VA-Shinseki thoughts drafted. For now I think about knees and trees.

My thoughts on the resignation of Gen. Eric Shinseki as Department of Veterans Affairs secretary is in draft form and in the cooler. I’ve been sitting here writing for awhile and my knee has begun to bother me as it has more and more during the last couple of days. Hopefully, I will get back to my draft and publish it tomorrow.

I haven’t written a whole lot lately because I’ve gone to physical therapy several times a week around the time I usually write after work. My knee has become more painful in the last week. I was hoping surgery and some therapy would help. Something doesn’t seem right about it so my therapist said he would try to talk to my surgeon. He said it could be that I need a brace that puts less pressure on the part that is giving me trouble.

My normal routine in physical therapy has been to wire me up with a TENS-like electrical stimulus and place a heating pad on top of it. And when I say a heating pad, I mean that mother is HOT. I also have undergone some ultrasound and dry laser therapy as well as numerous leg lifts of several types and a leg lift while lying on my stomach. Usually, I have them ice down my knee for about 10 minutes before leaving. The results I have experienced have been mixed.

Now I am at a point where I wonder how long I will have to wear a brace? Is the problem I had not fixed? Will I need a knee replacement? I have already “wasted” what I consider to be four months since I first injured my knee to surgery and up to now in two weeks of physical therapy. It seems so long ago that I was hiking through the Big Thicket or the Angelina National Forest. I can’t even imagine what is in store in the future. In part, I don’t want to think about it.

If you haven’t read this blog before, then you know it is mostly for me to indulge myself in one of the main past-times I enjoy and which also has been, in the past, a living. At least I can still write. Now if only I can walk out among the pine trees again and listen to the wind whistle its song through the tree tops. That would be about all I could really ask for. That and to not end sentences with prepositions.

 

Marshall or Moon plan: Help for VA needs big fix

Each time another new scandal breaks involving shoddy health care practices at the Department of Veterans Affairs does it seem a case of deja vu arises.

That the newest VA scandal, in which patients are allegedly dying because specialty care has not come quick enough as well as the “secret lists” regarding that specialty care seems as if the scope would indicate a large-scale scandal. And since the Republican opposition is always hunting the new “Watergate” or “Benghazi,” if you will, this counts as the first major VA scandal for the Obama administration.

The truth, sad to say, is that similar albeit smaller-scale scandals have occured for years. Take for instance a personal anecdote.

From middle 2000 to the same time in 2001, I was suffering from a very painful and near disabling episode of a couple of ruptured cervical discs. I was taking several pain-numbing opiates which left me in a cloud, all the while my neck and arm pain was not abating and my left hand had nearly gone numb. I had a job with insurance then although my meds were more affordable at the time with the VA than through civilian doctors.

I later would be diagnosed with depression but at this time, the pain and the opiates were leading me down the path to Crazyville. I finally asked to see a VA neurosurgeon, though that was much more easier said than done. I was told that the Dallas area VA system — I had to ask there because the Temple (Texas) VA hospital that was my hospital said they didn’t have a neurosurgeon at the time– had but one neurosurgeon. I found that incredible to say the least. I knew for fact that Dallas, like most large VA hospitals, operate in conjunction with big medical centers and medical schools. In the case of Dallas it is the University of Texas Southwestern Medical School. The Temple VA Hospital is the clinical campus for the Texas A & M University medical school. Nevertheless, I ended up going to the Dallas VA hospital where I was told it would be six months until I would get to see a neurosurgeon.

Eventually, I relented after the pressure from my boss. I saw a civilian neurosurgeon in Waco and I was able to give this doctor all the test information including a MRI, that was done by the VA. About a month after first seeing the neurosurgeon, I received a call from Dallas VA saying an spot had opened so I could see a VA neurosurgeon early. Could I possibly come to Dallas on Aug. 9? As it so happened, I was scheduled for neurosurgery in Waco on that date.

My major concern with having surgery performed by a non-VA doctor was the price. I had already wrecked my personal finances with an initial cervical spine surgery. I was not sure how I could keep from going into another fiscal black hole with what would probably be an even more expensive surgery. But I was pleasantly surprised in the financial sense at least. With the VA paying for all my expensive tests and a co-insurance taking care of added expenses, I probably spent no more than $1,000 out of pocket for my operation. That was astonishing. It was also probably the only bright light of this dismal experience. Well, that and the fact the surgery gave me a couple of years without pain and my hand no longer was numb.

By the time of my surgery I had begun covering the VA as part of my beat as a reporter. I also wrote a weekly column on veterans issues. The column was distributed internationally through The New York Times News Service. I was once visiting one of my brothers in East Texas and I happened to see a column of mine on the op/ed page of the local daily. I called it to my brother’s attention.

“Yeah, you’re getting to be a regular Cal Thomas,” my brother wisecracked. Not the comparison I would have preferred, but it was a notice nonetheless.

I began to study what was happening nationally with the VA, not just in my local hospital — where Washington had by then threatened the shuttering of our local hospital along with some others in the nation.

I found then as now, the biggest problem facing the VA — given the past and this most recent scandal — is money. Or rather the lack of a steady funding stream and the wise deployment of funding.

No doubt, I have been disappointed with Gen. Eric Shenseki and his stewardship of the VA as secretary. The former Army Chief of Staff came at a time when firm leadership and innovative thinking was needed more than ever. Unfortunately, Shenseki did not seem to offer any such qualities.

The VA under the Bush Jr. administrations tried the tired old Republican ploy of shrinking resources as a way to manage fiscally. The wars that Bush pushed the country into — the types of war in general leading to many disfiguring amputations, brain injuries and PTSD — all began taxing the VA health care systems. By the time the wars were nearly over the VA tried to offer all the services to its expanding and an existing patient populations as if it were an everyday operation. It isn’t. A true crisis has hit the VA. Years of merely funding part of the VA’s needed dollars has finally come back to bite them in the ass. The problem of long waits for care has caused some administrators to do when they are truly backed into a corner: hide the problem.

These budget problems will continue until Congress finally comes to its senses — a truly scary wish — and makes funding for all VA programa mandatory. Currently, slightly less than half of VA expenditures comes from discretionary funds from Congress. Programs such as disability pensions and other programs are mandatory but the meat on the bones for medical care requires a mandatory funding system. Once that is accomplished, the VA needs a George Marshall Plan or a man on the moon-type program to make the VA function as it should. A seamless transition of care between the military and VA should also be established.

The problems with the VA are many but are solveable.

Working out the pain is its own pain

Today is “Hump Day” and like Caleb the Camel, one of GEICO’s most recent animated animal spokespersons, I am enthused the week is over the hump. My reason for enthusiasm though is that I now have only 10 of 12 physical therapy sessions left. By this time tomorrow the number will hit a reduction to nine.

A visit to my orthopedic specialist yesterday found me halfway hobbling into the examining room. I had arthroscopic work completed on my medial and lateral meniscus of the knee more than a month ago. I guess getting the fed workman’s compensation folks to deal with helped slow the process down to a crawl.

I have been restricted by my physician to standing for no more than two hours per day each day now for two months. That is something I am sure my work supervisor has tired of as much as me. Maybe not. I am most assuredly sick of it. And now I must complete physical therapy before I can return to full duty at a part-time job that seems as if it is full time. Ah, but thou dost complain too much!

Not really. The people at physical therapy are all nice, or at least so far. And they are patient, or at least so far.

I have not yet been asked to do anything that would make me cuss out anyone or throw up on them.

Maybe though, the one concern I have is my continuing bothersome pain in my operated-upon knee. I didn’t think it would be perfect right off the bat. Although, the doctor did shoot my knee up with some kind of pain killing substances when he did the arthroscopic surgery and I was pain free in that knee for a few days. But continual pain in the knee is no good. The reason could be arthritis, or it could be overwork of these body parts. It might be something else.

Hell’s bells.

I suppose I have a lot to be thankful for. But a wholly healed knee is not one of them. So I bitch and moan. And I tick off the time until physical therapy is finished in 10 days spread out through the next three weeks.

Another week another month. Here there and everywhere.

A month of medical appointments and physical therapy face me in this following month. Physical therapy is scheduled for 3 times per week for four weeks. I have the first appointment in an hour. I am so enthused.  Several clinics at the VA hospital in Houston each day during the next three weeks are also on my list although these clinics are ones I have mostly waited on for quite a few months. I also see my neurologist who has become like a second primary physician, if you will.

The last few weeks have been stressful, and ultimately sad. My older brother Robert, died last week at a young 66 years old. It was unexpected, I guess one could say. He had been sick but was on the liver transplant list. During the past couple of weeks in hospitals, his body just shut down on him and he suffered a couple of heart attacks. Physicians tried to save him with emergency heart surgery, but it didn’t work. His wife and children had a nice memorial service for him on Sunday at his Methodist church as he had been cremated.

It is difficult dealing with his loss and I don’t know if the fact that he is gone has set in just yet. Time will tell, I suppose. It’s been some 25 years since my parents passed away. My Dad died in June and Mother in the following April. I don’t suppose one ever gets over the death of a relative or close friend.

Right now, I am a bit sleepy. I haven’t slept well recently but I got a fairly nice rest yesterday and overnight. I am ready for my knee to heal. I’ve been ready. For now, I must get ready for physical therapy. Joy.

What one has to do to breathe these days

Probably an hour of my time was taken this afternoon learning how to use a humidifier on my CPAP machine. For those of you raised by wolves, a CPAP is a continuous positive airway pressure machine used for sleep apnea, which I have. If you want to know about sleep apnea, then I suggest you look for its meaning. Especially so if you snore so loud you wake yourself or others up in the night.

I received a new full face mask for my machine yesterday from the VA since mine has leaked air for awhile. Since the objective is continuous positive airway pressure then it would make sense you don’t want that air to leak. If you have sleep apnea like me, and you have insomnia like me, then a leaky mask is a worthless accessory to your nocturnal breathing. If you don’t know what nocturnal is, get a freaking dictionary. The new mask came with a couple of little manuals. A Velcro snap on a strap that runs across the crown of your head is meant for positioning the air hose over the back of your head, down your forehead and to the mask. I didn’t want that so it took me about another hour, manual included, to figure out how the mask fit on my head.

Last night I had the mask now set to easily pull it over my head and on to my face. I had to do a little adjusting because I wear a bandana around my head that I use for a sleep mask. It has become a habit,the nighttime bandana.

In a very short period of time it seemed as if I was getting more air than usual, plus my mouth and throat were drier than the Texas sand, to paraphrase the great songster Gary P. Nunn. Finally, I had to take the mask off. I just couldn’t keep getting up every hour and getting a drink of water. So, I decided upon finally using the humidifier.

Because  water is poured into the humidifier and failure to properly clean it can get one mold in their machine I had tried to avoid the accessory. The humidifier is about the size of the CPAP machine so the breathing apparatus expands in size by approximately two. It takes up more space, in other words, which I don’t have. I also fly somewhere once or twice a year so I don’t enjoy having one more object for the TSA to examine through security check.

Finally, the machine is hooked up and it seems to be working with the humidifier, so far. The test comes tonight. We shall see if the blogmeister has mastered the operation of a fairly simple CPAP machine in this day and age. How the new generations will learn all the stuff they need to operate in their lifetime, I don’t know. I suspect they’ll have an easier time than this old dog learning new technology. Let them worry about it. Hell, they are more technologically-adroit by the time they reach middle school these days, the kids probably know 10 times as much as I know. So let them have at.