ptsd The Short Version Of C& P

[RonP]

I'll be brief, I have heart problems since 911 current ptsd with 50% Tinutus 10 % USMC in country 67 68 DMZ 0331 Machine Gunner GruntI just had the AO IHD examThe doctors words are quoted from here.

"Diagnosis"Ischemic Heart disease,Cad,cardiomyamegally,S/P MI, S/P CABG, S/P Failed PTCA.Artereoseptal Wall MI, Old.Lateral Wall Ischemia.PVC'S in Quadridgeminy.Hypokinetic anterior,anterosepatal,inferoseptal,anterolateral walls from base to mid.Hypokinetic anterior,septal,lateral and inferior walls of the apex.LV Dysfunction.Dilated left atrium with no evidence of thrombus.FC 111.3 Mets.Problem associated with the diagnosis: Chest PainEFFECTS on usual occupation and resulting work problems:Severe restriction preventsEFFECTS on usual occupational activities: Lack of stamina;Weakness or fatigue; chest pain.Are there effects of the problem on usual daily activities? YES Description of the effects of the problem on usual daily activities: Moderate/Severe restriction.Was a medical opinion Requested? NO "

Now I have gotten this long winded because I have trouble figuring this out.It is way above my head. Is is possible one of you kind souls, will open your heart and tell me what to expect from uncle SaM...originally filed in 1995 and I am now in Manila PhilippinesContact me direct if the rules allow it. This C&P was given in Manila by a non VA DR. on 11/4/ 2010.......I am asking some one to guess a rating and a dollar amount ... My file is currently in San Diego and that is all I know.is that possible ?If not I'll take any answer I can get

[RonP]

The doctors statement said the Ejection Fraction was 28, this is the DR giving the Exam.

The Dr at the hospital made a statement verbally when she put the scan side by side with the previous one,

that the previous echo technician, and Dr missed the crucial difference and circled it on the 2 d echo. She also stated

Ejection Fraction 28, the previous va scan said 42.

The civilian 3d echo in color at the CAD was 26, it was done again and was 27, one year later done again

it was 28. The Dr at that time felt quite successful as she said it was the med change they gave me.

There were a total of 63 days of intensive care for these surgeries, including the 4 way by pass

and 4 heart attacks later. When I was younger I was on a transplant list but at 58 they have to remove you.

I was told the same thing at the VA. I also eluded I did not want to consider a transplant, after speaking

with other transplantation patients.

They decided to stabilize with drugs only when I turned 58.

I am 62 now and could not possibly hold down any job here in the Philippines, as I am not allowed to work according to Social Security and Philipino Law.

I just got off Skype with my VA advocate in California, my home state and he said my file in San Diego was leaving the raters desk on Friday, and then on to others that had to sign off on it.

Thats all I know at this point. The VA flat refused to accept a claim for a heart condition as I was referred by a Psychiatrist, even though a letter from the Chief Cardiologist was with the filing.

2 years later we filed again for the first time , I was given 0-0 but a claim date and so on. The VA have been providing me Meds for my heart but no other services other than seeing the VA

Cardiologist that rated me at 42 EJF, every 6 months. I have been to private cardiologist on my own nickel as the VA offered no treatment or follow up here except every 6 months

Mets were never brought up because of my condition, not able to test. There may be some code in the 2 d echo, But I am not aware of it.

I am estimating a 60day window to resolve this, with the exception of Republican intervention, or freezing up the system. as of today.

Good Luck to All Of You......

[RonP]

There is no mention of LVE / there is LV Dysfunction The answer you are looking for Berta is the first line LV Function

Mine stated Dysfunctional

Ejection Factor 28

Mets 3

There is a mention of Left Ventricular mass index 110g/m2 Normal Ratings partition normal values are 163 g/m for men and 121 g/m for women

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Left venticular hypertrophy (LVH) and abnormal LV geometry are both important markers of cardiovascular risk among hypertensive subjects. They are associated with increased cardiovascular morbidity due to progressive ischaemic

compromise, systolic and /or diastolic dysfunction, arryhthmias and sudden cardiac death [1-5]. LVH is defined as increase in left ventricular mass. It is usually associated with increase in wall tension, wall thickness or l

eft ventriclar cavity size. There is usually no increase in the cavity size until later when there may be accompanying volume overload [6,7].

LVH can be diagnosed by electrocardiography or echocardiography [8]. Though the sensitivity of various ECG criteria remains very low (ranging from 7 to 35% in mild hypertension and 10 to 50% in moderate and severe

hypertension),[9] it is still in use in many parts of the world. However,Echocardiography, though not widely available in many parts of the developing countries, remains the more sensitive and acceptable modality for

diagnosing LVH [10]. According to the Framingham’s study, a 40% rise in the risk of major cardiovascular events can be expected for each 39 g/m² or standard deviation increase of left ventricular mass [11].

Left ventricular hypertrophy in hypertension is associated with increased prothrombotic state, microalbuminuria, higher systolic hypertension, increased body mass index, fasting serum lipids and blood sugar levels [12-15].

Left ventricular mass and left ventricular mass index more than two standard deviations of normal is defined as Echo LVH. One of the echocardiographic criteria for LVH are 134 and 110 g/m² in men and women respectively,

although there is a relatively wide range of published cutoff values [16,17]. Findings from the Framingham Heart Study also suggested that normalization to height might be more accurate;

the partition normal values are 163 g/m for men and 121 g/m for women [18]. Other studies have suggested different thresholds of 145 g/m in men and 120 g/m in women [19].

Various left ventricular geometrical pattern occurs as a result of adaptation of the left ventricle to increasing wall tension, pressure and volume changes in hypertension.

The geometric patterns have significant impact on systolic and diastolic function of the left ventricle [1]. The geometric pattern of the left ventricle is therefore also important in

cardiovascular prognosis. Four types of LV geometry have been described based on relative wall thickness (RWT) and left ventricular mass (LVM). They are: Normal geometry

(normal RWT and LVM), concentric remodelling (Normal LVM and increased RWT), concentric hypertrophy (increased RWT and LVM), and eccentric hypertrophy (normal RWT

and increased LVM). Patients with concentric remodelling may equally have increased adverse cardiovascular risk as those with concentric hypertrophy [20]. The aim of this study

was to study the pattern of left ventricular hypertrophy and geometry among treated hypertensive and associated clinical correlates.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Abstract

Background: 2-D Echo is often performed in patients without history of coronary artery disease

(CAD). We sought to determine echo features predictive of CAD.

Methods: 2-D Echo of 328 patients without known CAD performed within one year prior to

stress myocardial SPECT and angiography were reviewed. Echo features examined were left

ventricular and atrial enlargement, LV hypertrophy, wall motion abnormality (WMA), LV ejection

fraction (EF) < 50%, mitral annular calcification (MAC) and aortic sclerosis/stenosis (AS). High risk

myocardial perfusion abnormality (MPA) was defined as >15% LV perfusion defect or multivessel

distribution. Severe coronary artery stenosis (CAS) was defined as left main, 3 VD or 2VD involving

proximal LAD.

Results: The mean age was 62 ± 13 years, 59% men, 29% diabetic (DM) and 148 (45%) had > 2

risk factors. Pharmacologic stress was performed in 109 patients (33%). MPA was present in 200

pts (60%) of which, 137 were high risk. CAS was present in 166 pts (51%), 75 were severe. Of 87

patients with WMA, 83% had MPA and 78% had CAS. Multivariate analysis identified age >65, male,

inability to exercise, DM, WMA, MAC and AS as independent predictors of MPA and CAS.

Independent predictors of high risk MPA and severe CAS were age, DM, inability to exercise and

WMA.

2-D echo findings offered incremental value over clinical information in predicting CAD by

angiography. (Chi square: 360 vs. 320 p = 0.02).

Conclusion: 2-D Echo was valuable in predicting presence of physiological and anatomical CAD

in addition to clinical information.

I am told it is on a raters desk in SanDiego

Still waiting.

Ronald

to understand 2 d Doppler index scores go to

http://eurheartj.oxf...25/24/2220.full

from oxford. It concerns morbidity rating

To understand the importance of a 2 d Doppler go to

http://www.ekerala.n...oppler&type=web

I can find no mention of (LVE)

Here is the complete Breakdown of 2 D Doppler

http://www.ekerala.n...2%20d%20doppler

I was denied a heart claim in a since, they gave me 0% with -0- compensation.

The current Ejection Fraction is 28 / no they called something a Simpsons =33/26

Thanks

Edited March 15, 2011 by RonP

[Berta]

If this is diagnosed as Ischemic heart disease (Most CAD- but not all -is)

this should warrant an AO award.

"There is no mention of LVE / there is LV Dysfunction The answer you are looking for Berta is the first line LV Function

Mine stated Dysfunctional

Ejection Factor 28

Mets 3"

I dont understand how they rated you as "0"% in the past for this condition.

Hopefully you will hear something soon as your SO indicated signatures were pending.

I wonder if some AO claims were sort of on hold awaiting a potential gov shut down last week.

The VA 800# told me my claims had been set to "go forward" as of March 7th.

One is from 2004 and the other is a formal IHD claim of Aug 2010.Both under Nehmer.

He couldnt tell me what the "go forward" entry meant on the PC when he looked up my claims.

I have noticed a big drop in the AO decisions lately so I think it might have been due to an anticipated possible gov shut down that never happened.???

[RonP]

Thanks for the update Berta, It seems we all our hands full ( of Paper ) We just have to find a way to convert it To Double Eagles, or Krugerands

Good luck....I am at the end of comments about this subject. I live in the Philippines, I am goin fishen.

Ron Prince

If this is diagnosed as Ischemic heart disease (Most CAD- but not all -is)

this should warrant an AO award.

"There is no mention of LVE / there is LV Dysfunction The answer you are looking for Berta is the first line LV Function

Mine stated Dysfunctional

Ejection Factor 28

Mets 3"

I dont understand how they rated you as "0"% in the past for this condition.

Hopefully you will hear something soon as your SO indicated signatures were pending.

I wonder if some AO claims were sort of on hold awaiting a potential gov shut down last week.

The VA 800# told me my claims had been set to "go forward" as of March 7th.

One is from 2004 and the other is a formal IHD claim of Aug 2010.Both under Nehmer.

He couldnt tell me what the "go forward" entry meant on the PC when he looked up my claims.

I have noticed a big drop in the AO decisions lately so I think it might have been due to an anticipated possible gov shut down that never happened.???

[RonP]

Basically I just wanted to update everyone.

My physical condition is worsening, and they just might get to keep the money.

Not feeling real well today, up downs....and now I have the go around.

I wet the bed last night, The Catholic Church here in the Philippines puts on a show,

I'm serious, so I'm dead asleep on my drugs, hear the bugles blow.....Well at Quangtri it meant

the NVA was making an assault, I grabbed a Machete and a club and went out in the front yard

in my Pajamas. For those of you that are to young to know, this is a real flashback......

I was at the Namo Bridge in tet.......the bugles blew loud

Ron

PS The government is still up to the norm.....no letters, no cash, I did find a Dead lizard in my mailbox...

not a coin in his pocket.....but the ants put him out of his misery pretty quick.

I need a bigger mail Box 2ft by 6ft.....come on ants...I dare ya.

[RonP]

The latest Saga of the ineptitude of the Va:

To bring you current, I wrote the Inspector General at the suggestion Of Congressman Fillner.

I asked the VA why I was not receiving treatment in Manila, Republic of the Philippines I am at a total loss, and consider my self to be the ultimate BUTT ov the VA system

For my 100 % award. The Inspector General's answer is as follows and is a QUOTE

" I understand very clearly that Ischemic Heart Disease is a presumptive condition resulting from exposure to Agent Orange.

Let me also be clear that I am not a lawyer and I am not a VA Benefits or Comp and Pen expert. I investigate quality of care issues.

To the best of my review of your record, the reason that you are not service connected for your heart disease is because the question asked at your Comp and Pen exam for your heart disease was not, “Is this related to Agent Orange exposure,” but, “was this caused or made worse by your PTSD.”

I highly recommend you request, in writing, a Comp and Pen exam for your ischemic heart disease on the basis that it may likely be related to you Agent Orange exposure.

Do you understand what I am saying? You need to have a Comp and Pen exam for service connection between your heart disease and Agent Orange exposure (not PTSD).

Here is the directive that guides services to veterans in the Philippines. I am not sure the link will work for you, but you should be able to Google the VHA Directive Number and access the document on the internet. This is not a new directive, but just a renewal of an expired version.

VHA Directive 2012-019, Outpatient Health Care for United States Veterans Residing In or Visiting the Philippines at the Department of Veterans Affairs (VA) Clinic in Manila, has been approved for publication; it can be found by clicking on the following link (http://vaww1.va.gov/...asp?pub_ID=2767). I understand very clearly that Ischemic Heart Disease is a presumptive condition resulting from exposure to Agent Orange.

Let me also be clear that I am not a lawyer and I am not a VA Benefits or Comp and Pen expert. I investigate quality of care issues.

To the best of my review of your record, the reason that you are not service connected for your heart disease is because the question asked at your Comp and Pen exam for your heart disease was not, “Is this related to Agent Orange exposure,” but, “was this caused or made worse by your PTSD.”

I highly recommend you request, in writing, a Comp and Pen exam for your ischemic heart disease on the basis that it may likely be related to you Agent Orange exposure.

Do you understand what I am saying? You need to have a Comp and Pen exam for service connection between your heart disease and Agent Orange exposure (not PTSD).

Here is the directive that guides services to veterans in the Philippines. I am not sure the link will work for you, but you should be able to Google the VHA Directive Number and access the document on the internet. This is not a new directive, but just a renewal of an expired version.

VHA Directive 2012-019, Outpatient Health Care for United States Veterans Residing In or Visiting the Philippines at the Department of Veterans Affairs (VA) Clinic in Manila, has been approved for publication; it can be found by clicking on the following link (http://vaww1.va.gov/...asp?pub_ID=2767).

Response from the Inspector General

I received your fax. Thank you. That is the information I was looking for. I will let you know as soon as I receive their response.

Office of the Medical Inspector (10MI)

810 Vermont Avenue, NW

Washington, DC 20420

Office 202-461-4087 BB 202-281-9015

I sent this email to VISN 21 and to (at Manila):

faxed me documentation that he was awarded service connection for his heart condition, with a rating decision on May 3, 2011.

The decision states:

“ Service connection for coronary artery disease with scar status post coronary artery bypass graft (CABG)(originally claimed as heart condition) associated with herbicide exposure is granted with an evaluation of 60 percent effective February 25, 2005. An evaluation of 100 percent is assigned from July 1, 2008.” The decision was reached through the San Diego Regional Office. I can fax or send you this information if you like.

Please let me know how you folks can amend his record to reflect this decision. I do think it will make a difference in the care he receives from the Manila Outpatient Clinic.

Thank you.

If you fight long enough and hard enough and fall down and cry, Stand up Be a Marine...Charge on..I did I achieved the objective / Semper FI

Edited July 25, 2012 by RonP