hypertension Post Stroke Sleep Apena

[Ricky]

Although I have a couple of episodes in my military records of sleep problems no one ever suggested that I have sleep apena. Now since my stroke in Jan 05 I have real problems with my sleeping. A recent sleep study found apena. The Doc says it is most likely due to my SC'ed stroke. However, I have not found any research to suggest such a connection. If this is true would I be able to have it SC'ed secondary to my stroke or should I explore the possibility of SC'ing it to the two or three references in my SMR's which are listed as DX - sleep difficulities? I also have complaints of sleep problems on my exit physical which were commented on as probably due to service in Gulf War (GWS). This was followed on by severe sleep problems two years after my retirement which was treated with a sleep med which did no good and the doctor finally provided that I needed to lose weight, stop smoking and change my diet.

Summary:

96-98 two complaints during active duty for sleep problems main complaint was insomia - dx sleep difficulties

2000 - retirement physical complaint sleep problems main complaint was insomia - dx unknown - possible GWS

03-04 post service complaints of sleep problems - dx unknown possible diet, weight and smoking

2005 Stroke SC'ed to Hypertension and DMII

2006 complaint of insomia and waking during night gasping for breath. Neuro sent me to sleep clinic. Sleep study conducted, CPAP started. Doc said most likely due to 05 SC'ed Stroke.

Which way do I need to go with this one? Thanks

[Berta]

Ricky- if I would you I would ask them to secondarily service connect the sleep aphnea and tell them everything you told us here as potential ways for them to service connect the apnea.

Did the doc wrote down what he said as it being due to the SC stroke?

Also it can be secondary to your SC diabetes.as this link shows:

http://www.pslgroup.com/dg/FC0B2.htm

This link from the National Institute of Neurological disorders suggest that sleep alnea can even cause stroke by putting the patient at high risk for stroke:

http://www.ninds.nih.gov/disorders/sleep_a...sleep_apnea.htm

This veteran received 50% for sleep apnea and diabetes- the VA is fully aware of the connection:

"1. The schedular criteria for a disability evaluation in

excess of 50 percent for the veteran's service-connected

sleep apnea syndrome under Diagnostic Code 6847, secondary to

diabetes melius, have not been met. 38 U.S.C.A. § 1155 (West

2002); 38 C.F.R. Part IV, Diagnostic Code 6847, and §§ 3.321,

4.1, 4.97."

He lost his appeal for more comp but this is good example of how these conditions are assessed and rated.

from:http://www.va.gov/vetapp06/files3/0611810.txt

You have very good evidence and it never hurts to search the net for anything else that could help. There is a wealth of info on the net on these conditions and how they can be interrelated-thus secondary to DMII.

By the way= DMII, HBP, CVA and the apnea- how much are they giving you in compensation?

This is a severe disability picture.

[Berta]

PS- Ricky I am not a doctor but has the VA service connected you for any atherosclerotic heart disease due to the Diabetes?

Has the VA ever given you an ECHO to assess your ejection fraction%

or any complete cardiac work up?

Most strokes in a diabetic (not all) are caused by atherosclerosis and heart disease.

The Lipid hypothesis ( cholestrols that are abnormal values ) can show potential heart problems as cholestrol forms arterial plague and blood clots whch can pass from the heart to the brain, therefore causing a stroke.

Not all strokes are from these -some are hemmoriagic in nature-

On VA med recs, under the Blood CHem, the tryglyceride and cholestrol values are there.

Three values usually appear.

Abnormally high values should be treated and can be with diet and exercize.

If a veteran has lipid abnormalieties noted in their med recs, this is the lipid hypothesis and the VA should

not ignore those findings as it can lead to heart disease and stroke.

[Ricky]

Berta, thanks for the post. I get 20 for the DMII, 20 for hypertension, and 10 for the stroke. The stroke has caused a syndrome termed Dejerine Roussy Syndrome (Centeral Stroke Pain) which has resulted in the loss of function of the hand and foot due to pain. The pain is 24 - 7 and there is no pain medication for it. The stroke rating is under appeal. I have good documentation from the neuro on this. The nod I did resulted in a SOC which provided no reference to any of the documentation and no reason or basis. The appeal has been sitting at the RO now for about 14 months.

I just found a research paper conducted by a doctor who provided her title as Chief, Medical Studies, VA Medical Center XXXXXXX which provides that approximately 70-85 percent of those who suffer from stroke develop sleep apena. I will submitt that with my claim and see how the try and wiggle out of it hahahaha.

My doctor's notes provide - dx severe sleep apena due to stroke - post stroke sleep apena tmt - CPAP.

Although I have a pending claim for sleep disturbances due to undiagnosed illness - GWS I will submitt this new claim and include a summary of my sleep problems along with my doctor's diagnosis and the VA doctor's research paper. I guess now that it is a diagnosed illness hahahaha.

No mention of heart problems yet but my primary tricare doctor is scheduling me with a cardio guy next month. Stroke was due to a thrombsis (clot) with primary fault of 15 plus years of hypertension and secondary fault of DMII of about 8 years.

Ricky

[Berta]

Ricky-have you applied for TDIU?

The stroke rating seems way too low to me- and even the DMII- do you tale insulin?

If you are not working if I were you I would apply for TDIU and also ask for SMC (Speccial Monthly COmpensation) for loss of use of hand and foot- 38 USC 1114.

Here is the TDIU form attached-

When the cardio work up is over add anything else you can to the claim-regarding those results.

Was your care completely VA?

I am wondering why it took a stroke for them to know you had a clot that caused it-

What was diagnosed first- the HBP or the Diabetes-

WHy would someone have a stroke due to a clot and not have a complete cardio work up done right them and there.

This is exactly why I am a widow-"No mention of heart problems" yet undiagnosed heart disease caused my husband's strokes (he had 6-all misdiagnosed-all from clots) and his death ----among other VA screw ups they admitted to.

You mght have the potential for a Sec 1151 claim as well as SC to higher rating.

TDIU_form.pdf

Edited September 28, 2006 by Berta