Vets: The VA doesn’t feel your pain.

I am being involuntarily removed from my methadone prescription for chronic pain. I was taking 5 mg three times a day. The doctor says she is “weaning” me off of methadone. She didn’t say why.

Some months ago I went to the so-called “Pain Evaluation Clinic” at the Michael E. DeBakey Veterans Medical Center in Houston. I saw a psychologist for about an hour and spent about the same with a physician assistant who proceeded to make clear that I would be taken off methadone. I have taken the drug for more than 11 years. I had a couple of medical tests on the horizon that concerned me so I was spared from the weaning for the time being.

I never really received an explanation why I was being taken off methadone. The PA told me that my prescription for 15 mg was equivalent to 60 mg morphine equivalence. In extensive reading this afternoon, I found nothing to indicate whether this equivalence is accurate due to the medication itself.

The PA, I suppose, tried to scare me out of my methadone prescription. She gave me the impression that I could all of a sudden overdose while taking just a normal dose. I found nothing to support such claims.

It is true that methadone overdose deaths represent about 1-of-4 total fatal ODs. I found this on one government medical site:

“Methadone is a very strong painkiller. It is also used to treat heroin addiction. Methadone overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

 “Methadone overdose can also occur if a person takes methadone with certain painkillers. These painkillers include oxycontin, hydrocodone (Vicodin), or morphine.”

Look Ma, no spontaneous overdose from normal dosage for years.

Don’t bother going to the VA for severe pain. They want you to hurt. I guess service to the country wasn’t enough.

Here is some additional illumination about methadone overdose from CRC Health Group, a West Coast addiction and behavioral treatment group based in California:

“Between 1999 and 2004, deaths attributed to methadone increased by 390%, an effect primarily related to increased utilization in pain clinics , as well as diversion.

 “Methadone accumulation can lead to sedation, respiratory depression, respiratory arrest and even death. Lethal respiratory depressive effects can occur in doses as low as 30 mg in non-tolerant persons

  “Initial efforts to characterize risk factors derive largely from Australia, where deaths related to methadone tablets prescribed for chronic pain increased markedly between 1984 and 1994. Diversion of methadone tablets accounted for about half the deaths, whereas deaths from prescribed methadone declined over this period. “

As CRC quite succinctly pointed out:

  “You must take methadone responsibly and with respect for its power, but the careful and considered use of methadone has proven quite safe, even for long-term consumption. Methadone has been proven not to harm the lungs, heart, brain, liver, kidneys, or any other organ.n 4,000 deaths. However, many of these deaths did not involve methadone treatment for opiate addiction — instead, they involved individuals who were using methadone without medical supervision for pain treatment, or who were otherwise abusing methadone.

 “Methadone use saves far more lives than it endangers. According to the National Alliance of Methadone Advocates (NAMA), opiate addicts who are not on methadone are more than three times more likely to die than are individuals who are using methadone as part of a supervised addiction recovery program.

 “Methadone, much like any strong opiate analgesic, has a respiratory depressive effect. If you take too much methadone, you can stop breathing and die.”

Simple enough!

A registered nurse friend of mine said recently:

 “You’re right that it’s the fentanyl and oxy and it’s the serious main-liners fucking it up for all of us. This entire thing is blown up by big pharma – I’m sure we could follow the $ and figure it all out, but the guy in pain is paying the real cost of trying to make it without his pain meds. It’s a mess,” she said. “It’s horrible and I can’t believe the medical system is letting them interfere with medical practice like this. It’s illegal and malpractice not to treat a patient with the correct medication when it’s available. Period.”

My weaning is in a rapid fashion. It makes me wonder if VA practitioners receive a bonus for cutting off opioids for some old vets with severe pain.

I started with being prescribed 10.5 mg three times per day. This month I received a prescription for 5 mg twice a day. Next  month it will be 5 mg once a day and 2.5 mg once a day.

I was never given a firm reason why I should quit taking methadone. I don’t have to though. It seems most VA top leaders want to look good for their boss in the White House. I doubt he could tell an opioid from a hemorrhoid.

Even worse than how I will fare without methadone from a withdrawal standpoint — almost 12 years is a long time on an opioid — is the pain.

I have not been offered a firm solution to the often severe chronic pain from spinal stenosis in my cervical spine, this despite having two surgeries. I also suffer from excruciating lower back pain that doctors at the VA have never seemed to agree on the reason. It limits my walking and the problem has never been substantially addressed, with the exception of a diagnosis of arachnoiditis. The condition is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord.  The diagnosis seems dubious after seeing a number of different doctors.

Most disturbing are the VA pain strategies involving high doses of over-the-counter analgesics such as Tylenol or Ibuprofen. For real? Do they seriously believe such OTC drugs will help after taking methadone for almost 12 years?

Other VA “pain control” suggestions include physical therapy, chiropractic, acupuncture and group therapy. I just know sitting with a group singing “Kumbaya” will kill the pain.

I don’t know what will happen in the future. Most certainly, I am scared. I was put on methadone by a VA pain doctor in Dallas who suggested methadone after he told me there was nothing he could do to help. I have tried all the VA has had to offer since 2006 and those strategies that do not work for me have only grown 12 years later.

I can certainly understand why many VA patients may go elsewhere for help with pain. I don’t plan to seek black market opioids. Beyond that, I will do what I need to do to survive severe pain on a daily basis.

Veterans Day 2017 — Who are we

Veterans of the U.S. Armed Forces celebrate Veterans Day today, Nov. 10, the official federal holiday, and on Saturday, Nov. 11, the date of the WWI armistice.

World War II veteran Daniel Lau attends a Veterans Day ceremony at the National Memorial Cemetery of the Pacific in Honolulu, Nov. 11, 2016. Lau served in both theaters during World War II and fought in The Battle of the Bulge. Navy photo by Petty Officer 2nd Class Aiyana S. Paschal

Veterans Day is a day of memory. Memory of days past, when we wore the uniform, during both war and peace. We remember those veterans who are no longer with us, and those we strongly remember, among those are our friends.

So one might ask, just who are the veterans? Here are some interesting statistics from the U.S. Census Bureau:

Veterans Day 2017: Nov. 11
Veterans Day originated as “Armistice Day” on Nov. 11, 1919, the first anniversary marking the end of World War I. Congress passed a resolution in 1926 for an annual observance, and Nov. 11 became a national holiday beginning in 1938. President Dwight D. Eisenhower signed legislation
in 1954 to change the name to Veterans Day as a way to honor those who served in all American wars. The day honors military veterans with parades and speeches across the nation and a remembrance ceremony takes place at the Tomb of the Unknowns at Arlington National Cemetery in Arlington, Va. The ceremony honors and thanks all who served in the U.S. armed forces.
The following facts are made possible by the invaluable responses to the U.S. Census Bureau’s surveys. We appreciate the public’s cooperation as we continuously measure America’s people,
places and economy.

Veterans
18.5 million
The number of military veterans in the United States in 2016.
Source: 2016 American Community Survey
1.6 million
The number of female veterans in the United States in 2016.
Source: 2016 American Community Survey
11.6%
The percentage of veterans in 2016 who were black. Additionally, 78.0 percent were non-Hispanic
white, 1.6 percent were Asian, 0.7 percent were American Indian or Alaska Native, 0.2
percent were Native Hawaiian or Other Pacific Islander, and 1.3 percent were some other race.
(The numbers for blacks, non-Hispanic whites, Asians, American Indians and Alaska Natives,
Native Hawaiians and Other Pacific Islanders, and some other race cover only those reporting a
single race.)
6.5%
The percentage of veterans in 2016 who were Hispanic.
9.2 million
The number of veterans age 65 and older in 2016. At the other end of the age spectrum, 1.6
million were younger than age 35.

For more information on Veterans Statistics, see https://www.census.gov/content/dam/Census/newsroom/facts-for-features/2017/cb17-ff22-veterans-day.pdf

 

VA Official: Flooded Beaumont VA to reopen soon. Nearby the saddest and most remarkable event from Tropical Storm Harvey

Southeast Texas veterans and their families can return in November to the Beaumont VA Outpatient Clinic. I hope that if you read this, pass it on to other veterans.

My local Department of Veterans Affairs Outpatient Clinic has been closed since being, at least partially, swallowed by the Great Flood of Ought-17. The clinic I use, which is only a block from Interstate 10 in Beaumont, TX. The flooding was due to Hurricane-Tropical Storm Harvey. I have to go to that Clinic at least every two months or so for various reasons. Thus, I looked at the VA information on the ‘net and saw that the Beaumont VA clinic was closed when the flooding began at the end of August. It remains closed here on Oct. 25, 2017.

An RV hosts a mobile Vet Center in Beaumont after flooding from Harvey. VA photo.

A spokeswoman for the VA at the Michael E. DeBakey VA Medical Center in Houston said the Beaumont clinic building will open soon.

Maureen Dyman, Houston VA spokesperson said in an email that the clinic is set to reopen “sometime in November.”

” … we are seeing more than 100 patients a day in 5 mobile medical units set up out in the parking lot of the clinic. We are really committed to serving our Beaumont Vets during this time,” Dyman said.

Those units outside the water-logged clinic building are reminiscent of “M.A.S.H.” in the movie and television series. That is due to the series of tents outside the clinic. There are also some big RVs helping such as the photo of the mobile Vet Center. Still, in all of this, it seems the staff is getting things done the best they can, at least that was my one experience.

I figured the clinic would be hard hit with flooding. Just off I-10 and near the clinic was where a nurse for a Port Arthur hospital had, for some reason parked in rising flood waters at at a medical building. When Collette Sulcer stepped out of her car with her 3-year-old daughter Jordyn, she was swept away in the swift water, hanging on. Local police and firefighters in a Zodiac boat happened to see a woman in the flood waters with a little girl hanging on. The first responders plucked the child from the flood waters as well as her mother. The police and fire people saved Jordyn but Collette didn’t make it though those responders and others tried mightily, giving the mother CPR all the way to a hospital. The mother died holding onto Jordyn Grace Sulcer.

Some say Collette is a hero for the remarkable feat of hanging on to her daughter in the racing water that claimed the mother’s life. Maybe. Perhaps so. But Collette Sulcer was also doing her most important job as a mother.

Living through another pain-in-the-ass disaster

If I could sum up the past week here in Beaumont, Texas, in one sentence, it would be: Natural disasters suck!

The town I live in has been in the news quite often over the week during the tremendous flooding that was a result of first, Hurricane, then Tropical Storm Harvey. The first hurricane I experienced was 12 years ago this month, Hurricane Rita. Three years later, Hurricane Ike, blew in from the Gulf and left a good portion of the Texas and Louisiana Gulf Coast flooded.

Rita had extensive wind damage and it took quite some time for Southeast Texas to rebuild. As was the case with both Rita and Ike, I was fortunate enough to sustain no property damage from Harvey. I did evacuate Rita though in my hometown some 60 miles northeast, although the damage there was also quite extensive as it was in Beaumont.

The biggest problem in Beaumont I have faced with Harvey’s deluge was having no running water due to the city losing its water supply system. That is, after the brief power outage we faced.

The water pump station is located along the Neches River and draws water from the river as the main source of water for the City’s water system. The City also lost the secondary water source at the Loeb wells in Hardin County. At this time there is no water supply for the City water system. It looked like after going through all of this, my apartments faced evacuation due to management’s concern about water supplies should a fire threaten us. We were given about 24 hours to find somewhere else to live.

But, we were told the next morning that we would be staying. Albeit, it was without running water.

The next day, a somewhat weaker water supply was evident with running water in the taps and in the toilets. However, we are required to boil any water we get from taps. One hopes boiling it will be a good fix because who knows what all kind of pollution is in the floodwaters.

There was a shortage of places to buy needed staples. Those stores are slowly but surely opening. The same goes for restaurants. I had a burger and onion rings yesterday from Willy Burger. Today, I bought a buffet carry-out meal at Golden Corral. It is the water supply that is also hampering regular operations of restaurants.

 

An Army vehicle carries a woman through flood waters in Orange, TX. The troops are from the 1-143 Infantry Regiment, Airborne Battalion. Army photo by Spc. Austin Boucher

Next in my big bag of flooding complaints is the fact that the flooding has cut off Beaumont from pretty much the rest of the world. First, almost every road leading in or out of the city was shuttered due to rising water. Today, Interstate 10 from Beaumont to the Louisiana line is closed mainly due to flooding in an around Vidor. U.S. Hwy. 96 which leads to Jasper and points north is closed due to the collapse of a bridge over Village Creek from flood waters. I-10 from Beaumont is open again, and I will have to use it to drive to a medical appointment on Wednesday at the Houston VA.

While Harvey did quite a lot of storm damage as a hurricane upon landfall near Corpus Christi, it was its unending rain that caused so much damage in Houston. Upon the storm re-entering the Gulf and making another landfall near the Texas-Louisiana border, that rain only became worse. I did see a lot of trees swaying to and fro as the tropical storm moved to the south of us. But it caused little wind damage up here.

There is no doubting that I am very fortunate in not having severe hardships such as requiring military helicopters to pick me up and taking me to some shelter. Just how many homes and other abodes will require repair or rebuilding, it is hard to say. Likewise, the human loss seems to climb every day. The toll has surpassed 60, ABC News reported tonight.

Finally, many societal questions have risen in Harvey’s aftermath. The first responders from across the U.S., and at least one person from Israel, came to help. A lot has been made about the “Cajun Navy” who have come to help. During such a crisis, there is often a tremendous sense of “coming together.” But we are a nation divided that continues down that path, I think, until that moron in the White House is gone. Even rebuilding will be negatively affected by Trump and his fellow assholes. The easy reconstruction process made so easy by ready Mexican labor during Rita will be in severe demand because of the racist moves of the administration to rid our nation of immigrants.

Our newest challenge is once again North Korea which exploded a hydrogen bomb during a test this weekend. The concern that nation is causing makes a 1,000-year flood look like a spring rain.

 

Trump: “Bring me more smoke and mirrors!”

More smoke and more mirrors. I know a little about smoke. In the header-photo above, I am the one on the tail-end of the 2 1/2-inch fire hose. I know 2 1/2 inches of hose does not sound like much of a hose. But it is. A normal uncharged section of 2 1/2-inch hose is not the easiest of objects to maneuver.  But once you charge that hose and the principles of fire hydraulics begin its activities, you have a whole lot of water and weight.

Now the picture above shows much more fire than smoke. It’s funny. When my lieutenant and I were fighting this blaze, it seemed to me that the heat, and smoke was much more intense than the blaze itself. As you look in this wonderful photo, you see the house outlined in fire. Thus, I saw much more in that picture of a house blazing than from when the house was right before my eyes.

lt is simple to say, the picture defies reality. What  that means is something entirely different. This afternoon, I heard something that defied  reality. That was when our president was collectively blowing smoke up our asses. It seems that Donald Trump does that quite often.

President Doofus was exercising his almost daily ritual, often times more than once, of blowing smoke and employing mirrors. Why? Well, if a little smoke looks good much more of it has to appear even better. Or so would such an argument — as stupid as it seems — might go.

Today’s grand illusion is the Department of Veterans Affairs.

By employing his weapon of choice, the presidential executive order, President All About Donald can claim all the credit should the VA order turns out to be an unqualified win.  And if matters should fail … Well … ?

There is no doubt that the VA has many problems although  many of its problems fall not so much in the area of health care.

The VA provides benefits to millions of veterans and their families. The third of the three largest branches of the VA handles nothing but cemeteries and veteran burial benefits. Even in the area of health care, a gigantic bureaucracy  looms to ensure the agency will be paid, one way or the other.

It is amazing how many people believe all veterans are due free health care. I once corrected a member of Congress on that fact. Only certain groups of veterans receive free care, among those are those whose illnesses or injuries are connected to the vet’s military service. Then, the percentage of that disability is service connected goes into the equation of what amount, if any, co-pay a veteran will pay.

I am at the low end end of care which is means-based. Last year, quite suddenly, the VA decided I owed them co-payments for medicines and afterwards were charged  for co-pays of actual medical care in addition to those for prescriptions. Many of those who know little of the VA may also not realize that one’s ability to pay is based on gross income. Let’s say my income is $45,000 a year. But I don’t work full-time so I might make no more than $24,000 after taxes. You see the problem there.

I spent quite a few years reporting on and writing about the VA. I saw the agency from a number of vantage points. Most recently I have seen the many views of fiscal accounting, or lack there of, from a patient’s point of view.

There are at least three and possibly more offices one must deal with in settling debts. These offices sometimes do not deal with each other directly.

If the president thinks he can sign a piece of paper and the VA will have its problem solved, then he will definitely require a lot of help. That, and much much more smoke and mirrors.