FloridaNative

I agree with getting a sleep study. I have complex sleep apnea going back to my time in the Navy. It wasn't diagnosed until I developed A-fib. My A-fib wasn't diagnosed for a couple of years after I reported symptoms. I had another nurse check me and write a letter. My primary had me monitored and each time nothing happened. I can usually tell when I am in A-fib. One day I was getting my vitals checked before an appointment and the nurse told me I was in A-fib. I had a sleep study. It turned out I was having apneic periods over 40 times an hour. I ended up with a bipap. Sleep apnea is a serious condition despite what some in the medical community claim. In time it will cause A-fib which in turn increases the risk of a heart attack or stroke. When a patient goes into a-fib heart rate rises to dangerous levels along with blood pressure. The the upper chamber of the heart beats so fast that blood get pumped properly and may coagulate. This in turn risks having a clot go to the brain or heart's blood vessels. Additionally the lack of sleep increases the risk of having an accident.

Here is an article on one patient's sucide. The physicians lost that one to the tune of seven million dollars. While physicians might be terrified that the DEA will come calling that is no excuse for treating a patient like crap. I didn't mention in my original post when I reviewed my medical records from that visit I discovered that they charted I had a pain level of 2 which is not what I told them. I raised hell about that and suddenly it was changed to 6. You can make material changes to a medical record without preserving the original. Unfortunately I trusted the VA system and didn't copy the original. 6 is not what I told them. They pulled that number out of the air. Meanwhile that behavior is responsible for veteran suicides when it becomes apparent the VA doesn't care about pain. The Washington Post did an investigative article on veteran suicide after the FDA issued the 201 guidelines. Unsurprisingly it increased substantially. The FDA has since issued new guidelines meant to improve physician flexibility when it comes to treating pain. Unfortunately it appears the VA ignored the change. https://www.statnews.com/2021/11/22/her-husband-died-by-suicide-she-sued-his-pain-doctors-a-rare-challenge-over-an-opioid-dose-reduction/

I am a 100% disabled vet. I am also a retired registered nurse. Last year I went to the ER at a VA facility when I had a severe exacerbation of chronic lower back pain and siatica. The CT scan revealed severe Foraminal Stenosis in one area along with multiple herniated discs. I was told to take Tylenol and make an appointment with my primary care physician. The pain was so severe I could barely walk. I had to use the rail on the wall to get to and from the ER. I spent the next 3 days in bed with excruciating pain unable to do much of anything. Just getting in bed caused tremendous. I was unable to extend my right leg without severe pain. The solution according to the VA was physical therapy. I was in too much pain to particate. Several months later after seeing VA pain management I was sent to acupuncture which has helped considerably. I was still not given medication to relieve some of the pain. After doing some research I discovered multiple studies that indicate Tylenol is NOT appropriate for severe pain. I saw a VA pain management pharmacist who recommended pregabalin which I agreed to. It was my understanding they were going to recommend it to my physician. A week later I discovered the recommendation was not made. I was told since the acupuncture was helping they were planning to wait. Acupuncture is not going to correct the structional problems in my back. The surgeon I saw didn't want to operate even though the procedure would have been minimally invasive. I explained to the pharmacist that after my prior experience with the ER I feared another exacerbation. If that occurs I expect I would be treated in the same manner as the last visit. Basically we don't care how much you hurt we are not going to treat it on a timely basis. I will be seen again in a month to discuss starting the pregabalin. The VA has become so fearful of appropriately treating pain that they send veterans home without treatment. I did further research into veteran suicide and as I suspected chronic pain is a significant cause. There have even been successful malpractice lawsuits filed by survivors of persons with severe chronic pain who committed suicide after their medication was cut. No every veteran who goes to the ER complaining of pain is malingering. From the attitude and care I saw I strongly suspect the physician thought I was malingering. I am afraid to go to the ER for any reason after the episode because I suspect I will not be take seriously by the physicians. Has anyone else had a similar problem getting chronic pain addressed?

In my instance I contacted the facility I was last in and was told my records had been transferred to the National Archives. As in my previous post I began a months long quest to obtain copies of my medical records which I finally did. The VSOs I worked with were nice but not much help. They did do me a great favor though and had me file a notice of intent. As previously mentioned a few years of my VA health records disappeared. The VA blamed the loss on a facility move. I am a registered nurse. No longer practice but I still know how to read medical records and do medical research. In the course of reviewing the voluminous records (old Sears catalog size) I discovered a significant diagnostic error. I have chronic kidney disease rated at 80% along with other conditions that resulted in a rating of 100%. It appears someone took the easy way out and decided my type 2 diabetes was the cause. I discovered upon looking at my eye exam I had "no diabetic retinopathy" but I did have hypertensive retinopathy. Hypertension was one of the conditions I was service connected for. I confirmed my findings with my endocrinologist. My A1C blood sugar readings were over 7 only twice in 20 years. Occasionally they were in normal range. Under 7 isn't high enough to do the kind of damage my kidneys have. A later visit with a VA nephrologist further confirmed my findings. He told me after reviewing my records I have a profile of a prediabetic. With 1 exception (I had a qualified practitioner do my records review for 1 condition) I did my own scholarly research (via Google Scholar) and created files for each of the secondary and tertiary conditions. When I went for my comp physicals the examiners agreed with the research documents. I ended up with a 100% service connected rating on my first attempt. VSOs know which forms to file but do not have a medical background. I was told by one I saw that he would file my claim when I had a physician statement supporting my conclusions. I actually filed the claims myself online after I had all my research info. As I said before the VSO kept me from losing a year of benefits by having me file the notice of claim. For that I am forever grateful.

I don't know where you are in terms of getting a diagnosis. Thought this might be helpful. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831134/

I had to get my records from the National Archives. My first request got me a narrative summary not the complete records I had requested. I contacted my US Senator and his staff sent another request. Got more records but still not my complete files. Notably they lacked the records of my lengthy hospitalization. The third try with the Senators office got the rest of the records. Noteworthy my records with the VA for a period of several years after I was discharged magically disappeared. Fortunately I had enough to file my claims. Good Luck. If you don't get what you request keep trying and request assistance from your senator or congressman.

Back in June of this year I went to our local veteran's service officer. I was advised to file a notice of intent and to file a fully developed claim. I am service connected @ 10% for hypertension, and 0% for sarcoidosis with secondary pain and a skin condition. I sent release of information requests to my local VA in Gainesville, Fl, To the regional office in St. Petersburg, fl for my C-file and one to Tampa for the time I was living in Tampa. When I applied earlier in the year for my military medical records after 3 attempts they finally sent the records for Naval Regional Medical Center, Jacksonville. They claim they cannot find my records from Orlando which is where I was first hospitalized. Likewise I have my records from Gainesville but the Jacksonville outpatient office claims they can only find records bacK to the mid 1990s. The records from Jacksonville contain my medical history immediately after discharge in 1976. I am working with Dr. Bash to obtain nexus letters for my various medical conditions that are linked to my service or secondary to my service connected conditions. Among my conditions is stage 3 CKD. One of the VA docs apparently without looking at my history decided my CKD is secondary to type II diabetes. He apparently didn't notice I had hypertensive retinopathy and NO diabetic retinopathy listed ever since they began doing eye exams looking for diabetic retinopathy. I was seen by a VA endocrinologist this past week for another condition. I asked the 2 docs present if my CKD is hypertensive related given my hemoglobin A1Cs (all in the very good range over they years) and my retinopathy. Both said it was hypertensive. Unfortunately they did not put that part of the visit in the record. I would like to go ahead and file for the CKD while continuing to work on developing the other conditions. Is they any reason I would not be able to file on the single condition given the multiple conditions on my notice of intent?