Sunday, May 25, 2014

23 May 2014 from a Grateful nation

25 May 2014 Cassi Creek  Back to where it was
          In 1972 I did part of my clinical rotations at HST  VA Hospital.  The system then was restricted to vets with service-connected injuries.  The patient wards were occupied by older men who were essentially being warehoused after their service in WWI, WWII, &/or Korea. 
          In those days clinical lab instrumentation didn’t all have the high-pitched alarms to summon the operator.  I learned to keep a mechanical timer with me so that I could work with the instruments of my profession. 
          My hearing loss and tinnitus, was documented by the Army but no one suggested that I might be eligible for follow-on care with VA.  I didn’t have enough information about service connected hearing loss to file my own claim with VA.  My hearing deteriorated progressively and I was finally brought into the VA system in 2002.  The criteria for admission to the system and the hospitals had been expanded since my last contact with VA in 1980 – Agent Orange screening .  It took about 6 months to run through various screening appointments and I spent a lot of days in the VA waiting rooms. 
          After moving to TN, my hearing was re-evaluated and I was provided a 2nd set of hearing aids.  I’ve also become further disabled (service connected) due to PTSD and Parkinson’s Disease – both service connected.  There is an appeal pending on the degree of disability due to Parkinson’s that has been somewhere in the clerical chain for about 6 months now.  I’m told it will take another 18 or so to migrate toward review. 
          In the mean time, I see various providers for glaucoma, Parkinson’s and my primary care doctor.  Previously, I’ve been happy with the quality of care I’ve received.  I would probably be seeing private- outside – physicians at about the same frequency as I currently see my VA providers.  Lately, my hearing has become even more damaged and my hearing aids less useful and less comfortable.  I’ve been trying to schedule a new audiology evaluation for almost a year now.  Audiology  is one of the services that is poorly staffed when the number of veterans with hearing loss is considered.  My primary care doctor’s clerk was asked to schedule an appointment.   He told me that I could call and schedule my own.  That led nowhere when I was told by the Audiology intake desk that I hadn’t been seen in over two years and would need a referral from my primary care doc, or from the audiology techs who work on hearing aids.  So far, I’ve been going round in circles with no one able or willing to schedule a new evaluation. 
          While I really haven’t encountered much delay and misdirection, I have hit some walls in obtaining treatment.  When I tried to schedule a screening colonoscopy the first available appointment was 11 months distant.  That was then canceled and rescheduled for 13 months from the initial request.  The vision clinics are also overloaded and under staffed.  Now I’m finding the same delays as I try to have my hearing re-evaluated. 
          I’ve looked at my VA outpatient care as objectively as possible.  I don’t believe that private insurance and providers would have offered any higher level of care.  But I’m running into situations and delays now that seem to stem from what has once more become an over-loaded, under-staffed, and badly underfunded system.  While I’ve never encountered any resentment or been made to feel unwelcome by VA staff, I see the levels of satisfaction with VA care dropping as other veterans experience the same problems. 

          I don’t think that I’m encountering the hidden schedules that have surfaced in Arizona and other facilities.  But the possibility that VA is once more becoming the agency it was in the 1970’s is very disturbing.  

Tuesday, May 6, 2014

6 May 2014 Shake shuffle and slice

Cassi Creek:  after a long delay mostly due to some serious fatigue and a desire to actually say something of significant value, I take pen in hand once more.
          It’s called literary license.  Did we fail to listen in high school English?  Of course we did.  Well, most of us did not listen.
          Into VA today for neurology follow-up.  0800 appointment, requiring me to roll out at 0500 to make check in time.  The parking lot dance was not too bad this morning and I made check in with 10 minutes of window remaining.  The LPN for the Neuro OP clinic did her bit, vitals, within two minutes of the time I sat down in Neuro OP waiting.  Then there was no action until 0920.  Today was Neuro grand rounds.  So my early appointment generated a long hold time but I was still the first patient to be seen by a neuro resident this morning. 
          Naturally, my tremor was fairly well controlled this morning and I was able to walk without shuffling.  They were both quite pronounced about 0500, the trough level for the dopamine meds I take.
          Tomorrow, we send the generator out for overhaul.  It has been unnecessary since 2011.  I’m fine with that lack of need.  But it does need some replacement parts.  It will be accompanied by the riding mower.  That valiant tool encountered some sort of rock or other frost-heaved obstacle last weekend.  It will run no more until it is seen by a small engine mechanic. 
          The generator may take some time to find and obtain parts.  It was manufactured in China.  The mower probably was as well but the label, at least, indicates U.S. manufacture. 
          Burgers to grill tonight.  Prep is done  for dinner.  Last Saturday I managed to slice one finger and one thumb while slicing garlic.  The unwanted protein was extremely thin and not even deep enough to bleed.  But that is decidedly a warning about future days in the kitchen.