ptsd Dh Got Notice Of Ptsd Comp & Pen Appt - Worried Sick!

[hedgey]

Okay, not worried sick just yet, but I don't think he's slept at all since he got the letter Saturday. I'm the one who's sick over it (I have IBS and it's been extra wicked :P )

I'm not sure if this is in the right forum, maybe it should be in PTSD?

I'm worried because when I filed my claim for PTSD, I wrote a long, very detailed stressor letter. I just sat down one night and poured it all out, just me and the computer. (I still haven't told my therapist most of the things...) And I got a letter from a family member and my ex-husband.

But my husband hasn't done that. He submitted his 4138 and the 761 (the special one for PTSD) through a VA representative and a VSO. None of the stuff he's submitted has much detail, just that he was in an accident, badly injured and burned, long time recovering and a few other sentences about the pain of the recovery and his isolation and nightmares and flashbacks now.

His MH records show a lot of detail, and his psychiatrist even wrote in her notes that his PTSD stems from the accident he had while in the service (great nexus, if they read it!!).

I feel like throwing up. One of the big worries is that my darling has rages. He doesn't have a short fuse, exactly, but he will very suddenly be overwhelmed by rage, even when you can't readily see what sparked it. Most of the time he's able to suppress it, or he leaves the area and goes for a long walk. He's lucky he can do that at work, and his supervisor is understanding (though I think they're praying for the day he retires).

He's afraid about the C & P interview because he's afraid the examiner will ask something or say something and he will go off. Being able to escape is core to his sense of safety, and he's afraid he'll blow up at the examiner or will burst out of the room and escape.

I'm worried about that too.

Sorry if I'm not being very coherent. I'm tired and kerfutzeled.

[carlie]

He submitted his 4138 and the 761 (the special one for PTSD) through a VA representative and a VSO.

None of the stuff he's submitted has much detail,

just that he was in an accident, badly injured and burned, long time recovering and a few other sentences about the pain of the recovery and his isolation and nightmares and flashbacks now.

His MH records show a lot of detail, and his psychiatrist even wrote in her notes that his PTSD stems from the accident he had while in the service (great nexus, if they read it!!).

He's afraid about the C & P interview because he's afraid the examiner will ask something or say something and he will go off.

he's afraid he'll blow up at the examiner or will burst out of the room and escape.

I'm worried about that too.

hedgey,

Sit your DH down at the computer and have him read this.

DH - your child hood was average and OK - no problems.

You went into the military - a horrible event happend - you were burned - long recovery, etc...

you might even still experience pain and discomfort as a residual effect of the injuries.

Your psychiatrist has stated - you have a diagnosis of PTSD and related this to be a result

of the accident (stressor event) on active duty.

It is important that the C&P examiner pretty much come to this same conclusion (so they will most

likely try to find out through your records and talking to you) in regards to diagnosis of PTSD

and it's nexus.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

* * * Below is the criteria they consider for an actual DIAGNOSIS of PTSD

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

• The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
  
• The person's response involved intense fear,helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.
  
  Criterion B: intrusive recollection
  
  
  

  The traumatic event is persistently re-experienced in at least one of the following ways:

  • Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
    
  • Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content
    
  • Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes,including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.
    
  • Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
    
  • Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
    
    Criterion C: avoidant/numbing
    
    
    

    Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

    • Efforts to avoid thoughts, feelings, or conversations associated with the trauma
      
    • Efforts to avoid activities, places, or people that arouse recollections of the trauma
      
    • Inability to recall an important aspect of the trauma
      
    • Markedly diminished interest or participation in significant activities
      
    • Feeling of detachment or estrangement from others
      
    • Restricted range of affect (e.g., unable to have loving feelings)
      
    • Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
      

    Criterion D: hyper-arousal

    Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

    [*]Difficulty falling or staying asleep

    [*]Irritability or outbursts of anger

    [*]Difficulty concentrating

    [*]Hyper-vigilance

    [*]Exaggerated startle response

    Criterion E: duration

    Duration of the disturbance (symptoms in B, C, and D) is more than one month.

    Criterion F: functional significance

    The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

    Specify if:

    Acute: if duration of symptoms is less than three months

    Chronic: if duration of symptoms is three months or more

    Specify if:

    With or Without delay onset: Onset of symptoms at least six months after the stressor.

    * * * Below is the VA's criteria for the evaluation of the percentage level to assign once service connection has been

    established.

    General Rating Formula for Mental Disorders: Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name 100

    Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships

    70

    Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships

    50

    Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)

    30

    Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication

    10

    A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication

    0

    You will be OK - ou will not go off on the examiner or storm out of the

    exam - these are just things we feel and things we worry about and it these feelings

    and fears are due to our PTSD.

    Good luck - you will be OK - just stick to how your PTSD and any associated pain effects you.

    JMHO - carlie

    Editing to add :

    BE SURE TO TAKE A COPY OF THE FOLLOWING EVIDENCE - to leave with the C&P examiner.

    The examiner doesn't have to allow you to leave it - so just real easy say I brought this TO LEAVE with you

    because I don't think it's in my records yet.

    " His MH records show a lot of detail, and his psychiatrist even wrote in her notes that his PTSD stems from the accident he had while in the service (great nexus, if they read it!!)."

[hedgey]

Carlie, you're the best. DH is taking tomorrow off and I'll have him read this then. He had a therapy session today and came out very tense. He's been prowling the house like a caged puma all evening. If I thought he could settle his mind enough I'd have him read this now, but he's pretty keyed up. The lorazepam doesn't seem to be doing much... He's okay, not bouncing off the walls, but just can't sit still.

I'm pooped, but anxious at the same time. Playing chess on the computer like a robot. I have to get the 180 signed & faxed in the morning.

Carlie, thanks. I think your message to him will really help. It'll inform him, plus he'll see he's not alone in this. I'm here for him, but seeing someone else care enough to write all you did will mean a lot to him. Thank you. cyber huggy thank you.

[Pete53]

Good Luck and be happy you are closer to finish line now

[hedgey]

Thanks, Pete.

I still haven't gotten the poor guy to sit still long enough to read this message. I pull it up, with my laptop on the kitchen table and he keeps jumping up to wash a cup, let the dog out, let the dog in.

He's a wreck. At this rate I'm going to wheeling him into the exam in a shopping cart, gnawing on a chew toy.

I've never seen him this bad. Thankfully he sees the psychiatrist next week, maybe she can prescribe something stronger than lorazepam, or at least let him take a little more of it.

I'm already at my daily limit of 4, just because he's so rattled and I'm feeling so helpless to comfort him.

But I checked his MyhealtheVet account and the appointment is listed, so it's definite.

I called the Release of Information guy at the VAMC to ask best way to get his MH records quickly. See, DH only has on hand up to October last year. The VSO recommends having as current as possible.

The ROI guy said don't worry, the examiner will have all the latest notes right at his fingertips, it'll be all in the computer.

I'm still worried.

[carlie]

hedgey,

Tell him to sit down and read it now - there isn't anything to be wigged out

about - and if he will go ahead and sit down and read it -

he could save me a trip to Buffalo !

[hedgey]

Carlie, I think the only way I'm going to get him to read this is to plop the laptop on his tummy and force him. He's like a ferret in a jewelry store, running every direction.

Oh, no!! Don't go to Buffalo!! We're 6 hours away! I'll tell him you will send some one.... a nun!! He went to catholic school... nuns are all-powerful. Yes, that would do it, if he won't read it you will send a nun to see that he does. Not one of the nice ones, a good old fashioned one in a penguin habit. And a big one at that!

We will get him through this.