Filling In The Missing Pieces

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Y’all might have noticed that I’ve posted a couple of very task specific entries to the blog the last couple of days and might be asking why now, why the push of information about filing a VA claim and the bewildering plethora of related data. Good and fair questions. If you weren’t wondering then that is okay as well, because I’m going to try to explain it all right now. In previous posts I wanted to express to any and all veterans the importance of arming oneself with the proper information. This is very fresh in my own skull since I just re-re-opened my own claim so I can provide additional relative information to strengthen the facts in my own file in hopes that I can get an increase in my own personal rating from the VA.

My process actually started in March of 2014, not with the claim, but with my claim in mind. I fulfilled a large portion of the leg work to eventually get the ball rolling. How so? Up until then I wasn’t in the medical portion of the VA, only in the claims side. But, when I was laid off I soon found myself in dire straights. Forget everything else, I was finding out fast that I was headed for a dilemma which if not contained may have had some major health complications involved. Why? I’m an insulin dependent diabetic. If you aren’t aware of the nature of that beast just look it up. So, my number one priority was to contain that fire before it spread. Since I was already in the system and a VA card holder, enrolling for medical benefits was simple enough, time consuming, yet fairly easy, even for a simpleton such as myself. Good grief I blew through some trees filling out that paperwork, it was insane, it was as if they couldn’t share the same sheet of paper in my file around the office, everyone needs a completely originally signed document in order to proceed. That is nothing compared to the mountain of papers (records and reports) I face at this exact moment. I have mentioned what a pain in the ass the VA makes the process, haven’t I?

As well, at the time of my lay off I was in line to do an exploratory and maintenance surgery on my knee to clear away debris, old hardware, and torn ligaments. Being told beforehand they couldn’t repair anything since it would only complicate things down the road. I had an my surgery date, I had time arranged to be off from work, and then I’m laid off. Talk about coming to a screeching halt, Yea, dead in my tracks, cancel all plans until further notice. Being laid off screwed up allot, allot more than I will mention here. Then, and only then did I considered enrollment into the VA medical program, something my wife says I should have done back in 2000, but I was stubborn, I had private insurance, I saw no need in being in VA medical. For the most part I was right, everyone hears the horror stories about veterans trying to get care, getting the wrong care, how slow the process is, and the same mistakes made over and over. Who wants to be a part of that kind of mess? But then, who do I turn to in my true time of need, who do I expect to be waiting there for me at the edge of the red carpet, you guessed it, the VA. I will be one, of millions who can attest to the slowness of the VA. Fuck their timelines because they look good on paper but have no relation in real time with real people, and that blows ass for every single one of us veterans.

Reluctantly, yet willingly, I got “in line” and jumped into the process. The process wasn’t hard, but it was time consuming, lucky for me, at the time, all I had was time on my hands. I had four months to ride this pony for the big show or it wasn’t going to happen. It took longer, duh, and when I was hired to a new company last October I hated the fact that I needed to take time off here and there to button up all the loose ends, and there were allot of loose ends. I was seen multiple times at the clinic’s version of an orthopedics office, where we discussed my direct interest in seeing the orthopedic surgeon downtown. But there is a process, first the PA has to be convinced of a “need” before we “bother” the busy orthopedic surgeons with what might all be in my head. In my fucking head you say? Let’s review, for the sake of argument, that this PA went through my private sector medical records, my military medical records, started my new VA medical records, the MRIs, the CT Scans, the x-rays, the exams, and so forth, and this motherfucker was convinced ALL of my pain was in my head. Look, I know real pain and I know manifested pain, there is a distinct difference. As well, I know that there is very little help in eliminating the pain of degenerative joint disease, also known as osteoarthritis, and that steroid enhanced visco supplementation injections are a sick fucking joke. There is NO over the counter medications or prescription medications which can stop the pain of bone on bone contact. Just ask me, I have tried many, many combinations, and get the same result, pain. Hyaluronan injections (rooster comb) are nice and beautiful by design, but I don’t just have arthritis is my knee.

Finally, somehow, someway, I convinced the PA to give me the recommendation I was wanting, after a final review I was scheduled to finally see an orthopedic surgeon, 13 months after originally asking. My first visit to the orthopedic surgeon gave me the impression the doctor was blown away with the damage in my knee and he was a little shocked I was still walking. The overall decay within the joint is estimated, by him and one other doctor, to be a 97% coverage. At first he discussed surgery to remove the weight bearing of the joint to shift it more out to the outside, but after further review, eight weeks later, I was told I’m not a candidate because I would need the unloader surgery on both sides, which cant be done. My only option was to have my knee replaced. However, that option is gone as well because it is claimed that because I’m under the age of 50 that the VA will not do that particular surgery. Even though the governing regulations state that age cannot be used as a determining factor but is still an option of the individual physician. Nice double talk, right? Right. In reality, I was told to tough it out, move on with my life, and just try to “take it easy” for the next 4 years. Needless to say, I’m beyond pissed. What a fucking joke! Now I can’t get treatment? Isn’t the VA here to take care of my service connected injury? Seems that the answer is they will do it at their leisure. Hell, I don’t mind waiting in line if that is the issue, I know times are tough, money is tight, and y’all are having your asses handed to you by the media and the investigations right now, but why just tell me flat out no.

I don’t take rejection well. I really don’t. I did my part. I played the game. I followed the rules. For what? For nothing, that’s what. I know, boohoo wo is me. Well, okay, getting up to go to work every day is a bitch. A bitch I don’t mind riding because there are bills to be paid. Plus, I’m not the kind to sit on my couch all day to watch Jerry Springer. I have a drive to get out and work, to be functional on a daily basis. I’m at a loss here. I decided, after a careful review of the entries into my visits to the doctor, where he cites in black and white, that I’m not a candidate for either surgery due to age and complications down the road in the future that “could” happen, and his recommendation is daily, regular doses of over the counter anti inflammatory medications and more quarterly injections. I will have my way, one way or another, so I re-re-opened my claim with the VA, providing all the supporting evidence from day one back in 1990 until now, to include findings from a civilian orthopedic surgeon which I see next week. We’re doing a review of my records to review treatment, and follow up with his recommendations. I really don’t give a shit about the money, I just want to get this knee fixed, hell or high water. It’s never been about the benefits, it never will be, it’s about not being taken of because of one jack asses opinion. In the end, my goal is to rattle enough cages to get my knee replaced, which is recommended by two VA surgeons and two civilian surgeons, so come on motherfuckers, replace it already.

Yes, y’all have found a sore subject with me. I’m tired of doing battle, the VA is supposed to be here to help me and fellow veterans, not give us the run around, not to deny us care, and certainly not to individually bend us over because it is the easier thing to do. They can kiss my hairy white ass first, I came to fight, I came to get what I need, I came to see that the VA does the right thing by me. Hopefully, my education along the way can be used by other veterans who are getting the big shaft. So, my plan is to continue writing and sharing information about how to make sure all your bases are covered. It doesn’t need to be a battle to receive care, the VA just makes it that way. I have friends within the VA system, many of them veterans, and they encounter the same bullshit the rest of us do. Who knows what will happen with my case/claim, anyway it turns out I hope that someone has read some of my postings and figured out how to get through to the VA. I know it is bureaucracy at work, policy and so forth, set in place to curb abuse and better promote the health and well-being of veterans, but it has backfired, and now we all suffer, thanks. Next time y’all think that we are being handed freebies, remember we are people too, we just want to live our lives as normally as possible.

Spending The Entire Day Waiting

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Yesterday I spent the entire day at the Michael E. DeBakey Veterans Affairs Medical Center in Houston waiting for assistance at the pharmacy. When I say all day what I really mean is I was in line for mandatory valet parking at 7:04 am, by line I mean there were already 64 vehicles ahead of me, for a service which doesn’t even start until 7:30 am. This is after a 55 minute drive from my house. But, before I begin my monologue about my personal frustrations with the VA Medical wait times or my personal complaints, my experience is minor compared to most others trying to get more critical treatment. In no way am I saying I have bigger problems, just I have my own problems. Regardless of what a person’s reason for visiting a VA Medical center, things should happen in a more timely manner than what it does currently.

My reason, and I had only one reason, for visiting the VA Medical center was a very clear and simple mission, to find out who and why my insulin changed. I would waste time explaining the significance to everyone but only a diabetic and doctors (most) would understand. Let’s just say we don’t change insulin for no reason at a whim. What started this quest was simple, Friday I got my new 30 day supply of insulin which was the wrong “brand” and the wrong dose. Names change so I did a little research and found what they sent me was wrong altogether. I called the pharmacy, and the short version is, I was told I must be mistaken and if a mistake was made it was because I ordered refills for the wrong insulin. Really? I’m that fucking stupid? I referred to my Rx # and so forth directly from the myhealth website and I was again told the mistake was all me. After hanging up I contacted my PCP in Conroe, spoke with her nurse, and was assured nothing had changed in my prescription details. Well, at that point in the day it way too late to drive into the VA so I made plans for Monday morning. Unfortunately those plans got scrapped and I was delayed until Tuesday. For your curiosity purposes I have included a screen capture from today to illustrate how vets can use this website to order and track prescriptions and yes this is my own personal list.

After driving, after waiting for mandatory valet parking, and after getting my number at the pharmacy, I sat there prepared to have a discussion with the pharmacist. I had my last vile, the vile they sent me, and the printed version of what you see below. So, I waited. after 2 1/2 hours my number came up so I got in line to wait another 20 minutes. Finally, when it was my turn to speak with a pharmacy technician, I was told that he could not help me with my problems and that I would need to take a different number so I could be consulted by the pharmacist. WTF? Again, I sat and waited in the sparsely populated waiting room of the pharmacy. Now, we are in lunch time so the slowness begins creeping to an almost halt. I’m hungry, but not hungry enough to leave and lose my place in line. Good thing I had brought a baggie full of spicy roasted almonds for a snack. Somewhere around 2:30 pm I was again alerted my number was up and got back in the line to wait behind the others whose numbers were called. Finally, the light at the end of the tunnel appears, I’m next. I was so close I could taste it.

The pharmacist very nicely asked what my problems were and how could he assist me. After explaining it all again to him he looked at me and told me any and all changes had to come directly from my PCP. Really? What changes did she make which changed not only my insulin but almost triples my dose? Of course, there ate no changes on record. The he pulled the “you must have ordered the wrong insulin when you did your refill request” bullshit. How in the hell can I do that? I have one fucking choice and that is what in the fuck I clicked. Here is the real kick in the balls, he tells me regardless of anything that is said that the current 30 day supply of insulin has already been verified, processed, and shipped which means he can not refill any more until July and if changes through my PCP happen then those will need to happen prior to that date. WTF are you smoking? If I am in need of this insulin immediately then I need to purchase it on my own. If I thought I would look good in prisoner orange I would have just ended his smart ass right then and there. FUCK I hate this fucking place!

And, by the way, one can not simply go to a civilian pharmacy and get insulin without a fucking prescription. I can, however, go on line and order it from a pharmacudicals supply in Canada with no prescription for a mere $260.10 plus express shipping. Yea, like that’s gonna fucking happen. Who knows what the fuck would be in that vile. As a result, my civilian PCP was nice enough to see me this morning. That only cost me $167.30 but he did give me a prescription for the correct insulin and the correct dosage. Which was generous of him, probably since I have been a patient of his for the last 15 years. So I got lucky, this time. At the pharmacy I had to pay the self-pay cost of $208.08 but now I have what I need for the next thirty days. I also am able to get in to see my VA PCP at the end of June so things hopefully work out and get back on track, hopefully.

No, I do not think I can ever get them to admit this whole thing was their mistake. I have come to a conclusion in the short time of dealing with the medical portion of the VA, they have to not have a soul or something to work there. I wonder how in the fuck they sleep at night. I do know, it is because they operate with no conscience. But, to be fair, I base this opinion solely on the people I have encountered myself. However, I have met ex-VA doctors, nurses, and technicians who say that they did not agree with how things worked but their hands were always tied when trying to make a positive difference. I can’t say I know what every veteran is going through and I know my problems are simple compared to most because my are Rx related. I would hate to see the state of my “health & wellbeing” if my only option was the VA. I am deeply sorry our Veterans must endure such bullshit as a course of their own survival, they truly deserve better, they deserve the best that is offered, and maybe with their asses in the news now the VA will clean their act up. I know, I know, wishful thinking.

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Dealing With Difficult People In Your Life

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I have spent a considerable amount of time, which I sort of consider to be wasted time now, either dealing with difficult people or wondering what is the best way(s) to actually deal with the difficult people I encounter in my daily life. I have spent much quality time being a “people watcher” for many reasons. No, I do not have aspirations of being a great “people whisperer” but I have found that observation and silence are tools that give proven results in my life. Maybe you experience them as well. First, I had to be able to recognize the different kinds of difficult people. Second, I had to develop questions to ask myself about how I wanted to best deal with the difficult people I have in my life. Third, I had to learn different strategies to help me interact with the difficult people in my life. So, I was reading some things I wrote over time which have really been just “notes to self”. I started writing my questions, methods, answers, and strategies down back when I was in the Air Force since I learned that just because I perceived a person as difficult didn’t actually mean that person was difficult. These observations have grown year to year, job to job, marriage to marriage, and as I have aged or matured. So lets begin.

Do you recognize any of these 9 types of people?

  • The Know-It-Alls – They are the arrogant and always have an opinion on every single subject. When they are wrong they get very defensive.
  • The Passives – These are the people who never have an opinion and never offer a clue to where they stand.
  • The Dictators – These people are constantly demanding and are overly brutally critical of others. They enjoy being the intimidating bully.
  • The “Yes” People – These people will agree to everything and rarely follow through with any commitment they make. You learn fast that you cannot trust them.
  • The “No” People – These are the inflexible people who are very quick to point out why something is wrong and show negativity towards making something work,
  • The Gripers – They prefer complaining instead of finding solution because nothing is ever “right” for them to begin with.
  • The Extremely Religious – This person has an extreme and unconditional approach with life and people. These are the people who fear their God(s) in such a way they feel they must spread the fear with every word they speak to anyone that will listen.
  • The Bullshitter – They are the habitual liars who are habitually undependable in every aspect of their own being.
  • The Fucktard – This is an extraordinarily stupid individual who is so willing to disregard all common sense. They are obviously oblivious to everything about everything in every way. This is a person of unbelievable, inexcusable and indescribable stupidity.

Now, I know damn well you recognize each and every one of the people listed above. I know, also, that this is a pretty short list, more “types” can be added of course, as well as sub-categorized. Being able to notice people is the key. These are the people you live with, work with, rely on, and communicate with on a daily basis. Once you recognize what kind of person they are you can develop a strategy to quickly, confidently, and effectively deal with every kind of difficult person. It’s actually easier than it sounds.

Ask yourself the following 20 questions:

  1. Do you want to be able to understand the difficult people in your life?
  2. Do you want to learn how they think, what they fear, and why they do what they do?
  3. Do you want the ability to understand how to make dealing with them less frustrating?
  4. Would you like to know specifically what to do and say in every difficult situation?
  5. Would you like to be less of a target for the difficult people in your life?
  6. Would you like to be able to derail difficult people and teach them to treat you with respect?
  7. Do you want to bring out the best or worst in people?
  8. Did you know that difficult people are not difficult people all the time?
  9. Do you want to know what makes a difficult person tick?
  10. Do you want to know why complainers are complaining?
  11. Would you like to know how to get people to keep their word to you?
  12. Would you like to be able to respond to those who practice one-upmanship?
  13. Want to react better when you are being yelled at?
  14. Is it possible to be in sync with a difficult person and get along?
  15. Do you wish you reacted better when you are criticized unfairly?
  16. Do you know when to back down or to hold your ground?
  17. What do you do with excuse makers and blamers in your life?
  18. Do you wish people didn’t or couldn’t push your “buttons”?
  19. Can you give an aggressive person an alternative direction to the aggression and conflict?
  20. Did you know that specific “body language” is a more powerful tool than actual words.

In the end I think everyone gets tired of over-blown promises that turn out to just be an empty bucket. You can take control. You can be in charge. You can own what you think and break out of the bad habits that you have created or that have been created by others. Are you one of the 9 types of people I listed? Oddly enough most people are a collective of many types based on the people that surround them. Over time your actions, voice, and personality will become contagious to those who are around you. Toxic people become less of a threat once you understand what makes them the way they are. There are many factors to understanding others and most often begins with understanding oneself first. It is hard to heal a wound that cannot be seen. Now, I know you are waiting for the “punch-line” or the “answer” and unfortunately I don’t have either to offer. I can, however, offer unsolicited advice which shows that tact and skill in handling difficult people become very enviable traits in a person. Changing your ways will be something that is noticed immediately and at that point you have balanced the playing field. Once you realize your own person power over difficult people your confidence in any situation will become one of your best traits. If you take nothing more away from this information just remember to just smile at a difficult person because it will throw them off guard because they will spend endless amounts of time wondering why you are smiling at them. Meanwhile they tend to forget why they were being difficult and often dismiss themselves from the conversation or situation. Personally, I know I can defuse any difficult person by doing two simple things, being silent and smiling. It works.