderson was constructed to aid in determining a fluid rating predicated over time (retroactively) on an original claim. Think of it like this: You win after 10 years of VA intransigence. They give you 10%. No way, you say. I qualified for 60% on such and such a date 5 years ago and 30% 7 years back. They split it and give you 10% to begin with 10 years back, up it to 20% @ 7 years, 40% @ 8 and 60% now. “Now” was 2 years ago so you file another NOD and say  Hold the phone. Now its 100% in 2010. And on and on the dance goes. But- and its an important but, Fenderson only applies to new claims, not the restoration of an old, protected rating based on CUE. You can never use Fenderson on a claim for increase and go retroactive either. Mr. Carpenter aptly points out the incongruity of bending Fenderson around like a pretzel and inserting it into 38 CFR § 3.105(a) and (e) to the judges. He’s a silver tongued devil, that man. If I am ever forced to venture into the hallowed halls of the Court or the Fed. Circuit, I hope he’s by my side. I have no qualms about sharing my take with him.

Mr. Hamer got his severance package in 1985- fully 7 years after his grant of SC. As such, it was a stabilized rating which, absent a medical finding and proper severance notice, could not be disturbed. He argued in 2000 for a finding of CUE in the 1985 severance and several months later for an increase back to TDIU immediately. His RO gave him back the IU but declined the CUE revision. He won that in 2004 at the BVA, but got saddled with the Fenderson criteria. Based on that he got the lollipop stick sans lollipop from 89 to 2000.

The Court didn’t see eye to eye with Mr. Carpenter’s arguments and found nothing wrong with this business. They utilized existing jurisprudence in Reizenstein and O’Connell to rationalize their decision. This is all well and fine if, and it’s a big if here, O’Connell and Reizenstein are truly on point and good jurisprudence.

Mr. Carpenter reaches back to SEC v. Chenery Corp. 332 U.S. 194 (1947). The SEC did what the Board did. They invented a rule to fix an inequity during the course of the adjudication. The BVA got the appeal and re-adjudicated it based on a VAOPGCPREC designed and promulgated solely to deal  with Mr. Hamer’s  predicament or, more properly, their predicament. This constitutes creating law out of whole cloth to buttress their argument for their inevitable decision which, lo and behold, supported their theory of how this should have been adjudicated. Mr. Carpenter has really earned his shekels if he prevails here. What it means to Mr. Hamer is a free paycheck for IU from 1989 to 2000. I agree with the precept that he’s not entitled to it, but the VA threw the first rock and then admitted their error 19 years later in an underhanded attempt to fix a very sticky wicket..

In all fairness, we shouldn’t come down on Mr. Hamer. He got the end of the stick with the defecation all over it in 85 and didn’t appeal. He legitimately won his argument for CUE in 2004 and that should have been the end of the matter. The BVA, in its own inimitable way, went to its paymaster the VA General Counsel and basically asked them how to fix Mr. Hamer’s wagon.

Those funny guys at the VA  Office of General Counsel came up with this predictable “finding”:

PREC 1-2007    Applicability of 38 C.F.R. § 3.105(e) to TDIU Award Reinstated Based on CUE

I suppose if you were a scientist of the horizontal persuasion and wanted to prove your case that the world truly was flat, the best jury of your peers would be fellow members of the Flat Earth Society. In essence this is what the VLJ opted for.

That the Court didn’t pick this apart and see the non sequitur is appalling. Normally they are all over this kind of inequity like white on rice. A General Counsel finding in the middle of an adjudication should have made their collective hair stand on end. I wrongly impugned Mr. Hamer’s motives for appealing this last year and I humbly apologize to him and Mr. Carpenter. You cannot bend the law to prevent unjust awards. Yes, you read that right. Mr. Hamer is not legitimately entitled to his TDIU from 89 to 2000 because he was “working” in the truest sense of the word. He wouldn’t have been if the VA hadn’t committed CUE in 85, but that is a tenuous argument that will not avail him here. No, the injustice was in severing him in the first place. They compounded their error by asking the GC to craft a bulletproof finding that would cover their ass. Once they had it in the form of the VAOPGCPREC, they could walk all over his rights and dictate a new decision a la Fenderson. The Court aided and abetted this with even poorer reasoning.  We can only hope Mr. Hamer’s appearance yesterday will inevitably prove to set another benchmark to VA law in our favor. We also pray the members of the Court take notes on this and avoid similar mistakes in the future.

As there is a vacancy on the Court bench, I would admonish our President to seriously consider appointing the Kenster to fill it. He sure isn’t making a killing representing us. On the other hand, this would deprive us of that which we sorely need when we appeal injustice.

This is part 2 of a three part judicial adventure. Here’s part 3:

https://asknod.wordpress.com/2012/11/23/surprise-surprise-surprise-hamers-baaaaaaack/

Posted in Fed. Cir. & Supreme Ct., Important CAVC/COVA Ruling, vARO Decisions | Tagged | 7 Comments

BVA– PCT= HCV?

Posted on November 7, 2011 by asknod

I found another one of these years ago and didn’t bookmark it. When I finally found this, I decided to print it anyway even if the case was remanded. It involves the reverse concept that PCT, as a known side-effect of HCV can be used to show a correlation to it as a claim. Our Veteran here has been rated for PCT as a presumptive disease associated with Agent Orange. He is now trying to swim upstream and reach HCV. I pointed to the same thing when I filed for Hep. The PCT was what clued me in to the Hep. initially, but I filed for both simultaneously. He’s represented by DAV and they have that “AO causes HCV” mentality. We know otherwise but VSOs haven’t gotten the briefing. Or, if they have, they’re still helping Vets lose by claiming thus. No conspiracy here- just stupidity.

This is interesting. I haven’t seen anything come up the ladder to the CAVC, so my feeling is that VA gave him all this. He was already rated in 05 and it will eventually end in TDIU or P&T if he gets really sick. Denying now (or then, when this was remanded)  is an exercise in putting off the inevitable. Giving the Vet SC for hep. especially in lieu of his rating for PTSD would almost be axiomatic. You never know what these fellows will do, though. Vindictiveness runs in their blood. Reality is the only thing that makes them sky down.

http://www.va.gov/vetapp05/Files1/0500244.txt

 

Another important aspect illustrated for you is the concept of the Fenderson Staged Rating process outlined here. This is an appeal of an original rating with added issues. The Vet is appealing his denial of PTSD (and wins) but is also appealing his initial rating for his PCT (granted by the VARO). He has done his homework as I definitely don’t believe for a moment that the DAV chucklehead was aware of the 40% available under DC 7704 for PCT. I’ve only seen it used 6-7 times mostly by pro se Vets and only on appeal at the BVA. It is so basic a concept that it doesn’t warrant a trip up to the Big House. I like this one because it has a lot of excellent info for HCV/PCT guys like me.

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HCV AND COUMADIN

Posted on November 7, 2011 by asknod

This is amzing stuff. I’m on Coumadin because I had a heart attack while I was in the VAMC in 09. They did a pre-op physical on me to make sure I was good to go for surgery to take down my ileostomy diversion and reconnect my small bowel to the large. The EEG dude says( and he talks like this) “Dude. You have had a serious heart bummer since your last EEG . That’s bogus. We did this last Oct. 15th  and it sure didn’t look like this. Hmm. You feel okay?” I assured him I did and asked if this would change their plans to operate. He assured me it wouldn’t. When I finally got my records several months later, it said myoicardial infarction or possibly a septal infarction during the peritonitis with a mega T wave abnormality, etc.

Lately my ALT number (also called SGPT) has been climbing which is not good. The last time this happened was after my first dose of Interferon. It went up to 635.  Mine’s up and down but staying  around 300. While surfing for liver/Coumadin connections on Google I hit on some articles which deal with this. Most amzing stuff. Perhaps this is why I’m avoiding the liver disaster of cirrhosis. It’s short and a good read:

http://www.hcvanonymous.com/SMF/index.php?topic=8963.0

And this:

http://www.hepatitis-central.com/mt/archives/2008/08/popular_blood_t.html

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VA Obamacare?

Posted on November 6, 2011 by asknod

This is weird and I don’t mean funny-ha ha weird. I got a letter in the mail several days ago from the VA. What first caught my eye is the the date- May 5th, 2011. What? they ran short on stamps? If that wasn’t cause for alarm, the brainwashing attempt that followed was.

Any time someone or a government entity says they have found a way to save money and improve the system, I back into a corner and put my hand on my wallet. This missive was to announce a new VA-wide initiative to revamp the VA health care system. Seems reasonable considering the sucker is on the verge of a hernia. The new campaign touts the Patient-Aligned Care Team or PACT. The letter goes on to tell how they are going to form a “partnership” between you and your health care team “to make sure you receive  personalized whole-person care with an emphasis on prevention and health promotion”.

This all sounds sweet but I hear these things and my anti-social personality with passive aggressive tendencies kicks in and asks  Jez! Was I receiving half-person care before? If I wasn’t going to the the doctor for preventive medicine and a proactive approach to my health, then what exactly was I engaged in? Did they suddenly “get it” and decide to up the ante? Does this mean they are actually going to start caring for me?

The next paragraph spills the beans. Taking the same letters (PACT), they artfully reiterate their point with this:

Partnerships= with Veterans (as opposed to…?)

Access to care= using diverse methods (read concertina wire)

Coordinated care= among team members (determines who goes to get the coffee)

Team-based care centered around the Veteran. (Based on Hillary Clinton’s book “It takes a village”)

Seems like they took a page from one of my posts because they have suddenly started capitalizing the V in Veteran. About two years ago someone asked me why I always capitalize the V. My answer was that there are a lot of veterans. A veteran can be one who worked at Ford Motor Co. for 20 years or someone who has been reelected to Congress way too many times whereas a Veteran is one who served his or her country unselfishly. There’s a big difference and it deserves a big V.

Here we have a schmooze campaign in progress. In case any of you hadn’t noticed, if you want to see your PCP now, the wait can be several months. The newest trick is to just pop in to the “urgent care” model they have constructed at VAMCs and see a nurse. If it requires a doctor, you may get 5 minutes of face time and an attaboy with the Rx.  The VA’s new model of health care is going to be:

1) Call in to you Team and identify your concern. If you have internet access, you can email it and pose the question and they’ll “get back to you”.

2) If they can get away with it, you will be seen by a nurse or other pecker checker.

3) Since most questions can be answered over the phone, this will save you an unnecessary visit.

I understand most medical abbreviations attached to medical personnel such as MD and RN. My new PACT has four members . Does anyone know what an HT is? How about a MAA? These appear after the names of two of my team. I googled it but came up with a zero. Knowing the VA, these are made up by them. HT might stand for “Hope Technician” as in “I hope you’re not in a hurry, sir”. The MAA? “Mostly an Administrative Assistant” as in one who answers the phone and takes your BP/temperature  at lunch when the HT is on break.

Over the years we have seen the birth of nurses with more and more authority. I now see ARNPs, PAs and others who have the power of an MD. Where will it end? I envision a computer terminal in the VAMC lobby with the latest accouterments. “Please be seated and state your name and last four. Thank you. How may I help you? Place your right wrist in the cuff. Please lean forward until your forehead touches the sensor. Please remove the prescription form from the tray below and take it to the pharmacy.”

They are being blatantly honest when they say they’re offering “access to care using diverse methods.” This will undoubtedly turn out to be a redux of the claims process. If you wait too long you’ll give up and go away… or die. This is a win-win for VA and the Vet because there will be fewer Vets clogging up the medical care system and the waiting time will decrease.

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