ptsd Trip To The Contract Cboc With Dh

[hedgey]

Warning! This is mostly a rambling grumble-fest. Some legitimate concerns and complaints mixed in....

Yesterday DH had an appt. with his new primary care guy at the Valor Healthcare CBOC for our area. This appointment was for bloodwork followup and to discuss his pain in his shoulder, etc. Please Note: DH's blood was drawn on May 2nd, 2011. There was a followup appointment scheduled for the May 9th, but when DH checked in, he was told that OOPS, he should have been called that morning to let him know the appointment was canceled because the PCP had called in sick. The next available appointment was yesterday, September 12th. I am not making this up. DH asked to be put on a cancelation list, but there was never any call.

So yesterday, we arrive at the CBOC 20 minutes early, and DH stands in line for 10 minutes because they can only check in one person at a time, and the vets ahead of him had questions, etc. Okay, he still manages to check in at 10 minutes early for his appointment. We sat for a few more minutes, then a nurse(?) calls him and we hobble down the hall after her (I walk with a cane and felt like I was having to hurry ... & DH stays at my speed as he always does). She has NO name tag, and never once introduces herself or tells DH her name. She weighs him (with his steel toed boots on, plus his loaded cargo pockets), takes his temp, vitals, etc. "Are you in pain?" "YES!, shoulder, hands, etc." Then she jumps up and says come on, we'll go see the doctor now.

We follow her into the next room where the doctor is sitting reading a book (no idea what kind, hardcover with solid red covers). He doesn't get up, he doesn't introduce himself. The nurse shows DH to sit on the table, I sit in the extra chair. First thing the doctor says is "I ask all my patients to arrive 15 minutes early so I can stay on schedule" he hands DH a cut off piece of an appointment letter, with the words 15 minutes circled. "It's now a full 10 minutes into your appointment time", he says. DH, my poor DH, who has PTSD.. I can see his body start to tense and his face start to change. I told this doctor that we were here early, but it took 10 minutes to get checked in. Doctor says, "Well, be earlier next time." DH is getting agitated, but staying calm, I'm holding his hand.

The nurse had asked why DH was there, and had written on the PCP's note that DH was there for bloodwork followup. So the Doc looks at DH and says "Your cholesterol is up, but then again, these numbers are 4 months old. Where is your pain? Why do you have pain?"

It has become clear to us that even though this PCP had to waste his precious time waiting for us, he didn't spend it reviewing DH's records. So DH had to tell this guy about his accident, about being nearly burned to death, how his hands and shoulder were burned down to the bone, etc. Doc says are you going to the pain clinic? "What's a pain clinic???" You were taking Meloxicam? "Yeah, but it doesn't touch the pain..." So the doctor is getting more contentious, and DH is getting more stressed. The doc's attitude is well, if you've been in pain, why haven't you been getting treatment?? DH tells him that the VA & Military docs said "Tough break, guy, learn to live with the pain unless you want to take opiates, etc.

DH is extremely opposed to taking medications that alter his mind and or perception. He has to drive to do his job (has to drive from site to site during the day), plus he is just extremely anxious about not being in full control of his faculties (PTSD issue!).

So the PCP at the CBOC says, well, you should try Gabepentin. I'll put you on 900 mg of gabepentin per day, plus an antidepressant to augment it's effectiveness. (Don't remember the name of the antidepressant, it's not showing on MyHealthEvet yet.).

The the doctor notices that DH has an appointment with the Psychiatrist next week (first one since June... too many patients, not enough providers!!). What are you seeing him for?? "Uhhhhh.... PTSD" "Oh, yes, I see it here now." We also told him that DH was seeing the therapist in the next office (not part of the CBOC, part of a Rural Health thing, weird because they're in the same building, but one is Valor Healthcare, the other is run directly by the VAMC downstate).

I was so p-o'd. If the guy had looked over DH's records, he would have known that DH was PTSD, being treated for it, and hopefully would NOT have asked him to relive the memory of the trauma.

Also, the guy NEVER looked at DH's shoulder or hands or his elbow. Didn't get out of the chair. Didn't listen to his heart or look in his ears.... nothing.

Gave DH an appointment for fasting labs & followup in January.

Scurried out to get the nurse to give us flu shots. Asked if it was Marylin who saw us. I growled under my breath, "We wouldn't know, she didn't tell us her name..." He didn't hear me.

I think he was a little afraid of DH... maybe of me, too. It was funny (not haha) but after he saw the PTSD in my DH's records, he dropped his bossy attitude and became noticeably softer-spoken. Stupid fool. We know the guy has been working in the CBOC for over a year. (noticeable because they have huge turn-over in providers). You'd think he would've have the courtesy to review the records ahead of time, the sense to at least have a clue who they might be dealing with. Presumably, the time spent with the nurse getting vitals gives the PCP a chance to do this.

It was an awful experience. DH was shaking he was so upset. I was in tears when we got to the car. I was driving because I knew DH would be stressing over the doctor visit, so I couldn't take my lorazepam until we got home.

The CBOC waiting room is plastered with outreach-type placards, touting the VA's burning desire to help vets, especially with PTSD....But then they act like they've never dealt with patients with MH issues at all.

I don't know what to do. I feel like I need to do something, but I don't know what.

[john999]

Does DH have any private insurance? If so I would find a real doctor. Nobody should be treated with disrespect.

[hedgey]

We do have a private Primary Care doctor... in fact we met her when she was working for Valor Healthcare, before she quit.

This visit yesterday was mainly keeping the foot in the door kind of thing. When we're sick, we don't call Valor.

But since DH's diagnosis for PTSD is fairly new, and he's only been in treatment for it since May, we thought it was important to keep him in the VA system as far as the psychiatrist & MH. The VA therapist he sees is great, a vet who "gets it". He's trying to get DH set up to see a different VA Psychiatrist, one who will see him at least monthly and actually be available to him.

I see a private psychiatrist, but then I'm already SC'd for PTSD. DH would like to see a private shrink, too, but feels like while he's planning to file a claim (still not started) he should stick with the VA doctors.

I know he needs the diagnosis to come from a VA psychiatrist, and according to the VA social worker (and now the trip to the PCP) there is a PTSD diagnosis in his records. I don't know if the psychiatrist's notes include a nexus-type statement. His accident, time in the burn center, etc., are all in his SMRs. Still don't know what's in his C-file because he still hasn't opened it.

[john999]

Hedgey

Yes, if he has just be filed for PTSD it is a good idea to stay in the loop. DH can see the VA shrink, but get his real treatment from your doctor, perhaps. What the VA does is they cut you down to seeing the VA shrink once every three months for a medcheck. They don't do psychotherapy. DH could join a PTSD group therapy via the VA. I know DH wants to document his PTSD as much as possible through the VA.

[Notorious Kelly]

Hedgey,

Sorry y'all had to deal with this institutionalized disrespect; would love to have been there after to tell that doc to get his head right.

I was fortunate that Portland VA was courteous and professional but, recently in Missoula, got one of those quintessential institutional attitudes on the phone from a woman; I was so wound up and ready to jump her case in person weeks later (funny- they don't talk to me like that in person ).

Consider writing your account for the patient advocate to spare another vet the same indignities. If enough of us complain, they might take notice.

Pass on thanks to your DH for his service and thank YOU for being devoted to your vet!