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Question About Clinic Practice And Appointments Abbreviation?

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Hello To All,

Wondering about some things here and wondering if anybody may be familiar with an appointment abbreviation? I signed up on myhealthevet and noted an appointment for mental health, but it's not listed as any of my other past appointments. It's noted as "mh-pac" and I'm curious if anybody knows what that would mean? The appointment came to me rather oddly, so my suspiciousness was alerted since I'd never experienced an offer for an appointment for mh, without me requesting it, certainly not for a mh evaluation. Is this a new way of VA doing things? Anyways, if someone is familiar with that abbreviation, I'd very much appreciate your sharing any knowledge about it with me.

Then, I have a question regarding blood testing at VAMC? I suspect once I've placed myself under care of the VA medical, there's many things I am not aware of, but do we not have any privacy? I also noted that some drug tests were ran on me that I was not aware of. I don't do any type of illegal drugs, but it still bothered me that my pcp would have included drug testing with what I was surmising was a routine yearly exam, with the usual blood testing. I was very surprised that the blood test order had included for marijuana, cocaine, and I can't now remember what other drugs were being tested for, but all were illegal drugs. Of course, everything was negative as it well should be, but makes me question why she would do that? If asked about any drug use, I respond negative, since that is the truth. Am I to expect that what I say is not believed? Yet, that same doctor didn't catch important stuff from the blood test which is still boggling my mind and I don't know what to make of it.

Well, that's what I get for signing up for what I thought was a good thing, even as I'm not so sure I'm liking some of what I'm noting on there. I've had trouble with that same doctor in the past, so she is not my doctor anymore, but I find it troubling that I should have been alerted to what could be occuring with my body before I was finally diagnosed with Diabetes by an outside provider in an emergency situation. I raised a concern at the clinic after I was diagnosed, just days after I'd complained to my pcp at VA about the symptoms I was experiencing. I was sent for a blood glucose test, but was told that everything looked fine, so she didn't know what could be wrong. I was sent home with more questions than answers because I certainly did not feel well. Yet, in looking at the previous glucose testing that had been done on me at the clinic, there appears to be levels out of more normal range that I was never informed about. At that time, the VA was my only source of medical care. The outside diagnosis came from an immediate care facility because I was not convinced that nothing was wrong when I was feeling deathly ill still days after I'd visited my VA pcp, and it turned out that I was, indeed, diabetic and the extremely high sugar levels was making it critical.

Now, as I look at the posted lab results I note that the testing from my last visit to that pcp with diabetic symptoms has been left out. I know that I need to get up to the clinic and request a copy of my file for that time period, inclduing the lab tests, but it seems curious that the time frame in question is not also listed, even as everything else is. It could be an honest mistake (I'm trying to be real fair in my thining), but have medical information ever been known to disappear from the chart?

Thank you very much to anyone that may have a response to my questions. I truly appreciate it. Please, everyone, may you all have a beautiful day!!

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To me "ma-pac" would be mental health and the scheduled providers initials.

Yes, VAMC's do drug tests - they don't need your permission and they do it all the time,

you have not been singled out.


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Thank you for the reply, Carlie...

No, they are not his initials. Plus, my other mh appointments from past history are not listed as such, but with mh, followed by doc's name. The new appointment has the mh, followed by the pac, then the doc's name. The difference and the manner in which I received the appointment were what was making me wonder. Thank you, though. I doubt this information would be readily available unless one were to work in that area, or at least, in the scheduling department. Again, thank you very much.

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"finally diagnosed with Diabetes by an outside provider in an emergency situation"

If the VA should have diagnosed diabetes sooner and you have any disability resulting from their ommision of a timely diagnosis and and proper treatment, you would have the basis for a Sec 1151 and/or FTCA case.

"I was sent for a blood glucose test, but was told that everything looked fine" The blood work results could verify that.

The best test for diabetes is the HBIAC test and the OGTT if required by regular glucose blood work results.

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Thank you very much for your reply, Berta.

I've seen your very informative comments on 1151 before and I do believe that I have a potential claim for it, but am still not totally oriented about if I do, or not. I should have been diagnosed by the VA, or at the very least sent for further testing, in light of the out of range glucose test details that I was not aware of until now that I've signed up for the healthevet site and can see the actual test results. I had complained numerous times about what I later found out were symptoms, but always disregarded by with nothing is found for why the symptoms are there. Unfortunately, I knew very little about diabetes at that time, but on my last visit to the pcp I'd made the appointment because I'd been feeling so sick. I'd previously been alerted by a VA mh nursing staff that her review of my chart was not jiving well with her because her husband was a diabetic and my numbers didn't look right to her, but I had not been informed of that prior to her review, nor had any of my previous complaints of symptoms been taken seriously. She was going to question it with the VAMC staff and would get back to me. On my next visit, she said the following glucose test was within normal limits, so perhaps it was something I'd eaten and didn't remember since it was a fasting test. I knew I'd not eaten anything, but in consideration of what I'd been told that it appeared fine, nothing more developed from that. However, when I last saw the pcp with the symptoms, I informed her that the glucose had been out of normal range before as I'd been told, but she said my test results were not showing why I was having the type of symptoms I was presenting with. I had no other medical care at that time, besides the VAMC, but I went to the outside immediate care clinic a few days later because everything felt wrong with me, so I was not trusting that all was well as I'd been led to believe by the VA pcp. It was there that I was diagnosed by the simple prick test with sugars nearing the 600 level. They saved my life, I honestly believe, because they immediately gave me insulin several times, and treated me even when the clinic hours were past. I was not allowed to go home until the levels went below 300, with a referral for the endocrinologist, insulin, and a lesson on insulin use and what to watch out for, until I saw the endocrinologist. When I inquired of the immediate care doctor how it could happen as I'd recently been seen at the VA clinic, but was told that my levels were fine, he told me that it could not have been fine, but it was missed. His explanation made sense. He said that a fasting blood glucose does not always show out of range, but at the time of the symptoms if I'd been immediately tested, even with a blood glucose monitor, they may have caught it. He said with the high glucose levels that I'd presented with to him, I'd have to have been walking around with this for quite some time because, according to his experience, those numbers don't just get that high overnight. I'd never been tested with the monitor, nor was an A1C done at the VA clinic, nor did I even know at that time that existed. The numbers that I'm noting from the lab results I now find on healthevet are from a standard lab exam for primary care and one from the VA mh clinic that had been requested by the psych. I find only those two...one is 130, one is 169 both noted as "high" next to them, so they don't appear to be as high, but not within normal range, according to the Diabetes Association as I now know, even as they'd been done while fasting. The last one that was done, right before I was diagnosed days later, is missing from the site. I would always ask about any testing and was told everything looked fine, except for the cholestrol levels. Even so, I am overwhelmed with the requirements for an 1151 claim with the resulting disability as what I ended up with is the diabetes II, am insulin dependent, and carry a diagnosis of neuropathy which is creating havoc on my body, besides the diabetes. I was not aware that I was high risk for diabetesII until this happened to me as my diabetes education was minimal. I had gestational diabetes while on active duty, but I was not aware that could be a risk to diabetes II many years later. But, how can one get proper treatment if stating the symptoms, but no further development is requested from a doctor? I'd had symptoms numerous times and I'd taken them to the pcp always with the same response. The earliest glucose level out of normal range that I notice on there is from 2002, the same year I entered VA medical care, and my diagnosis was arrived at in 2004. I do believe that had I been properly heard and treated, I may still have been diagnosed, but it may have been before insulin would have become necessary. Can you be so kind and expand on your thoughts on this as it may relate to an 1151? Thank you very much, again, for your help.

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