Sinus Bradycardia, Cardiomyopathy

[shann]

My question I guess is there anybody else out there that knows about this and have you filed a claim for it. I had shoulder problems about my third year in the Air Force. I went to the base clinic and complained about my shoulder. It did not hurt all the time but I was weak and fatigued not to mention constipated but they never made a relationship to my heart even though my heart rate at times when I was complaining was down to 52, 56 beats a minute. I got out and went to the VA hospital in fort lyons colorado and they showed on the ecg or ekg that I had sinus bradycardia. They never did an ecg on me in the service even when I got discharged or this would of showed. I seperated from active duty in January of 1993. I started going to school at KU lawrence ks in the fall of 93 and joined a reserve unit at Richard-Gebaur AFB MO. In the spring I went back to western kansas cause I wasnt feeling good and wanted to be closer to family after being in the AF for five years. I seperated from the reserve unit in dec of 93. I went to school at a juco in Garden city ks and my feet swelled up huge and hurt. I went to the va at fort lyons and thats where they diagnosed me with gout and also the sinus bradycardia. I am filing a claim on both. I currently get treatment at the kcva. I have a blood test when on active duty showing high uric acid level. I also have copies of records showing my heart rate being low. My status right now is DRO appeal on heart, shoulder and ear infections. Initial claim on gout started Feb of 2007. Heart started in Feb of 2006. I filed an initial claim when I first got to the va at the DAV office and was rated 0% in 1994. That was for deviated septum I had it operated on while in the service. I have had it operated on since then. I had never thought to appeal their decision since that time but as I have gotten older and developed problems I am scared that i will one time reach a point where I wont be able to care for myself financially. I have had several bouts where my legs and knees have swollen up on me and I have struggled through them. I have no other medical care right now but the va. They say I have gout but a couple of years ago the rheumatologist said it wasnt and might be rheumotoid arthritis. At that time both my knees were swollen up three or four times there size right now. They had me on alpurinol I think but with that my legs hurt bad and they were putting me on steroids at times but that is no good. I have gone to the health food store and when my feet, ankles, or knees start to hurt or swell I take some joint medicane and heart medicane not medicane but health food supplements from the health food store and msm gloucosamene. This has helped me. I still have the problem but this is my way to keep it under control. The heart is another story I went for a physical in 2003 for an environmental job we had to wear a gas mask. They took a ecg and said I had a heart attack. I thought they were full of something and anyway I ended up going to the VA. They confirmed that I had Cardiomyopathy, mitral valve regurgitation and sinus bradycardia. They sent me to KU Medical center and did a cardiac MRI. I guess my question is do I have a chance of winning my claim?

[augoldminer]

I hope i get this right

Was this shoulder pain in your left shoulder. If yes this may have been a sign of a mild heart attack that affected the right side (right ventricle) if your heart(swollen feet and legs) and the AV Node.

damage to the AV node causes a condition called a Atrioventricular Block. (AV BLOCK)and bradycardia. the Av Node is also on the right side of the heart

The cause may be in what you wrote. That you were constipated and had gout. These are signs of possible dehydration.

Dehydration can cause clots that can migrate to the heart.

were you working in areas like the flightline and not getting Enif fluids.

I have bradycardia but mine i believe is due to damage to the trigeminal nerve and the vagus nerve due to exposure to trichloroethylene. I also have sleep apnea and gerd. Control of the muscles of the throut, acid levels, and heart rate are all controlled by the vagus nerve. and it is feed from the trigeminal node.

G.E.J.

EMT-B

[Berta]

If I were you- I would get all of your SMRs -Service Medical Records, and a copy of all of your VA med records.

also a copy of the employment physical that showed prior heart attack.

This type of claim needs a step by step approach-what I mean is

documenting the actual dates that any abnormal heart rates etc showed up in service as well as the

first time the heart disease was diagnosed.

Has anyone suggested that the swollen legs might be due to the heart problems?

Did you have an ECHO done?

Did the VA ever ruled out diabetes?

The high Uric acid reading is an indicator of gout.

Has the VA ever referred you to their cardiologist?

In my opinion- it would help a lot if you went to a Real doctor who could do a full work up on you and also prepare an independent medical opinion.

These opinions can be quite costly but in a case like this-

but if VA sees heart problems or cardiomyopathy without more details, then a C & P could be very limited and not help your claim.

The MRI findings are critical to your claim and they should be in a narrative when you get your complete VA med records.

What actually is VA doing medically to treat your heart problem?

It looks to me as though your etiology is inservice-

meaning the initial cardiac problems were evident then and got worse.

If you do consider an IMO there is an IMO criteria here at hadit that an independent doctor should follow to help gain you service connect.

The gout seems to have definite link to your service-the high uric acid reading-

the cardio problems have a link that needs to be clearly explained to VA in medical terms.

What did the VCAA letter you got say as to what evidence the VA needed from you?

[hayley3]

Berta, Could you tell us more about the IMO criteria the doctor should follow?

Thanks!

[Berta]

There is considerable info under the Search feature- here is one of my posts on this:

http://www.hadit.com/forums/index.php?show...amp;#entry48882

[hayley3]

Thanks Berta! That is REALLY good info for an IMO.

Maybe this should be posted under the Veterans Resources or put under Important Topics because there is sooo much information in here, I am currently suffering overload. I also have bad eyes and I can miss alot of important info trying to read too fast. I had a hard time figuring out what an IMO was.

Anyway this is great info! Thanks!

There is considerable info under the Search feature- here is one of my posts on this:

http://www.hadit.com/forums/index.php?show...amp;#entry48882

[Berta]

I should add- and it is probably in the older IMO posts that an IMO doctor shoiuld have the VA schedule of Ratings, as well as the denial and the SOC narrative-as well as any C & P exam results etc- it all depends on the type of claim.

I added a cover letter for my initial IMO request with the evidence tabbed and listed in the cover letter.

In a subsequent IMO I obtained, the evidence was expanded to include a VA opinion and why it was wrong.

Often the fee depends on how many records the IMO doctor needs to consider.

My claim was for AO presumptive so Dr. Bash did not need the SMRs of my husband-

I have contacted medopinions if I need a 4th IMO (I have one brief freebee from a former VA doctor which supports my claim too and Dr. BAsh incorporatedf this into his IMOs.)

First they said $2100 or 2200 for the IMO -then the guy asked me what type of IMO I needed and what evidence I had-

he reduced the fee to $1750 and said they could do it in a week.

The evidence needed only involved one VA med rec, the DMII training letter, and the IMos from Drs. BAsh and Rabiee, and the VA Central's FTCA wrongful death report.

I also had some significant treatises and I think he said to send one or two also.

IMos are expensive because they often take a considerable amount of time to prepare.

I think they are these days the best investment a vet can make in many claims.

The VA cannot reject an IMO that complies with the IMO criteria, unless they have real medical evidence to fully knock it down and with a complete medical rationale to back up their findings.They cannot ignore an appropriate IMO either.(38 CFR 4.3 and 4.6)

If a claimant has a probative supporting IMO and the VA gets a negative med opinion-the Benefit of Relative Equipoise comes into play and ,if the evidence is weighed for and against the claim equally-the vet should succeed.

(Of course VA owns the scale they weigh it on however)