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C & P Frustration

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ssg_rw_brown

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My husband had his C & P and we got the rating back last week. I am so frustrated and agrivated I just want to rip my hair out. I knew it would not be good but to see it in black and white just made me so angry.

First I acutally went into the C & P with him. I hadn't before because they wouldn't "allow"me to. But after research when the C& P rater said "do you need to be here" my husband said I would like her to be and he said "oh, o.k" that simple! Wow!

So we go into the room and he asks my hsuband all these questions and when he would say well I dont' think it's a problem but my wife would disgree I would explain. I would even raise my hand and ask if I could comment and he would say yes, and write as I spoke. So i thought he might be listening....wrong....Everything we said he said no, I don't think it's TBI it's the PTSD. Which angered me because at the PTSD hearing they said it was all the TBI!

Everything I read about TBI and the symptoms associated with it I brought up. The change in tastes, he said awe that's just a preference. Problems with concept of time and place, when he passes out and comes to he thinks he's in Iraq. The sleep deprivation, the change in personality, the anger and hostility, the paranoia. Not being able to make minute decisions such as what to have for dinner. Calling me 30 times a day to ask me a how to do the littlest thing, the C & P guy just "poo poo" it as irrelevant! and then when we go the ruling letter nothing, I mean nothing was in there about what we had told him! I wrote this long letter with all of it in there and nothing was mentioned about the letter I wrote nor the other 2 letters we sent either from friends and family's observations How do I know they even read them? I just don't know where to go from here! Everything they mention in the rulings says to be at the next level you would have to have x? and he has that and we mentioned it in meeting and in the letters. He goes for a complete Neuro work up on the 23rd of this month so my only hope is that will help and we can possibly get something in writting there but not even sure now. I just feel like I am getting no where and don't know what else to do. Thanks for letting me vent!

wife of

SSG_RW_Brown

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  • HadIt.com Elder

I really doubt the VA is doing comprehensive testing for TBI. That cost money and takes time. I think they are letting vets languish because they do not have the experts to do the proper exams. Another reason to just give us a card equal to medicare and let us find our own doctors.

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  • HadIt.com Elder

Thanks for your input on this thread Time.

I have heard that TBI & MS patients being diagnosed without anything showing on MRI's CT's etc. But, if something does show, it would possibly help toward a diagnoses of TBI.

Diagnoses of TBI is what the C&P examiner didn't agree with.

A vet must have a current diagnoses in order to claim the issue is service connected.

I think what you have explained is far more detailed & helpful to all of us than what i've commented. The MRI results is what was used to make my diagnoses. This may not be what works for everyone, but may be helpful to some.

****************************************************

Abstract

Neurosurgery. 2004 Dec;55(6):1306-15; discussio 1316-7.

Subcortical white matter metabolic changes remote from focal hemorrhagic lesions suggest diffuse injury after human traumatic brain injury.

Wu HM, Huang SC, Hattori N, Glenn TC, Vespa PM, Hovda DA, Bergsneider M.

Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095-6901, USA.

OBJECTIVE: We used positron emission tomographic studies to prospectively examine the relationship between glucose and oxidative metabolism in the subcortical white matter (WM) acutely after traumatic brain injury (TBI). The objective was to determine the nature, extent, and degree of metabolic abnormalities in subcortical brain regions remote from hemorrhagic lesions. METHODS: Sixteen normal volunteers and 10 TBI patients (Glasgow Coma Scale score, 4-10; age, 17-64 yr; 6 with focal and 4 with diffuse injury) were studied. Each subject underwent dynamic positron emission tomographic studies using [(15)O]CO, (15)O(2), [(15)O]H(2)O, and fluorodeoxyglucose plus a magnetic resonance imaging scan acutely after TBI. Parametric images of the metabolic rate of oxygen and metabolic rate of glucose were generated, and a molar oxygen-to-glucose utilization ratio was calculated. Data from gray matter and WM remote from hemorrhagic lesions, plus whole brain, were analyzed. RESULTS: There was a significant reduction in the subcortical WM oxygen-to-glucose utilization ratio after TBI compared with normal values (3.99 +/- 0.77 versus 5.37 +/- 1.00; P < 0.01), whereas the mean cortical gray matter and whole-brain values remained unchanged. WM metabolic changes, which were diffuse throughout the hemispheres, were characterized by a reduction in the metabolic rate of oxygen without a concomitant drop in the metabolic rate of glucose.

CONCLUSION: The extent and degree of subcortical WM metabolic abnormalities after moderate and severe TBI suggest that diffuse WM injury is a general phenomenon after such injuries. This pervasive finding may indicate that the concept of focal traumatic injury, although valid from a computed tomographic imaging standpoint, may be misleading when considering metabolic derangements associated with TBI.

PMID: 15574212 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances, Grant Support

http://www.ncbi.nlm.nih.gov/pubmed/15574212

*****************************************************************

Traumatic Brain Injury

http://www.nlm.nih.gov/medlineplus/traumaticbraininjury.html

Diagnosis/Symptoms

Computed Tomography (CT) -- Head(American College of Radiology, Radiological Society of North America)

Functional MR Imaging (fMRI) -- Brain(American College of Radiology, Radiological Society of North America)

Allan

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Allen,

I don't dissagree that an MRI can be usefull in some cases for a DX. I disagree with this statement, "If it's TBI it will show on the MRI". Most MTBI or PCS, including mine, do not show on MRI's. I beleive most of the SC TBI veterans that post here have been DX'd by psychaitrists and psychologist rather than neurologists.

I believe this veteran does have a TBI diagnoses.

It wasn't in the original post but I took it to mean the tbi has been SC. It says they got a rating but doesn't say for what. It also talks about "the next level". I was assuming this pertains to the residual facets wich indicates that SC has been granted. That's why I asked if the TBI is service connected.

My post was not meant to discredit you. It can't hurt to get an MRI.

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  • HadIt.com Elder

Time,

[My post was not meant to discredit you.]

I didn't take it that way either.

Open discussion is how we help each other.

I don't believe I implied that "all" TBI's will show lesions on MRI's/Cat scans. If I did, that wasn't my intention.

TBI is definitely a neurological disorder that causes mental symptoms.

As i've pointed out, white matter lesions are common with TBI's.

All of this is how we understand TBI's and how their diagnosed.

Helping SSG_RW_Brown, his wife and others, is what we're both trying to achieve.

I hope this discussion does just that.

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Yes, he is SC at 10% , angry because I think he qualifies for the at least a 40% by what I'm reading.

I'm sorry to hear that your going through this.

Psychiatrists are not neurologists.

You will need to get an MRI that shows a diagnoses of TBI.

Look for lesions in the white matter. Stay away from VA Doctors if at all possible for the neuro workup.

On Hadit we have a TBI section. Go there & look over the symptoms carefully. If he was exposed to any IED's or physical trauma, don't let them push it off as just a mental issue.

With TBI it's very difficult to keep things altogether & get it across to Dr's. You can go to the VAMC team Social Worker and get a medical power of attorney filled out. This will insure that you can be present during "all" examinations & medical decisions on your husbands behalf, including C&P's.

Make sure to always have a small tablet to take notes. Make sure to request copies of "all" medical examination, diagnostic workups & treatment records on the request form.

It took the VA over ten yrs to finally diagnose me with TBI. Getting someone to focus on the symptoms & diagnostic tests results at the same time was a problem.

If it's TBI it will show on the MRI and they won't be able to get around it with it's just "PTSD", depression or a figment of his imagination.

Hang in there. You have a fight on your hands. Keep pushing for those diagnostic tests & get copies of everything.

Allan

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yes it's SC with a low rating 10% We go for the Neuro on the 23rd at the VA it is with the head of the TBI department there, I'm not sure if it's just neuro or neuro psych but i'm going so I will be able to ask lots of questions

He has never had a MRI that I"m aware of. He has no paralysis but short term, memory loss, change in personality, problems making decisions, passing out for no known reason, changes in taste, anxiety, depression, ect. ect.

Well, I have some questions.

Was TBI service connected at all? Or was it service connected and the rating low?

Of course you should NOD.

Has he had Neuro-psychological testing? If he has not, he has not been fully evaluated. This is the most important aspect of TBI evaluation in the absence of obvious paralisis.

"He goes for a complete Neuro work up ". Is this with a neurologist or neuro-psychologist?

I'm going to disagree with Alan. Most closed head injuries do not show up on MRI. So unless there is obvious paralisis(a weak side of the body, slured speach, ect. the things we can readily see) a neurologist is usually usless. I suggest neuro-psychological evaluation if it hasn't been performed over a neurologist in every situation when a veteran does not have obvious paralisis.

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