Help Understanding Presumptive Illness Due To Gwi

[dfears]

Hello all,

I am currently appealing a decision on a claim. I am a cancer survivor. I was diagnosed with Esophageal Cancer in November of 2013. It was found to be the result of prolonged GERD, which also caused Barrett's Esophagus, Hiatial Hernia and dysphasia. I have since had an Esophagectomy. My entire esophagus was removed in February 2014. I had also gone through Chemotherapy and radiation therapy prior to the procedure. I filed my claim with my local VSO. I retrieved all the necessary documents from my doctors and surgeons. I currently take medications so I can eat that cause side effects that limit my ability to work. My employer has since placed me on long term non paid disability with a future date of administrative termination.

I also filed a claim because I have developed a tremor in my right hand with severe insomnia that my neurologist could not explain. The were able to rule out Parkinson's Disease but have not answer as to why I have the tremors.

The regional office of the VA denied my claim stating there is no evidence I suffered these symptoms during active duty. It was my understanding that it is presumed since I was on the front lines during Desert Shield/Desert Storm. My NOD has been filled out and supposedly sent in my by local VSO.

How do I prove that my illnesses (which are unexplained) are GWI and that they are presumed?

One of my doctors specified in his first DBQ that the cancer, Barrett's Esophagus, hiatial hernia, and dysphasia was a manifestation of the GERD. He has since sent in another DBQ that states he believes my GERD is a direct result of GWI and that the cancer is secondary to the GERD.

Thank you and sorry for the rambling.

David

.

[Berta]

The Gulf War Presumptives are very confusing.
IBS seems to be the most comon condition under the functional gastrointestinal presumptives.

Have you been on long term usage of any NSAIDs prescribed by the VA?

"NSAIDs are non-steroidal anti-inflammatory drugs, also known as NAIDs, non-steroidal anti-inflammatory agents/analgesics (NSAIAs) or non-steroidal anti-inflammatory medicines (NSAIMs). They are medications with analgesic (pain reducing), antipyretic (fever reducing) effects. In higher doses they also have anti-inflammatory effects - they reduce inflammation (swelling). Non-steroidal distinguishes NSAIDs from other drugs which contain steroids, which are also anti-inflammatory. NSAIDs are non-narcotic (they do not induce stupor).

The most common NSAIDs are aspirin, ibuprofen and naproxen - probably because they are available over-the-counter (OTC, no prescription required).


http://www.medicalnewstoday.com/articles/179211.php

Reason I asked......
"ORDER

Service connection for a gastric disorder, secondary to
service-connected lumbar spine degenerative disc disease and
bilateral knee degenerative joint disease, is granted."

In part the case states:
" Moreover, private medical records from May 1986 and
VA medical records from October 1990, July 1999, and November
2000 contain opinions that a gastrointestinal disorder was
caused by medications prescribed for service-connected
disabilities."

"In October 1990 VA medical record noted there was
gastrointestinal distress and reflux and that the causative
agent was nonsteroidal anti-inflammatory drugs (NSAIDs)"

http://www.va.gov/vetapp07/files2/0714635.txt

You stated:
"One of my doctors specified in his first DBQ that the cancer, Barrett's Esophagus, hiatial hernia, and dysphasia was a manifestation of the GERD."
That makes sense.
" He has since sent in another DBQ that states he believes my GERD is a direct result of GWI and that the cancer is secondary to the GERD."


These are the presumptive disorders that I think he meant by the GWI nexus.

Functional gastrointestinal disorders, a group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues. Examples include irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain syndrome. - See more at: http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp#sthash.LpBA4cFQ.dpuf

This is a good explanation as well of GWI.

http://www.purpleheart.org/ServiceProgram/Training2012/7-M%20-%20Gulf%20War%20Presumptions.pdf

Did the doctor prepare the second DBQ AFTER they denied? Did you send that in with the NOD?

I have seen problems whereby GWVets tried to get GERD to fit into the criteria of those regulations and couldnt.

Do you have a copy of your SMRS and do they reveal any inservice symptoms and nexus of the GERD?

What do you get the 30% SC for now?

[dfears]

At this time I am 30% due to RT knee injury. 10% for initial and 20% for secondary. Over the years they have tried a number of medications to help with inflammation in the knee. They have tried Meloxicam, Naproxine,. I have also been given the standard hydrocodone by the bucket full over the years, along with knee braces. I have multiple tears in the knee. I have been off and on to the VA clinic and to the VA Orthopedic clinic over the years trying to get my knee fixed.

The doctor that filled out the DBQ is my oncologist. He was at one time a VA oncologist. The second DBQ was filled out by him as requested by my VSO and was sent in with the NOD. When it comes to Barrett's Esophagus, that is a structural change in the lining of the esophagus to resemble the lining of the stomach caused by excessive acid within the esophagus, which left unchecked can lead to cancer.

[Berta]

http://www.drugs.com/sfx/meloxicam-side-effects.html

meloican has multiple side affects to include


"Diarrhea
gas
heartburn
indigestion

and
trembling or shaking of the hands or feet"

http://www.drugs.com/sfx/meloxicam-side-effects.html

"Meloxicam (Mobic) is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body."

http://www.drugs.com/meloxicam.html

Naproxine,. as well is a NSAID:
http://www.drugs.com/health-guide/esophagitis.html

It is possible you develeoped the GERD and even the seondarys due to the NSAIDs .

I dont have time to research any other meds you are on but, unless there is some other etiology for your conditions, a strong IMO might help you, if you claim these disabilities under secondary to the disability they are prescribed by VA for, or under Sec 1151,due to the NSAIDs.

I am not a doctor.

But it is worth doing some leg work and having your complete VA med recs, to include the drug profiles , as well as doing some research on the net as to these meds.

Part of my past 1151 award was diue to the VA prescribed two meds for my husband that contraindicated each other.

One med Sudafed, precribed at a high dosage daily , for 6 years, .I found after his death in his med recs, had no medical reason to be prescribed at all.

You stated:

When it comes to Barrett's Esophagus, that is a structural change in the lining of the esophagus to resemble the lining of the stomach caused by excessive acid within the esophagus, which left unchecked can lead to cancer."

Do you feel the VA gave you timely diagnosis and care for these problems?

How soon after your service discharge did any of these problems appear?

Is there anything in your SMRs that could established a service nexus?

[dfears]

Well might have found a medical link to my GERD along with GWI. I was able to find through My HealtheVet my list of VA meds since 2000.(I usually go to a private Dr for non service related medical needs) I have had the meds mentioned before and was also prescribed an acid reducer Omeprazole. Another med was prescribed Hydroxyne which causes tremors and insomnia. I am going to speak with my VSO about these prescriptions. The Hydroxyne was for anxiety I started having a few years after returning. The NSAIDS were for the knee injury. The VA did not treat me for my GERD, I self treated after I was prescribed the Omeprazole. I could find it over the counter or use OTC like Tums. I went into a Gastrointologist for reflux and he preformed an endoscope and discovered the Barrett's Esophagus, the Hiatal Hernia and the Tumor. He and the oncologist advised that it takes several years for the esophagus lining to change.

Thank you for your advise. It is much appreciated.

[Berta]

You had stated:

"One of my doctors specified in his first DBQ that the cancer, Barrett's Esophagus, hiatial hernia, and dysphasia was a manifestation of the GERD."
That makes sense.
" He has since sent in another DBQ that states he believes my GERD is a direct result of GWI and that the cancer is secondary to the GERD."

If he could submit that as a formal IMO ( following the IMO criteria here) using the actual GWI regulations, as well as opine on any VA meds you took that could have caused or aggravated the GERD etc., that would be a strong support for the claim.He., as an oncologist, is in a good position to opine on the cancer as secondary to GERD with a full medical rationale and with excerpts from many of the studies done, on GERD and secondarys as well as the med issue.
.
His credentials alone would surely outweight some C & P Nurse, or PA, etc. opining negatively on the claim.

He should also provide VA with a Curriculum Vitae to prove his expertise.

[BlastDaddy]

I also have tremors in my right hand. The neurologist said they are called essential tremors. I filed a claim for them and it was denied.