Josephine

John999, This one made me laugh. If you ever decide to make your fantasies a reality, would you please start in Virginia. Josephine

Jstacy, You are correct, it is the only true test for nerve damage. Josephine

Jstacy, Boy do I ever remember the needle test. I just hate to see the poor guy go through this unless it is absolutely necessary. Believe me I have had it done and when all was said and done, they couldn't do a thing to help my balance. Mine is plain inner ear with damage to the brain stem. Josephine

Bound4Heaven, If I remember correctly, isn't this veteran 74 years of age? Why in the world does this doctor want to put him through this test? I am assuming that a Neurologist or Psychiatrist will be doing the examination. I had one done and it is painful and I am a heck of a lot younger than this poor guy. I was like 48 when I had it done and what can they do to help when they are finished? I am sure that there are other vets that have had it done and can go into more detail. I would have to make sure that there is a sound reason for putting him through it. This will tell you all about the test from the internet: What are some problems for which EMGs are ordered? EMGs are usually ordered when patients are having problems with their muscles or nerves. They test the nerves and muscles of the body’s extremities, looking for a problem in either one of these areas. An EMG may be ordered to see if you have a pinched nerve in the back or the neck. If you have tingling or numbness in your arms or legs, an EMG may show if you have a nerve entrapment somewhere or a nerve injury. Weakness of the muscles or “fatigue” (tiredness) may be indicative of nerve or muscle disease and require an EMG. There are many other medical problems that might suggest the need for an EMG. If you have any doubts as to why you need this test, ask your doctor. What happens during an EMG? During this test, you will be lying on an examination table, next to an EMG machine (which looks like a desktop or laptop computer). The test consists of two parts, though at times one may be done without the other. The first part is called Nerve Conduction Studies. In this part some brief electrical shocks are delivered to your arm or leg in an effort to determine how fast or slowly your nerves are conducting the electrical current and therefore in what state of health or disease they may be. You see, a nerve works something like an electrical wire. If you want to see if the wire is functioning properly, the easiest thing to do is to run electricity through it. If there are any problems along its length, you will know it by a failure of the current to go through. To do this, the doctor will attach small recording electrodes to the surface of one part of your limb, and will touch your skin at another point with a pair of electrodes delivering the shock. When this happens, you will feel a tingling sensation that may or may not be painful. Between the brief shocks you will not feel pain. As there are several nerves in each extremity which need to be tested, the procedure is repeated 3 or 4 times or more per extremity studied. The amount of current delivered is always kept at a safe level. Patients wearing pacemakers or other electrical devices need not worry since this current will rarely interfere with such devices. During the nerve conduction study, the doctor or the technician performing the study will occasionally be pausing to make calculations and measurements. The second part of the test is called Needle Examination and as the name implies, involves some needle sticking. The needles used are thin, fine and about one and a quarter inches long. This part tests the muscle to see if there has been any damage to it as a result of the nerve problem or if the disease involves the muscle itself rather than the nerve. Usually 5 to 6 muscles are sampled in one extremity, but occasionally, if you have problems in more than one area, additional muscles may need to be studied. The needle is usually inserted in the relaxed muscle and moved inside gently in order to record the muscle activity. When this is done, you will be able to hear the sound of the muscle activity amplified by the EMG machine; it will sound something like radio static. The painful part of this section is when the needle is first inserted through the skin since all of the pain receptors are located in this area. Once inside the muscle, the sensation is usually perceived as discomfort or pressure rather than pain. During the needle exam, no electrical shocks are delivered. Also, since the needle probe is used here only as a recording device, no injections are given through the needle into the muscle. On the average, a muscle can be sampled in 2 to 5 minutes though this may vary with the type of problem being investigated. How long does an EMG take? The nerve conduction part of the test usually takes longer than the needle exam because one needs to make calculations and measurements during it. On average, if one extremity is studied, the nerve conductions take anywhere between 15 and 30 minutes. The needle exam for one extremity usually takes 15 to 20 minutes. You can count on being in the examination room for about one hour if only one extremity is requested; longer if more extremities need to be tested. What kind of preparations are necessary for an EMG? Few preparations are needed on the day you have an EMG. You do not need to fast, or eat any particular kinds of food before the test. You can drive yourself to and from the test, so you do not need to bring a friend or a relative with you, any more than you would say if you went to the dentist. You can count on resuming your regular activity after the test is completed. As for clothing, it is not as much what you wear as it is what you don’t wear. Since in a great majority of cases the low back and buttocks area may need to be studied or in cases of neck problems, the back of the neck and shoulder areas studied, it is best not to wear clothes which will interfere with access to these areas. With few exceptions, you may continue taking medication prescribed by your physician as ordered without this interfering with the EMG. However, if you are taking a blood thinner, you should notify the Lab where your EMG is being done, since in that case the needle part of the test may cause bleeding inside the muscle. Also if you are on any medication for Myasthenia Gravis such as Mestinon or other, your medication may interfere with the test, so you should also notify the Lab. If you have any doubts about other medications you are taking, it is best to check with the Lab to be on the safe side. Can I ask for some pain medication? Different labs have different policies about pain medication. Some physicians may recommend you take two Aspirins or Tylenols before the test. Others may mail you a prescription drug to take an hour before the test. Sometimes you may be given an injection prior to the test. It is common however, that no sedation is given in any form since in most instances, patients wish to return to work or other regular activity after the test is completed. Another reason for not giving sedation is that you should always have someone accompany you to drive you home after receiving sedation and this is not always easy to arrange. How soon will I find out the results? Though the physician performing the test has a general idea of what the findings are during the test, the full results are only arrived at after more calculations and measurements are performed after the end of the test. The results are therefore usually not ready until later that day or even the next in complicated cases. They are usually not released directly to the patient. Instead they will be conveyed to the referring physician since he or she has to assess the results in light of the patient’s other findings. God Bless, Josephine

This is just my honest opinion. I think that your letter is straight from the heart and should be sent to the R. O as you have it written and sign it and have the date and your file number or social security number on it. Do have your wife write her letter and if she prefers to type hers, that would be fine, but leave yours in your hand writing. Please do as Berta said and take out the part about the work at home. I don't carry a lot of Va knowledge with me, but I can tell a sincere letter when I read one. God Bless, Josephine

John999 and Hoppy, Again, many many thanks. I don't know how I could keep this going without your help. John, Hoppy is a very intelligent person and has been so much help to me and such an inspiration. The Va made sure that they kept him homeless for years, and this is such a disgrace. John, You are very intelligent also and I sure don't want you to think that I do not value your opinion also. I am training my brain to soak up everything that everyone is saying like a sponge. I am going to paste what Hoppy has sent to me and place this in my suitcase with all of my other records and take them with me to the other examination. I am not going to get emotional about this C&P. I have been through a wringer washer machine now and I am ready to fight fire with fire. I think that the last C&P, I was just a little too nice. Under their hynopsis it was difficult to keep myself focused on what they were saying. They will always deny this, but they know that they did it. I am presently taking Valium every 4 hours as needed and have found that this drug has worked best for me for the last 29 years and of course all of my others meds for H.P. Diabetic and etc. I will thank the lady shrink for placing my medications in my C&P examination. She has down Librium and Caffergot in service in 1964. Since the service extensive medical records began in 1965 with her pregnancy and then pick up again on Novemver 25, 1967 when Librium was ordered 5 mg. prn. From that point through 1979 she was given Elavil in 1975 ,Etrafon and Adapin; Valium in 1976 and Elavil; Elixir of Bitisol, Ativan in 1978 along with Stelazine for " chronic anxiety reaction." and then in 1979 she was begun on Valium again 5 mg daily. Also in 1979 there are prescriptions for Serex, Doxepin, Vistaril, Tranxene and Ativan. In 1976 was also given Fiorinal for headaches, Valium and Dalmane; In 1980 she began seeing Dr. P. who continued the Valium and began Darvocet on a regular basis for headaches. I see that she has left out some, but I will take it all with me. I have looked these drugs up on the internet and they are all for Anxiety, Depression and Headaches. I filed for service connection for Anxiety, depression and Headaches and they have called it a " Acquired Psychiatric Disorder. thanks a bunch to the both of you!! Psychopaths don't need librium since they feel they are perfectly fine and the world is wrong. This is what I call the Lady Shrink!! Josephine

Hoppy, Glad that you are back, but I sure know what you mean by a break. I think that most of the Psychiatrist out there need to go to one thereselves. Most of them don't have any sense. I did post my letter from my treating physician in service on line and the letters by by treating internist of 28 years. If you care to go to the first page and read under the Topic Preponderance of Evidence, it is all there. I appreciate all the support from everyone on this site. Today, I was just about ready to call it quits. It is beginning to get to me. I am like you were, just about fought out and for some reason, I come back for another beating!! I have been told by the Counselors at The Management Center that I am to have another C&P and this Psychiatrist is susposed to be an expert. I thought that I had already met them all!!! This one is a joke. I can tell that you have had a stomach full of all of this years ago and now it is my turn. Have a Good One and God Bless, Josephine

Thanks John999, I know that an IMO will be ideal, but under the circumstances of the years past, it is almost impossible to secure one. I will see how all of this information goes over at the next C&P examination that I am to have for the Management Center. Thanks Again, Josephine

Berta, That picture says it all!! Josephine

John999, Had I not baby sit for him and his wife, he would have never remembered me. If he hadn't gotten me out of that place, I know that I would have killed myself. I remember it all just like it was yesterday. Will his letter help me? I had no ideal when I filed in 1978 and they sent me a rejection letter and then again in 2002, that the psychiatric records were never in my claims file. I secured them all myself in 2004 and presented the Psychiatric consulation letters and the letter from my commanding officer to the Va. The three of them speak of my working conditions etc. I located this year from the archives my long lost transfer papers to get out of that place, but my discharge came first. I just typed his name and all these medical articles that he had written for the Mayo Clinic were there and tracked him down. I knew where he and his wife were from, but never knew that I would need his help one day. I have kept his message on my answering machine all this time stating that he had received my fed ex and had reviewed the records to please call him at his home with his telephone number. I am hoping with his letter and all my medical records of 42 years can help me win this claim. If you know your doctors name and place of residency, you may luck out as I did. It was a miracle that I located mine. Thanks so much for your time, Josephine

Perhaps some of the older vets to this site, will come forward and offer you their success stories. Take Care, Josephine

John 999, & Vike 17, Dr. P believes that this Va Psychiatrist should have to back up what she says against my medical records. If she wants to say an eating disorder, when in truth we are talking about Diabetic. That I have 3 children, when my medical records clearly state that I have two. Self inflicted injuries, where are they? I don't have any and anyone can clearly see this. Beating up my husband when he has written a notarized letter that is a lie and the same for tearing our home to shreds. They are all lies and she should have to prove what she has stated. I agree with you, but there is not a Psychiatrist around that will go with a claim of 42 years. They have all told me that there is no way in the world that they could say that my anxiety today began in service. That is when I wrote to Dr. C. my military physician in 1964 to please clarify his military treatment records of me. Here is the letter that he typed for me. To whom to it concern: ___, formerly, ______, has requested that I write documenting my care of her during the time period of February and March, 1964, at the US Naval Dispensary, 19th and Constitution In Washington D.C. She was an enlisted person and I was a General Medical Officer practicing at that facility. The question she has asked me to address is whether I helped her obtain a discharge from the Navy. _____ has provided documents from her medical record as well as a recent letter to me, which is undated. My - evaluation of her on 2/20/64 and a follow up visit on 2/27/64 are available. Two psychiatric consultations are also available for review. The fist performed on 3/12/64 to Dr. J and the second performed on 3/27/64 by Dr. M. Finally the letter from Co H recommends an Honorable discharge by reason of unsuitability. My understanding is that her discharge occurred shortly thereafter. After phone discussion with ______ I did remember her as an enlisted person at the Dispensary with whom I worked with on occasion. My workup of 2/20/64 concluded that she had tension versus vascular headaches and I added a tranquilizer to her headache medicine for her anxiety. The note from 2/27/64 documents that the lab test were normal and I recognize personal shorthand in my notes that I often used for a counseling session. After 40 years I do not remember whether I started the process for a discharge, but I suspect that I may have been supportive. She had seen a Navy Psychiatrist on 3/12/64 with no indication of further workup or return visit. Two weeks later she saw another Psychiatrist to whom I frequently referred patients who needed special understanding and sensitivity. While there is no documentation that I referred her, the fact that she saw Dr. M. scarcely two weeks after a first consultation and with no worsening of her condition does suggest to me that I may had sent her for the evaluation relative to discharge. Both C H. and Dr. M. comment on ----- immaturity and that she is uncooperative in her duties. After she reminded me and recalled specific instances, I did recall that she baby-sit in our home on multiple occasions with our two children ages 2 and 1. I know that my wife and I would have not allowed her to stay with the children if there had been any question of her suitability. The Dispensary staff was closely knit and I would have likely been made aware of any poor behavior on --------part. While my memory does not allow me confident documentation of my role in her discharge there is circumstantial evidence that her story is credible . I hope that you will give her case every consideration. BCC

You did ask for opinions and here goes. I can relate to your cancer, as I have cancer myself. You don't hear me venting off to the most generous and thoughtful veterans that you will ever meet. Just ask yourself, just how many people have you came in contact with that even care if you have cancer or of you win your claim? These veterans have spent their precious time trying to help you and me. If we don't agree with what they say, if may be, because of what they say is the truth, and we are emotionally involved with our own fight with the Va. These veterans do go out of their way to research and to post the most latest issues concerning your claim and mine. I feel that Dr. Bash, just like any other physician calls it just the way he sees it. If we don't like it, then we do not need to use this Board to express that opinion. I appreciate each comment and all the time that the nice veterans post on this Board. helping me win a claim which seems impossible. I have bogged them down with a claim that extends most of my life time - 42 years. Now, I have said it. Please offer your appology to each and ever member of this site which you have cut down with your rude and crude remarks. Cut me down, for I can take it, we share a common bond, we both have Cancer. Always, Josephine

Hi guys, Here are two letters that my private physicans has written for me. I know that he is not a psychaitrist, but after 29 years, I will not go the other way. I saw a Psychaitrist in 1977 and he was terrible. The first letter is written concerning those two examinations and his findings of the two. The second letter is another letter the BVA requested. I first I will have to locate in my tons of papers. My psychiatric records didn't show up until I located them myself in 2004. I received a dishcharge code 460 - Emotional Instability. Dr. BCC has written to letter only to clarify his treatment records of me in service. Did my private physician say enough for Nexus?? Thanks Bunches!!! Josephine Letter 2 To Whom it May Concern: RE: This letter is written as an addendum to a previously written letter dated 4/ 5/2006. It is written after I reviewed records from a compensation and pension examination by Dr. M. I have also reviewed another compensation and pension examination from 4/15/2006 by Dr. L. I have treated this patient since 1979, Moreover, I have had multiple family contacts with her mother and her sister through the years. It is considered my medical opinion that she does not have a personality disorder. Some of the facts of the later consultation from Dr. L are patently incorrect. True, I am not a psychiatrist, but I am a board certified physician in internal medicine. Her primary diagnosis is that of a chronic anxiety disorder. Sincerely Yours Dr. P Letter 3 April 28, 2006 Re: To Whom It May Concern: The above is currently undergoing an appeal process with The Board of Veterans Affairs. This letter is written as an addendum to previously written letters dated 4/5/2004 and 1/23/2006 in regard to her current appeal with the Department of Veterans Affairs. The basis for my previous noted diagnosis of this veteran was based on knowledge of personal interaction, history taking and physical exams going back to 1979. I am aware of the fact by reviewing all of the military records of this veteran that the patient was treated with Librium and Caffergot while in the military service, 1964, presumptively for treatment of anxiety and associated migraine headaches, by Dr. BCC, followed by two Psychiatric consultations thus leading to her early discharge. This veteran has been on anti-anxiety medication from 1967 to date making it plausible that I am correct. I have maintained all of the veterans civilian records from 1965 to date and all of her military records todate. As I have stated previously, It is my considered medical opinion that her subsequent problems with anxiety/depression have been of a significant magnitude to adversely affect her overall health and result in disability. I have no specific training in Psychiatry but I have the usual level of expertise that would be expected in an internist, board certified in 1976 and actively practicing internal medicine since that time. I graduated from the University of Florida Medical School in 1973 was board certified in internal medicine in 1976 and have remained in active practice since that time. Sincerely Dr. P Health Grades What is a Board Certified Internist? A Physician who provides long-term comprehensive care in the office and at the hospital, managing both common illnesses and complex problems for adolescents, adults and the elderly. Trained in disease prevention, wellness, substance abuse, mental health, and treatment of common problems of the eyes, ears, skin, nervous systems and reproductive organs

Vike 17, The PHD Psychologist, to whom I saw first made perfect sense as to his opinion and his reasoning. It was the Psychistrist that made no sense. To say that nothing bothered me in service made no sense, when in the line before that , she stated, she took Librium and Caffergot. I just can't figure out why the need for the second examination within 5 months of the first C&P with no one adjudicating the exam. The Psychiatrist took 42 years of my private medical records and twisted and turned them and didn't use any records to back up a thing that she was saying. I feel that the Management Center is sending me for another examination to get rid of this open claim of 1978. How does filing for Anxiety with Depression and Headaches, become an Acquired Psychiatric Disorder? The ruling from the R.O stated, we place our weight with the Psychatrist, becaue they are Psychaitrist, with no reasoning behind that either, except they thought that a Psychaitrist was more crediable then a PHD Psycholgist. Thanks for I am trying to reason in my mind what this system is all about. Josephine

Thanks John 999, Josephine

Vicki, Thanks so much, I hope to hear from them soon and get this mess behind me. Josephine

The application of, "as likely as not" itself is not speculation. The " as likely as not" standard equates to the statutory standard of the " approximate balance of positive and negative evidence", accepted by VA. to grant service connection. See 38 U.S.C.A. & 5107 (:D; C.F. R. & 3.102.43. The preponderance of the evidence supports granting the benefits sought on appeal. At the very least, an approximate balance of a claim, is present to cause a reasonable doubt to exist. Therefore, I point to 38 C.F.R. & 3.102 which provides that when a reasonable doubt exist " regarding service original, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant.". If this is true and you go to the BVA and are remanded to The Appeals Management Center and you have two C&P's 1. More likely than not service was the origin of her anxiety by Va. PhD. Psychologist. 2. Nothing in service bothered her by a VA Psychiatrist. 3. Buddy letter by witness to all events mentioned in my claim 4. 3 letters by my pastor before and after service, that I did not have anxiety before service. 5. Letter by my Board Certified Internist of 29 years, that in his opinion with reading my military records and all private medical records from 1965 to date, my anxiety began in service 6. Letter from a friend that has known me since I was 8 years of age. The before and after service again with no signs of nervousness or anxiety until after service and no medication, until after service. 7. Letter by my treating physician in service to explain that his wording of " vascular versus tension headaches, was a concept and that the cafergot was for a headache and that the librium was for my nerves. 8. Clinical report by Military Psychiatrist Jones for mild nervesness, headaches and irrability. 9. Clinical by Board Psychiatrist recommending an early discharge due to same. 10. Letter by husband, and two daughters. Where does the preponderance of the evidence lie? Why would The Management Center say to me on the telephone, it appears that I will be going for another C&P examination? Does the Preponderance of the evidence deal with the Credentials of the two have a Greater Baring on the Decision? Actually the PHD Psychologist was a great deal more on the ball than ever the Psychiatrist. Josephine