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  1. 1970-74 weighed 130 in and 134 out, I had 4 yrs USAF Jet Engine Mechanic experience – much exposure to JP4, Jet Exhaust, PD-680 degreaser, carbon soot, noise, etc. I don’t have much medical information in my service records package, but I do have several pages of upper respiratory sickness, sore throats and earaches from one USAF base. None of my other medical records from other bases were in my service file. While in-service I married for the 1st time, we lived off base and thanks to my wife I was pretty good at getting to work on time. She would complain that I kept her up half the night with my snoring and would go back to bed after I would leave. She also described the loud outbursts and would try to put a pillow over my head to muffle the sounds – eventually she even bought some earplugs. The marriage didn’t last very long and we divorced in less than a year. After the divorce I moved back into the barracks, I was always tired and difficult to wake up and often fall back asleep. I eventually received an Article 15 for repeatedly being late for rollcall, and a reduction in pay scale for several months. Prior to entering service I had lived with my older sister Kathy and her husband. I did not exhibit the typical SA symptoms, I snored and I physically did not fit the profile. They told me I it got much worse after I got out and that I sometimes scared them when I would quiet down and suddenly let out a loud gasping/snoring sound… which sometimes woke me up too. I remarried in 85 and this was the first time I was told I may have sleep apnea. My wife Laura has a medical background and told my doctor what goes on at night and he made arrangements for me to have a sleep study done. It was confirmed and I received my first CPAP machine and have been using one ever since. My weight then was 203lbs. In 2006 I had this mysterious bout of ITP, of which I was hospitalized and transfused with platelets for several days. Aftercare was 6 months of prednisone, many needle sticks, bone marrow aspiration and finally tapering off they prednisone for 3 more months. In 2010 I had several significantly blocked arteries and underwent CABG dbl bypass at the San Francisco VAMC. During the surgery the urologist came out of the OR and ask my wife if I had any known bladder problems, which I didn’t, but their concern was that I was passing blood through my urine. He advised to follow up with urology once I recover and have it worked up. I had a cystoscopy and everything looked fine. In 2012 I put in a claim for IHD 60%, DMII 10%, MMD 70%, ED $125, Hearing Loss 0% and Tinnitus 10%, I was awarded, using VA funny math it was 90% scheduler with 100% compensation for TDIU plus SMC. At one of my recent psych visit I confided in something I never told anybody, not my wife, nor friends (not that I have many, quite the loner) or anyone else. Back in my last year of service I was sexually assaulted by another male, I was so ashamed I stuffed it for 40 yrs, but it just came out. I have been in several PTSD clinics and they helped me to realize I was a victim, that my assailant was a perpetrator, purposefully got me drunk and assaulted me in my sleep. Dec 2013 my wife gets annoyed with the VA doctors because they are all ignoring that some of my blood work always come back a little under the lower range so they blow it off. Via her pushing I get a Hem/Onc consult and it is discovered that I have an Ultra Rare illness called Paroxysmal Nocturnal Hemoglobinuria (PNH), is a rare acquired (not hereditary), life-threatening disease of the blood. The disease is characterized by destruction of red blood cells (hemolytic anemia), blood clots (thrombosis), and impaired bone marrow function (not making enough of the three blood components). It is closely associated with AA & MDS, all are bone marrow failures diseases. Benzene is known to be a toxic chemical which causes bone marrow failure illnesses. My illness is stable so it is in watch & wait state. I’m followed by Hem/Onc once a month to evaluate blood labs and I was prescribed Folic Acid for now. Jan 2016 it is discovered that I have L/carotid artery blockage at 80%, and R/carotid at 60%. I am supposed to have CEA on the left one but first wanted to consult with a well-known PNH specialist in New York NYU to discuss risks of thrombosis. He wants me on an intravenous medication call eculizumab (Soliris tm $$$,$$$ per year) prior to surgery for the carotid artery. Part of his workup for new patients is to check for venial clots with a Head MRI, Abdomen MRI and Lower extremity Doppler studies. No clots found, but I apparently had a chronic lacunar infarct of the left caudate head (stroke) that apparently was asymptomatic. The report also indicated that Scattered areas of white matter signal abnormality in a configuration most suggestive of chronic small vessel ischemic disease. Not sure what that means but it sounds interesting… Now here are my questions: Should I leave well enough alone with my TDIU award or file some additional claims? PTSD due to MST or should I file for increase in MMD PNH due to toxic chemical exposure (Agent Orange, PD680, Carotid artery due to IHD Chronic small vessel ischemic disease in the brain due to IHD Exacerbated my non-SC Sleep Apnea due to PTSD (central & OSA) previous reports only show OSA I am revisiting this since I saw the post on this site that the VA doctors can no longer hide behind not filling out a DBQ because they were told not to. I’m sure I’ll still need to get IMO for the non-SC items.
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