ptsd Should I Claim This? Ptsd? Treated By Psychiatrist

[MDB1968NM]

Hi Everybody,

Well, I should be getting a copy of my SMRs this week and I have few questions but will start with this one.  In 2006, I had major orthopedic surgery that created a ton of pain.  I was on all sorts of pain killers and anti nausea medicines and was "found" the next day in "respiratory arrest" and "ashen colored" in my recovery room (I was not on monitoring).  The eventual outcome was a morphine overdose (still have not received all the information from Wilford Hall Med Center) and I spent several days in the ICU.  I had some "cardiac ischemia" and after 3 months of testing I was given a clean bill of health.   It was all very scary and up until Dec 2008, I never spoke of the "incident".  I went to see the psychiatrist at the base for some chronic pain problems (looking for relaxation and coping skills) and walked out of there crying my eyes out.  Yup....I had a problem.  We conducted "Exposure Therapy" for months and I finally was able to relive the "incidents" and discuss them without crying my eyes out.

A VSO rep stated ( I have not chosen one yet ) that I should most definitely claim this as PTSD.  I was not in combat at the time and the rep stated that does not matter.....it was a traumatic incident "dying" in the hospital.  I feel pretty OK about the whole situation but at times I still get a bit anxious about it when discussed.

My psychiatrist and I think that I am good to go now...much better than before, but I am trying to understand if this should be mentioned on my claim.  I don't want to frivolously place things on a govt document.  Like I stated earlier I feel pretty OK about the whole incident and can talk about it without breaking down so essentially I feel that I am OK!

I appreciate all your thoughts on the matter and want to do the right thing.

Thank you.....

:P

[john999]

I think a claim for depression due to a major medical condition and chronic pain would fly better. If you had a horrible accident that resulted in the surgery then that would seem to be more in line with a PTSD claim. The incident you are talking about is surgery and a reaction to medication. I don't know if that is considered a life threatening event of the PTSD variety. I think these VSO's are going hog wild with PTSD diagnosis. What kind of mental health medications do you take now? You have to prove a stressor. What in your case is the stressor? I guess it would be nearly dying from a drug overdose the hospital gave you. I guess that is PTSD, but if you are taking pain meds and depression meds that would be just right for a depression claim due to medical condition. Your operation was for a service connected condition correct? Others may feel that you do have a strong PTSD claim. I would like to hear their reasoning. I am playing devil's advocate a little to make sure you are not going down some blind alley.

[Berta]

I hope this USAF nurse Fontana didnt treat you at Wilford-

http://outside.in/places/wilford-hall-medi...ter-san-antonio

Due to the Feres Doctrine I dont know if anyone can sue him-

Court Dates Set for A.F. Nurse Accused of Murder

FOX San Antonio - July 15, 2009

A Lackland Air Force nurse accused of killing 3 terminally ill patients is expected to be formally charged. Air Force officials announced today that Captain Michael Fontana is scheduled for an ar... »

http://outside.in/places/wilford-hall-medi...ter-san-antonio

[john999]

Berta

Yes, if this was an intentional overdose by a nurse it would be a PTSD incident. That I can see. MDB19 would be the victim of attempted murder.

[timetowinarace]

Hi Everybody,

Well, I should be getting a copy of my SMRs this week and I have few questions but will start with this one.  In 2006, I had major orthopedic surgery that created a ton of pain.  I was on all sorts of pain killers and anti nausea medicines and was "found" the next day in "respiratory arrest" and "ashen colored" in my recovery room (I was not on monitoring).  The eventual outcome was a morphine overdose (still have not received all the information from Wilford Hall Med Center) and I spent several days in the ICU.  I had some "cardiac ischemia" and after 3 months of testing I was given a clean bill of health.   It was all very scary and up until Dec 2008, I never spoke of the "incident".  I went to see the psychiatrist at the base for some chronic pain problems (looking for relaxation and coping skills) and walked out of there crying my eyes out.  Yup....I had a problem.  We conducted "Exposure Therapy" for months and I finally was able to relive the "incidents" and discuss them without crying my eyes out.

A VSO rep stated ( I have not chosen one yet ) that I should most definitely claim this as PTSD.  I was not in combat at the time and the rep stated that does not matter.....it was a traumatic incident "dying" in the hospital.  I feel pretty OK about the whole situation but at times I still get a bit anxious about it when discussed.

My psychiatrist and I think that I am good to go now...much better than before, but I am trying to understand if this should be mentioned on my claim.  I don't want to frivolously place things on a govt document.  Like I stated earlier I feel pretty OK about the whole incident and can talk about it without breaking down so essentially I feel that I am OK!

I appreciate all your thoughts on the matter and want to do the right thing.

Thank you.....

:P

I think you should get a copy of your treatment records from the psychiatrist. See what DX was put on paper. Your symptoms may be mild now and I hope they stay that way for you, but my advice would be to file for SC for the DX given by the psych. Even if you get a 0% rating because your symptoms are mild and you are Okay with that, you can't foresee the future. Your condition may worsen and having the condition already SC will make a big differenc in getting treatment from the VA and a increase in rating if it is needed.

[MDB1968NM]

I think you should get a copy of your treatment records from the psychiatrist. See what DX was put on paper. Your symptoms may be mild now and I hope they stay that way for you, but my advice would be to file for SC for the DX given by the psych. Even if you get a 0% rating because your symptoms are mild and you are Okay with that, you can't foresee the future. Your condition may worsen and having the condition already SC will make a big differenc in getting treatment from the VA and a increase in rating if it is needed.

Thanks for all the input.  I think some clarification is in order....

1.  I do NOT think that the incident was anything other than an accident.  The entire anesthesiology team was with me throughout the entire process and cared TREMENDOUSLY for my pain.

2.  The Lead Anesthesiologist (O-6) told me that he felt the diagnosis of a morphine overdose was wrong.  He stated that my body probably shut down due to all the junk going in there...epidural, femoral nerve block, morphine PCA pump every 8 Min, oral pain meds, and anti nausea meds.  He thinks that what most likely happened is that someone accidentally misread one of the dosage instructions and thats what triggered the shutdown of my body.  Sounds reasonable to me and I accept that accidents happen and I harbor NO ILL WILL towards the med team at WHMC whatsoever.  The bottom line is that they found me, saved my life, and as far as I can tell this was in no way intentional.

3.  John999....I do not consider myself depressed at all.  In a ton of pain but not as a direct result of this.  I am on NO medication for the condition.  As far as stressors....talking about dying in the hospital was pretty bad (blocked it from memory, seeing doctors on TV or in real life hospital settings put me through the roof, tearing up when talking about it).  Those issues, aside from getting choked up about it now, are gone.  THAT IS A GOOD THING!  My psychiatrist is incredible and she really really helped me through a great deal with this.

What I am concerned about is the fact that since the incident, of which they have no idea on how long I was not breathing or getting oxygen to my body parts, I have had some issues that MAY be associated with this.  In March of 2008 I began losing my vision at times...no migraine pain but lost the vision in 1/3 of my field of view.  Then after this, I have had about 10 bouts with migraines (some with vision loss preceding the pain).  Doctor prescribed Zomig and Naprosen and that pretty much will "get me through" but the day is essentially lost to me as I end up in bed with a frozen bad of peas over my eyes.  

I was sent for numerous tests: MRI, bubble test on heart, carotid doppler scan, etc and everything was normal.

What is truly frustrating and bad on my part from a treatment point of view, is that when these incidents happen, I essentially sucked them up for fear of being relieved of duties.  I am not a doctor and have no idea why the migraines/vision losses started or if they will continue....its pretty scary essentially when driving.  I was medically disqualified from flying (no MEB as the reg changed according to the FS) and the reason for the DQ was the Total Knee Replacement and two shoulder surgeries (shoulders were a result of an aircraft severe turbulence incident that dislocated both of them temporarily and knocked a molar loose).

My body has a myriad of issues right now.  There are major things that I will most definitely claim but I was curious as to if the VSO rep was correct in stating that I should at least claim the PTSD for the incident at WHMC.  What I am concerned about, is that although the exposure treatment went very well, and I have since had two major surgeries....I still get a bit choked up about talking about what happened.  Sometimes I have to have my wife stop watching ER or House on TV because it just hits too close to home.  I do not want to go BACK to where I was a year ago.

I also think, correct me if I am wrong, that PTSD is not something that should be considered lightly.  I have many friends that have truly been in crappy situations and it is obvious that they have issues.  For my situation I consider it, lets say an "inconvenience", and don't want to burden the system if it is not warranted.  That may not make sense but I do not want to claim something if it will waste the people already swamped with claims.  I also have some other major issues that are really bothering me and by claiming something that would be "questionable" to some and only an "inconvenience" to me now, I would think would just make me look as if I were trying to "game" the system.  Hence my question here....the PTSD issue never came up until I spoke with a VSO rep about my issues....she seems to really care and have my best interests at heart.

Sorry for going on more than I intended to but hopefully that will help get me some answers on how to proceed!

Thanks again for all your responses and I look forward to the continued advice!

:P

[Berta]

If I were you I would not claim PTSD at all Based on what you just said here.

Do you have proof of the in air turbulence incident and proof of the inservice treatment?

"What I am concerned about is the fact that since the incident, of which they have no idea on how long I was not breathing or getting oxygen to my body parts, I have had some issues that MAY be associated with this. In March of 2008 I began losing my vision at times...no migraine pain but lost the vision in 1/3 of my field of view. Then after this, I have had about 10 bouts with migraines (some with vision loss preceding the pain). Doctor prescribed Zomig and Naprosen and that pretty much will "get me through" but the day is essentially lost to me as I end up in bed with a frozen bad of peas over my eyes."

I think you should be concerned about this-you mentioned MRI-ECHOs etc-did they include MRI of brain?

Have you googled the meds to see if they are causing side affects and exactly what they were prescribed for?

I dont mean to alarm you or anyone-

but I see their medical error as negligence.

Then again-I am biased.

My husband and I thought he was receiving adequate VA health care.

They admitted to causing his death.

Money cannot in any way whatsoever compensate for malpractice.

I think you were victim of extraordinary negligence and malpractice here-

it is good that you can get that behind you.

I only hope your VA care (if you do get VA care now) is a heck of a lot better.

The visual problem could be result of the in hospital incident.But that would take a Neurologist to determine.

You might want to consider getting a private doctor to exam you and get an independent medical opinion.That could be costly but a real doctor can assess your disabilities and opine on what the cause of them is.

Did the VSO rep fully assess your medical records to determine what disabilities other then PTSD you could possibly claim?

Edited September 13, 2009 by Berta (see edit history)

[Berta]

Forgot to ask- do you have documented residuals of the shoulder injury?

[JamesBreckenridge]

Re the PTSD... it doesn't sound like you're back to "normal." It sounds like you still have some re-experiencing, and anxiety regarding hospitals. No, it's not debilitating... but it pretty obviously had an affect on you.

I think you should claim it, because it HAPPENED, and you've got good documentation on it. Let the examiner decide how bad the symptoms are now that you've been treated and probably reached maximum medical benefit. Let us go ahead and service connect you for non-combat PTSD, even if it's just at 0 percent. If you wind up having to be on medication for it, or if during stressful episodes it affects your social or occupational life, that's worth 10 percent. You don't know the future, and the thing about PTSD is that it can sneak up on you years later. It might get worse.

[jim n ok]

Re the PTSD... it doesn't sound like you're back to "normal." It sounds like you still have some re-experiencing, and anxiety regarding hospitals. No, it's not debilitating... but it pretty obviously had an affect on you.

I think you should claim it, because it HAPPENED, and you've got good documentation on it. Let the examiner decide how bad the symptoms are now that you've been treated and probably reached maximum medical benefit. Let us go ahead and service connect you for non-combat PTSD, even if it's just at 0 percent. If you wind up having to be on medication for it, or if during stressful episodes it affects your social or occupational life, that's worth 10 percent. You don't know the future, and the thing about PTSD is that it can sneak up on you years later. It might get worse.

good answer james

[MDB1968NM]

Hmmmm...for some reason the multi quote is not working so please bear with me...

For everyone this may change or help assist the discussion:  I am STILL on Active Duty.  I got accepted for retirement on Friday!!!  In June I will have 20 years and ONE day....LOL.  Terminal Leave starts in Feb 2010.  

Berta:  As far as the in-service treatment....100% yes.  It is documented, the Summary of Conditions they now have on the top of each entry has Aircraft Incident.  I have been operated on each shoulder...once with a USAF Ortho Surgeon and the other from a civilian Ortho surgeon....both within the past year.  They have done MRIs of the brain...the most recent one was about 3 weeks ago as I have another issue going on and they wanted to see if there were any changes to it.  Everything appears normal...no tumors, no masses, nothing out of the ordinary.

My Civ Ortho Surgeon who just happened to do my total knee replacement 3 months ago also was the one that did my shoulder.  He will be seeing me again in a month or so and indicated that he may have to go back in because of the pain and issues that are going on with them.  I am half tempted to just say screw it but being on pain medication (narcotics) is really no way to go through life.  They ease the pain...do not make me feel any different...but they make me very constipated and if I do not take them as scheduled, withdrawls happen very fast.  I am seeing a pain management specialist for all of the pain issues to include severe lower back and groin pain (we start injections in November).  I am STILL waiting to see the urologist after some "issues" with incontinence a month ago.  Those episodes have passed thankfully as they were highly embarrassing to say the least.  ( I received 2 emergency MRI's, Xrays, and a CT scan as well as lots of blood tests all showed normal indications).  The Ultrasound of my groin showed varioceles, hydroceles, a 4mm stone in the left testicle, some cysts etc.  I have no earthly idea if these causing some of the symptoms.  Again I am awaiting the Urologist....very frustrating wait.

Lets just say I have some med issues to sort through....most of which are frustrating and confusing.

As far as meds....they have had me on NUMEROUS ones for over a year now.  I have looked at the side effects but to be honest, I wouldn't even begin to understand them all.  Current medications are Ambien for sleep (have not been able to sleep w/o it for over a year due to pain), morphine twice daily, percocet up to 6 times daily for breakthrough pain (I take one or two a day now), clonazepam for "anxiety" but it is actually used to help me through the detox as my dosages are reduced.  It was successful in getting me off of the Oxycontin which is the worst substance known to man as far as I am concerned (this was used for the knee pain prior to the total knee replacement).  So I am on a significant amt of drugs all regulated by my wife and the pain management doctor who I see every three weeks or so.  He is a former Army Anesthesiologist and has been my constant anchor throughout this whole ordeal (he is in civilian practice now...I have been referred to him since the beginning of the year).

Berta...I am not sure what documented residuals are?  Civilian OS is aware of my situation, base PT has been treating me for it with no success for many months now, and as I mentioned earlier I will most likely be recommended for surgery again (not sure if I want to go through that).  You also bring up an excellent point.  I saw a neurologist about a year ago at the same time of the migraines because I was losing feeling in my hands and had elbow pain/tingling.  He conducted EMG testing and said my nerves were firing just fine but diagnosed me with Carpal Tunnel syndrome...which I wear braces on the wrists when I sleep since.  They seem to have helped a bit, but I still get tingling/numbness in the hands each day (not anywhere near as bad as prior).

I am sorry to hear of your loss.  If I did not make it through the situation, my wife would probably feel pretty strongly as you do.  I, however, am fortunate to be here and count my blessings every day.

James.....very good point.  I think you are spot on with your recommendation and I think that is what the VSO was getting at with me.

Thanks for everyone's help....believe it or not it is just good to talk about this.....makes feel better that people care!

:P

[john999]

I think taking all those narcotics will cause depression over time. I have chronic pain and morphine is hell. I think you have a great claim for a mental health condition secondary to the physical injuries. Also, the aircraft incident would be good as a PTSD claim since you were badly injured. What happened in the hospital I am not sure about as far as a PTSD claim. Usually, things like accidents where you are severely injured are a easily verifiable stressor. I have never heard of a surgery being seen as a stressor. You have a lot of claims to make. Make all of them. Make sure all these things are documented before you get discharged.

[MDB1968NM]

Thanks John,

I really don't feel saddened or depressed.  I am praying that in a couple of months they will be able to get me off of the narcotics altogether.  Yes that would mean some increased pain but to be honest not having to be constipated all the time would be nice  (probably too much information...LOL).  As far as the aircraft incident...it is listed in my medical records as "Aircraft Accident" but really is just part of doing the job.  What I mean by this, is that the severe turbulence and the injuries that were a result of that, did not or does not cause me to feel any angst whatsoever.  I was more scared getting shot at than this.  It is just the nature of the beast....sometimes crap just happens when flying.

I have a copy of a part of my SMRs that my last base was kind enough to make for me on CD.  What is a bit troubling are the errors contained within.  Everything from missing information to contradictory information from one doctor to the next.  Funny how many errors actually do happen.  There were pages from other people in there....last time I checked I was not being reviewed for a PAP smear...LOL! (Some woman's information is in there, tomorrow I will make sure that the current records have that sent to her base).

I really will need some help developing this claim.  I hope to find a great VSO to help walk me through this (with my assistance) as there are 3 huge volumes of things in there....literally.  I will take the folks advice here seriously.  You have all been down this road before and I truly value all of your advice.  THANK YOU for that!!!!!

:P

[john999]

Do you have documentation of being shot at? That would be a PTSD stressor. Yes, it is the long term affects of narcotics on your emotional state that will depress you. The king of morphine you get will turn the normal human colon into concrete. I don't take it any more even though it would be better than oxycodone.

[MDB1968NM]

Yes 100% via awards and combat time in my flight history.  But I definitely do not consider this as a stressor for PTSD in my case as I don't have any issues with that....REALLY.  The PTSD was brought up from the VSO in regards to the "death" in the hospital....it really has nothing to do with the combat time I have....HONESTLY, with regards to any of my flying duties I simply will not be claiming for any sort of PTSD at all, it simply is not affecting my life whatsoever.  I do appreciate the insight though...it may help some other folks in a similar situation.  I know what you mean by colon concrete....LOL....not fun at all!  I will be happy the narcotics are over and done with hopefully for good....I am not sure what I would do if I have to take them for the rest of my life!  NO THANKS!